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https://www.readbyqxmd.com/read/28967117/how-to-write-a-critically-appraised-topic-evidence-to-underpin-routine-clinical-practice
#1
J Callander, A V Anstey, J R Ingram, J Limpens, C Flohr, P I Spuls
Critically appraised topics (CATs) are essential tools for busy clinicians who wish to ensure that their daily clinical practice is underpinned by evidence-based medicine. CATs are short summaries of the most up-to-date, high-quality available evidence that is found using thorough structured methods. They can be used to answer specific, patient-orientated questions that arise recurrently in real-life practice. This article provides readers with a detailed guide to performing their own CATs. It is split into four main sections reflecting the four main steps involved in performing a CAT: formulation of a focused question, a search for the most relevant and highest-quality evidence, critical appraisal of the evidence and application of the results back to the patient scenario...
October 1, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28960730/reasoning-evidence-and-clinical-decision-making-the-great-debate-moves-forward
#2
EDITORIAL
Michael Loughlin, Robyn Bluhm, Stephen Buetow, Kirstin Borgerson, Jonathan Fuller
When the editorial to the first philosophy thematic edition of this journal was published in 2010, critical questioning of underlying assumptions, regarding such crucial issues as clinical decision making, practical reasoning, and the nature of evidence in health care, was still derided by some prominent contributors to the literature on medical practice. Things have changed dramatically. Far from being derided or dismissed as a distraction from practical concerns, the discussion of such fundamental questions, and their implications for matters of practical import, is currently the preoccupation of some of the most influential and insightful contributors to the on-going evidence-based medicine debate...
October 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28924688/the-barrier-to-informed-choice-in-cancer-screening-statistical-illiteracy-in-physicians-and-patients
#3
Odette Wegwarth, Gerd Gigerenzer
An efficient health care requires both informed doctors and patients. Our current healthcare system falls short on both counts. Most doctors and patients do not understand the available medical evidence. To illustrate the extent of the problem in the setting of cancer screening: In a representative sample of some 5000 women in nine European countries, 92% overestimated the reduction of breast cancer mortality by mammography by a factor of 10-200, or did not know. For a similar sample of about 5000 men with respect to PSA screening, this number was 89%...
2018: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/28922229/micrornas-as-clinical-biomarkers-and-therapeutic-tools-in-perioperative-medicine
#4
Simone Kreth, Max Hübner, Ludwig Christian Hinske
Over the past decade, evolutionarily conserved, noncoding small RNAs-so-called microRNAs (miRNAs)-have emerged as important regulators of virtually all cellular processes. miRNAs influence gene expression by binding to the 3'-untranslated region of protein-coding RNA, leading to its degradation and translational repression. In medicine, miRNAs have been revealed as novel, highly promising biomarkers and as attractive tools and targets for novel therapeutic approaches. miRNAs are currently entering the field of perioperative medicine, and they may open up new perspectives in anesthesia, critical care, and pain medicine...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28841383/refinement-of-the-affordable-care-act
#5
Vivian Ho
Regardless of what legislation the federal government adopts to address health insurance coverage for nonelderly Americans, private insurance will likely play a major role. This article begins by listing some of the major reasons critics dislike the Affordable Care Act, then discusses the validity of these concerns from an economics perspective. Criticisms of the ACA include the increased role of government in healthcare, the ACA's implicit income redistribution, and concern about high and rising insurance premiums...
August 25, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28756159/automatic-identification-of-high-impact-articles-in-pubmed-to-support-clinical-decision-making
#6
Jiantao Bian, Mohammad Amin Morid, Siddhartha Jonnalagadda, Gang Luo, Guilherme Del Fiol
OBJECTIVES: The practice of evidence-based medicine involves integrating the latest best available evidence into patient care decisions. Yet, critical barriers exist for clinicians' retrieval of evidence that is relevant for a particular patient from primary sources such as randomized controlled trials and meta-analyses. To help address those barriers, we investigated machine learning algorithms that find clinical studies with high clinical impact from PubMed®. METHODS: Our machine learning algorithms use a variety of features including bibliometric features (e...
September 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28749248/update-in-perioperative-medicine-practice-changing-evidence-published-in-2016
#7
REVIEW
Dennis W Regan, Deanne Kashiwagi, Brian Dougan, Karna Sundsted, Karen Mauck
This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change...
October 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28686557/the-biopsychosocial-model-40-years-of-application-in-psychiatry
#8
G Papadimitriou
In 1977, the American pathologist and psychiatrist George Engel (1913-1999) published in the Journal Science his paper "TheIn 1977, the American pathologist and psychiatrist George Engel (1913-1999) published in the Journal Science his paper "Theneed for a new medical model: A challenge for biomedicine", introducing the term Biopsychosocial Model. This model basedon the results of Engel's studies in ulcerative colitis, depression and psychogenic pain, constituted a challenge for biomedicineand the biomedical model...
April 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/28574536/perceptions-of-hospital-dependent-patients-on-their-needs-for-hospitalization
#9
Tao Liu, Eliza Kiwak, Mary E Tinetti
In the United States, older adults account for a significant proportion of hospitalizations, and a subset become hospital-dependent, for reasons that are unclear. We conducted a qualitative study to explore these individuals' perspectives on their need for hospitalizations. Twenty patients hospitalized at an academic medical center underwent semistructured qualitative interviews. Criteria for selection included age 65 and older, at least three hospitalizations over six months, admission to the medical service at the time of the study, did not meet criteria for chronic critical illness, was not comfort measures only, and did not have a conservator...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28554932/the-role-of-academic-health-centres-in-building-equitable-health-systems-a-systematic-review-protocol
#10
Alexandra Edelman, Judy Taylor, Pavel V Ovseiko, Stephanie M Topp
INTRODUCTION: Academic health centres (AHCs) are complex organisations often defined by their 'tripartite' mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28532613/the-practice-of-evidence-based-medicine-involves-the-care-of-whole-persons
#11
W Scott Richardson
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28481831/outcome-of-pediatric-critical-care-medicine-abstracts-presented-at-north-american-academic-national-meetings
#12
Sonali Basu, Murray M Pollack
OBJECTIVES: Pediatric critical care medicine abstracts presented at North American national academic meetings have not been followed up to determine their publication outcomes. Our objective was to determine the following: 1) the proportion of these presentations that are published in peer-reviewed journals within 5 years; 2) the impact of trainee status on time to and success of publication; and 3) the quality of the research as reflected in the publishing journal's impact factor. DESIGN: Four years of abstracts (2007-2011) were reviewed from the American Academy of Pediatrics, Pediatric Academic Societies, and Society of Critical Care Medicine national meetings...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#13
REVIEW
A Gries, M Bernhard, M Helm, J Brokmann, J-T Gräsner
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment...
May 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28411354/preventing-the-complications-associated-with-the-use-of-dermal-fillers-in-facial-aesthetic-procedures-an-expert-group-consensus-report
#14
REVIEW
Fernando Urdiales-Gálvez, Nuria Escoda Delgado, Vitor Figueiredo, José V Lajo-Plaza, Mar Mira, Francisco Ortíz-Martí, Rosa Del Rio-Reyes, Nazaret Romero-Álvarez, Sofía Ruiz Del Cueto, María A Segurado, Cristina Villanueva Rebenaque
BACKGROUND: The use of dermal fillers in minimally invasive facial aesthetic procedures has become increasingly popular of late, yet as the indications and the number of procedures performed increase, the number of complications is also likely to increase. Paying special attention to specific patient characteristics and to the technique used can do much to avoid these complications. Indeed, a well-trained physician can also minimize the impact of such problems when they do occur. METHODS: A multidisciplinary group of experts in aesthetic treatments reviewed the main factors associated with the complications that arise when using dermal fillers...
June 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28411289/evaluating-automated-rules-for-rapid-response-system-alarm-triggers-in-medical-and-surgical-patients
#15
Santiago Romero-Brufau, Bruce W Morlan, Matthew Johnson, Joel Hickman, Lisa L Kirkland, James M Naessens, Jeanne Huddleston
BACKGROUND: The use of rapid response systems (RRS), which were designed to bring clinicians with critical care expertise to the bedside to prevent unnecessary deaths, has increased. RRS rely on accurate detection of acute deterioration events. Early warning scores (EWS) have been used for this purpose but were developed using heterogeneous populations. Predictive performance may differ in medical vs surgical patients. OBJECTIVE: To evaluate the performance of published EWS in medical vs surgical patient populations...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28384249/a-systematically-structured-review-of-biomarkers-of-dying-in-cancer-patients-in-the-last-months-of-life-an-exploration-of-the-biology-of-dying
#16
Victoria Louise Reid, Rachael McDonald, Amara Callistus Nwosu, Stephen R Mason, Chris Probert, John E Ellershaw, Séamus Coyle
BACKGROUND: The Neuberger review made a number of recommendations to improve end of life care, including research into the biology of dying. An important aspect of the biology of dying is the identification of biomarkers as indices of disease processes. Biomarkers have the potential to inform the current, limited understanding of the dying process and assist clinicians in recognising dying, in particular how to distinguish dying from reversible acute deterioration. OBJECTIVES: To critically appraise the literature on biological factors that may be used as prognostic indicators in advanced cancer patients and to identify candidate biomarkers of the dying process that can be measured serially in cancer patients' bodily fluids...
2017: PloS One
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#17
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28125823/effect-of-a-handover-tool-on-efficiency-of-care-and-mortality-for-interhospital-transfers
#18
Cecelia N Theobald, Neesha N Choma, Jesse M Ehrenfeld, Stephan Russ, Sunil Kripalani
BACKGROUND: Interhospital transfer is frequent, and transferred patients experience delays in the provision of care and higher mortality rates when compared to patients directly admitted. The interhospital handover is a key opportunity to improve care but has not been evaluated. OBJECTIVE: To determine the effect of a universal handover tool on timeliness of care, length of stay (LOS), and mortality among interhospital transfer patients. DESIGN, SETTING, AND PATIENTS: Retrospective cohort of patients transferred to an academic medical center between July 1, 2009 and December 31, 2010 with interrupted time-series design...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28116010/an-analysis-of-the-top-cited-articles-in-emergency-medicine-education-literature
#19
Brendan W Munzer, Jeffery Love, Barbara L Shipman, Brendan Byrne, Stephen J Cico, Robert Furlong, Sorabh Khandelwal, Sally A Santen
INTRODUCTION: Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. METHODS: Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28109324/reporting-of-critical-care-trial-abstracts-a-comparison-before-and-after-the-announcement-of-consort-guideline-for-abstracts
#20
Akira Kuriyama, Naomi Takahashi, Takeo Nakayama
BACKGROUND: An extension of the Consolidated Standards of Reporting Trials (CONSORT) statement provides a checklist of items to improve the reporting quality of abstracts of randomized controlled trials (RCTs). However, authors of abstracts in some fields have poorly adhered to this guideline. We did an extensive literature survey to examine the quality of reporting trial abstracts in major critical care journals before and after announcement of the CONSORT guideline for abstracts. METHODS: We reviewed abstracts of RCTs published in four major critical care journals with publication dates ranging from 2006 to 2007 (pre-CONSORT) and from 2011 to 2012 (post-CONSORT): Intensive Care Medicine (ICM), Critical Care (CC), American Journal of Respiratory and Critical Care Medicine (AJRCCM), and Critical Care Medicine (CCM)...
January 21, 2017: Trials
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