scholarly journals Involuntary treatment in the community: role of community treatment orders

2010 ◽  
Vol 34 (10) ◽  
pp. 441-446 ◽  
Author(s):  
Sarah Woolley
Keyword(s):  
Mental Health ◽  
Evidence Based Medicine ◽  
Community Treatment ◽  
Evidence Based ◽  
Involuntary Treatment ◽  
Community Treatment Orders ◽  
Literature Reviews ◽  
The Common ◽  
Based Medicine

SummaryAlthough community treatment orders (CTOs) have been used internationally since the 1980s, they were only introduced into England and Wales in 2007 by amendments to the 1983 Mental Health Act. Aimed to replace the common use of extended Section 17 leave to enforce community treatment, CTOs are believed to offer patients more protection owing to stringent criteria for their use. Literature reviews, however, do not demonstrate any evidence favouring the use of CTOs and in this age of evidence-based medicine it is questionable whether psychiatrists will change from a familiar practice to an unproven one.

The Limits of Evidence-Based Medicine and Its Application to Mental Health Evidence-Based Practice: Part One

2013 ◽  
Vol 15 (1) ◽  
pp. 18-34 ◽  
Author(s):  
Tomi Gomory
Keyword(s):  
Mental Health ◽  
Clinical Judgment ◽  
Evidence Based Medicine ◽  
Process Model ◽  
Best Practice ◽  
Political Process ◽  
Community Treatment ◽  
Evidence Based ◽  
Systematic Analysis ◽  
Based Medicine

The present article outlines the major limitations of evidence-based medicine (EBM) and through a close review demonstrates that the three component EBM process model is a pseudoscientific tool. Its “objective” component is the collection, systematic analysis, and listing of “effective” treatments applying a research hierarchy from most rigorous (systematic reviews of randomized controlled trials [RCTs]) to least rigorous (expert opinion). Its two subjective components are the clinical judgment of helping professionals about which “evidence-based” treatment to select and the specific and unique relevant personal preferences of the potential recipients regarding treatment. This procedural mishmash provides no more rigor in choosing “best practice” than has been provided by good clinical practitioners in the past because both turn out to be subjective and authority based. The article also discusses EBM’s further methodological dilution in the National Institute of Mental Health (NIMH) endorsed Evidence-Based Mental Health Practice (EBP) movement. In EBP, the allegedly rigorous EBM protocol is altered. Instead of systematic expert protocol-driven EBM reviews of RCTs, NIMH sanctioned expert consensus panels decide “evidence-based practices.” This further problematizes the development of best practices in mental health by converting it to a political process. The article concludes with some observations on these issues. In a second article (part two) forthcoming, assertive community treatment (ACT) is examined as an example of an EBP that fails as a scientifically effective treatment despite its EBP certification and general popularity among practitioners.

The Limits of Evidence-Based Medicine and Its Application to Mental Health Evidence-Based Practice (Part Two): Assertive Community Treatment Assertively Reviewed

2013 ◽  
Vol 15 (2) ◽  
pp. 73-86 ◽  
Author(s):  
Tomi Gomory
Keyword(s):  
Mental Health ◽  
Assertive Community Treatment ◽  
Evidence Based Medicine ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Community Treatment ◽  
Evidence Based ◽  
Health Delivery ◽  
Based Medicine ◽  
Over 40 Years

This article is the second of two published in Ethical Psychology and Psychiatry; the first appeared in Volume 15, Number 1. The first article argued the very serious limitations of evidence-based medicine (EBM) and its very popular mental health offshoot evidence-based practice (EBP; Gomory, 2013). This article is meant to be a consolidation and update of a 1999 analysis of Assertive Community Treatment (ACT), the best “validated” mental health EBP according the National Institute of Mental Health (NIMH) and academic researchers. This analysis reconfirms the failure of ACT as a treatment modality and a platform for successfully reducing hospitalization; its touted consistent effect except when ACT can apply administrative coercion to keep its clients out of the hospital or quickly discharge them. When ACT fails to have such administrative coercive control, it does no better than other community mental health delivery systems. The use of ACT coercion begun over 40 years ago, the article further argues, set the table for conventionalizing psychiatric coercion as evidence-based best practice.

scholarly journals From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics

2011 ◽  
Vol 33 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Bob Wilffert ◽  
◽  
Jesse Swen ◽  
Hans Mulder ◽  
Daan Touw ◽  
...  
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine

The role of evidence-based medicine in naturopathy

2017 ◽  
Vol 4 (2) ◽  
pp. 47-48 ◽  
Author(s):  
Joshua Z. Goldenberg ◽  
Erica B. Oberg ◽  
Jane Guiltinan ◽  
Rachelle L. McCarty
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine

scholarly journals Psychiatry in the future

2004 ◽  
Vol 28 (8) ◽  
pp. 277-278
Author(s):  
Frank Holloway
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Cochrane Collaboration ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
Policy Makers ◽  
The Future ◽  
The Cochrane Collaboration ◽  
Based Medicine

In an era of evidence-based medicine, policy-makers and researchers are preoccupied by the task of ensuring that advances in research are implemented in routine clinical practice. This preoccupation has spawned a small but growing research industry of its own, with the development of resources such as the Cochrane Collaboration database and journals such as Evidence-Based Mental Health. In this paper, I adopt a philosophically quite unfashionable methodology – introspection – to address the question: how has research affected my practice?

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.

Evidence-based Medicine in Mental Health: Towards Better and Fairer Treatment?

2005 ◽  
pp. 65-75
Author(s):  
Andreas Reis ◽  
Christian Lenk ◽  
Cristiane Reis-Streussnig ◽  
Nikola Biller-Andorno
Keyword(s):  
Mental Health ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine

Cowboys and Pirates in Mental Health Care: A Musical Autoethnography

2020 ◽  
pp. 153270862097065
Author(s):  
David Carless
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Evidence Based Medicine ◽  
Spoken Word ◽  
Evidence Based ◽  
Health Care Professions ◽  
Personal Consequences ◽  
Or Organization ◽  
Based Medicine

A cowboy can be defined as “an unscrupulous tradesman” and a pirate can be “a person or organization broadcasting without official authorisation.” Looking through a subversive lens, I see both cowboys and pirates operating within the mental health care professions. Cowboys can be validated, authorized, rewarded, and empowered through the machinery of evidence-based medicine. Pirates may be criticized, restricted, marginalized, or dismissed by the same machinery. Through a layered performance of song and spoken word, I explore some of the personal consequences of all this for those living—and suffering—within differing paradigms of health care.

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