The Evolution of Evidence Based Clinical Medicine

2020 ◽  
pp. 1-15
Author(s):  
Paul Dimitri
Keyword(s):  
Clinical Medicine ◽  
Evidence Based

scholarly journals Place of piracetam in the modern practice of medicine

2017 ◽  
Vol 15 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Victor V Vostrikov
Keyword(s):  
Clinical Medicine ◽  
Evidence Based ◽  
Clinical Effects ◽  
Practical Application ◽  
Main Attention ◽  
Dependent Relation ◽  
Practice Of Medicine ◽  
High Doses ◽  
Based Medicine ◽  
Dose Dependent

The review considers the stages of experimental and clinical study of piracetam in the framework of evidence-based medicine, its wide practical application in various fields of clinical medicine. The main attention pays to the mechanisms of action of the drug, its properties and physiological effects. The specific dose-dependent relation is revealed for the clinical effects of piracetam: the efficiency grows higher dependent on high doses and prolongation of courses.

scholarly journals Psycho-social and clinical aspects of diabeto-criticare

2013 ◽  
Vol 01 (02) ◽  
pp. 70-74
Author(s):  
Sukhminder Bajwa ◽  
Vishal Sehgal
Keyword(s):  
Critically Ill ◽  
Clinical Medicine ◽  
Social Aspects ◽  
Clinical Aspects ◽  
Diabetic Patients ◽  
Evidence Based ◽  
Current Review ◽  
And Control ◽  
Social Management ◽  
Lines Of Evidence

AbstractA progressive rise in the number of diabetes mellitus (DM) patients has been observed globally with India becoming a new diabetic capital. In spite of numerous advancements in the pharmacotherapeutics, diabetes is still difficult to manage and control. Besides clinical management of DM, an increasing need is felt to manage the psycho-social aspects related to DM, which have not been given adequate attention. Similar trends can be observed in the critically ill diabetic patients in intensive care units (ICU), which is treated on the lines of evidence based clinical medicine. The psycho-social management of diabetes is somewhat a newer concept for the intensivist that was being practiced occasionally, but unknowingly. The newer psycho-social guidelines to manage DM can be of immense help in ICU if such guidelines are modified to suit the needs of the intensivists and critically ill patients. The current review is aimed at analyzing the clinical, biological, social and psychological aspects of critically ill DM patients and the possible therapeutics measures and modifications in the current regimens so as to effectively treat the rising epidemic of DM.

scholarly journals Answering Clinical Questions with Knowledge-Based and Statistical Techniques

2007 ◽  
Vol 33 (1) ◽  
pp. 63-103 ◽  
Author(s):  
Dina Demner-Fushman ◽  
Jimmy Lin
Keyword(s):  
Evidence Based Medicine ◽  
Information Needs ◽  
Semantic Processing ◽  
Question Answering ◽  
Clinical Medicine ◽  
Statistical Techniques ◽  
Evidence Based ◽  
Knowledge Based ◽  
Clinical Questions ◽  
Based Medicine

The combination of recent developments in question-answering research and the availability of unparalleled resources developed specifically for automatic semantic processing of text in the medical domain provides a unique opportunity to explore complex question answering in the domain of clinical medicine. This article presents a system designed to satisfy the information needs of physicians practicing evidence-based medicine. We have developed a series of knowledge extractors, which employ a combination of knowledge-based and statistical techniques, for automatically identifying clinically relevant aspects of MEDLINE abstracts. These extracted elements serve as the input to an algorithm that scores the relevance of citations with respect to structured representations of information needs, in accordance with the principles of evidence-based medicine. Starting with an initial list of citations retrieved by PubMed, our system can bring relevant abstracts into higher ranking positions, and from these abstracts generate responses that directly answer physicians' questions. We describe three separate evaluations: one focused on the accuracy of the knowledge extractors, one conceptualized as a document reranking task, and finally, an evaluation of answers by two physicians. Experiments on a collection of real-world clinical questions show that our approach significantly outperforms the already competitive PubMed baseline.

scholarly journals Computer analysis of the emotional modality of 20 million publications in PUBMED database indicates ways to increase the effectiveness of pharmacotherapy by identifying pseudoscientific publications aimed at negative emotional "pumping" of doctors

2021 ◽  
pp. 19-40
Author(s):  
V. A. Maximov ◽  
I. Yu. Torshin ◽  
O. A. Gromova ◽  
A. N. Galustyan ◽  
I. V. Gogoleva ◽  
...  
Keyword(s):  
Evidence Based Medicine ◽  
Clinical Medicine ◽  
International Standards ◽  
Scientific Quality ◽  
Evidence Based ◽  
Treatment Standards ◽  
Pronounced Increase ◽  
Pubmed Database ◽  
Based Medicine

The search for original publications on fundamental and clinical medicine that would produce results of the highest scientific quality represents an urgent need for every medical researcher. Such publications are essential, in particular, for the development of reliable treatment standards. The Englishlanguage resources PUBMED and EMBASE are essential to help in solving this problem. However, there is an obvious problem in assessing the quality of the studies found. The paper formulates a method for analyzing the texts of biomedical publications, which is based on an algorithmic assessment of the emotional modality of medical texts (so-called sentiment analysis). The use of the topological theory of data analysis made it possible to develop a set of high-precision algorithms for identifying 16 types of sentiments (manipulative turns of speech, research without positive results, propaganda, falsification of results, negative personal attitude, aggressiveness of the text, negative emotional background, etc.). On the basis of the developed algorithms, a point scale for assessing the sentiment quality of research was obtained, which we called the "β-score": the higher the β-score, the less the evaluated text contains manipulative language constructions. As a result, the ANTIFAKE system (http://antifake-news.ru) was developed to analyze the sentiment-quality of Englishlanguage scientific texts. An analysis of ~ 20 million abstracts from PUBMED showed that publications with low sentiment quality (β-score <0, that is, that the prevalence of manipulative constructions over meaningful ones) is only 19 %. In the overwhelming majority of thematic headings (27,090 out of 27,840 headings of the MESH system PUBMED), a positive dynamics of sentiment quality of the texts of publications is shown by years). At the same time, as a result of the study, 249 headings were identified with sharply negative dynamics of sentiment quality and with a pronounced increase in manipulative sentiments characteristic of the "yellow" English-language press. These headings include tens of thousands of publications in peer-reviewed journals, which are aimed at (1) legalizing ethically unacceptable practices (euthanasia, perversions, so-called "population control", etc.), (2) discrediting psychiatry as a science, (3) media the war against micronutrients and (4) discrediting evidence-based medicine under the guise of developing the so-called "international standards of evidence-based medicine". In general, the developed system of artificial intelligence allows researchers to filter out pseudoscientific publications, the text of which is overloaded with emotional manipulation and which are published under the guise of "evidence-based standards".

Toward an evidence-based toxicology

2006 ◽  
Vol 25 (9) ◽  
pp. 497-513 ◽  
Author(s):  
S Hoffmann ◽  
T Hartung
Keyword(s):  
Test Performance ◽  
Large Scale ◽  
New Technologies ◽  
Clinical Medicine ◽  
Evidence Based ◽  
Use Of Resources ◽  
Testing Strategies ◽  
Mechanistic Understanding ◽  
Traditional Approaches ◽  
Based Medicine

The increasing demands on toxicology of large-scale risk assessment programmes for chemicals and emerging or expanding areas of chemical use suggest it is timely to review the toxicological toolbox. Like in clinical medicine, where an evidence-based medicine (EBM) is critically reviewing traditional approaches, toxicology has the opportunity to reshape and enlarge its methodology and approaches on the basis of compounded scientific knowledge. Such revision would have to be based on structured reviews of current practice, ie, assessment of test performance characteristics, mechanistic understanding, extended quality assurance, formal validation and the use of integrated testing strategies. This form of revision could optimize the balance between safety, costs and animal welfare, explicitly stating and, where possible, quantifying uncertainties. After a self-critical reassessment of current practices and evaluation of the thus generated information, such an evidence-based toxicology (EBT) promises to make better use of resources and to increase the quality of results, facilitating their interpretation. It shall open up hazard and also risk assessments to new technologies, flexibly accommodating current and future mechanistic understanding. An EBT will be better prepared to answer the continuously growing safety demands of modern societies.

scholarly journals The Nocebo Effect and Pediatric Concussion

2021 ◽  
pp. 1-7
Author(s):  
Michael W. Kirkwood ◽  
David R. Howell ◽  
Brian L. Brooks ◽  
Julie C. Wilson ◽  
William P. Meehan III
Keyword(s):  
Pediatric Patients ◽  
Clinical Medicine ◽  
Evidence Based ◽  
Placebo Effects ◽  
Nocebo Effect ◽  
Pediatric Concussion ◽  
Nocebo Effects ◽  
Clinical Interactions ◽  
Negative Expectations

While placebo effects are well recognized within clinical medicine, “nocebo effects” have received much less attention. Nocebo effects are problems caused by negative expectations derived from information or treatment provided during a clinical interaction. In this review, we examine how nocebo effects may arise following pediatric concussion and how they may worsen symptoms or prolong recovery. We offer several suggestions to prevent, lessen, or eliminate such effects. We provide recommendations for clinicians in the following areas: terminology selection, explicit and implicit messaging to patients, evidence-based recommendations, and awareness of potential biases during clinical interactions. Clinicians should consider the empirically grounded suggestions when approaching the care of pediatric patients with concussion.

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