Ranson’s Criteria for Acute Pancreatitis

2017 ◽  
Author(s):  
Michael P. Catanzaro
Keyword(s):  
Acute Pancreatitis ◽  
Conservative Management ◽  
Evidence Based Medicine ◽  
Decision Rules ◽  
Clinical Decision ◽  
Historical Study ◽  
Evidence Based ◽  
Surgical Disease ◽  
History Of ◽  
Based Medicine

This chapter provides a summary of a landmark historical study in surgery. It describes the history of pancreatitis, gives a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: clinical decision rules. The management of pancreatitis has evolved from primarily a surgical disease to one in which operation is rarely undertaken, in part because stratification tools such as Ranson’s criteria have enabled more conservative management of those likely to have favorable outcomes. The development of Ranson’s criteria also paved the way for newer clinical scores that may have more discriminatory power.

Hinchey Classification of Acute Diverticulitis

2017 ◽  
Author(s):  
Michael P. Catanzaro ◽  
Rachel J. Kwon
Keyword(s):  
Evidence Based Medicine ◽  
Paradigm Shift ◽  
Acute Diverticulitis ◽  
Scoring Systems ◽  
Historical Study ◽  
Evidence Based ◽  
Hinchey Classification ◽  
History Of ◽  
Based Medicine

This chapter provides a summary of a landmark historical study in surgery: the Hinchey classification of acute diverticulitis. It describes the history of the disease, gives a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: validation of scoring systems. Hinchey’s classification of diverticulitis has become the most widespread system and while the Hinchey score may currently have less clinical relevance as it did in his time, its publication and eventual adoption marked a practice-changing paradigm shift in the way diverticulitis is viewed and managed today.

Evidence-Based Medicine

2016 ◽  
Author(s):  
Emily R. Winslow
Keyword(s):  
Evidence Based Medicine ◽  
Critical Appraisal ◽  
Reporting Guidelines ◽  
Evidence Based ◽  
Treatment Benefits ◽  
Therapeutic Decisions ◽  
History Of ◽  
Evidence Based Surgery ◽  
Key Resources ◽  
Based Medicine

Descriptions of “evidence-based” approaches to medical care are now ubiquitous in both the popular press and medical journals. The term evidence-based medicine (EBM) was first coined in 1992, and over the last two decades, the field has experienced rapid growth, and its principles now permeate both graduate medical education and clinical practice. The field of EBM has been in constant evolution since its introduction and continues to undergo refinements as its principles are tested and applied in a wide variety of clinical circumstances. This review presents a brief history of EBM, EBM: fundamental tenets, a critical appraisal of a single study, reporting guidelines for single studies, a critical appraisal of a body of evidence, evidence-based surgery, and limitations in EBM. Tables list strength of evidence for treatment decisions (EBM working group), Oxford Centre for Evidence-Based Medicine revised levels of evidence for treatment benefits , “4S” approach to finding resources for EBM, critical appraisal of individual studies examining therapeutic decisions, reporting guidelines by study design, and key resources for evidence-based surgery. This review contains 6 tables and 85 references

scholarly journals Tips for teaching evidence-based medicine in a clinical setting: lessons from adult learning theory. Part one

2008 ◽  
Vol 101 (10) ◽  
pp. 493-500 ◽  
Author(s):  
Kausik Das ◽  
Sadia Malick ◽  
Khalid S Khan
Keyword(s):  
Evidence Based Medicine ◽  
Clinical Decision Making ◽  
Adult Learning Theory ◽  
Clinical Decision ◽  
Evidence Based ◽  
Educational Training ◽  
Practice Teaching ◽  
Approach To Teaching ◽  
Indispensable Tool ◽  
Based Medicine

Summary Evidence-based medicine (EBM) is an indispensable tool in clinical practice. Teaching and training of EBM to trainee clinicians is patchy and fragmented at its best. Clinically integrated teaching of EBM is more likely to bring about changes in skills, attitudes and behaviour. Provision of evidence-based health care is the most ethical way to practice, as it integrates up-to-date, patient-oriented research into the clinical decision making process, thus improving patients' outcomes. In this article, we aim to dispel the myth that EBM is an academic and statistical exercise removed from practice by providing practical tips for teaching the minimum skills required to ask questions and critically identify and appraise the evidence and presenting an approach to teaching EBM within the existing clinical and educational training infrastructure.

scholarly journals Tips for teaching evidence-based medicine in a clinical setting: lessons from adult learning theory. Part two

2008 ◽  
Vol 101 (11) ◽  
pp. 536-543 ◽  
Author(s):  
Sadia Malick ◽  
Kausik Das ◽  
Khalid S Khan
Keyword(s):  
Adult Learning ◽  
Evidence Based Medicine ◽  
Clinical Decision Making ◽  
Adult Learning Theory ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Use ◽  
Evidence Based Healthcare ◽  
Based Medicine ◽  
Oriented Research

Summary Evidence-based medicine (EBM) is the clinical use of current best available evidence from relevant, valid research. Provision of evidence-based healthcare is the most ethical way to practise as it integrates up-to-date patient-oriented research into the clinical decision-making to improve patients' outcomes. This article provides tips for teachers to teach clinical trainees the final two steps of EBM: integrating evidence with clinical judgement and bringing about change.

Internal Mammary Artery Ligation versus Sham Sternotomy for Angina Pectoris

2017 ◽  
Author(s):  
Michael P. Catanzaro
Keyword(s):  
Angina Pectoris ◽  
Internal Mammary Artery ◽  
Historical Study ◽  
Evidence Based ◽  
Artery Ligation ◽  
Sham Surgery ◽  
Internal Mammary ◽  
History Of ◽  
Clinical Questions ◽  
Based Medicine

This chapter provides a summary of a landmark historical study in cardiac surgery related to internal mammary artery ligation versus sham sternotomy for angina pectoris. It describes the history of the procedure and a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: blinding and sham surgery. Whether or not sham surgery is ethical remains under debate. Proponents for sham surgery agree that it should be used only when a question cannot be answered adequately by other methods. Cobb and his colleagues were among the first to demonstrate the value of sham studies in addressing important clinical questions.

Evidence-based medicine and machine learning: a partnership with a common purpose

2020 ◽  
pp. bmjebm-2020-111379
Author(s):  
Ian Scott ◽  
David Cook ◽  
Enrico Coiera
Keyword(s):  
Machine Learning ◽  
Evidence Based Medicine ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Therapeutic Interventions ◽  
Evidence Based ◽  
Rigorous Approach ◽  
Common Purpose ◽  
Future Outcomes ◽  
Based Medicine

From its origins in epidemiology, evidence-based medicine has promulgated a rigorous approach to assessing the validity, impact and applicability of hypothesis-driven empirical research used to evaluate the utility of diagnostic tests, prognostic tools and therapeutic interventions. Machine learning, a subset of artificial intelligence, uses computer programs to discover patterns and associations within huge datasets which are then incorporated into algorithms used to assist diagnoses and predict future outcomes, including response to therapies. How do these two fields relate to one another? What are their similarities and differences, their strengths and weaknesses? Can each learn from, and complement, the other in rendering clinical decision-making more informed and effective?

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