scholarly journals Evidence-based policy as reflexive practice. What can we learn from evidence-based medicine?

2016 ◽  
Vol 22 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Roland Bal
Keyword(s):  
Clinical Trials ◽  
Evidence Based Medicine ◽  
Clinical Guidelines ◽  
Policy Making ◽  
Evidence Based ◽  
Evidence Based Policy ◽  
Reflexive Practice ◽  
History Of ◽  
The Creation ◽  
Based Medicine

The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine – clinical trials, and the production and use of clinical guidelines – I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively. In the conclusion, I discuss the prospects of such a practice for evidence-based policy.

scholarly journals How much do we trust randomised clinical trials, and related guidelines for disease management? A critical appraisal

2020 ◽  
pp. 87-92
Author(s):  
Demosthenes B. Panagiotakos
Keyword(s):  
Clinical Trials ◽  
Disease Management ◽  
Evidence Based Medicine ◽  
Clinical Guidelines ◽  
Critical Appraisal ◽  
Randomized Clinical Trials ◽  
Evidence Based ◽  
Research Questions ◽  
Meta Analyses ◽  
Based Medicine

In the “era” of evidence-based medicine it is now well appreciated that systematic reviews and meta-analyses of randomized clinical trials are more powerful than other designs in their ability to answer research questions regarding the effectiveness of interventions. In this paper a critical appraisal is made regarding the validity of clinical trials and their role in formulating clinical guidelines.

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.

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

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.

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