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Evidence-based Medicine

David Kault
A sad little story about a maimed Martian astronaut is used to illustrate a method of improving confidence interval (CI) calculations. CIs in medical statistics are currently calculated from the data available in a clinical trial or meta-analysis considered in isolation from all other information available on earth. Likewise, the Martian in the story uses only information available to it, in isolation from further information from earth. However, there is further objective knowledge available to people on earth to improve the Martian's estimate...
January 10, 2017: Evidence-based Medicine
Theodore R Levin
No abstract text is available yet for this article.
January 10, 2017: Evidence-based Medicine
Yüksel Peker, Patrick J Strollo
No abstract text is available yet for this article.
January 9, 2017: Evidence-based Medicine
Matthew Greenhawt, Carina Venter
No abstract text is available yet for this article.
January 4, 2017: Evidence-based Medicine
Jan Mekkes
No abstract text is available yet for this article.
January 4, 2017: Evidence-based Medicine
Stephen Honeybul
No abstract text is available yet for this article.
January 4, 2017: Evidence-based Medicine
Ju Lee Oei
No abstract text is available yet for this article.
December 23, 2016: Evidence-based Medicine
Robert DuBroff
The global campaign to lower cholesterol by diet and drugs has failed to thwart the developing pandemic of coronary heart disease around the world. Some experts believe this failure is due to the explosive rise in obesity and diabetes, but it is equally plausible that the cholesterol hypothesis, which posits that lowering cholesterol prevents cardiovascular disease, is incorrect. The recently presented ACCELERATE trial dumbfounded many experts by failing to demonstrate any cardiovascular benefit of evacetrapib despite dramatically lowering low-density lipoprotein cholesterol and raising high-density lipoprotein cholesterol in high-risk patients with coronary disease...
December 20, 2016: Evidence-based Medicine
Michael Williams, Mairead Boohan, Allen Thurston
BACKGROUND: Effective education of relevant professionals underpins provision of quality eye healthcare. OBJECTIVES: This scoping systematic review had 2 aims: first to investigate the extent and nature of scholarly output published on ophthalmic and paraophthalmic education, and second to focus on the quality of reporting of randomised controlled trials (RCTs) identified. STUDY SELECTION: A search strategy was created and applied to PubMed...
December 19, 2016: Evidence-based Medicine
Primiano Iannone, Giorgio Costantino, Nicola Montano, Gian Marco Podda, Monica Minardi, James Doyle, Antonino Cartabellotta
Any evidence-based recommendation needs careful assessment of its methodological background as well as of its content trustworthiness, especially given that following it will not necessarily produce the intended clinical outcomes. There are no established instruments to evaluate guidelines for their content, while useful tools assessing the quality of methods followed are well recognised and adopted. We suggest a 'safety bundle' considering methodological aspects and content trustworthiness of guidelines, by adopting the GRADE method in a backward fashion...
December 16, 2016: Evidence-based Medicine
Bassel H Al Wattar, Javier Zamora, Khalid S Khan
Evidence from randomised trials and their meta-analyses is typically formed of head-to-head comparisons of a couple of treatments; multiarm trials are infrequent. However, in real-life healthcare, there are many more than two treatment options for a particular condition. To be relevant for the shop-floor of practice, evidence-based medicine requires the use a comprehensive approach to compile, compare and contrast evidence on all options in one synthesis. Network meta-analysis (NMA) offers exactly such a solution...
December 16, 2016: Evidence-based Medicine
Primiano Iannone, Nicola Montano, Monica Minardi, James Doyle, Paolo Cavagnaro, Antonino Cartabellotta
Evidence-based guidelines are considered an essential tool in assisting physicians, policymakers and patients when choosing among alternative care options and are considered unbiased standards of care. Unfortunately, depending on how their reliability is measured, up to 50% of guidelines can be considered untrustworthy. This carries serious consequences for patients' safety, resource use and health economics burden. Although conflict of interests, panel composition and methodological flaws are traditionally thought to be the main reasons undermining their untrustworthiness, corruption and waste of biomedical research also contribute...
December 16, 2016: Evidence-based Medicine
Fares Alahdab, Samer Alabed, Ahmed Al-Moujahed, Mohammad Anass Al Sallakh, Tareq Alyousef, Ubai Alsharif, Munes Fares, M Hassan Murad
Healthcare infrastructure and medical schools in Syria have been greatly compromised by military conflict and humanitarian disaster. Medical students and healthcare professionals reached out for remote learning opportunities. Surprisingly, they desired a curriculum in evidence-based medicine. We report on a curriculum that was delivered to 126 learners using an online remote delivery platform. This experience demonstrates the feasibility of this approach in disaster-stricken areas and underscores the importance of evidence-based medicine even under such conditions...
December 13, 2016: Evidence-based Medicine
M Hassan Murad, Jehad Almasri, Mouaz Alsawas, Wigdan Farah
Evidence-based practitioners who want to apply evidence from complex interventions to the care of their patients are often challenged by the difficulty of grading the quality of this evidence. Using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and an illustrative example, we propose a framework for evaluating the quality of evidence that depends on obtaining feedback from the evidence user (eg, guideline panel) to inform: (1) proper framing of the question, (2) judgements about directness and consistency of evidence and (3) the need for additional contextual and qualitative evidence...
December 8, 2016: Evidence-based Medicine
W Scott Butsch, Fatima Cody Stanford
No abstract text is available yet for this article.
November 23, 2016: Evidence-based Medicine
Michael A Weber
No abstract text is available yet for this article.
November 21, 2016: Evidence-based Medicine
Jean Adams, Susanna D H Mills
No abstract text is available yet for this article.
November 17, 2016: Evidence-based Medicine
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