What Is “Evidence-Based” Treatment?

2020 ◽  
pp. 245-266
Author(s):  
Jonathan J. K. Stoltman ◽  
Laura R. Lander
Keyword(s):  
Substance Abuse ◽  
Case Reports ◽  
Evidence Based ◽  
Randomized Control Trials ◽  
The Us ◽  
Evidence Based Treatments ◽  
Substance Abuse Disorders ◽  
Behavioral Treatments ◽  
Behavioral Therapies ◽  
Randomized Control

This chapter discusses the range of evidence for efficacy in evidence-based treatments for substance abuse disorders. The authors draw their information from both case reports and multisite randomized control trials, presenting both the controversies over evidence-based behavioral therapies and the reasons given for the utilization of less evidence-based behavioral treatments. The chapter also discusses the reasons for the lack of approval from the US Food and Drug Administration (FDA) for evidence-based pharmacotherapy treatments in substance use disorders and details the corresponding reasons for clinicians’ use of non-FDA-approved pharmacotherapies, all while stressing the importance of transparency and documentation.

Substance Use Disorders

2020 ◽  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Evidence Based ◽  
Need For Treatment ◽  
The Past ◽  
The Us ◽  
Evidence Based Treatments ◽  
Behavioral Therapies ◽  
Illegal Activities ◽  
Lay Public

Over the past few years there has been an increased interest in the identification and treatment of substance use disorders, due at least in part to the widespread drug overdose epidemic. Clinicians and the lay public have gained a greater understanding of the need for treatment of substance use disorders and the consequences of avoiding treatment. In addition, there has been a growing understanding of substance use disorders as medical or mental health disorders, rather than as character flaws or merely illegal activities. This book builds on this nascent understanding and presents epidemiology, basic science, and treatment from the perspective of a clinician who wants to gain the knowledge and background needed to work with this patient population. The overall theme of the book is to discuss evidence-based rather than anecdotal or unproved treatments. Section I begins with the epidemiology, etiology, and neurobiology of substance use disorders, including preclinical data. Section II discusses pharmacotherapy for substance use disorders, focusing on medications approved by the US Food and Drug Administration (FDA). Section III focuses on other evidence-based treatments for substance use disorders, including behavioral therapies, and ends with potential future treatments.

Neurorobiology and Evidence-Based Biological Treatments for Substance Abuse Disorders

CNS Spectrums ◽  
2006 ◽  
Vol 11 (11) ◽  
pp. 864-877 ◽  
Author(s):  
Iliyan S. Ivanov ◽  
Kurt P. Schuiz ◽  
Robyn C. Palmero ◽  
Jeffrey H. Newcorn
Keyword(s):  
Substance Abuse ◽  
Behavioral Changes ◽  
Evidence Based ◽  
Biological Factors ◽  
Increase Risk ◽  
Emerging Treatments ◽  
Substance Abuse Disorders ◽  
Pharmacologic Agents ◽  
Drug Free

ABSTRACTBehavioral patterns of addiction include compulsive drug-seeking, persistent abuse of substances despite the often dire consequences on social functioning and physical health, and the high probability of relapse even after prolonged drug-free periods.The recent focus on the biological basis of addiction has provided evidence to support the hypothesis that behavioral manifestations for addiction are influenced by biological factors, and biological factors often produce behavioral changes that can further increase risk. The current understanding of the role of the dopaminergic, glutamatergic, γ-aminobutyric acidergic, and opioid receptor systems in the pathophysiology of addiction as well as the clinical implications of these systems for new and emerging treatments will be discussed. This article will also review the pharmacologic agents used in the treatment of substance abuse disorders and presents evidence-based data for their safety, efficacy, and feasibility of use in different patient populations.

Clinical Cardiology

2016 ◽  
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Reference List ◽  
Evidence Based ◽  
Cardiac Diseases ◽  
Randomized Control Trials ◽  
Clinical Tool ◽  
Clinical Cardiology ◽  
On Line ◽  
Randomized Control ◽  
User Friendly ◽  
Physical Findings

The purpose of this book is to provide a useful, easily accessible, and user-friendly clinical tool that can be used in the every day clinical practice. Definition, epidemiology, aetiology, and pathophysiology and genetics of cardiac diseases are summarized according to recent evidence. Presentation of diseases, physical findings and investigations for a contemporary, evidence- based approach are organized in a clear and instructive manner. The management of the patient is presented according to most recent randomized control trials and recommendations of guidelines by the ACC/AHA and the ESC. Most recent guidelines and updates have been collected for each topic, and current recommendations have been extracted and presented in abbreviated tables. The reference list is aimed at presenting seminal studies that support statements in the book, randomized control trials that are dictating modern management, and scholarly, instructive reviews that have appeared in the major cardiology journals. Recent only articles are presented in order to guide potential further reading. The on-line editions of the book are updated on a regular basis.

The Matter of ‘Evidence’ in the Inclusive Education Debate

2020 ◽  
Author(s):  
Christopher Boyle ◽  
George Koutsouris ◽  
Anna Salla Mateu ◽  
Joanna Anderson
Keyword(s):  
Inclusive Education ◽  
Gold Standard ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Randomized Control Trials ◽  
Evidence Based Practices ◽  
Or Groups ◽  
Need Support ◽  
Randomized Control ◽  
The Many

Understanding how best to support all learners to achieve their goals is a key aspect of education. Ensuring that educators are able to be provided with the best programs and knowledge to do this is perfectly respectable. But what is “evidence” in education, and at what point is it useful and informative in inclusive education? The need exists for a better understanding of what should constitute evidence-based inclusive education. Research with a focus on evidence-based practices in special and inclusive education has been increasing in recent years. Education intervention, by its very definition, should be tailored to suit individuals or groups of learners. However, immediately this is at odds with the gold standard of research intervention, that of randomized control trials; however, there are many advocates for evidence-based practice confirming to the highest form of research methodology. This seems laudable, and who could argue with wanting the best approaches to inform programs and teaching in all facets of education? Nevertheless, the requirements for research rigor mean that it is not practically possible to measure interventions in inclusive education so that they are generalizable across the many students who need support, because the interventions must be specific to individual need and therefore are not generalizable, nor are they intended to be. A narrow approach to what is evidence-based practice in education is unhelpful and does not take into consideration the nuances of inclusive education. Evidence of appropriate practice in inclusive education entails much more than robust scientific methodologies can measure, and this should be remembered. “Good” education is inclusive education that may or may not be recognized as evidence-based practice.

The role of electroconvulsive therapy in the treatment of bipolar disorder

2017 ◽  
Author(s):  
Roumen Milev
Keyword(s):  
Bipolar Disorder ◽  
Electroconvulsive Therapy ◽  
Case Reports ◽  
Bipolar Disorders ◽  
Seizure Threshold ◽  
Randomized Control Trials ◽  
Mixed States ◽  
Everyday Clinical Practice ◽  
Randomized Control

This chapter examines the use of electroconvulsive therapy (ECT) for treatment of patients with bipolar disorders. It briefly reviews the basics of ECT, stimulus parameters, placement of electrodes, and seizure threshold. The data for efficacy and tolerability of ECT for bipolar disorder, including mania, depression, mixed states, and across the lifespan is reviewed. Although there is a paucity of good-quality randomized studies, all available data, including case reports and naturalistic observations, support the use of ECT in this population, and reinforce the widespread use of ECT in everyday clinical practice. Good-quality randomized control trials are urgently needed to address numerous unanswered questions, in order to improve efficacy and reduce side-effect burden of one of the best treatments for bipolar disorder.

scholarly journals A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder

2016 ◽  
Vol 31 (7) ◽  
pp. 857-870 ◽  
Author(s):  
Nick Preston ◽  
Sara Magallón ◽  
Liam JB Hill ◽  
Elizabeth Andrews ◽  
Sara M Ahern ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Motor Skills ◽  
Systematic Reviews ◽  
Developmental Coordination Disorder ◽  
Motor Training ◽  
Evidence Based ◽  
Randomized Control Trials ◽  
High Quality ◽  
Randomized Control ◽  
Coordination Disorder

Objective: To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using objective criteria) for the purpose of informing evidence-based clinical practice. Data sources: We followed the guidance for conducting systematic reviews issued by the Centre for Reviews and Dissemination. Six OvidSP electronic databases (AMED, All EBM reviews (including Cochrane), Embase, Ovid MEDLINE, PsychARTICLES Full Text, PsycINFO) were searched systematically. We aimed to retain only randomized control trials and systematic reviews of randomized control trials, defined as the highest level of evidence by the Oxford Centre for Evidence-Based Medicine. We searched reference lists of retained articles to identify further appropriate articles. Review methods: Two reviewers critically appraised and categorized articles by effect size (including confidence intervals), inclusion of power calculations and quality using the Physiotherapy Evidence Database (PEDro) scale. Only studies scoring seven or more on the PEDro scale (classed by the PEDro as high reliability) were retained. Results: No systematic reviews met our criteria for inclusion from 846 articles yielded by the systematic search. Nine randomized control trials investigating 15 interventions to improve motor skills met our inclusion criteria for ‘high quality’. Nevertheless, not all included studies were adequately powered for determining an effect. Conclusion: Large effect sizes associated with 95 % confidence intervals suggest that ‘Neuromotor Task Training’, ‘Task-oriented Motor Training’ and ‘Motor Imagery + Task Practice Training’ are the most effective reported interventions for improving motor skills in children with developmental coordination disorder.

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