Evidence-based medicine in otolaryngology journals

2002 ◽  
Vol 126 (4) ◽  
pp. 371-376 ◽  
Author(s):  
Boris L. Bentsianov ◽  
Marina Boruk ◽  
Richard M. Rosenfeld
Keyword(s):  
Clinical Research ◽  
Internal Control ◽  
Evidence Based Medicine ◽  
Research Articles ◽  
Control Group ◽  
Evidence Based ◽  
Supporting Evidence ◽  
Level Of Evidence ◽  
Therapeutic Recommendations ◽  
Based Medicine

OBJECTIVE: We set out to assess, within the context of evidence-based medicine, the levels of supporting evidence for therapeutic recommendations made in leading otolaryngology journals. DESIGN: We used a cross-sectional survey of clinical research articles published in 1999 in 4 high-circulation otolaryngology journals. OUTCOME MEASURES: We used study design methodology and level of evidence for clinical research articles with therapeutic recommendations. Outcomes were stratified by type of recommendation (positive vs negative) and by study focus (medical vs surgical therapy). RESULTS: Of the 1019 articles identified, 737 (72%) were clinical research and 268 (36%) made therapeutic recommendations. Median sample size was modest (27 subjects), with only 38% of studies reflecting planned research and 22% including an internal control or comparison group. positive studies were 20 times more prevalent than negative ones, but were 69% less likely to have an internal control group ( P = .042) and 93% less likely to include confidence intervals ( P = .020). Moreover, the level of evidence for positive studies was lower than for negative studies ( P = .037), with twice as many negative recommendations supported by analytic research. Similarly, the level of evidence for operation was lower than for medical therapy ( P < .001), with 3 times as many medical recommendations supported by analytic research. CONCLUSIONS: Most therapeutic recommendations in otolaryngology journals are on the basis of descriptive case series (80%) and least often on randomized controlled trials (7%). A dual standard appears to exist for negative versus positive studies and for medical versus surgical recommendations. Greater scrutiny of the breadth and quality of evidence levels supporting therapeutic recommendations is likely to occur as the popularity of—and demand for—evidence-based medicine increases. SIGNIFICANCE: Evaluation of levels of evidence in otolaryngology decision making.

Calculation of sample size when planning a clinical study of the Bovhyaluronidaze azoximer preparation in companion animals urological practice

2020 ◽  
Vol 1 ◽  
pp. 140-144
Author(s):  
A.V. Nazarova ◽  
Keyword(s):  
Veterinary Medicine ◽  
Clinical Study ◽  
Sample Size ◽  
Evidence Based Medicine ◽  
Statistical Significance ◽  
Companion Animals ◽  
Control Group ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Based Medicine

Nowadays both international and Russian medical sciences are actively working to improve the methods of evidence and the formation of standards of research and treat-ment. The necessity to develop common criteria for evaluating the effectiveness of methods of diagnosis, treatment and prevention of diseases exists in veterinary medicine. To achieve this goal, both general veterinary medicine and scientific research in the field of veterinary medicine, must reach the level of evidence that answers the requirements of Evidence Based Medicine. In accordance with the current require-ments of Evidence Based Medicine and Good Clinical Practice, at the stage of plan-ning a clinical study of the use of Bovhyalu-ronidaze azoximer preparations in the com-panion animals urological treatment, we have calculated the required sample size. In the calculation, we used the results of a pilot study, in which the incidence of post-operative complications in the experimental group was 0.10, in the control group — 0.55. We calculated that for statistical significance testing with significance level α = 0.05 and power β = 0.80 in a clinical trial of the use of bovhyaluronidaze azoximer prepara-tion in the urological practice of companion animals, the sample size should be at least 22 animals in each group (taking into ac-count the possible retirement of patients from the clinical study). And the groups must be equal in volume to achieve the max-imum test power.

scholarly journals Impact of deliberate practice on evidence-based medicine attitudes and behaviours of health care professionals

2020 ◽  
Author(s):  
Eelco Draaisma ◽  
Lauren A. Maggio ◽  
Jolita Bekhof ◽  
A. Debbie C. Jaarsma ◽  
Paul L. P. Brand
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Research ◽  
Health Care Professionals ◽  
Evidence Based Medicine ◽  
Deliberate Practice ◽  
Medical Decision ◽  
Evidence Based ◽  
Teaching Activities ◽  
Based Medicine

Abstract Introduction Although evidence-based medicine (EBM) teaching activities may improve short-term EBM knowledge and skills, they have little long-term impact on learners’ EBM attitudes and behaviour. This study examined the effects of learning EBM through stand-alone workshops or various forms of deliberate EBM practice. Methods We assessed EBM attitudes and behaviour with the evidence based practice inventory questionnaire, in paediatric health care professionals who had only participated in a stand-alone EBM workshop (controls), participants with a completed PhD in clinical research (PhDs), those who had completed part of their paediatric residency at a department (Isala Hospital) which systematically implemented EBM in its clinical and teaching activities (former Isala residents), and a reference group of paediatric professionals currently employed at Isala’s paediatric department (current Isala participants). Results Compared to controls (n = 16), current Isala participants (n = 13) reported more positive EBM attitudes (p < 0.01), gave more priority to using EBM in decision making (p = 0.001) and reported more EBM behaviour (p = 0.007). PhDs (n = 20) gave more priority to using EBM in medical decision making (p < 0.001) and reported more EBM behaviour than controls (p = 0.016). Discussion Health care professionals exposed to deliberate practice of EBM, either in the daily routines of their department or by completing a PhD in clinical research, view EBM as more useful and are more likely to use it in decision making than their peers who only followed a standard EBM workshop. These findings support the use of deliberate practice as the basis for postgraduate EBM educational activities.

scholarly journals Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

2020 ◽  
Author(s):  
Guido Paolini ◽  
Guido Firmani ◽  
Francesca Briganti ◽  
Michail Sorotos ◽  
Fabio Santanelli di Pompeo
Keyword(s):  
Decision Making ◽  
Patient Satisfaction ◽  
Patient Selection ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Patient Factors ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Complex Reconstruction ◽  
Based Medicine

Abstract Background Nipple-areola complex reconstruction (NAR) most commonly represents the finishing touch to breast reconstruction (BR). Nipple presence is particularly relevant to the patient’s psyche, beyond any shadow of doubt. Many reconstructive options have been described in time. Surgery is easy, but final result is often disappointing on the long run. Methods The goal of this manuscript is to analyze and classify knowledge concerning NAR techniques and the factors that influence success, and then to elaborate a practical evidence-based algorithm. Out of the 3136 available articles as of August 8th, 2020, we selected 172 manuscripts that met inclusion criteria, which we subdivided into 5 main topics of discussion, being the various NAR techniques; patient factors (including patient selection, timing and ideal position); dressings; potential complications and finally, outcomes/patient satisfaction. Results We found 92 articles describing NAR techniques, 41 addressing patient factors (out of which 17 discussed patient selection, 14 described ideal NAC location, 10 described appropriate timing), 10 comparing dressings, 7 studying NAR complications, and 22 addressing outcomes and patient satisfaction. We elaborated a comprehensive decision-making algorithm to help narrow down the choice among NAR techniques, and choose the correct strategy according to the various scenarios, and particularly the BR technique and skin envelope. Conclusions No single NAR technique provides definitive results, which is why we believe there is no “end-all be-all solution”. NAR must be approached as a case-by-case situation. Furthermore, despite NAR being such a widely discussed topic in scientific literature, we still found a lack of clinical trials to allow for more thorough recommendations to be elaborated. Level of Evidence III This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Exploring the Real World: Medical Librarians' Involvement in Supporting Evidence-Based Medicine (EBM) Practice

2013 ◽  
Author(s):  
Ping Li ◽  
Lin Wu
Keyword(s):  
Data Analysis ◽  
Survey Data ◽  
Real World ◽  
Evidence Based Medicine ◽  
Online Survey ◽  
Evidence Based ◽  
Supporting Evidence ◽  
The Real ◽  
Based Medicine

This paper reports the results of an online survey that explores medical librarians’ roles and activities in supporting EBM practice. More than 500 medical librarians replied to the survey. Data analysis reveals that librarians have been taking on various EBM-related responsibilities both routine by nature and project-related.Cet article présente les résultats d’un sondage en ligne portant sur les rôles et les activités des bibliothécaires du domaine des sciences de la santé pour soutenir les pratiques de médecine fondée sur les preuves (MFP). Plus de 500 bibliothécaires ont répondu au sondage. L’analyse des données révèlent que ces bibliothécaires ont participé à des activités routinières et à des projets relevant du domaine de la MFP. 

The Principles of Evidence-Based Medicine

Cephalalgia ◽  
2000 ◽  
Vol 20 (2_suppl) ◽  
pp. 10-13 ◽  
Author(s):  
S Wiebe
Keyword(s):  
Clinical Practice ◽  
Clinical Research ◽  
Evidence Based Medicine ◽  
Information Overload ◽  
Clinical Performance ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Performance Information ◽  
Research Findings ◽  
Based Medicine

Evidence-based medicine (EBM) integrates individual clinical expertise with the best available external evidence in the care of individual patients. By enabling clinicians to directly appraise and apply current clinical research, EBM deals with the problems of deterioration in clinical performance, information overload, and lag in application of research findings to clinical practice. Thus, EBM is a useful tool to address the problems faced by clinicians attempting to provide optimum, current care for their patients. The rationale for EBM, its principles and application, as well as some limitations, are described here.

scholarly journals Efficacy of a complex intervention comprising the guideline evidence-based health information and a training programme on the quality of health information: study protocol of a randomised controlled trial

2020 ◽  
Author(s):  
Julia Lühnen ◽  
Birte Berger-Höger ◽  
Burkhard Haastert ◽  
Jana Hinneburg ◽  
Jürgen Kasper ◽  
...  
Keyword(s):  
Health Information ◽  
Evidence Based Medicine ◽  
Information Quality ◽  
Controlled Trial ◽  
Training Programme ◽  
Control Group ◽  
Evidence Based ◽  
Study Results ◽  
Based Medicine

Abstract Background Evidence-based health information (EBHI) is a prerequisite for informed and shared decision-making. The criteria for EBHI have been described comprehensively but the implementation in practice is still insufficient. The guideline evidence-based health information addresses providers of health information. Its goal is to improve the quality of health information. The evidence-based guideline emerged from the German Network for Evidence-based Medicine (DNEbM) and was published in February 2017. In addition, the competences of providers of health information were explored and a training programme was developed. Aim of this study is to evaluate the efficacy of a training programme addressing providers of health information to support the application of the guideline evidence-based health information. We expect the intervention to improve the quality of health information in comparison to provision of the guideline only. Methods The trial uses a superiority randomised control group design with ten months follow-up. 26 providers of health information (groups with up to ten members) will be enrolled to compare the intervention (guideline & training programme) with usual care (guideline publicly available). The 5-day training programme comprises an evidence-based medicine training module and a module to prepare the application of the guideline. The primary outcome parameter is the quality of the health information. Quality is operationalised as the extent of adherence to the guideline’s recommendations. Each provider will prepare a single health information informing a health-related decision on a freely chosen topic. The quality of this information will be rated using the Mapping Health Information Quality (MAPPinfo) checklist. An accompanying process evaluation will then be conducted. Discussion The study results will show whether the efficacy of the intervention justifies implementation of the training programme to enhance health information developers’ competences in evidence-based medicine and to ensure high quality EBHI in the long-term. Trial registration ISRCTN registry, registration number: ISRCTN96941060, Date: 7 March 2019, URL: http://www.isrctn.com/ISRCTN96941060

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