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https://www.readbyqxmd.com/read/29451516/-evidence-based-medicine-vs-personalized-medicine
#1
Lucio Capurso
Evidence-based medicine (EBM) and personalized medicine (PM) are driven by two diverse modes of reasoning about «evidence making». EBM has been criticized since his quality mark has been misappropriated by vested interests, the benefits statistically significant may be marginal in clinical practice, rigid rules and technology may produce care that is management driven rather than patient centered. On the contrary PM (or "precision medicine") refers to the tailoring of medical treatment to the specific characteristics of each patient involving the ability to classify individuals into subpopulations that are uniquely susceptible to a specific treatment, sparing expense and side effects and is derived from doubts on the results of subgroup analyses and on non responders in clinical trials typical of EBM...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29427531/osseointegration-of-3d-printed-microalloyed-cocr-implants-addition-of-0-04-zr-to-cocr-does-not-alter-bone-material-properties
#2
Furqan A Shah, Edvin Jergéus, Akihiko Chiba, Anders Palmquist
Electron beam melting (EBM) is a 3D printing technique for the production of metal structures where complex geometries with interconnected porosities can be built. Incorporation of as little as 0.04% Zr into the CoCr alloy can significantly improve the biomechanical anchorage of constructs fabricated by EBM. Here we investigate bone material properties, including microstructure and composition, adjacent to 3D printed CoCr implants with and without addition of 0.04% Zr, after 8 weeks of healing in the rabbit femur...
February 10, 2018: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/29421793/phytotherapy-in-functional-gastrointestinal-disorders
#3
Olaf Kelber, Rudolf Bauer, Wolfgang Kubelka
BACKGROUND: Phytotherapy is an important therapeutic option in functional gastrointestinal diseases (FGID). It has a large tradition, with different approaches in different regions of the world, some of which have made their way into modern evidence-based medicine (EBM). SUMMARY: Taking into account the number of herbs in use, and also the cumulated scientific evidence on them, FGID are possibly the most important indication in phytotherapy. This does not only apply for European phytotherapy, but also for other regions, such as Asia...
February 8, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29416241/evidence-based-medicine-a-survey-among-perioperative-health-care-professionals-in-india
#4
Reshma Ambulkar, Priya Ranganathan, Vasanth Karthik, Jigeeshu Divatia
Background and Aims: Evidence-based medicine (EBM) is defined as the use of scientifically proven evidence for delivering best possible health care to patients. Despite growing emphasis on the need for EBM-based practice, acceptability, and perceptions toward EBM might differ among health professionals. The objective of this study was to assess the attitude, knowledge, and current practices of EBM among perioperative care health professionals in India. Material and Methods: This was a single point paper-based questionnaire survey carried out in February 2014 among delegates registered for an EBM conference on "perioperative care" held at a Tertiary referral Cancer Centre in India...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29403607/obstacles-facing-evidence-based-medicine-in-physical-medicine-and-rehabilitation-from-opinion-and-knowledge-to-practice
#5
Seyed Ahmad Raeissadat, Mohammad Hasan Bahrami, Seyed Mansoor Rayegani, Hossein Hassanabadi, Marzieh Babaee, Sharif Najafi, Reza Aghabozorgi
Background: Evidence-based medicine (EBM) is a new approach to medicine which can guide clinical services toward effective and beneficial results with the least side effects or errors. Up to now, there have been few available articles about specialists' EBM status, specifically the status of physiatrists in the area of EBM. Objective: To determine the present status of physiatrists' attitudes, knowledge and skill in the area of EBM and the existing obstacles. Methods: The cross-sectional study was performed in 2014 among physiatrists in Iran...
November 2017: Electronic Physician
https://www.readbyqxmd.com/read/29394938/expertise-in-evidence-based-medicine-a-tale-of-three-models
#6
Sarah Wieten
BACKGROUND: Expertise has been a contentious concept in Evidence-Based Medicine (EBM). Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against-the authoritarian pronouncements about "best" interventions dutifully learned in medical schools, sometimes with dire consequences. Since then, some proponents of EBM have tried various ways of reincorporating the idea of expertise into EBM, with mixed results. However, questions remain...
February 2, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
https://www.readbyqxmd.com/read/29363020/health-state-utility-values-for-ileostomies-and-colostomies-a-systematic-review-and-meta-analysis
#7
Fahima Dossa, Jonathan Josse, Sergio A Acuna, Nancy N Baxter
BACKGROUND: Ileostomies and colostomies may affect the quality of life of patients after colorectal surgery; however, the impact has been difficult to quantify using questionnaire-based measures. Utilities reflect patient preferences for health states and provide an alternate method of quality of life assessment. We aimed to systematically review the literature on utilities for ileostomy and colostomy health states. METHODS: We searched MEDLINE, EMBASE, and EBM Reviews (to August 16, 2017) to identify studies reporting utilities for colostomies or ileostomies using direct or indirect, preference-based elicitation tools...
January 23, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29358756/design-of-novel-materials-for-additive-manufacturing-isotropic-microstructure-and-high-defect-tolerance
#8
J Günther, F Brenne, M Droste, M Wendler, O Volkova, H Biermann, T Niendorf
Electron Beam Melting (EBM) is a powder-bed additive manufacturing technology enabling the production of complex metallic parts with generally good mechanical properties. However, the performance of powder-bed based additively manufactured materials is governed by multiple factors that are difficult to control. Alloys that solidify in cubic crystal structures are usually affected by strong anisotropy due to the formation of columnar grains of preferred orientation. Moreover, processing induced defects and porosity detrimentally influence static and cyclic mechanical properties...
January 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29357042/nimura-lecture-three-ebms
#9
Shinichi Minagoe
The three EBMs in the title refer to the following concepts: evidence-based medicine, experience-based medicine, and echo-based medicine. Evidence-based medicine: I have carried out the following clinical research using transthoracic Doppler echocardiography: (1) noninvasive pulsed-wave Doppler echocardiographic detection of the direction of shunt flow in patients with atrial septal defect: usefulness of the right parasternal approach (1985), (2) significance of laminar systolic regurgitant flow in patients with tricuspid regurgitation: a combined pulsed-wave, continuous-wave, and two-dimensional echocardiography (1990), (3) obstruction of the inferior vena caval orifice by the giant left atrium in patients with mitral stenosis: a Doppler echocardiographic study from the right parasternal approach (1992), and (4) demonstration of a localized acceleration flow signal in the transmural penetrating coronary artery using transthoracic color and pulsed-wave Doppler echocardiography in patients with hypertrophic cardiomyopathy (1996-2017)...
January 22, 2018: Journal of Echocardiography
https://www.readbyqxmd.com/read/29348609/effects-of-vitamin-d-supplementation-on-inflammatory-markers-in-heart-failure-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Alexander J Rodriguez, Aya Mousa, Peter R Ebeling, David Scott, Barbora de Courten
Vitamin D is reported to have anti-inflammatory properties; however the effects of vitamin D supplementation on inflammation in patients with heart failure (HF) have not been established. We performed a systematic review and meta-analysis examining effects of vitamin D supplementation on inflammatory markers in patients with HF. MEDLINE, CINAHL, EMBASE, All EBM, and Clinical Trials registries were systematically searched for RCTs from inception to 25 January 2017. Two independent reviewers screened all full text articles (no date or language limits) for RCTs reporting effects of vitamin D supplementation (any form, route, duration, and co-supplementation) compared with placebo or usual care on inflammatory markers in patients with heart failure...
January 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29343223/the-impact-of-age-on-the-implementation-of-evidence-based-medications-in-patients-with-coronary-artery-disease-and-its-prognostic-significance-a-retrospective-cohort-study
#11
Tian-Li Xia, Fang-Yang Huang, Yi-Ming Li, Hua Chai, Bao-Tao Huang, Yuan-Wei-Xiang Ou, Qiao Li, Xiao-Bo Pu, Zhi-Liang Zuo, Yong Peng, Mao Chen, De-Jia Huang
BACKGROUND: Elderly patients with coronary artery disease (CAD) frequently complicated with more cardiovascular risk factors, but received fewer evidence-based medications (EBMs). This study explored the association of EBMs compliance in different age groups and the risk of long-term death. METHODS: A retrospective analysis was conducted from a single registered database. 2830 consecutive patients with CAD were enrolled and grouped into 3 categories by age. The primary end point was all-cause mortality and secondary endpoint is cardiovascular mortality...
January 17, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29342074/characterization-of-an-additive-manufactured-tial-alloy-steel-joint-produced-by-electron-beam-welding
#12
Gloria Basile, Giorgio Baudana, Giulio Marchese, Massimo Lorusso, Mariangela Lombardi, Daniele Ugues, Paolo Fino, Sara Biamino
In this work, the characterization of the assembly of a steel shaft into a γ-TiAl part for turbocharger application, obtained using Electron Beam Welding (EBW) technology with a Ni-based filler, was carried out. The Ti-48Al-2Nb-0.7Cr-0.3Si (at %) alloy part was produced by Electron Beam Melting (EBM). This additive manufacturing technology allows the production of a lightweight part with complex shapes. The replacement of Nickel-based superalloys with TiAl alloys in turbocharger automotive applications will lead to an improvement of the engine performance and a substantial reduction in fuel consumption and emission...
January 17, 2018: Materials
https://www.readbyqxmd.com/read/29340887/toward-evidence-based-chinese-medicine-status-quo-opportunities-and-challenges
#13
Yao-Long Chen, Chen Zhao, Li Zhang, Bo Li, Chuan-Hong Wu, Wei Mu, Jia-Ying Wang, Ke-Hu Yang, You-Ping Li, Chiehfeng Chen, Yong-Yan Wang, Chen Wang, Zhao-Xiang Bian, Hong-Cai Shang
How to test the treatments of Chinese medicine (CM) and make them more widely accepted by practitioners of Western medicine and the international healthcare community is a major concern for practitioners and researchers of CM. For centuries, various approaches have been used to identify and measure the efficacy and safety of CM. However, the high-quality evidence related to CM that produced in China is still rare. Over the recent years, evidence-based medicine (EBM) has been increasingly applied to CM, strengthening its theoretical basis...
January 16, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29335485/electron-beam-melting-in-the-fabrication-of-three-dimensional-mesh-titanium-mandibular-prosthesis-scaffold
#14
Rongzeng Yan, Danmei Luo, Haitao Huang, Runxin Li, Niu Yu, Changkui Liu, Min Hu, Qiguo Rong
The study was designed to fulfill effective work-flow to fabricate three-dimensional mesh titanium scaffold for mandibular reconstruction. The 3D titanium mesh scaffold was designed based on a volunteer with whole mandible defect. (1) acquisition of the CT data; (2) design with computer aided design (CAD) and finite element analysis (FEA). The pore size and intervals with the best mechanic strength was also calculated using FEA. (3) fabrication of the scaffold using electron beam melting (EBM); (4) implantation surgery...
January 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29331000/evaluation-of-peer-assisted-learning-in-evidence-based-medicine-course-a-pilot-study-at-university-of-glasgow
#15
Syed Hamid Habib, Muhammad Omar Malik, Sadia Fatima, Inayat Shah
BACKGROUND: Peer Assisted Learning (PAL) is a well-established approach in learning and is increasingly being utilized in the medical education system. It is a process where active help of peer group members is taken for learning. This study aimed to look at the impact of peer assisted learning on the students at the end of the session. METHODS: Sixteen Postgraduate students attending Evidence Based Medicine (EBM) course spanning over two semesters (6 months each) were recruited...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#16
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
February 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29325555/the-readiness-of-hospital-pharmacists-in-kuwait-to-practise-evidence-based-medicine-a-cross-sectional-study
#17
Ali Jasem Buabbas, Fatemah Mohammad Alsaleh, Hamza Mohamad Al-Shawaf, Ali Abdullah, Abdullah Almajran
BACKGROUND: The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators...
January 11, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29320995/metformin-asian-ethnicity-and-risk-of-prostate-cancer-in-type-2-diabetes-a-systematic-review-and-meta-analysis
#18
Christopher B Chen, Maxim Eskin, Dean T Eurich, Sumit R Majumdar, Jeffrey A Johnson
BACKGROUND: Metformin is associated with a reduced risk of some cancers but its effect on prostate cancer is unclear. Some studies suggest only Asians derive this benefit. Therefore, we undertook a systematic review with particular attention to ethnicity. METHODS: Medline, Embase, Scopus, Web of Science, and EBM Reviews were searched from inception to 2015. Two reviewers identified and abstracted articles. Studies were pooled using random effects model and stratified by Western- vs Asian-based populations...
January 10, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29315969/effectiveness-of-interventions-to-decrease-image-ordering-for-low-back-pain-presentations-in-the-emergency-department-a-systematic-review
#19
Chaocheng Liu, Shashwat Desai, Lynette D Krebs, Scott W Kirkland, Diana Keto-Lambert, Brian H Rowe
BACKGROUND: Low back pain (LBP) is an extremely frequent reason for patients to present to an emergency department (ED). Despite evidence against the utility of imaging, simple and advanced imaging (i.e., computed tomography [CT], magnetic resonance imaging [MRI]) for patients with LBP has become increasingly frequent in the ED. The objective of this review was to identify and examine the effectiveness of interventions aimed at reducing image ordering in the ED for LBP patients. METHODS: A protocol was developed a priori, following the PRISMA guidelines, and registered with PROSPERO...
January 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29314096/formats-of-responsibility-elective-surgery-in-the-era-of-evidence-based-medicine
#20
Ariel Ducey, Shoghi Nikoo
This article illustrates what pragmatic sociology refers to as investments in form, by examining the formats created and used by a group of surgeons to determine when elective surgery for pelvic floor disorders could be responsibly undertaken. Drawing upon ethnographic observations of surgical consultations at an academic medical centre in Canada, we show how two specific formats - that the patient is sufficiently bothered and the patient accepts the risks of surgery - allow for justifiable action in conditions of uncertainty and contingency and in light of the demands of dominant imperatives in medicine and health care, especially evidence-based medicine (EBM)...
January 3, 2018: Sociology of Health & Illness
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