scholarly journals Using Medline to achieve an evidence-based approach to diagnostic clinical biochemistry

2002 ◽  
Vol 39 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Andrew M Fielding ◽  
Anne Powell
Keyword(s):  
Key Words ◽  
Literature Search ◽  
Clinical Biochemistry ◽  
Evidence Based ◽  
Search Technique ◽  
National Library ◽  
Mesh Terms ◽  
The Us ◽  
Minimum Number ◽  
Structured Approach

Medline is the US National Library of Medicine database that is used for searching the medical biochemistry literature. The database is structured using medical subject subheadings (MeSH terms) to classify the content of references; indexing is done manually using MeSH terms as key words. Searching the database effectively means finding the maximum number of relevant references together with the minimum number of irrelevant ones. This article is aimed at explaining the limitations of Medline and suggesting some solutions to key problems. The goal is that users can improve their literature search technique by employing a structured approach. As usual, asking relevant questions before starting a search is essential.

Minimum retesting intervals in practice: 10 years experience

2021 ◽  
Vol 59 (1) ◽  
pp. 39-50
Author(s):  
Tim Lang
Keyword(s):  
Literature Search ◽  
Clinical Biochemistry ◽  
Demand Management ◽  
Management Tool ◽  
Published Data ◽  
Evidence Based ◽  
Laboratory Practice ◽  
Total Saving ◽  
Healthcare Settings ◽  
Published Evidence

AbstractBackgroundMinimum retesting intervals (MRI) are a popular demand management solution for the identification and reduction of over-utilized tests. In 2011 Association of Clinical Biochemistry and Laboratory Medicines (ACB) published evidence-based recommendations for the use of MRI.AimThe aim of the paper was to review the use of MRI over the period since the introduction of these recommendations in 2011 to 2020 and compare it to previous published data between 2000-2010.MethodsA multi-source literature search was performed to identify studies that reported the use of a MRI in the management or identification of inappropriate testing between the years prior to (2000–2010) and after implementation (2011–2020) of these recommendations.Results31 studies were identified which met the acceptance criteria (2000–2010 n=4, 2011–2020 n=27). Between 2000 and 2010 4.6% of tests (203,104/4,425,311) were identified as failing a defined MRI which rose to 11.8% of tests (2,691,591/22,777,288) in the 2011–2020 period. For those studies between 2011 and 2020 reporting predicted savings (n=20), 14.3% of tests (1,079,972/750,580) were cancelled, representing a total saving of 2.9 M Euros or 2.77 Euro/test. The most popular rejected test was Haemoglobin A1c which accounted for nearly a quarter of the total number of rejected tests. 13 out 27 studies used the ACB recommendations.ConclusionsMRI are now an established, safe and sustainable demand management tool for the identification and management of inappropriate testing. Evidence based consensus recommendations have supported the adoption of this demand management tool into practice across multiple healthcare settings globally and harmonizing laboratory practice.

Systematic review methodology for development: An example from microfinance

2018 ◽  
Vol 43 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Carina Van Rooyen ◽  
Ruth Stewart ◽  
Thea De Wet
Keyword(s):  
Systematic Review ◽  
International Development ◽  
Health Sector ◽  
Evidence Based ◽  
Systematic Review Methodology ◽  
Development Interventions ◽  
The Us ◽  
Sub Saharan ◽  
The Impact ◽  
Evidence Based Decision Making

Big international development donors such as the UK’s Department for International Development and USAID have recently started using systematic review as a methodology to assess the effectiveness of various development interventions to help them decide what is the ‘best’ intervention to spend money on. Such an approach to evidence-based decision-making has long been practiced in the health sector in the US, UK, and elsewhere but it is relatively new in the development field. In this article we use the case of a systematic review of the impact of microfinance on the poor in sub-Saharan African to indicate how systematic review as a methodology can be used to assess the impact of specific development interventions.

scholarly journals Computed Tomography Colonography as a Sensible Option for Colorectal Cancer Screening: Evidence Based on Metanalysis

2021 ◽  
Vol 41 (01) ◽  
pp. 087-095
Author(s):  
Ingrid Chaves de Souza Borges ◽  
Natália Costa Resende Cunha ◽  
Amanda Marsiaj Rassi ◽  
Marcela Garcia de Oliveira ◽  
Jacqueline Andréia Bernardes Leão-Cordeiro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Cancer Screening ◽  
Literature Search ◽  
Web Of Science ◽  
Screening Method ◽  
Colorectal Polyp ◽  
Evidence Based ◽  
Polyp Detection ◽  
Computed Tomography Colonography

Abstract Objective This metanalysis aimed to evaluate the sensitivity and specificity of computed tomography colonography in colorectal polyp detection. Methods A literature search was performed in the PubMed and Web of Science databases. Results A total of 1,872 patients (males 57.2%, females 42.8%) aged 49 to 82 years old (mean age 59.7 ± 5.3 years) were included in this metanalysis. The estimated sensitivity of computed tomography colonography was 88.4% (46.3–95.7%, coefficient of variation [CV] = 28.5%) and the estimated specificity was 73.6% (47.4–100.0%, CV = 37.5%). For lesions up to 9 mm, the sensitivity was 82.5% (62.0–99.9%, CV = 25.1%) and the specificity was 79.2% (32.0–98.0%, CV = 22.9%). For lesions > 9 mm, the sensitivity was 90.2% (64.0–100.0%, CV = 7.4%) and the specificity was 94.7% (80.0–100.0%, CV = 6.2%). No statistically significant differences in sensitivity according to the size of the lesion were found (p = 0.0958); however, the specificity was higher for lesions > 9 mm (p < 0.0001). Conclusions Most of the studies analyzed in the present work were conducted before 2010, which is about a decade after computed tomography colonography started being indicated as a screening method by European and American guidelines. Therefore, more studies aimed at analyzing the technique after further technological advancements are necessary, which could lead to the development of more modern devices.

scholarly journals The hospital telemedicine TELEMED database: Providing information on evidence-based telemedicine services to hospital managers and healthcare professionals

2021 ◽  
pp. 1357633X2110155
Author(s):  
Kristian Kidholm ◽  
Ida W Svendsen ◽  
Knud Yderstræde ◽  
Anne M Ølholm ◽  
Kathrine Rayce ◽  
...  
Keyword(s):  
Literature Search ◽  
Healthcare Professionals ◽  
Economic Effects ◽  
Control Group ◽  
Evidence Based ◽  
Implementation Challenges ◽  
Hospital Managers ◽  
Pubmed Database ◽  
Significant Difference ◽  
Hospital Patients

Background Increased use of telemedicine in the healthcare system is a political goal in Denmark. Although the number of hospital patients using interventions such as the video consultation has increased in recent years only a small proportion of the outpatient and inpatient visits involve telemedicine. The TELEMED database ( https://telemedicine.cimt.dk/ ) has been launched at the Center for Innovative Medical Technologies in Denmark to ensure that hospital managers and healthcare professionals have access to information about telemedicine services and their effectiveness. This article describes the development and the content of the TELEMED database. Methods A structured literature search was made in the PubMed Database for randomised controlled trials or observational studies with a control group that investigated the effect of telemedicine interventions for hospital patients. Data were extracted from each article on the clinical effectiveness, patient perceptions, economic effects and implementation challenges. As the database should only provide inspiration to healthcare professionals regarding possibilities for use of telemedicine, the risk of bias in the studies was not assessed. Results The literature search resulted in 2825 hits. Based on full text assessment, 331 articles were included for data extraction and assessment. These articles present telemedicine services used in 22 different medical specialities. Forty-eight percent of the studies found a positive, statistically significant clinical effect, while 47% showed no statistically significant difference. In 48% of the studies, patients’ experiences were examined and of these 68% found positive patient experiences. Fifty-four percent of the articles included information on the economic effects and, of these, 51% found reduction in healthcare utilization. In the majority of studies between two and four types of implementation challenges were found. Conclusions and recommendations: The TELEMED database provides an easily accessible overview of existing evidence-based telemedicine services for use by hospital managers and health professionals, who whish to to implement telemedicine. The database is freely available and expected to be continuously improved and broadened over time.

Premature birth (Clinical lecture)

2018 ◽  
pp. 9-12
Author(s):  
I.B. Ventskovskaya ◽  
◽  
V.V. Bila ◽  
O.S. Countryside ◽  
◽  
...  
Keyword(s):  
Magnesium Sulfate ◽  
Key Words ◽  
Gestational Age ◽  
Evidence Based Medicine ◽  
Premature Birth ◽  
Preterm Labor ◽  
Evidence Based ◽  
Advantages And Disadvantages ◽  
Based Medicine ◽  
Tocolytic Agents

The article presents modern views on the pathogenesis of preterm labor, their relevance and classification. From the perspective of evidence-based medicine methods of prevention are considered. A comparison of the main tocolytic agents, their advantages and disadvantages is presented. Key words: premature birth, perinatal and infantile mortality, tocolysis, magnesium sulfate, gestational age.

Laryngopharyngeal Reflux and GERD

2021 ◽  
Author(s):  
Shumon Ian Dhar ◽  
Lee Akst
Keyword(s):  
Key Words ◽  
Laryngopharyngeal Reflux ◽  
Evidence Based ◽  
Mechanism Of Injury ◽  
Esophageal Reflux ◽  
Laryngeal Injury

Since the early 1990s, the consequences of extra-esophageal reflux in the larynx have been recognized to be related to a variety of laryngeal symptoms with certain endoscopic manifestations. The paper by Dr. Koufman described various types of laryngeal injury which were attributed to extra-esophageal reflux also known as laryngopharyngeal reflux (LPR). The mechanism of injury was postulated to be a consequence of acid refluxate as well as from pepsin. Since that time there has been a surge of literature devoted to the topic of LPR seeking to refine its diagnosis, elucidate its pathophysiology, and treat its symptoms and sequelae. Our goal in this chapter is to provide a balanced, evidence-based framework for identifying LPR and providing treatment while balancing the benefits versus the risks of overtreatment and escalating therapy. This review contains 13 figures, 7 tables and 49 references. Key Words: LPR, GERD, PPI, RSI, TLESR

Evidence Based Medical Prevention: International Experience

2016 ◽  
pp. 34-37
Author(s):  
Olha Puzanovа
Keyword(s):  
Health Care ◽  
Preventive Medicine ◽  
Scientific Information ◽  
International Experience ◽  
Evidence Based ◽  
Task Forces ◽  
Cochrane Reviews ◽  
The Us ◽  
Based Medicine

The objective: was to study the international experience of evidence based preventive medicine development as well as to estimate its perspectives in Ukraine. Patients and methods. Main principles and methods of scientific knowledge and research have been used including universal ones, methods of systemic approach, quantitative and qualitative information analysis, classification and systematization of theoretical and empirical data, hystorical and logical methods, health statistics as well). In total 529 scientific information sources have been studied, particularly a number of evidence based medicine (EBM) computer databases, special task forces recommendations and Cochrane reviews on prevention, Register of medical and technological documents for health care standards in Ukraine et al. Results. The contribution of foreign scientific schools in the development of EBM has been determined, as well as the crucial role of scientific works carried out in the US and Great Britain in 1930–80s as to the development of evidence based preventive medicine. The international experience of the development and functioning of evidence based practice centers’ and special task forces on prevention has been summarized, as the experience of the development and implementation of recommendations on prevention in primary health care (PHC) in high income countries acceptable for Ukraine. The concept of evidence based prevention has been first proposed. It is revealed, that EBM implementation in Europe has been prioritized in both the field of infectious diseases prevention and PHC, while there are both the development of differentiated evidence based prevention and early evidence based diagnosis in PHC in the US. Conclusion. The results proved importance of taking into consideration of international experience while evidence based PHC is being developed as a priority in Ukraine.

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