MD35S01: Kidney stones

Bottom line: Information on kidney stones was used to maintain the management of a patient (medication). There were no information-related patient health outcomes.

Acquisition: On June 25, 2008, MD35 did a search by themselves, at work in their office, and after an encounter with a patient. They retrieved three information hits about tamsulosin. The reported search objectives were: to address a clinical question and to search in general or for curiosity. “I had a patient who is fairly young, about 28, who is on Flomax. And he couldn’t explain to me why he was on it and I thought he was fairly young for someone to be on Flomax. […] It actually triggered a memory of one of the residents asking me if I use Flomax or any of the related family of medication when people have reno-colic. And that’s why I actually start to read through this stuff on reno-colic. […] It [the information] actually did answer the question as to why that patient would be on or could be on the medication. And then, the curiosity was just leading a little bit on how it’s used in reno-colic or what the results have been.” According to MD35, Essential Evidence+ (EE+) was the only source for information, and the found information was relevant.

Cognition: Three information hits were associated with a report of a highly positive cognitive impact (practice improvement). “I actually had not used it [alpha-blocker or nefidipine] for reno-colic previously. And I am actually considering using it. I probably will, in the future.”

Retrieved information hit(s):

1) InfoPOEMs (CIRT): Alpha-blocker or nefidipine may help pass kidney stones

2) InfoPOEMs (CIRT): Tamsulosin effective for renal colic

3) InfoPOEMs (CIRT): Alpha-blockers equally effective for treating nephrolithiasis

Application: Information on tamsulosin was retrieved, and was used to maintain the management of the patient (information used as presented in EE+). “Just in terms of finding out […] more precisely why he would be on that medication [treatment unchanged].”

Outcomes: Regarding patient health, MD35 did not associate the information with any health outcomes.

Type of path: No outcome

Acquisition	Cognition	Application	Outcomes
Address a clinical question Satisfy curiosity	Practice improved Learned something Reminded something Reassured	Be more certain Understand issue	No outcome