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Evidence-based medicine

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https://www.readbyqxmd.com/read/28220931/the-role-of-extracorporeal-photopheresis-in-the-management-of-cutaneous-t-cell-lymphoma-graft-versus-host-disease-and-organ-transplant-rejection-a-consensus-statement-update-from-the-uk-photopheresis-society
#1
Arun Alfred, Peter C Taylor, Fiona Dignan, Khaled El-Ghariani, James Griffin, Andrew R Gennery, Denise Bonney, Emma Das-Gupta, Sarah Lawson, Ram K Malladi, Kenneth W Douglas, Tracey Maher, Julie Guest, Laura Hartlett, Andrew J Fisher, Fiona Child, Julia J Scarisbrick
Extracorporeal photopheresis (ECP) has been used for over 35 years in the treatment of erythrodermic cutaneous T-cell lymphoma (CTCL) and over 20 years for chronic and acute graft-versus-host disease (GvHD) and solid organ transplant rejection. ECP for CTCL and GvHD is available at specialised centres across the UK. The lack of prospective randomised trials in ECP led to the development of UK Consensus Statements for patient selection, treatment schedules, monitoring protocols and patient assessment criteria for ECP...
February 21, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28220367/routine-placement-of-subdural-drain-after-burr-hole-evacuation-of-chronic-and-subacute-subdural-hematoma-a-contrarian-evidence-based-approach
#2
Laxminadh Sivaraju, Ranjith K Moorthy, Visalakshi Jeyaseelan, Vedantam Rajshekhar
The objective of this paper was to evaluate whether available evidence supporting placement of subdural drain placement after evacuation of chronic subdural haematoma (CSDH) is applicable to a cohort of patients managed by us. In this observational cohort study, clinical follow-up was obtained in 166 patients who underwent burr hole evacuation of CSDH without placement of subdural drain followed by 3 days of bed rest. The primary outcome studied was recurrence requiring reoperation. Factors predicting recurrence were also analysed...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28220317/role-of-narrative-based-medicine-in-proper-patient-assessment
#3
Giovanni Rosti
Improving patient-physician communication is an area of medicine that deserves greater attention. Narrative medicine can be considered as one tool that can aid in fostering better communication. Current medical practice is dominated by evidence-based medicine, and dictates what therapies the clinician will offer in a given circumstance, ideally supported by (evidence-based) guidelines. However, when taken alone it tends to decentralize the patient. There are many different approaches that can be used to understand the patient and what he or she is experiencing as a result of their illness...
February 21, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28218890/peer-review-in-clinical-pharmacology-using-the-8-d-assessment
#4
Barry G Woodcock
The requirement for editors of clinical pharmacology journals to maintain an overview of the peer review process for manuscripts submitted can be facilitated by use of the 8-D Assessment. The 8-D Assessment comprises peer review criteria to determine if the:1. Design of the study, 2. Diagnoses employed, 3. Drug molecules involved, 4. Dosages applied, 5. Data collected, 6. Discussion of the findings, 7. Deductions made, and 8. Documentation are in accord with the objectives of the study and meet the requirements of evidence-based medicine...
March 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28215660/progress-in-evidence-based-medicine-a-quarter-century-on
#5
REVIEW
Benjamin Djulbegovic, Gordon H Guyatt
In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making...
February 16, 2017: Lancet
https://www.readbyqxmd.com/read/28214724/where-biomedicalisation-and-magic-meet-therapeutic-innovations-of-elite-sports-injury-in-british-professional-football-and-cycling
#6
Alex Faulkner, Michael McNamee, Catherine Coveney, Jonathan Gabe
Injury is a conspicuous feature of the practice and public spectacle of contemporary elite sports. The paper argues that the 'biomedicalisation' thesis (medico-industrial nexus, techno-scientific drivers, medical optimisation, biologisation, the rise of evidence and health surveillance) goes some way to capturing the use in elite sports injury of some highly specialised mainstream therapies and some highly maverick biological therapies, which are described. Nevertheless, these main strands of biomedicalisation do not capture the full range of these phenomena in the contexts of sports medicine and athletes' practices in accessing innovative, controversial therapies...
February 9, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28214463/bridging-the-gap-in-peripheral-nerve-repair
#7
Donato Perretta, Steven Green
Peripheral nerve injuries following trauma present an ongoing challenge to the hand surgeon. This review presents an overview of the topic with a historical perspective. Nerve anatomy and nerve injury classifications are discussed followed by a description of the biology of nerve regeneration. Methods used to bridge gaps in peripheral nerve repair are discussed in detail with a critical appraisal of the most recent literature. Recommendations for surgical treatment are formulated based on evidence-based medicine...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214461/wide-awake-hand-surgery
#8
Matthew Cantlon, Steven Yang
Wide awake hand surgery employs local-only anesthesia with low-dose epinephrine to create a bloodless field without the use of an arm tourniquet. Despite traditional teaching, evidence-based medicine suggests epinephrine is safe for use in hand and digital anesthesia. Eliminating an arm tourniquet reduces the requirement for sedation and general anesthetic. This confers particular advantage in surgeries such as tendon repairs, tendon transfers, and soft tissue releases in which intraoperative active motion can used to optimize outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214351/evidence-based-and-precision-medicine-two-of-a-kind
#9
W J Fokkens
In the last two decades, an enormous expansion of evidence has been produced in upper airway research. When writing the first EPOS document in 2005 only 5 RCT per year were performed in the area of CRS, in 2007 this changed to 25 per year and it became even higher in the recent years. Randomized Controlled Trials (RCTs) are the "gold standard" for evaluating treatment outcomes providing information on treatments "efficacy". To make life easier for clinicians, systematic reviews and meta-analysis further condense the available evidence...
February 18, 2017: Rhinology
https://www.readbyqxmd.com/read/28214137/japanese-guidelines-for-allergic-rhinitis-2017
#10
REVIEW
Kimihiro Okubo, Yuichi Kurono, Keiichi Ichimura, Tadao Enomoto, Yoshitaka Okamoto, Hideyuki Kawauchi, Harumi Suzaki, Shigeharu Fujieda, Keisuke Masuyama
Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 8th edition was published in 2016, and is widely used today...
February 14, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28214005/-review-of-national-and-international-guidelines-for-sentinel-lymph-node-biopsy-and-complementary-axillary-dissection-in-breast-cancer
#11
REVIEW
Laura Vincent, François Margueritte, Jennifer Uzan, Clémentine Owen, Julien Seror, Nicolas Pouget, Eugénie Guillot, Roman Rouzier
Management of breast cancer is based on national and international guidelines. These are defined on evidence-based medicine. The main purpose of this review is to compare the different guidelines for sentinel lymph node biopsy and completion axillary dissection after positive sentinel lymph node biopsy. This review of breast cancer guidelines led to identify consensus, but in some specific situations, they differ. The guidelines cannot be applied to all clinical cases, mandatoring multidisciplinary meetings are essential...
February 14, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28213967/extracellular-vesicles-from-bone-marrow-derived-mesenchymal-stem-cells-improve-survival-from-lethal-hepatic-failure-in-mice
#12
Hiroaki Haga, Irene K Yan, Kenji Takahashi, Akiko Matsuda, Tushar Patel
Stem cell-based therapies have potential for treatment of liver injury by contributing to regenerative responses, through functional tissue replacement or paracrine effects. The release of extracellular vesicles (EV) from cells has been implicated in intercellular communication, and may contribute to beneficial paracrine effects of stem cell-based therapies. Therapeutic effects of bone-marrow derived mesenchymal stem cells (MSC) and vesicles released by these cells were examined in a lethal murine model of hepatic failure induced by d-galactosamine/tumor necrosis factor-α (TNF-α)...
February 18, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28213454/towards-evidence-based-medicine-for-paediatricians
#13
Bob Phillips
No abstract text is available yet for this article.
March 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28212971/should-countries-set-an-explicit-health-benefits-package-the-case-of-the-english-national-health-service
#14
Peter C Smith, Kalipso Chalkidou
BACKGROUND: A fundamental debate in the transition towards universal health coverage concerns whether to establish an explicit health benefits package to which all citizens are entitled, and the level of detail in which to specify that package. At one extreme, the treatments to be funded, and the circumstances in which patients qualify for the treatment, might be specified in great detail, and be entirely mandatory. This would make clinicians little more than automata, carrying out prescribed practice...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212647/an-interpretive-review-of-consensus-statements-on-clinical-guideline-development-and-their-application-in-the-field-of-traditional-and-complementary-medicine
#15
Jennifer Hunter, Matthew Leach, Lesley Braun, Alan Bensoussan
BACKGROUND: Despite ongoing consumer demand and an emerging scientific evidence-base for traditional and complementary medicine (T&CM), there remains a paucity of reliable information in standard clinical guidelines about their use. Often T&CM interventions are not mentioned, or the recommendations arising from these guidelines are unhelpful to end-users (i.e. patients, practitioners and policy makers). Insufficient evidence of efficacy may be a contributing factor; however, often informative recommendations could still be made by drawing on relevant information from other avenues...
February 17, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28212313/chemoprevention-of-rat-mammary-carcinogenesis-by-apiaceae-spices
#16
Farrukh Aqil, Jeyaprakash Jeyabalan, Radha Munagala, Srivani Ravoori, Manicka V Vadhanam, David J Schultz, Ramesh C Gupta
Scientific evidence suggests that many herbs and spices have medicinal properties that alleviate symptoms or prevent disease. In this study, we examined the chemopreventive effects of the Apiaceae spices, anise, caraway, and celery seeds against 17β-estrogen (E2)-mediated mammary tumorigenesis in an ACI (August-Copenhagen Irish) rat model. Female ACI rats were given either control diet (AIN 93M) or diet supplemented with 7.5% (w/w) of anise, caraway, or celery seed powder. Two weeks later, one half of the animals in each group received subcutaneous silastic implants of E2...
February 16, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28210658/patellar-maltracking-persists-in-adolescent-females-with-patellofemoral-pain-a-longitudinal-study
#17
Victor R Carlson, Barry P Boden, Aricia Shen, Jennifer N Jackson, Katharine E Alter, Frances T Sheehan
BACKGROUND: Patellofemoral pain is one of the most common conditions seen in sports medicine practices, particularly among adolescent females. However, the natural history of the underlying pathology in patellofemoral pain during puberty remains poorly understood. PURPOSE: The purpose of this longitudinal study is to assess changes in patellar maltracking patterns in subjects with patellofemoral pain as they mature from mid- to late adolescence. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210654/postoperative-rehabilitation-after-rotator-cuff-repair-a-web-based-survey-of-aana-and-aossm-members
#18
Scott Mollison, Jason J Shin, Alexander Glogau, R Cole Beavis
BACKGROUND: Postoperative rehabilitation after arthroscopic rotator cuff repair (ARCR) remains controversial and suffers from limited high-quality evidence. Therefore, appropriate use criteria must partially depend on expert opinion. HYPOTHESIS/PURPOSE: The purpose of the study was to determine and report on the standard and modified rehabilitation protocols after ARCR used by member orthopaedic surgeons of the American Orthopaedic Society for Sports Medicine (AOSSM) and the Arthroscopy Association of North America (AANA)...
January 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210521/the-right-to-die-in-chronic-disorders-of-consciousness-can-we-avoid-the-slippery-slope-argument
#19
REVIEW
Rocco Salvatore Calabrò, Antonino Naro, Rosaria De Luca, Margherita Russo, Lory Caccamo, Alfredo Manuli, Alessia Bramanti, Placido Bramanti
Managing individuals with chronic disorders of consciousness raises ethical questions about the appropriateness of maintaining life-sustaining treatments and end-of-life decisions for those who are unable to make decisions for themselves. For many years, the positions fostering the "sanctity" of human life (i.e., life is inviolable in any case) have led to maintaining life-sustaining treatments (including artificial nutrition and hydration) in patients with disorders of consciousness, allowing them to live for as long as possible...
November 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28210367/academic-primer-series-eight-key-papers-about-education-theory
#20
Michael Gottlieb, Megan Boysen-Osborn, Teresa M Chan, Sara M Krzyzaniak, Nicolas Pineda, Jordan Spector, Jonathan Sherbino
INTRODUCTION: Many teachers adopt instructional methods based on assumptions of best practices without attention to or knowledge of supporting education theory. Familiarity with a variety of theories informs education that is efficient, strategic, and evidence-based. As part of the Academic Life in Emergency Medicine Faculty Incubator Program, a list of key education theories for junior faculty was developed. METHODS: A list of key papers on theories relevant to medical education was generated using an expert panel, a virtual community of practice synthetic discussion, and a social media call for resources...
February 2017: Western Journal of Emergency Medicine
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