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Evidence Based Medicine

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https://www.readbyqxmd.com/read/28230903/-evidence-based-medicine-in-eating-disorders-research-the-problem-of-confetti-p-values
#1
Helena Chmura Kraemer
Eating disorders hold a unique place among mental health disorders, in that salient symptoms can be objectively observed and measured rather than determined only from patient interviews or subjective evaluations. Because of this measurement advantage alone, evidence-based medicine would be expected there to make the most rapid strides. However, conclusions in Eating Disorders research, as in all medical research literature, often continue to be misleading or ambiguous. One major and long-known source of such problems is the misuse and misinterpretation of "statistical significance", with "p values" strewn throughout research papers like so much confetti, a problem that has become systemic, that is, enforced, rather than corrected, by the peer-review system...
February 23, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28229917/factors-related-to-self-directed-learning-readiness-of-students-in-health-professional-programs-a-scoping-review
#2
REVIEW
Craig E Slater, Anne Cusick
BACKGROUND: Academic and professional drivers have stimulated interest in self-directed learning of students in pre-certification health professional programs. Particular attention has focussed on factors which may influence a students' readiness for self-directed learning. METHOD: A five stage structured scoping review of published literature was conducted to identify measures of self-directed learning readiness used with students in pre-certification health professional programs and those factors that have been investigated as potential determinants...
February 14, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28228864/innovative-payer-engagement-strategies-will-the-convergence-lead-to-better-value-creation-in-personalized-medicine
#3
REVIEW
Ildar Akhmetov, Rostyslav V Bubnov
BACKGROUND: As reimbursement authorities are gaining greater power to influence the prescription behavior of physicians, it remains critical for life science companies focusing on personalized medicine to develop "tailor-made" payer engagement strategies to secure reimbursement and assure timely patient access to their innovative products. Depending on the types of such engagement, pharmaceutical and diagnostic companies may benefit by obtaining access to medical and pharmacy claims data, getting invaluable upfront inputs on evidence requirements and clinical trial design, and strengthening trust by payers, therefore avoiding uncertainties with regards to pricing, reimbursement, and research and development reinvestment...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/28228571/who-cares-the-lost-legacy-of-archie-cochrane
#4
Clemet Askheim, Tony Sandset, Eivind Engebretsen
Over the last 20 years, the evidence-based medicine (EBM) movement has sought to develop standardised approaches to patient treatment by drawing on research results from randomised controlled trials (RCTs). The Cochrane Collaboration and its eponym, Archie Cochrane, have become symbols of this development, and Cochrane's book Effectiveness and Efficiency from 1972 is often referred to as the first sketch of what was to become EBM. In this article, we claim that this construction of EBM's historical roots is based on a selective reading of Cochrane's text...
March 2017: Medical Humanities
https://www.readbyqxmd.com/read/28228230/expanding-professional-pharmacy-services-in-european-community-setting-is-it-cost-effective-a-systematic-review-for-health-policy-considerations
#5
REVIEW
Clémence Perraudin, Olivier Bugnon, Nathalie Pelletier-Fleury
OBJECTIVE: To synthesize cost-effectiveness analyses on professional pharmacy services (PPS) performed in Europe in order to contribute to current debates on their funding and reimbursement. METHODS: Systematic review in PubMed, Embase and the Centre for Reviews and Dissemination databases to identify full economic evaluation studies of PPS in community setting from 2004. FINDINGS: Twenty-one studies were included, conducted in the United-Kingdom (n=13), the Netherlands (n=3), Spain (n=2), Belgium (n=1), France (n=1) and Denmark (n=1)...
December 2016: Health Policy
https://www.readbyqxmd.com/read/28226421/opening-plenary-speaker-human-genomics-precision-medicine-and-advancing-human-health
#6
Eric D Green
Starting with the launch of the Human Genome Project in 1990, the past quarter-century has brought spectacular achievements in genomics that dramatically empower the study of human biology and disease. The human genomics enterprise is now in the midst of an important transition, as the growing foundation of genomic knowledge is being used by researchers and clinicians to tackle increasingly complex problems in biomedicine. Of particular prominence is the use of revolutionary new DNA sequencing technologies for generating prodigious amounts of DNA sequence data to elucidate the complexities of genome structure, function, and evolution, as well as to unravel the genomic bases of rare and common diseases...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225542/historical-overview-of-leprosy-control-in-cuba
#7
Enrique Beldarraín-Chaple
INTRODUCTION Leprosy, an infectious disease caused by Mycobacterium leprae, affects the nervous system, skin, internal organs, extremities and mucous membranes. Biological, social and environmental factors influence its occurrence and transmission. The first effective treatments appeared in 1930 with the development of dapsone, a sulfone. The main components of a control and elimination strategy are early case detection and timely administration of multidrug therapy. OBJECTIVES Review the history of leprosy control in Cuba, emphasizing particularly results of the National Leprosy Control Program, its modifications and influence on leprosy control...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28224458/bridging-the-training-practice-gap-in-interprofessional-student-supervision
#8
Priya Martin, Saravana Kumar, LuJuana Abernathy
BACKGROUND: Workforce recruitment and retention issues are common in highly dispersed regions such as Queensland in Australia. Provision of student placements in these non-metropolitan areas is one way of promoting staff recruitment. However, healthcare professionals in these areas face a number of challenges in accessing training opportunities including student supervision training. Funding was made available to develop and run a series of targeted, evidence-based, interprofessional student supervision workshops in non-metropolitan Queensland...
February 21, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28224284/complementary-and-alternative-medicine-use-in-rheumatoid-arthritis-considerations-for-the-pharmacological-management-of-elderly-patients
#9
REVIEW
Sizheng Zhao, Fred Otieno, Asan Akpan, Robert J Moots
Complementary and alternative medicines (CAMs) are widely used by patients with rheumatoid arthritis (RA); however, a significant proportion of these patients do not inform their physicians. This has many potential implications in a group of predominantly elderly patients with altered pharmacokinetics, comorbidities and polypharmacy of potentially toxic drugs. CAM usage may affect compliance and pharmacokinetics of conventional therapy for RA and comorbidities; therefore, physicians should engage patients in dialogues regarding CAM usage...
February 21, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28224208/-prevention-of-postoperative-infections-evidence-based-principles
#10
F Pianka, A L Mihaljevic
BACKGROUND: Surgical site infections (SSI) are one of the most frequent postoperative complications worldwide and preventive measures are still an important research topic. High infection rates are not uncommon, especially in visceral surgery. At the same time, frequently not all evidence-based measures are carried out in a standardized manner. The aim of this article is to summarize the relevant literature on evidence-based measures for prevention of SSI. Although evidence-based medicine has already become well-established in surgery, the opinion of experts often still prevails...
February 21, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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