Current Controversies in Gastrointestinal Decontamination

2005 ◽  
Vol 18 (3) ◽  
pp. 209-220
Author(s):  
Elizabeth A. Clements ◽  
Jamie B. Shaskos
Keyword(s):  
Clinical Outcome ◽  
Gastric Lavage ◽  
Scientific Data ◽  
Poison Control ◽  
Evidence Based ◽  
The Past ◽  
Whole Bowel Irrigation ◽  
Route Of Exposure ◽  
Based Medicine ◽  
Gastrointestinal Decontamination

Most poisonings reported to American poison control centers occur in the home. The most common route of exposure is ingestion, which is responsible for most fatalities. The goal of gastrointestinal decontamination is to prevent absorption of the toxin. Trends in treating poisoned patients have changed over the past few decades in light of a move toward practicing evidence-based medicine. Efficacy and clinical outcome have come into question and have led to position papers published recently regarding syrup of ipecac, gastric lavage, activated charcoal, and whole-bowel irrigation. These different methods of decontamination and the scientific data supporting each one will be reviewed, and the current controversies surrounding each will be discussed.

Clinical outcome assessment in mental health

2018 ◽  
pp. 191-200
Author(s):  
Skye P. Barbic ◽  
Stefan J. Cano
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Outcome ◽  
Outcome Assessment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Evidence Based ◽  
Measurement Issues ◽  
Health Disorders ◽  
Based Medicine

Clinical outcome assessment (COA) in mental health is essential to inform patient-centred care and clinical decision-making. In this chapter, the reader is introduced to COA as it is evolving in the field of mental health. Multiple approaches to COA are presented, but emphasis is placed on approaches that generate clinically meaningful data. Understanding COA can position clinicians and stakeholders to better evaluate their own practice and to contribute to the ongoing evolution of COA research and evidence-based medicine. This chapter begins with the definitions of assessment and measurement. Conceptual frameworks and models of COA development and testing are then presented. These are followed by a discussion of measurement in practice that reviews measurement issues related to clinical decision-making, programme evaluation, and clinical trials. Finally, this chapter highlights the contribution of metrology to improving health outcomes of individuals who experience mental health disorders.

Using Science-Based Guidelines to Shape Public Health Law

2003 ◽  
Vol 31 (S4) ◽  
pp. 65-67 ◽  
Author(s):  
Stephanie Zaza ◽  
John Clymer ◽  
Linda Upmeyer ◽  
Stephen B. Thacker
Keyword(s):  
Public Health ◽  
Evidence Based Medicine ◽  
Scientific Literature ◽  
Scientific Information ◽  
Scientific Article ◽  
Evidence Based ◽  
Health Law ◽  
The Past ◽  
Different Types ◽  
Based Medicine

Compared to evidence-based public health, evidence-based medicine is a more familiar phrase. Evidence-based medicine has become increasingly popular in the past decade, due in large part to the emergence of computerized database search technology and advanced statistical tools which allow researchers to quickly identify and summarize vast amounts of scientific information.Today, the concept of evidence-based public health is gaining momentum and has grown in popularity. However, the term “evidence-based” lacks clarification and is subject to a variety of interpretations. The evidence that supports evidence-based medicine or public health may include individual experience, anecdotal information, the content of a single scientific article, or the results of a sophisticated systematic review of scientific literature. The imprecise language used to describe evidence leads to confusion over what types of evidence are most appropriate in answering different types of questions.

scholarly journals COVID-19: The Impact on Cardiovascular System

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1691
Author(s):  
Jozica Šikić ◽  
Zrinka Planinić ◽  
Vid Matišić ◽  
Tea Friščić ◽  
Vilim Molnar ◽  
...  
Keyword(s):  
Cardiovascular System ◽  
Evidence Based Medicine ◽  
Patient Monitoring ◽  
Scientific Literature ◽  
Careful Consideration ◽  
Evidence Based ◽  
The Past ◽  
Multidisciplinary Nature ◽  
Based Medicine ◽  
The Impact

SARS-CoV-2 has been circulating in population worldwide for the past year and a half, and thus a vast amount of scientific literature has been produced in order to study the biology of the virus and the pathophysiology of COVID-19, as well as to determine the best way to prevent infection, treat the patients and eliminate the virus. SARS-CoV-2 binding to the ACE2 receptor is the key initiator of COVID-19. The ability of SARS-CoV-2 to infect various types of cells requires special attention to be given to the cardiovascular system, as it is commonly affected. Thorough diagnostics and patient monitoring are beneficial in reducing the risk of cardiovascular morbidity and to ensure the most favorable outcomes for the infected patients, even after they are cured of the acute disease. The multidisciplinary nature of the fight against the COVID-19 pandemic requires careful consideration from the attending clinicians, in order to provide fast and reliable treatment to their patients in accordance with evidence-based medicine principles. In this narrative review, we reviewed the available literature on cardiovascular implications of COVID-19; both the acute and the chronic.

scholarly journals Effektivitas Suplementasi Vitamin D Dalam Mempercepat Konversi Sputum Pada Pasien Tuberkulosis

2021 ◽  
Vol 16 (1) ◽  
pp. 58
Author(s):  
Muhammad Sobri Maulana ◽  
Nurfadhilah Al Adabiyah
Keyword(s):  
Systematic Review ◽  
Clinical Trial ◽  
Vitamin D ◽  
Mycobacterium Tuberculosis ◽  
Clinical Outcome ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Mdr Tb ◽  
Sputum Conversion ◽  
Based Medicine

Latar Belakang: Tuberculosis merupakan penyakit infeksi oleh Mycobacterium tuberculosis. Tuberculosis merupakan  salah satu  diantara sepuluh  penyebab  utama kematian di  dunia. Penelitian terdahulu membuktikan bahwa suplementasi vitamin D dapat meningkatkan aktivitas anti-mikrobial, mempercepat konversi sputum dan kultur, mengurangi inflamasi, meningkatkan clinical outcome, serta meningkatkan mediator untuk aktivitas anti-mikrobial. Meskipun demikian, masih terdapat perbedaan pendapat akan manfaat suplementasi vitamin D pada pasien tuberculosis paru.Tujuan: Mengevaluasi bukti yang ada sampai saat ini terkait manfaat suplementasi vitamin D terutama dalam mempercepat konversi sputum. Metode: Pencarian literatur dilakukan pada tiga databases terkemuka yakni PubMed, SCOPUS, dan Cochrane dengan kata kunci berupa “Tuberculosis”, “Vitamin D”, “Suplementation”, dan “Sputum Conversion” dengan seluruh kata yang berhubungan. Dari seleksi artikel berdasarkan kriteria inklusi dan eksklusif didapatkan 1 systematic review oleh Jollifee D et al (2019) dan 1 clinical trial oleh Afzal A et al (2018), yang kemudian ditelaah berdasarkan aspek validity, importance, dan applicability menggunakan form telaah dari Oxford Center for Evidence Based Medicine. Hasil: Kedua artikel memenuhi kriteria validity, importance, dan applicability masing-masing. Dari segi efikasi, penelitian Jollifee D et al membuktikan bahwa pemberian suplementasi vitamin D tidak mempercepat konversi kultur sputum pada populasi umum (aHR 1.06, 95% CI 0.91-1.23; P=0.44; P for heterogeneity=0.84), namun mempercepat konversi kultur sputum pada populasi MDR-TB(aHR 13.44, 95% CI 2.96-60.90). Kedua studi membuktikan bahwa pemberian suplementasi vitamin D mampu mempercepat konversi apusan sputum namun konversi apusan sputum memiliki validitas yang lebih rendah sebagai marker prognosis untuk outcome suatu tatalaksana dibandingkan konversi kultur sputum. Kesimpulan: Pemberian suplementasi vitamin D tidak mempercepat konversi kultur sputum namun mempercepat konversi apusan sputum. Diperlukan penelitian lebih lanjut terkait manfaat suplementasi vitamin D pada percepatan konversi kultur sputum populasi MDR-TB.

The history of evidence-based medicine

2016 ◽  
Keyword(s):  
Randomized Controlled Trial ◽  
Evidence Based Medicine ◽  
Controlled Trial ◽  
Scientific Data ◽  
Therapeutic Interventions ◽  
Evidence Based ◽  
Randomized Controlled ◽  
History Of ◽  
Historical Accounts ◽  
Based Medicine

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.

Adoption of Evidence-Based Medicine in Clinical Laboratory Science: A Survey of the Prevalence of Systematic and Narrative Reviews

2018 ◽  
Vol 50 (3) ◽  
pp. 223-228
Author(s):  
Lauren N Pearson ◽  
Robert L Schmidt
Keyword(s):  
Evidence Based Medicine ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Critical Role ◽  
Publication Rate ◽  
Evidence Based ◽  
Clinical Laboratory Science ◽  
Laboratory Science ◽  
The Past ◽  
Based Medicine

Abstract Background Systematic reviews (SRs) play a critical role in evidence-based medicine. Objective To determine the publication trends of SRs in clinical laboratory science (CLS). Methods We searched Scopus to identify all reviews published in the top 20 CLS journals during the past 10 years (2008–2017). We determined year of publication, review type (systematic vs narrative), citations, and whether the review was accompanied by a meta-analysis (MA). Results We identified 2934 reviews. Of these, 2833 (96.6%) were narrative reviews, and 98 (3.3%) were SRs. A total of 67 (66.3%) of the SRs were accompanied by a MA. Three journals accounted for 68 of 98 (69.4%) SRs. The percentage of SRs (relative to all reviews) has increased during the past decade (P = .01). SRs were more frequently published in high-impact journals (P <.001). Conclusion The publication rate of SRs in CLS journals has increased during the past decade.

Using the Evidence Based Medicine Framework to Support Music Therapy Posts in Healthcare Settings

2002 ◽  
Vol 16 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Jane Edwards
Keyword(s):  
Music Therapy ◽  
Evidence Based Medicine ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Music Therapists ◽  
Medical Settings ◽  
The Past ◽  
Healthcare Settings ◽  
Research Findings ◽  
Based Medicine

The Evidence Based Medicine (EBM)1 framework has been incorporated into the field of healthcare practice over the past decade. Whatever our stance as to its benefits and disadvantages, more and more music therapists in health departments and related clinical posts will be asked to account for their work using this approach to the documentation of clinical effectiveness. It is important that music therapists working within clinical service guidelines understand the framework of EBM and are aware of ways in which they can include its precepts in their justifications for practice and posts. The levels of evidence in an EBM approach are presented and discussed and the issues particular to the application of music therapy research findings are explored. Given the author's experience in paediatric medical settings, some of the examples in this paper will refer to the children's hospital context in particular.

scholarly journals Response to Miles and Mezzich

2014 ◽  
Vol 2 (1) ◽  
pp. 83
Author(s):  
Andrew Turner ◽  
John Blakey ◽  
Roger Kerry
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based ◽  
Patient Centred Care ◽  
The Past ◽  
Comprehensive Account ◽  
Practice Models ◽  
Recent Developments ◽  
Based Medicine

Miles and Mezzich offer a welcome and comprehensive account of historical recent developments in healthcare and the role of its practice models. They identify a ‘crisis’ in medicine, which seems to have occurred in part because the science of medicine has been over-emphasised and the importance of compassion and care de-emphasised.  As they point out, this crisis has been perceived to have evolved over the past one hundred years. Evidence Based Medicine (EBM) is suggested to be inadequate to solve the crisis and it may be the case that EBM, in fact, has precipitated it because it ignores patients qua persons. It is also suggested that Patient Centred Care (PCC) seeks to address the imbalance, but that this is inadequate, too. Between these existing views it is claimed that Person Centred Medicine (PCM) solves the crisis by giving persons and evidence their proper roles and relative importances

scholarly journals Continuing metamorphosis of evidence-based medicine; the past, present and the future

2020 ◽  
Vol 25 (4) ◽  
pp. 117
Author(s):  
Asoka Gunaratne ◽  
Umesh Jayarajah ◽  
Anuruddha M. Abeygunasekera
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based ◽  
The Past ◽  
The Future ◽  
Based Medicine

scholarly journals THE MAIN FEATURES OF EVIDENCE-BASED MEDICINE IN THE TREATMENT AND REHABILITATION OF PATIENTS IN MAXILLOFACIAL SURGERY

ASJ. ◽  
2020 ◽  
Vol 1 (43) ◽  
pp. 30-33
Author(s):  
S. Тemirbolatova ◽  
A. Shogenov
Keyword(s):  
Evidence Based Medicine ◽  
Maxillofacial Surgery ◽  
Scientific Data ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Key Skills ◽  
Assessment Of Evidence ◽  
Based Medicine ◽  
Methods Of Treatment

The paper considers the features of modern evidence-based medicine, its role and place in modern clinical practice, the role of assessing the effectiveness of drug therapy, the principles of conducting clinical trials of drugs. The results obtained will find wide application in the choice of methods of treatment and rehabilitation of patients in the Department of Maxillofacial Surgery, which will contribute to the development of this branch of medicine. Introduced modern scientific data into practice, which includes 5 key skills: study of questions and problems, with a detailed detailed answer to them, to conclude a method of treating a patient, a conservative approach or the degree of effectiveness of surgery; a detailed analysis of electronic literature of the corresponding type and level of evidence; selection of research methods and assessment of evidence of their necessity; the ability to implement the final results, and use them in the process of treating patients.

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