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Evidence-base medicine

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https://www.readbyqxmd.com/read/28724154/mapping-residency-global-health-experiences-to-the-acgme-family-medicine-milestones
#1
Maureen O Grissom, Tochi Iroku-Malize, Rita Peila, Marco Perez, Neubert Philippe
BACKGROUND AND OBJECTIVES: Global health (GH) experiences are a unique part of family medicine (FM) training that offer an opportunity for residents to demonstrate development across a multitude of the milestones recently implemented by the Accreditation Council for Graduate Medical Education (ACGME). The GH experience presents an opportunity for resident development, and including a component of written reflection can provide tangible evidence of development in areas that can be difficult to assess...
July 2017: Family Medicine
https://www.readbyqxmd.com/read/28724128/topical-corticosteroid-phobia-in-atopic-dermatitis-a-systematic-review
#2
Alvin W Li, Emily S Yin, Richard J Antaya
Importance: Topical corticosteroid (TCS) phobia refers to the negative feelings and beliefs related to TCSs experienced by patients and patients' caregivers. This phenomenon may be a major contributing factor in treatment failure in patients with atopic dermatitis, yet it has been sparsely described in the literature. Objective: To systematically assess the nomenclature, prevalence, origins, and effect on treatment adherence of TCS phobia in atopic dermatitis. Evidence Review: A literature search was conducted using specific eligibility criteria across electronic databases, including Ovid (MEDLINE, EMBASE), PubMed, and Web of Science, for articles published from January 1, 1946, to October 31, 2016...
July 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28724044/alcohol-and-tobacco-use-and-the-diseases-treated-in-general-practice
#3
Maria Flora de Almeida, Filipe Fernandes Ferreira, Mílton de Arruda Martins, Mario Ferreira
Objective: To characterize the use of alcohol and tobacco and correlate both to the diseases of outpatients in a general practice outpatient clinic. Method: The ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) questionnaire was answered by 300 randomly chosen subjects assigned to different groups according to the diseases being treated at the Outpatient General and Teaching Clinic of the Department of Internal Medicine, Hospital das Clínicas of the University of São Paulo's School of Medicine (HC-FMUSP, in the Portuguese acronym), São Paulo, Brazil...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28722089/-how-to-carry-out-high-quality-clinical-trial
#4
Lai Xu, Yi Xiao
Evidence-based medicine derived from large-scale clinical trials has been widely accepted by clinicians, which strongly motivates the clinicians in medical institutions to conduct or participate in clinical trials. However, how to improve the clinical trial quality and management to achieve worldwide acceptance still remains challenging. By analyzing the difficulties faced by the majority of large Chinese clinical institutions and the opportunities during the evolvement of research modes, this paper proposes to improve the quality of clinical trial by closely following the domain development, raising clinical research thinking, ensuring rigorous research design, standardizing the steps and details of each operational session, as well as establishing a collaborative and well-communicated team...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28720642/evidence-based-medicine-manifesto-for-better-healthcare-a-response-to-systematic-bias-wastage-error-and-fraud-in-research-underpinning-patient-care
#5
EDITORIAL
Carl Heneghan, Kamal R Mahtani, Ben Goldacre, Fiona Godlee, Helen Macdonald, Duncan Jarvies
No abstract text is available yet for this article.
July 18, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28720121/the-effectiveness-of-daily-sms-reminders-in-pharmaceutical-care-of-older-adults-on-improving-patients-adherence-to-antihypertensive-medication-sppa-study-protocol-for-a-randomized-controlled-trial
#6
Zuzana Haramiova, Michal Stasko, Martin Hulin, Tomas Tesar, Magdalena Kuzelova, Donald M Morisky
BACKGROUND: Despite a variety of efficient and cost-effective antihypertensive medication, hypertension remains a serious health and economic burden. High consumption of cardiovascular drugs in the Slovak Republic does result neither in better hypertension control nor in significant decrease in cardiovascular mortality. At the same time, Slovakia has alarmingly low patients' adherence to medication intake. Studies have shown the efficiency of short messaging service (SMS) reminders to improve patients' adherence and health outcomes at low costs...
July 18, 2017: Trials
https://www.readbyqxmd.com/read/28720093/solanum-nigrum-unripe-fruit-fraction-attenuates-adriamycin-resistance-by-down-regulating-multi-drug-resistance-protein-mdr-1-through-jak-stat-pathway
#7
Sankar Jagadeeshan, Diana David, S Jisha, S Manjula, S Asha Nair
BACKGROUND: Solanum nigrum, herbal plant that commonly grows in temperate climate zone, has been used as a traditional folk medicine whose ripen fruits were proven to exhibit anti-tumor properties. In traditional Chinese medicine, it has been used for centuries to cure inflammation, edema, mastitis and hepatic cancer and in the Ayurvedic system of traditional medicine in India, S. nigrum is applied against enteric diseases, ulcer, diarrhea and skin diseases. A methanolic glycosidic extract fraction of unripe fruit of S...
July 18, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28719702/evidence-based-medicine-yet-more-concerns-editorial
#8
Robert T Sataloff
No abstract text is available yet for this article.
July 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28719223/from-bench-to-bedside-converting-placebo-research-into-belief-activation
#9
Jen Green, Heather Wright
Research on the placebo effect contains important elements that can be harnessed to improve clinical care. This paper proposes a new term, "Belief Activation," to describe the deliberate use of placebo effect tools by both patients and clinicians to catalyze healing. Belief Activation includes, but is not limited to, maximizing patient and practitioner expectations, classical and social conditioning, spirituality and prayer/intention, therapeutic relationship, healing environments, and minimizing the nocebo effect...
July 18, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28719221/biosimilars-biologics-that-meet-patients-needs-and-healthcare-economics
#10
Mark McCamish, William Yoon, James McKay
Biologics have revolutionized medical care, yet uniform access to these effective medicines remains difficult due to the increasing costs of healthcare. As patent exclusivity on the early biologics wanes, regulatory and legal systems are adapting to bring competition to the field in the form of biosimilars. Biosimilars are biologics that offer the same clinical benefit in one or more of the same indications as the reference biologic drug and bring competition to the biologics space. Legislation creating a pathway resulting in the first US approvals of biosimilars has been in place since 2010, but the regulatory methodology and science of evaluating the sameness of two biologics has been in use for decades...
September 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/28718723/core-addiction-medicine-competencies-for-doctors-an-international-consultation-on-training
#11
Astri Parawita Ayu, Nady El-Guebaly, Arnt Schellekens, Cor De Jong, Gabrielle Welle-Strand, William Small, Evan Wood, Walter Cullen, Jan Klimas
BACKGROUND: Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education...
July 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28718660/out-out-damned-blind-spot-the-problem-of-anxiety-with-dynamic-psychotherapy
#12
Neil Raveen Jeyasingam
OBJECTIVES: This article discusses Lady Macbeth's famous sleepwalking scene from the Shakespearean tragedy, and how it became used as a template for the formulation of obsessive-compulsive disorder. CONCLUSIONS: Psychoanalysis maintained its role in understanding the condition, despite the lack of evidence base and the repeated finding from many therapists of a failure to control symptomatology. It is suggested that psychodynamic psychotherapy suffered from a failure to recognise what components of its practice were aesthetically attractive concepts rather than evidence-based medicine and outcome measures, and is an important issue in considering its future directions...
July 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28717430/knowledge-attitude-and-practices-among-iranian-neurologists-toward-evidence-based-medicine
#13
Kaveh Shafiei, Fatemeh Sedaghati
Background: Evidence-based medicine (EBM) is a current practice in medicine to produce clinical practice guidelines from well-designed, randomized, controlled trials. We studied knowledge, attitude, and practice of EBM of neurologists who participated in the Iranian congress of neurology. Methods: A self-administered anonymous questionnaire was distributed and filled by neurologists. Results: A total of 200 neurologists were randomly sampled and with response rate of 56%. 33.9% of responder had previously participated in EBM courses...
January 5, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28716506/how-to-prevent-burnout-in-cardiologists-a-review-of-the-current-evidence-gaps-and-future-directions
#14
REVIEW
Maria Panagioti, Keith Geraghty, Judith Johnson
Burnout is rising in all physicians, and cardiologists are not an exemption. Cardiology is a very popular specialty among medical students as it is associated with outstanding training standards and high prestige and income. In this review, we critically summarize the evidence on consequences, causes, and evidence-based interventions for burnout with a view toward recommending the best strategies for promoting wellness in cardiologists. Only a handful of studies have examined burnout specifically in cardiologists...
July 4, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28715105/a-simulation-based-approach-to-measuring-team-situational-awareness-in-emergency-medicine-a-multicenter-observational-study
#15
Elizabeth D Rosenman, Aurora J Dixon, Jessica M Webb, Sarah Brolliar, Simon J Golden, Kerin A Jones, Sachita Shah, James A Grand, Steve W J Kozlowski, Georgia T Chao, Rosemarie Fernandez
OBJECTIVES: Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision-making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA; but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine teams. METHODS: We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement...
July 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28714187/a-critique-of-utilitarian-and-instrumentalist-concepts-for-the-teaching-of-gross-anatomy-to-medical-and-dental-students-an-opinion-piece
#16
Bernard J Moxham, Diogo Pais
Medical and dental curricula, together with anatomical sciences courses, are increasingly having to change, mainly because there is a drive to being what is termed, without adequate definition, 'clinically relevant'. The concept of 'clinical anatomy' has accordingly been invented and it is expected that, at all times, the teaching of anatomy is directly focussed on clinical scenarios, meaning almost invariably the 'disease-based model of medicine and dentistry'. Furthermore, students are not expected to have a detailed knowledge of gross anatomy and the time devoted to teaching and learning the subject has decreased significantly...
July 16, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28713436/the-traditional-chinese-medicine-and-relevant-treatment-for-the-efficacy-and-safety-of-atopic-dermatitis-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
REVIEW
Zhao-Feng Shi, Tie-Bing Song, Juan Xie, Yi-Quan Yan, Yong-Ping Du
BACKGROUND: Atopic dermatitis (AD) has become a common skin disease that requires systematic and comprehensive treatment to achieve adequate clinical control. Traditional Chinese medicines and related treatments have shown clinical effects for AD in many studies. But the systematic reviews and meta-analyses for them are lacking. OBJECTIVE: The systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were conducted to evaluate the efficacy and safety of traditional Chinese medicines and related treatments for AD treatment...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28711556/medicine-based-evidence-for-individualized-decision-making-case-study-of-systemic-lupus-erythematosis
#18
Ashley E Wivel, Kate Lapane, Christi Kleoudis, Burton H Singer, Ralph I Horwitz
To guide management decisions of an index patient evidence is required from comparisons between approximate matches to the profile of the index case, where some matches contain responses to treatment and others act as controls. We describe a method for constructing clinically relevant histories/profiles using data collected but unreported from two recent phase 3 RCTs assessing belimumab in subjects with clinically active and serologically positive SLE. Outcomes were the SRI (SLE Responder Index) measured at 52 weeks...
July 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28711551/from-evidence-based-medicine-to-medicine-based-evidence
#19
REVIEW
Ralph I Horwitz, Allison Hayes-Conroy, Roberto Caricchio, Burton H Singer
Evidence based medicine, using randomized controlled trials and meta-analyses as the major tools and sources of evidence about average results for heterogeneous groups of patients, developed as a reaction against poorly designed observational treatment research and physician reliance on personal experience with other patients as a guide to decision making about a patient at hand. However, these tools do not answer the clinician's question: will a given therapeutic regimen help my patient at a given point in her/his clinical course?' We introduce fine-grained profiling of the patient at hand, accompanied by comparative evidence of responses from approximate matches to this patient on whom a contemplated treatment has/has not been administered...
July 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28711131/care-of-special-populations-in-an-observation-unit-pediatrics-and-geriatrics
#20
REVIEW
Sharon E Mace
Infants and children and the elderly comprise a large and growing (especially the elderly) segment of the US population. The benefits of observation medicine have been documented in these two age groups: Based on the success of observation medicine, and recognizing the growth of these special populations, it is likely that observation medicine will be expanding in the future, especially within the pediatric and geriatric populations. Future studies should be able to provide further evidence regarding the value of observation medicine in these two diverse population age groups...
August 2017: Emergency Medicine Clinics of North America
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