how evidence based medicine is changing our practice

... Institute of Medicine (IOM) Entitled Evidence- Based Medicine and the Changing Nature of Health Care, this meeting was held on October 8, 2007, and focused on the potential of evidence- based medicine ... J Michael McGinnis, M.D M.P.P Executive Director, Roundtable on Evidence- Based Medicine Contents Summary 1 The Changing Nature of Health Care Introduction, 33 Evidence- based medicine and the ... the issues encountered in clinical practice This is due to too little clinical effectiveness research, to poor dissemination of the evidence that is available, and to too few incentives and decision...

Ngày tải lên: 06/03/2014, 09:20

... (flukes) Schistosoma haematobium Schistsomiasis Schistosoma japanicum Schistsomiasis Schistosoma mansoni Schistsomiasis Echinostoma spp Diarrhea Faxciola hepatica Liver necrosis and cirrhosis Paragonimus ... at risk The Missouri River, for instance, is the source of drinking water for some of the major cities of the Midwest Yet the distance between wastewater discharges and water supply intakes is ... 1968—the highest in our nation’s history.24 The Association of Metropolitan Sewerage Agencies’ resistance to action is more than matched by the Bush administration’s The administration is actively seeking...

Ngày tải lên: 17/02/2014, 10:20

... already lists more than 150,000 such trials, and they have become the underlying basis for what is currently called evidence- based medicine Evidence Based Medicine – Closer to Patients or Scientists? ... question: how ought we to practice medicine? The origins of evidence- based medicine The origins of the evidence- based medicine movement are traceable back to a series of lectures given by epidemiologist ... (Benitez-Bribiesca, 1999): 12 Evidence Based Medicine – Closer to Patients or Scientists? Evidence based medicine, ” one chemist said to me, “What other kind of medicine could there possibly...

Ngày tải lên: 16/03/2014, 21:21

... already lists more than 150,000 such trials, and they have become the underlying basis for what is currently called evidence- based medicine Evidence Based Medicine – Closer to Patients or Scientists? ... question: how ought we to practice medicine? The origins of evidence- based medicine The origins of the evidence- based medicine movement are traceable back to a series of lectures given by epidemiologist ... (Benitez-Bribiesca, 1999): 12 Evidence Based Medicine – Closer to Patients or Scientists? Evidence based medicine, ” one chemist said to me, “What other kind of medicine could there possibly...

Ngày tải lên: 27/06/2014, 09:20

... Comparison Outcome Finding the best evidence Secondary sources Primary sources Appraising the evidence Is it valid? Is it important? Can it help? Making a decision Evaluating your performance How ... appear in your patient in the same way Definition of evidence- based medicine Evidence- based medicine is the ‘conscientious, explicit and judicious use of current best evidence in making decisions ... Richardson WS Evidence based medicine: what it is and what it isn’t Br Med J 1996;312:71– Sackett DL, Straus SE, Richardson WS, Rosenberg WMC, Haynes RB Evidence- Based Medicine: How to practice and...

Ngày tải lên: 28/06/2014, 20:20

... WA: Suicide risk in patients with anxiety disorders: A meta-analysis of the FDA database Journal of Affective Disorders 2002, 68(2-3):183-190 Furukawa TA, Streiner DL, Young LT: Is antidepressant–benzodiazepine ... the odds ratio analysis and the percentage of responders (based on HDRS-17 improvement and CGI outcome) compared with placebo and TCAs All performed analysis showed a statistically significant ... remission Wilcoxon test and log rank test to evaluate the difference between the two distributions Discussion Fluoxetine is a widely and well-known drug successfully used in treating several diseases...

Ngày tải lên: 08/08/2014, 20:23

... presented in the current issue of Arthritis Research and Therapy make us realize that uncovering the true nature of apparent simple observations long held true in medicine is seldom straightforward ... risk of coronary heart disease events: the Heart and EstrogenProgestin Replacement Study (HERS) Ann Epidemiol 2006, 16:138-145 Campion EW, Glynn RJ, DeLabry LO: Asymptomatic hyperuricemia Risks ... Kremers HM, Wolfe F; National Arthritis Data Workgroup: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II Arthritis Rheum 2007, 58:26-35 ...

Ngày tải lên: 09/08/2014, 13:22

... [12,13,18], and evidence from other areas of care suggests providing patients with evidence- based educational materials in clinics may assist providers in justifying evidence- based treatment decisions ... decision latitude is unnecessarily diminished [24,29-31], and DTC marketing is controversial [32,33] What were provider attitudes towards this intervention that attempted to alter their decisionmaking ... a good reason for the decisions I make, and I worry about it giving the message to, uh, the patient that ‘your doctor should be doing this, and your doctor is not’.’ This concern was hypothetical...

Ngày tải lên: 10/08/2014, 10:22

... [12,13,18], and evidence from other areas of care suggests providing patients with evidence- based educational materials in clinics may assist providers in justifying evidence- based treatment decisions ... decision latitude is unnecessarily diminished [24,29-31], and DTC marketing is controversial [32,33] What were provider attitudes towards this intervention that attempted to alter their decisionmaking ... a good reason for the decisions I make, and I worry about it giving the message to, uh, the patient that ‘your doctor should be doing this, and your doctor is not’.’ This concern was hypothetical...

Ngày tải lên: 11/08/2014, 05:21

... interest in evidence- based medicine resulted in rapid development of a protocol and integration of evidence- based medicine into our ICU All ICU staff provided constructive criticism, and feedback ... Pulmonary haemorrhage (2.1) The aim of evidence- based medicine is to integrate current best evidence from research into clinical policy and practice However, this does not necessarily result in different ... B, Haines A: Barriers and bridges to evidence based clinical practice BMJ 1998, 317:273-276 Newman M, Papadopoulos I, Sigsworth J: Barriers to evidencebased practice Intensive Crit Care Nurs 1998,...

Ngày tải lên: 12/08/2014, 18:21

... part VIII: creating a journal club Laryngoscope 2003, 113:475-483 Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t BMJ 1996, 312:71-72 ... considerably since Osler’s time would be a gross understatement It is unlikely that he could have imagined the dissemination of journal club proceedings over the internet Even so, we are sure that ... based medicine: what it is and what it isn’t BMJ 1996, 312:71-72 Rosenberg W, Donald A: Evidence based medicine: an approach to clinical problem-solving BMJ 1995, 310:11221126 Guyatt GH, Rennie...

Ngày tải lên: 12/08/2014, 20:20

... ensure blinding Albumin is yellow and tends to foam during administration, making it very easy to distinguish from saline Specially designed masking cartons and administration sets were used ... pressing questions faced by intensivists The data showed that there is no advantage to resuscitation with albumin as compared to normal saline This study has several strengths worth mentioning First, ... outcomes at 28 days Recommendation Based on the results of this study, we conclude that the routine use of albumin for fluid resuscitation of critically ill patients is not warranted Albumin solutions...

Ngày tải lên: 12/08/2014, 20:20

... that is not surprising considering the drug’s mechanism of action In fact, exclusion criteria were amended midway through the trial to exclude subjects with any history, as opposed to a history ... address many of these issues is currently underway [5] This study will enroll 675 patients with primary ICH within hours of symptom onset, with the primary goal of reducing disability and improving ... within the prior 30 days, of thrombotic or vaso-occlusive disease The results of this study only apply to the treatment of primary ICH, which is due to spontaneous rupture of small vessels in the...

Ngày tải lên: 12/08/2014, 23:21

... above, ‘the truth’ is an unknowable construct, and as such, the epistemology of how evidence evolves is much debated The process of understanding how new evidence that is generated is translated into ... clinician for decision making and ultimately caring for patients [8] How a hierarchy of evidence is built On the basis of reasonable thought, common sense, rational analysis, and statistical principles ... care remains a great challenge [7] This is further complicated by the sheer magnitude of the evidence produced for any given issue in critical care Evidence is accumulating so rapidly that clinicians...

Ngày tải lên: 13/08/2014, 03:20

... patients with sepsis, is predictive of death [4,710] and is associated with a blunted response to vasopressors that can be reversed by hydrocortisone [9,11] Under this premise, initial studies ... administration of hydrocortisone 50 mg intravenously every hours and fludrocortisone 50 mcg per day reduced 28-day mortality by 10% in patients with RAI [8] At the time of publication, this was ... (COIITSS) study is completed, but not yet published [17] This study used a factorial design in 508 adults with septic shock to simultaneously compare hydrocortisone alone versus hydrocortisone plus...

Ngày tải lên: 13/08/2014, 18:22

... agency, or practice, we review the history of evidence- based treatment and discuss the reasons why evidence- based practice has come to the forefront at this time EARLY BEGINNINGS Evidence- based treatment ... Introduction to Evidence- Based Practices Randy A Hayes 02  Evidence- Based Practices in Supported Employment 10 Lisa A Razzano and Judith A Cook 03  Assertive Community Treatment 04  Evidence- Based Family ... Administrator’s Journal, Psychiatric Administrator Dr Saeed is currently involved in clinical work, teaching, research, and administration He has published in the areas of evidence- based practices;...

Ngày tải lên: 15/02/2014, 02:20

... Nursing Directors Specialist Cancer Nurses Pharmacist Dentist Haematologist Oncologist volume 2, issue 3, page 6, 1998 The information contained within Best Practice is based on the best available ... review and developing this Best Practice Information Sheet The review panel consisted of a multidisciplinary team that included: • • • • • • duration of mucositis? There is some evidence to suggest ... the damaged mucosa This information is based on Level IV evidence (expert opinion) 1) Mucositis Assessment Assess condition of the patient’s mouth daily While there is no evidence to suggest any...

Ngày tải lên: 15/02/2014, 05:20

... results (Weisz, 2004) This book, however, is not about evidence- based practices, which may be defined as techniques or treatments that have empirical support This book is about evidence- based practice ... undergirds this book In Chapter 2—EvidenceBased Practice: Definition and Process—I define evidence- based practice and dispel some myths I also describe the five basic steps of evidence- based practice ... philosophical 20 Evidence- Based Practice in School Mental Health approaches to EBP These include positivism, constructivism, and critical realism Positivism Positivism is the oldest and most established...

Ngày tải lên: 06/03/2014, 02:20

... avoidable disease is assessed – i.e how much of the disease is due to mutable risk factors and what proportion of the burden of disease is avoidable Numerous ways exist to measure the burden of disease ... forthcoming issues: www.karger.com/mpp_issues Evidence Based Practice in Dentistry Kuwait, October 2–4, 2001 Med Princ Pract 2003;12(suppl 1):1–2 DOI: 10.1159/000069848 Preface This supplement is based ... literature How to get started: The evidence- based medicine working group JAMA 1993;270:2093–2095 13 Sackett DL, Richardson WS, Rosenberg W, Haynes RB: Evidence- Based Medicine: How to Practice and...

Ngày tải lên: 06/03/2014, 12:21