440: Barriers to the Practice of Evidence Based Urology in the United States

2007 ◽  
Vol 177 (4S) ◽  
pp. 147-148
Author(s):  
Philipp Dahm ◽  
Hubert R. Kuebler ◽  
Susan F. Fesperman ◽  
Roger L. Sur ◽  
Charles D. Scales ◽  
...  
2019 ◽  
Vol 24 (3) ◽  
pp. 147-152 ◽  
Author(s):  
Daniel Eisenman

Introduction: A dramatic increase in the number of clinical trials involving gene-modified cell therapy and gene therapy is taking place. The field is on the verge of a boom, and the regulatory environment is evolving to accommodate the growth. Discussion: This commentary summarizes the current state of the field, including an overview of the growth. The United States (US) regulatory structure for gene therapy will be summarized, and the evolution of the oversight structure will be explained. Conclusion: The gene therapy field has recently produced its first FDA-approved therapeutics and has a pipeline of other investigational products in the final stages of clinical trials before they can be evaluated by the FDA as safe and effective therapeutics. As research continues to evolve, so must the oversight structure. Biosafety professionals and IBCs have always played key roles in contributing to the safe, evidence-based advancement of gene therapy research. With the recent regulatory changes and current surge in gene therapy research, the importance of those roles has increased dramatically.


2018 ◽  
Vol 39 (4) ◽  
pp. 543-568 ◽  
Author(s):  
Waapalaneexkweew (Nicole R. Bowman-Farrell, Mohican/Lunaape)

Culturally responsive evaluation and culturally responsive Indigenous evaluation (CRIE) within the broader field of evaluation are not often included in Western literature nor are they known or used by the majority of mainstream evaluators. In order to address this literature and practice gap, this article offers an overview and a broader origin story of CRIE prior to colonial or European contact in the United States and gives an overview of the historical, theoretical, and practical foundations for conducting CRIE in a contemporary evaluation context. Examples of evidence-based models, theories, and resources are provided to connect CRIE to Western evaluation designs and provide concrete strategies for the field of evaluation going forward. The article concludes with systemic and policy evaluation considerations as agencies from federal (i.e., United States), tribal, and international governments and partners from private or nonprofit sectors collaborate to carry out Indigenous evaluations in the future. Collectively this multijurisdictional, culturally responsive, and community-centered CRIE approach gives evaluators a new way to move forward.


Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. This book sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. The book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor's orders.” It offers vital insights into the limits of science, expertise, and professionalism in American politics. The book explains why evidence-based medicine is important. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.


2011 ◽  
pp. 1600-1622
Author(s):  
Joseph L. Kannry

Healthcare IT (HIT) has failed to live up to its promise in the United States. HIT solutions and decisions need to be evidence based and standardized. Interventional informatics is ideally positioned to provide evidence based and standardized solutions in the enterprise (aka, the medical center) which includes all or some combination of hospital(s), hospital based-practices, enterprise owned offsite medical practices, faculty practice and a medical school. For purposes of this chapter, interventional informatics is defined as applied medical or clinical informatics with an emphasis on an active interventional role in the enterprise. A department of interventional informatics, which integrates the science of informatics into daily operations, should become a standard part of any 21st century medical center in the United States. The objectives of this chapter are to: review and summarize the promise and challenge of IT in healthcare; define healthcare IT; review the legacy of IT in healthcare; compare and contrast IT in healthcare with that of other industries; become familiar with evidence based IT: Medical informatics; differentiate medical informatics from IT in healthcare; distinguish medical, clinical, and interventional informatics; justify the need for operational departments of interventional informatics.


2020 ◽  
pp. 27-49 ◽  
Author(s):  
Bryanna Fox ◽  
David P. Farrington ◽  
Andreas Kapardis ◽  
Olivia C. Hambly

Author(s):  
Martha P. Millman ◽  
Paul J. Limburg

Screening tests are used to differentiate between persons with and without the condition of interest in a defined population. Screening strategies, or mass screening, is applied relatively indiscriminately to a population. Cancer is the second-leading overall cause of death in the United States; however, it is the leading cause of death for those under 85. Cancer risk is associated with environmental risk factors. Racial disparities in cancer incidence and death persist in the United States; level of education also appears to affect cancer survival. The United States Preventive Services Task Force has established evidence-based guidelines for screening, counseling, and chemoprevention.


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