Hinchey Classification of Acute Diverticulitis

Author(s):  
Michael P. Catanzaro ◽  
Rachel J. Kwon

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.

Author(s):  
Michael P. Catanzaro

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.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Chang Shik Yin ◽  
Seong-Gyu Ko

Objectives. Korean medicine, an integrated allopathic and traditional medicine, has developed unique characteristics and has been active in contributing to evidence-based medicine. Recent developments in Korean medicine have not been as well disseminated as traditional Chinese medicine. This introduction to recent developments in Korean medicine will draw attention to, and facilitate, the advancement of evidence-based complementary alternative medicine (CAM).Methods and Results. The history of and recent developments in Korean medicine as evidence-based medicine are explored through discussions on the development of a national standard classification of diseases and study reports, ranging from basic research to newly developed clinical therapies. A national standard classification of diseases has been developed and revised serially into an integrated classification of Western allopathic and traditional holistic medicine disease entities. Standard disease classifications offer a starting point for the reliable gathering of evidence and provide a representative example of the unique status of evidence-based Korean medicine as an integration of Western allopathic medicine and traditional holistic medicine.Conclusions. Recent developments in evidence-based Korean medicine show a unique development in evidence-based medicine, adopting both Western allopathic and holistic traditional medicine. It is expected that Korean medicine will continue to be an important contributor to evidence-based medicine, encompassing conventional and complementary approaches.


2016 ◽  
Author(s):  
Emily R. Winslow

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


Author(s):  
Michael P. Catanzaro

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.


2020 ◽  
pp. 86-88
Author(s):  
Bishan Basu

Evidence-Based Medicine (EBM) came into fashion nearly three decades ago. However, over this short period, this system of medical philosophy has come to dominate the medical practice worldwide. Never in the history of medicine could a single way of medical practice could dominate the healthcare systems of diverse countries like EBM did, that too within such short time span. But, it is high time we should ponder over the pros and cons of EBM and if this way of medical practice is to be allowed to continue, we should consider integration of additional inputs from the traditional ways of medicine. Though article focusses upon the cancer care, the conclusions derived can be applied to any other disciplines of healthcare.


The pursuit of tests for therapeutic interventions has been a characteristic of Western medicine since ancient times. Historical accounts of the clinical trial are usually expressed through the lens of presentism: how the various components of the first modern randomized controlled trial-the comparison, blinding, and randomization-culminated in Austin Bradford Hill’s 1946 trial of streptomycin for tuberculosis. The factual context of the development of the randomized controlled trial is important if only to emphasize the historicity of contemporary research methodology. However, the adoption of the various components of the trial at any one time has as much to do with changing the socio-political and ethical contexts as the ‘objective’ scientific standards of evidence. Evidence is not just scientific data floating in some ethereal medium, but is also linked to facts and beliefs of the various members of diverse medical communities who interpret evidence and deploy it to legitimize various strategies. This introductory chapter aims to present the background and context through which evidence-based medicine has emerged.


Author(s):  
Michael P. Catanzaro ◽  
Rachel J. Kwon

This chapter provides a summary of a landmark historical study in surgery related to timing of cholecystectomy after biliary pancreatitis. It describes the history of the disease, a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: systematic reviews. This study was the first prospective randomized study to show that early removal of impacted gallstones did not prevent the progression of pancreatitis but did put patients at increased risk for other complications. Current guidelines, informed by this and subsequent studies, recommend that surgery be performed after pancreatic inflammation has subsided but ideally during the same hospital admission.


2013 ◽  
Vol 64 (10) ◽  
pp. 2157-2172 ◽  
Author(s):  
Jiantong Shen ◽  
Leye Yao ◽  
Youping Li ◽  
Mike Clarke ◽  
Li Wang ◽  
...  

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