• evidence-based medicine
• internet

Come with us while our clinical team makes rounds. As each patient is seen and discussed, we often find that we have gaps in our knowledge related to the clinical decisions we‘re making. In this Practice Corner, we‘ll illustrate how we meet some of those information needs rapidly using resources stored in a personal digital assistant (PDA),¹ placing in brackets the time it takes us to retrieve the evidence. We‘ll provide contact information in a table for selected resources and more information is available on our website (www.wsuim.org/PDA). Wherever possible, we use PDA resources that are evidence-based, meaning that their manufacturers are fully explicit about how they searched for evidence on clinical questions, appraised that evidence critically and rated its strength, and tied the strength of the evidence to the recommendations made.²

Our first patient is an older man admitted for pneumonia, in whom the medical student found a surprising abdominal pulsation. On examination we confirm that the aortic pulse contour is 3 cm wide. How accurate is this finding for detecting abdominal aortic aneurysm? On our Palm OS-based PDA, we tap the “Find” function, enter “AAA”, and then tap open a memo that tells us that the positive likelihood ratio of this clinical finding for abdominal aortic aneurysm is 12.0 [4 seconds]. In this memo we‘d written a synopsis of the evidence, similar in structure to the larger Critically Appraised Topic (CAT)² …