Mechanisms in Clinical Research and Medical Practice

2019 ◽  
pp. 735-749
Author(s):  
Omar Ahmad
Keyword(s):  
Clinical Research ◽  
Medical Practice

Looking beyond Translation — Integrating Clinical Research with Medical Practice

2012 ◽  
Vol 366 (18) ◽  
pp. 1659-1661 ◽  
Author(s):  
Annetine C. Gelijns ◽  
Sherine E. Gabriel
Keyword(s):  
Clinical Research ◽  
Medical Practice

Diagnostic Psychiatry

2019 ◽  
pp. 189-220
Author(s):  
Allan V. Horwitz
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Clinical Research ◽  
19Th Century ◽  
Medical Practice ◽  
American Psychiatric Association ◽  
Fundamental Principle ◽  
New System

Psychiatry faced a major predicament as it entered the 1970s: it lacked the disease conditions that would provide the field with medical legitimacy. The publication of the DSM-III by the American Psychiatric Association in 1980 marked a thoroughgoing change in thinking about mental illness. In one stroke, psychiatry discarded one intellectual paradigm that had little concern with diagnosis and adopted an entirely new system of classification that imported a model from medicine where diagnosis is “the keystone of medical practice and clinical research.” The promulgators of the DSM-III overthrew the broad, vague, and often etiologically oriented concepts that were embodied in the DSM-I and DSM-II, reclaiming the diagnostic tradition that dominated 19th-century psychiatry. The fundamental principle of the new manual was to define distinct mental disorders through using observable clusters of symptoms without reference to their causes. The DSM-III created a powerful standardized system of diagnoses that reigned virtually unchallenged for the following three decades. It allowed psychiatry to reorganize itself from a discipline where diagnosis played a marginal role to one where it was the basis of the specialty. The DSM-III revolutionized conceptions of mental disorder through transforming conditions that had been thought to be distinctively psychosocial into ones that were disease-like states.

scholarly journals The case for teaching and research experience and education within basic specialist training (registrar grade) in psychiatry

1990 ◽  
Vol 14 (3) ◽  
pp. 163-164 ◽  
Author(s):  
A. H. Crisp
Keyword(s):  
Clinical Research ◽  
Communication Skills ◽  
Medical Practice ◽  
Psychiatric Practice ◽  
Research Experience ◽  
Specialist Training ◽  
Teaching And Research ◽  
Research And Teaching

Medical practice can be reframed in terms of research and teaching, possessing and using the relevant knowledge, skills and attitudes. The doctor's curiosity and the diagnostic challenges of medical practice (and in particular of psychiatry) demand a capacity to think systematically, measure comprehensively and accurately and analyse the information obtained within the consultation as a preamble to management and treatment. The word ‘doctor’ means ‘teacher’ and the same communication skills are essential to both professions. Psychiatric practice is especially dependent upon them. They are also often essential for good clinical research.

Review: psychiatric and medical consequences of disordered sleep

2014 ◽  
Vol 32 (2) ◽  
pp. 209-217 ◽  
Author(s):  
G. Stores
Keyword(s):  
Clinical Research ◽  
Medical Practice ◽  
Clinical Assessment ◽  
Literature Search ◽  
Clinical Importance ◽  
Sleep Medicine ◽  
Medical Illness ◽  
Medical Conditions ◽  
The Subject ◽  
The Common

Objectives:The aim of this article is to draw attention to the clinical importance of disordered sleep in psychiatry and to demonstrate the growing awareness of medical illness as a complication of disordered sleep. As background to these main objectives, some general points are made to illustrate present-day approaches to the common and often serious problem of sleep disturbance.Methods:The review is based on a literature search from which key publications were selected to illustrate, in turn, main connections between disordered sleep and psychiatric and medical conditions.Results:Many such connections are described. Throughout psychiatry, regarding patients whatever their age, these connections have implications for clinical assessment and management. Emphasis is placed on the risk of misdiagnosis of sleep disorders as psychiatric or medical conditions. Examples of this are provided. The growing evidence that disordered sleep can predispose to medical illness is discussed.Conclusion:As the subject of sleep and its disorders is particular relevant in psychiatry, a working knowledge of modern sleep medicine is important in all branches of psychiatric and other medical practice as well as in clinical research.

CONNECTING PRE-MARKETING CLINICAL RESEARCH AND MEDICAL PRACTICE

2003 ◽  
Vol 19 (1) ◽  
pp. 202-219 ◽  
Author(s):  
Nicolien F. Wieringa ◽  
Jules L. Peschar ◽  
Petra Denig ◽  
Pieter A. de Graeff ◽  
Rein Vos
Keyword(s):  
Clinical Research ◽  
Medical Practice ◽  
Regulatory System ◽  
Daily Practice ◽  
Drug Regulation ◽  
Present System ◽  
Regulatory Authorities ◽  
Regulatory Standards ◽  
Post Marketing ◽  
Core Issues

Objectives: To identify core issues that contribute to the gap between pre-marketing clinical research and practice as seen from the perspective of medical practice, as well as possible changes and potential barriers for closing this gap.Methods: Interviews with 47 physicians and pharmacists who were liaised to drug regulation through their role in the pre- and post-marketing shaping of new cardiovascular drugs. Data were analyzed using methods of grounded theory and analytical evaluations.Results: Six core issues were identified that referred to the standards in drug regulation, the organization of the regulatory system, and conflicting interests. Pre-marketing trials should focus more on populations and research questions relevant to medical practice. In particular, variability in drug responses between subgroups of patients and demonstration of effectiveness should become major principles in drug regulation. An interactive post-marketing process in which public interests are represented was considered necessary to further guide research and development according to the needs in daily practice. Strategies for change could be applied within the present system of drug regulation, or affect its basic principles. Regulatory authorities were primarily identified to initiate changes, but many other parties should be involved. Barriers for change were identified regarding differences in interests between parties, organizational matters, and with respect to broader healthcare policies.Conclusions: Based on the respondents' opinions, there is a need to focus regulatory standards more on the needs in medical practice. Therefore, regulatory authorities should further develop their influence in the pre- and post-marketing drug development process, together with other parties involved, in order to bridge the gap between clinical research and medical practice.

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