Evidence-Based Medicine and Headache Patient Management by General Practitioners in Italy

Cephalalgia ◽  
2005 ◽  
Vol 25 (10) ◽  
pp. 767-775 ◽  
Author(s):  
A Bianco ◽  
MM Parente ◽  
E De Caro ◽  
R Iannacchero ◽  
U Cannistrà ◽  
...  
Keyword(s):  
Clinical Trials ◽  
General Practitioners ◽  
Evidence Based Medicine ◽  
Clinical Effectiveness ◽  
Clinical Approach ◽  
Evidence Based ◽  
Sources Of Information ◽  
Headache Patient ◽  
Practice Characteristics ◽  
Based Medicine

The study explores the awareness of technical terms used in evidence-based medicine (EBM) and manner of treating patients with migraine among a random sample of 500 general practitioners (GPs). A mailed questionnaire included questions on GPs' demographics and practice characteristics; awareness of EBM; sources of information about migraine and EBM; and patient's treatment behaviour. Only 27.2% of GPs agreed that clinical trials are needed to evaluate the efficacy of treatments and this awareness was higher in those who learned about migraine from scientific journals or continuing education courses and who attended courses on EBM. For two-thirds of GPs, disability is equivalent to illness diagnosis, and this behaviour was more prevalent in those who agreed that clinical trials are needed to evaluate the efficacy of preventive or curative treatments of migraine and that the clinical approach to migraine required an evaluation of clinical effectiveness, in those who treated a lower number of headache patients, who were older, and in those who did not use guidelines. The majority (93.1%) of GPs indicated that it is important to integrate clinical practice and the best available evidence, and this behaviour was significantly more frequent in those who agreed that the clinical approach to migraine required a clinical effectiveness evaluation, that clinical trials are needed to evaluate the efficacy of preventive or curative treatments of migraine, and in those who attended courses on EBM. Training and continuing educational programmes on EBM and guidelines on treatments of headache for GPs are strongly needed.

scholarly journals Bias against Vitamin C in Mainstream Medicine: Examples from Trials of Vitamin C for Infections

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 62
Author(s):  
Harri Hemilä ◽  
Elizabeth Chalker
Keyword(s):  
Clinical Trials ◽  
Vitamin C ◽  
Common Cold ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
The Third ◽  
Nutritional Recommendations ◽  
Mainstream Medicine ◽  
The Common ◽  
Based Medicine

Evidence has shown unambiguously that, in certain contexts, vitamin C is effective against the common cold. However, in mainstream medicine, the views on vitamin C and infections have been determined by eminence-based medicine rather than evidence-based medicine. The rejection of the demonstrated benefits of vitamin C is largely explained by three papers published in 1975—two published in JAMA and one in the American Journal of Medicine—all of which have been standard citations in textbooks of medicine and nutrition and in nutritional recommendations. Two of the papers were authored by Thomas Chalmers, an influential expert in clinical trials, and the third was authored by Paul Meier, a famous medical statistician. In this paper, we summarize several flaws in the three papers. In addition, we describe problems with two recent randomized trial reports published in JAMA which were presented in a way that misled readers. We also discuss shortcomings in three recent JAMA editorials on vitamin C. While most of our examples are from JAMA, it is not the only journal with apparent bias against vitamin C, but it illustrates the general views in mainstream medicine. We also consider potential explanations for the widespread bias against vitamin C.

scholarly journals Current Situation and Prospects of Evidence-Based Medicine in Russia Assessed by Physicians and Patients

2019 ◽  
Vol 47 (3) ◽  
pp. 123-143
Author(s):  
Natalia A. Vyatkina
Keyword(s):  
Evidence Based Medicine ◽  
Current Status ◽  
Pharmaceutical Companies ◽  
Criminal Prosecution ◽  
Evidence Based ◽  
Sources Of Information ◽  
Critical Situation ◽  
Based Medicine ◽  
Insight Into

The term "evidence-based medicine" is being increasingly used by various sources of information today, and becomes a discussion subject of professional communities and ordinary citizens. Apart from a brief insight into the origin and development of evidence-based medicine in the world and in Russia, the article deals with the anthropological analysis of the attitudes of the modern Russian physicians and patients towards both the understanding of the term and the current status, prospects and possible risks of the development of this discipline in our country. The views of respondents about the role of pharmaceutical companies, the state and the balance between the development and implementation of clinical guidelines and individual cases are considered. The article presents the arguments of patients about whether there is still a "physician blessed by God" and whether it is important for them that the person who they address for help works in the paradigm of evidence-based medicine. Physicians question whether healing itself is still an art, or evidence-based medicine has finally turned it into a business and well-organized mechanism, which could protect them from criminal prosecution in a critical situation.

The future of clinical trials

2010 ◽  
pp. 45-47
Author(s):  
Perry Nisen ◽  
Patrick Vallance
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Alternative Medicine ◽  
20Th Century ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Scientific Evaluation ◽  
New Treatments ◽  
Based Medicine ◽  
Short Section

Clinical trials are the bedrock of evidence-based medicine. Introduced in the mid 20th century, they heralded a move away from opinion and anecdote to a more scientific evaluation of new treatments. Indeed, it could be argued that it is the clinical trial and the application of scientific method to determine which treatments work that distinguishes ‘medicine’ from ‘alternative medicine’. The aim of this short section is to outline the way in which clinical trials are likely to evolve over the next few years....

An overview of study designs

2020 ◽  
Vol 81 (5) ◽  
pp. 1-6
Author(s):  
Julian Aquilina ◽  
Joana B Neves ◽  
Maxine GB Tran
Keyword(s):  
Clinical Trials ◽  
Study Design ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Advantages And Disadvantages ◽  
Valid Evidence ◽  
Study Designs ◽  
Based Medicine

The numbers of clinical trials have increased exponentially over the last decade, amplifying the pressure to select an appropriate study design to obtain reliable and valid evidence. The ability to find, critically appraise and use evidence to develop new interventions is fundamental to evidence-based medicine. Different study designs have their own advantages and disadvantages, and provide different evidentiary value. This article provides an overview of clinical trials, illustrating that, ultimately, the study design chosen needs to meet experimental and funding limitations, while minimising error.

scholarly journals Mental disorders of known aetiology and precision medicine in psychiatry: a promising but neglected alliance

2016 ◽  
Vol 47 (2) ◽  
pp. 193-197 ◽  
Author(s):  
D. Fraguas ◽  
C. M. Díaz-Caneja ◽  
M. W. State ◽  
M. C. O'Donovan ◽  
R. E. Gur ◽  
...  
Keyword(s):  
Personalized Medicine ◽  
Mental Disorders ◽  
Precision Medicine ◽  
Psychiatric Disorders ◽  
Evidence Based Medicine ◽  
Prediction Models ◽  
Deletion Syndrome ◽  
Clinical Approach ◽  
Evidence Based ◽  
Based Medicine

Personalized or precision medicine is predicated on the assumption that the average response to treatment is not necessarily representative of the response of each individual. A commitment to personalized medicine demands an effort to bring evidence-based medicine and personalized medicine closer together. The use of relatively homogeneous groups, defined using a priori criteria, may constitute a promising initial step for developing more accurate risk-prediction models with which to advance the development of personalized evidence-based medicine approaches to heterogeneous syndromes such as schizophrenia. However, this can lead to a paradoxical situation in the field of psychiatry. Since there has been a tendency to loosely define psychiatric disorders as ones without a known aetiology, the discovery of an aetiology for psychiatric syndromes (e.g. 22q11.2 deletion syndrome in some cases of schizophrenia), while offering a path toward more precise treatments, may also lead to their reclassification away from psychiatry. We contend that psychiatric disorders with a known aetiology should not be removed from the field of psychiatry. This knowledge should be used instead to guide treatment, inasmuch as psychotherapies, pharmacotherapies and other treatments can all be valid approaches to mental disorders. The translation of the personalized clinical approach inherent to psychiatry into evidence-based precision medicine can lead to the development of novel treatment options for mental disorders and improve outcomes.

scholarly journals Effect of an Evidence-based Medicine Seminar on Participantsʼ Interpretations of Clinical Trials

2000 ◽  
Vol 75 (12) ◽  
pp. 1212-1214 ◽  
Author(s):  
Philip Schoenfeld ◽  
David Cruess ◽  
Walter Peterson
Keyword(s):  
Clinical Trials ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine
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