MD55S02: Raynaud’s syndrome

Bottom line: Information on Raynaud’s syndrome was used to maintain the management of the patient (medication). There were no information-related patient health outcomes.

Acquisition: On July 16, 2008, MD55 did a search by themselves, at work in their office, and during an encounter with a patient, in the examination room. They retrieved two information hits about Raynaud’s syndrome. The reported search objectives were: to address a clinical question, to look up something they forgot, and to share the information with the patient. “This gentleman [54-years old] has had what looks like a herpes infection on his fingers and it wasn’t getting better. So we sent him to a dermatologist who said it was part of Raynaud’s phenomenon and he had a vasculitis. So he came back to see me about that. […] Having missed the initial diagnosis of Raynaud’s phenomenon and vasculitis, I was trying to get the connection in my mind so the patient and I could talk what it was the dermatologist had said.” According to MD55, Essential Evidence+ (EE+) was the only source for information, and the found information was relevant.

Cognition: Two hits were associated with a report of a highly positive cognitive impact (practice improvement). “I hadn’t realized Losartan could be used for that treatment. And [my practice] will be changed, [because] I have something else to use if Adalate doesn’t work.”

Retrieved information hit(s):

1) EBMG summaries (CIRT): Nifedipine for Raynaud’s phenomenon

2) InfoPOEMs (CIRT): Losartan helps Raynaud’s phenomenon

Application: Information on Raynaud’s phenomenon was retrieved for a patient, and was used to maintain the management of the patient (information used as presented in EE+). “I used the Adalate. […] I was going to do it anyway.”

Outcomes: Without this information hit, MD54’s management of the patient would have been the same. There is no clear relationship between the information use and expected health outcomes.

Type of path: No outcome

Acquisition	Cognition	Application	Outcomes
Address a clinical question Look up something forgotten Share information	Practice improved Learned something Confirmed Reassured	Be more certain Understand issue	No outcome