EVIDENCE-BASED PRACTICE IN SPLINTING THE INJURED HAND

Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 215-218 ◽  
Author(s):  
Cecilia W. P. Li-Tsang ◽  
Mary M. L. Chu
Keyword(s):  
Exponential Growth ◽  
Evidence Based Medicine ◽  
Clinical Evidence ◽  
Evidence Based Practice ◽  
Treatment Effectiveness ◽  
Daily Practice ◽  
Evidence Based ◽  
Asian Countries ◽  
Based Medicine ◽  
New Evidence

Evidence-based medicine has been practised in the early 1990s in the Western countries and its model has aroused interests in the Asian countries including Hong Kong in the late 1990s. The need for evidence-based practice was called upon by Sackett and his colleagues14–16 mainly because of the exponential growth of new evidence of treatment effectiveness. There is a great demand for clinicians to search for the best evidence and to incorporate into the daily practice so as to ensure the best quality and standard of treatment. This paper is to review the development and process of evidence-based practice in the area of hand splinting for our local clinicians. Some major problems were identified in the delivery of clinical evidence-based practice, and suggestions have been made to overcome these problems with a view in supporting its model in the local clinical field.

Evidence-Based Paediatric Oncology

2020 ◽  
pp. 46-51
Author(s):  
Leontien C.M. Kremer ◽  
Erik A.H. Loeffen ◽  
Robert S. Phillips
Keyword(s):  
Patient Care ◽  
Evidence Based Medicine ◽  
Evidence Based Practice ◽  
Guideline Development ◽  
Daily Practice ◽  
Paediatric Oncology ◽  
Evidence Based ◽  
The World ◽  
Optimal Patient Care ◽  
Based Medicine

The practice of evidence-based medicine (EBM) is very important in delivering optimal patient care and the terms evidence-based medicine, or evidence-based practice, are used all around the world. This chapter discusses evidence-based paediatric oncology, including its history, an outline of what EBM is, EBM in paediatric oncology, steps in evidence-based paediatric oncology for a user of EBM, steps in guideline development as an implementer of EBM, common criticisms of EBM, and the future of EBM. The chapter gives an overview how EBM can be used in a non-exhaustive but still comprehensive way in daily practice of care for children with cancer, and which tools are available for paediatric oncologists. The majority of the chapter focuses on how to learn to become a skilled user of EBM.

scholarly journals Clinical Physicians’ Attitudes towards Evidence-Based Medicine (EBM) and Their Evidence-Based Practice (EBP) in Wuhan, China

2019 ◽  
Vol 16 (19) ◽  
pp. 3758
Author(s):  
Jianan Hong ◽  
Jing Chen
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based Practice ◽  
Organizational Factors ◽  
Daily Practice ◽  
Evidence Based ◽  
Individual Factor ◽  
Cross Sectional ◽  
Positive Attitudes ◽  
Tertiary Hospitals ◽  
Based Medicine

Objective: Numerous studies have proved the importance of Evidence-Based Medicine (EBM) in daily clinical practice, however, clinicians’ attitudes play an important role in determining its implementation. The objective of this study was to investigate Chinese clinical physicians’ perception of and attitude towards EBM and their Evidence-Based Practice (EBP) as well as the barriers towards EBP. Methods: Using a cross-sectional design, self-response questionnaires were distributed to clinical physicians (internal medicine and surgery departments) across three tertiary hospitals in Wuhan, China. Results: In total, 131 out of 195 (67.2%) physicians completed and returned the questionnaire. A total of 64.9% of the physicians either knew moderately or a lot about EBM. The mean score of physicians’ attitude toward EBM was 2.35 ± 0.35, and that of their EBP skill/ competency was 1.51 ± 0.56 (on 0–3 Likert scale). In total, 76.0% of physicians often or sometimes applied EBM in routine daily practice. The largest barrier preventing implementation was the varying individual differences in diseases (61.0%), followed by a lack of investment from the hospital/department (39.8%), and a lack of patient cooperation (37.4%). Chinese physicians in tertiary hospitals possessed expressed positive attitudes towards EBM; however, they only retained a moderate level of clinical evidence competency. Both an individual factor (personal interest) and organizational factors (workload, hospital requirement) had an effect on physicians’ attitudes and their EBP skills. Management and organizational efforts, in addition to time dedicated for EBP projects could help reduce barriers that prevent EBP.

Evidence-Based Migraine Therapy: Learning Needs and Knowledge Assessment

Cephalalgia ◽  
2000 ◽  
Vol 20 (2_suppl) ◽  
pp. 5-9 ◽  
Author(s):  
RA Purdy
Keyword(s):  
Evidence Based Medicine ◽  
Assessment Tool ◽  
Great Majority ◽  
Daily Practice ◽  
Knowledge Assessment ◽  
Learning Needs ◽  
Evidence Based ◽  
Major Goal ◽  
Migraine Therapy ◽  
Based Medicine

One of the primary goals of continuing medical education (CME) is to enhance the learners' performance, and a major goal of evidence-based medicine (EBM) is to improve knowledge of current best care. This paper overviews the use of a Learning Needs and Knowledge Assessment tool to highlight the potential learning needs and knowledge of neurologists and to focus the issues, interest and interactions of neurologists in a workshop on EBM migraine therapy. Virtually all neurologists felt they used evidence-based medicine in their daily practice. Surprisingly, 50% of neurologists agreed that they were uncertain which triptan to use. The great majority of neurologists felt that the triptans were not all equally efficacious. Our survey identified significant knowledge gaps among neurologists regarding how to appraise the validity of evidence from a randomized clinical trial, and with regard to what are the most clinically useful measures of benefit in clinical trials.

scholarly journals Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management, Part I: Introduction and General Considerations

2008 ◽  
Vol 2;11 (3;2) ◽  
pp. 161-186
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Critical Appraisal ◽  
Evidence Based Practice ◽  
The United States ◽  
Evidence Based ◽  
Interventional Pain Management ◽  
Based Medicine

Evidence-based medicine, systematic reviews, and guidelines are part of modern interventional pain management. As in other specialties in the United States, evidence-based medicine appears to motivate the search for answers to numerous questions related to costs and quality of health care as well as access to care. Scientific, relevant evidence is essential in clinical care, policy-making, dispute resolution, and law. Consequently, evidence based practice brings together pertinent, trustworthy information by systematically acquiring, analyzing, and transferring research findings into clinical, management, and policy arenas. In the United States, researchers, clinicians, professional organizations, and government are looking for a sensible approach to health care with practical evidence-based medicine. All modes of evidence-based practice, either in the form of evidence-based medicine, systematic reviews, meta-analysis, or guidelines, evolve through a methodological, rational accumulation, analysis, and understanding of the evidentiary knowledge that can be applied in clinical settings. Historically, evidence-based medicine is traceable to the 1700s, even though it was not explicitly defined and advanced until the late 1970s and early 1980s. Evidence-based medicine was initially called “critical appraisal” to describe the application of basic rules of evidence as they evolve into application in daily practices. Evidence-based medicine is defined as a conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Evidence-based practice is defined based on 4 basic and important contingencies, which include recognition of the patient’s problem and construction of a structured clinical question, thorough search of medical literature to retrieve the best available evidence to answer the question, critical appraisal of all available evidence, and integration of the evidence with all aspects and contexts of the clinical circumstances. Systematic reviews provide the application of scientific strategies that limit bias by the systematic assembly, critical appraisal, and synthesis of all relevant studies on a specific topic. While systematic reviews are close to meta-analysis, they are vastly different from narrative reviews and health technology assessments. Clinical practice guidelines are systematically developed statements that aim to help physicians and patients reach the best health care decisions. Appropriately developed guidelines incorporate validity, reliability, reproducibility, clinical applicability and flexibility, clarity, development through a multidisciplinary process, scheduled reviews, and documentation. Thus, evidence-based clinical practice guidelines represent statements developed to improve the quality of care, patient access, treatment outcomes, appropriateness of care, efficiency and effectiveness and achieve cost containment by improving the cost benefit ratio. Part 1 of this series in evidence-based medicine, systematic reviews, and guidelines in interventional pain management provides an introduction and general considerations of these 3 aspects in interventional pain management. Key words: Evidence-based medicine, systematic reviews, clinical guidelines, narrative reviews, health technology assessments, grading of evidence, recommendations, grading systems, strength of evidence.

An Ontology-Driven Approach to Clinical Evidence Modelling Implementing Clinical Prediction Rules

2013 ◽  
pp. 257-284 ◽  
Author(s):  
Derek Corrigan ◽  
Lucy Hederman ◽  
Haseeb Khan ◽  
Adel Taweel ◽  
Olga Kostopoulou ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Based Medicine ◽  
Clinical Evidence ◽  
Evidence Based ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Support Provision ◽  
Primary Care Clinicians ◽  
Based Medicine

Diagnostic error is a major threat to patient safety in the context of the primary care setting. Evidence-based medicine has been advocated as one part of a solution. The ability to effectively apply evidence-based medicine implies the use of information systems by providing efficient access to the latest peer-reviewed evidence-based information sources. A fundamental challenge in applying information technology to a diagnostic clinical domain is how to formally represent known clinical knowledge as part of an underlying evidence repository. Clinical prediction rules (CPRs) can provide the basis for a formal representation of knowledge. The TRANSFoRm project defines the architectural components required to deliver a solution by providing an ontology driven clinical evidence service to support provision of diagnostic tools, designed to be maintained and updated from electronic sources of research data, to assist primary care clinicians during the patient consultation through delivery of up to date evidence based diagnostic rules.

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