scholarly journals Evidence-based surgery – evidence from survey and citation analysis in orthopaedic surgery

2011 ◽  
Vol 93 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Malhar Kumar ◽  
Chethan Gopalakrishna ◽  
Pazhayannur V Swaminath ◽  
Sanjay S Mysore
Keyword(s):  
Clinical Practice ◽  
Citation Analysis ◽  
Developed Countries ◽  
Evidence Based ◽  
Web Based ◽  
Professional Journals ◽  
Orthopedic Surgeons ◽  
Significant Difference ◽  
Level I ◽  
Evidence Based Surgery

INTRODUCTION The results of a survey on evidence-based surgery (EBS) among members of the American Academy of Orthopedic Surgeons (AAOS) and the British Orthopaedic Association (BOA) are presented. The study also analyzes the citations earned by articles with different levels of evidence (LOE) to see if LOE have any bearing on the importance attached to the articles by authors and contributors to the journals. SUBJECTS AND METHODS The questionnaire was e-mailed to 1000 randomly chosen consultant orthopaedic surgeons who were members of either the AAOS or the BOA. Participants were provided with the option of responding through web-based entry. For citation analysis, citation data were gathered from the Journal of Bone and Joint Surgery (American volume) between the years 2003 and 2007 (5-year period). RESULTS The survey showed that awareness and access to EBS have improved greatly over the years. At the present time, these factors are not important barriers to the implementation of EBS in clinical practice in developed countries. There was a statistically significant difference in those with and without additional qualifications with regard to the approach to EBS. However, an equal percentage of surgeons with and without additional qualifications felt that it was difficult to adhere to EBS guidelines in daily clinical practice. Citation analysis showed that readers of professional journals attach importance to LOE category of the article and tend to cite level-I evidence articles more than other articles.

scholarly journals Dietitians' perceptions and experience of blenderised feeds for paediatric tube-feeding

2016 ◽  
Vol 102 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Janis Armstrong ◽  
Elaine Buchanan ◽  
Hazel Duncan ◽  
Kathleen Ross ◽  
Konstantinos Gerasimidis
Keyword(s):  
Clinical Practice ◽  
Tube Feeding ◽  
Infection Risk ◽  
Previous Experience ◽  
Evidence Based ◽  
Web Based ◽  
Commercial Feeds ◽  
Evidence Based Guidelines ◽  
Professional Guidelines

ObjectiveThere is an emerging interest in the use of blenderised food for tube-feeding (BFTF). This survey explored paediatric dietitians' perceptions and experiences of BFTF use.DesignA web-based questionnaire was distributed to the Paediatric group of the British Dietetic Association. The survey captured dietitians' personal opinions and experience supporting children on BFTF, and the perceptions of carers.ResultsOf the 77 respondents, 19 were aware of professional guidelines and 63 had never received training on BFTF. Thirty-four would not recommend BFTF and 11 would advise against its use; yet 43 would recommend it to supplement commercial feeds. Fifty-seven would change their perception about BFTF if there were evidence-based guidelines. Forty-four would feel confident to support a patient using BFTF. Forty-three had previous experience supporting a patient with BFTF. The main concerns perceived by dietitians, pertinent to the use of BFTF, were nutritional inadequacy (n=71), tube blockages (n=64) and increased infection risk (n=59) but these were significantly higher than those experienced by themselves in clinical practice (p<0.001 for all three). A reduction in reflux and vomiting and increased carer involvement were the main perceived and observed benefits by both dietitians and carers.ConclusionsThe use of these feeds for tube-fed children is increasingly being seen as a viable choice. Dietitians experienced significantly fewer issues with the use of BFTF in clinical practice compared with their self-reported apprehensions in the survey. Well-controlled studies are now needed to objectively assess the benefits, risks, costs and practicality of BFTF.

scholarly journals Using blogging to promote clinical reasoning and metacognition in undergraduate physiotherapy fieldwork programs

2010 ◽  
Vol 26 (3) ◽  
Author(s):  
Shuyan Melissa Tan ◽  
Richard K. Ladyshewsky ◽  
Peter Gardner
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Clinical Reasoning ◽  
Education Program ◽  
Cognitive Skills ◽  
Evidence Based ◽  
Good Strategy ◽  
Web Based ◽  
The Impact ◽  
Physiotherapy Students

<span>This qualitative study investigated the impact of using blogs on the clinical reasoning and meta-cognitive skills of undergraduate physiotherapy students in a fieldwork education program. A blog is a web based document that enables individuals to enter comments and read each others' comments in a dynamic and interactive manner. In this study, final year physiotherapy students were randomly allocated to group blogs to share their reflections on their own and their peers' clinical practice. Blogging was used to help students reflect and focus on professional and evidence based practice within a supportive peer assisted learning environment. The text within each of the blogs was qualitatively analysed against concepts in the literature describing specific types of clinical reasoning and metacognition. A range of clinical reasoning typologies were found to exist in the blogs. Most notable were ethical, interactive and procedural reasoning along with evidence of metacognition. Blogging was found to be a good strategy for promoting clinical reasoning and metacognition in fieldwork education.</span>

scholarly journals Downhill skiing following total knee arthroplasty: a survey of Alberta orthopedic surgeons

2021 ◽  
Vol 64 (4) ◽  
pp. E414-E418
Author(s):  
Andrew Buckley ◽  
Paul Duffy ◽  
Robert Korley
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Full Range ◽  
Evidence Based ◽  
Full Time ◽  
Web Based ◽  
Orthopedic Surgeons ◽  
Downhill Skiing ◽  
Total Knee ◽  
Orthopaedic Society

Background: In older adults facing knee arthroplasty, the ability to resume downhill skiing postoperatively is unclear. This study aimed to determine the perspectives of Alberta orthopedic surgeons and senior residents regarding downhill skiing after total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). Methods: In May 2019, a Web-based survey was sent through the Alberta Orthopaedic Society to poll orthopedic surgeons performing arthroplasty and senior orthopedic residents (postgraduate year 4 or 5) in Alberta regarding the permissibility of downhill skiing after TKA or UKA. The survey also elicited information regarding under which conditions or restrictions, if any, surgeons would allow patients to return to downhill skiing, whether these recommendations were evidence based, and whether surgeons had seen complications from downhill skiing in their patients who had undergone knee arthroplasty. Results: Of the 41 respondents, 21 (51%) were full-time fellowship-trained orthopedic surgeons, 15 (37%) were specialists with some arthroplasty in their practice, and 5 (12%) were orthopedic residents. Ten of 40 respondents (25%) would allow unrestricted downhill skiing after TKA, and 1 (2%) would not allow any skiing at all. The remaining 29 (72%) indicated that they might allow downhill skiing under specific conditions, with the top 3 being limitations on speed and intensity (29 [71%]), return of full range of motion and strength in the operative knee (26 [63%]), and years of downhill ski experience (23 [56%]). Fourteen respondents (34%) would allow unrestricted downhill skiing after UKA, and 27 (66%) would allow skiing with the same top 3 conditions as for TKA. Thirty-two respondents (78%) reported that their decisions were not evidence based, and 35 (85%) had never seen complications from downhill skiing after TKA or UKA. Conclusion: Alberta orthopedic surgeons and senior residents are cautious regarding skiing after knee arthroplasty. The majority reported that their restrictions were not evidence based, which indicates the need for further investigation to develop an approach for surgeons to consistently and safely address return to downhill skiing after TKA or UKA.

scholarly journals Perceived Outcomes of Web-Based Modules Designed to Enhance Athletic Trainers' Knowledge of Evidence-Based Practice

2014 ◽  
Vol 49 (2) ◽  
pp. 220-233 ◽  
Author(s):  
Cailee E. Welch ◽  
Bonnie L. Van Lunen ◽  
Dorice A. Hankemeier ◽  
Aimee L. Wyant ◽  
Jessica M. Mutchler ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Knowledge Gain ◽  
Evidence Based ◽  
Web Based ◽  
Didactic Instruction ◽  
Telephone Interviews ◽  
National Athletic Trainers Association

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial. Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: We conducted 1 individual telephone interview with each participant. After transcription, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice. Conclusions: Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice.

scholarly journals Food Allergy Knowledge and Attitudes Among School Teachers in Jazan, Saudi Arabia

2018 ◽  
Vol 9 (1) ◽  
pp. 1-7
Author(s):  
Gassem Gohal
Keyword(s):  
Saudi Arabia ◽  
Food Allergy ◽  
Middle Eastern ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
School Teachers ◽  
Cross Sectional ◽  
Web Based ◽  
Significant Difference ◽  
Level Of Knowledge

Background: Food allergy topic has become more widely discussed in developed countries, but with less interest in Middle Eastern Arabian Countries. Objectives: The main objective of this paper is to assess the knowledge and perception of schoolteachers about food allergy. Methods: A cross sectional study was conducted among a sample of 360 school teachers between May 2013 and February 2014 in province of Jazan in Saudi Arabia, using a validated web-based self-administered survey. Results: The results revealed that almost (59.7%) of the schoolteachers had a medium insufficient knowledge about food allergy; only 17.3% had good knowledge about food allergy. Female teachers had higher knowledge scores (58.5 ± 17.2) as compared to male (51.8 ± 16.0) with statistically significant difference (p = 0.017). The majority of schoolteachers have a significantly poor knowledge in most of food allergy domains. More than half of responders either do not know or they disagree that the food allergy is a serious problem and can lead to death. Regression analysis revealed that participant’s level of knowledge is significantly associated with school teacher’s attitudes towards food allergy (OR = 0.06, 95% CI: 0.39 - 0.92, p = 0.01), practice (OR = 1.68, 95% CI: 1.11 - 2.56, p = 0.01), and years of experiences (OR = 1.8, 95% CI; 1.15 - 2.98, p = 0.011). Conclusion: Knowledge of food allergy among schoolteachers is not adequate, failing to recognize and treat fatal food allergy reactions necessitate an urgent need to set a school policy to improve the food allergy situation.

scholarly journals Neurosurgery - More Eminence than Evidence: Results of an International Survey (Preprint)

2017 ◽  
Author(s):  
Jill Martens
Keyword(s):  
Clinical Practice ◽  
Publication Rate ◽  
Formal Training ◽  
High Quality ◽  
Web Based ◽  
Medical Specialties ◽  
High Quality Evidence ◽  
Level Ii ◽  
Level I ◽  
Quality Evidence

BACKGROUND The publication rate of neurosurgical guidelines has increased tremendously over the past decade. However, only a small proportion of clinical decisions appears to be based on high-quality evidence. OBJECTIVE To evaluate the available evidence within neurosurgery and its value within clinical practice according to neurosurgeons. METHODS A web-based survey was sent to 2552 neurosurgeons, who were members of the European Association of Neurosurgical Societies. RESULTS The response rate to the survey was 7% (173 respondents). According to 49% of the respondents, neurosurgery is based on less evidence compared with other medical specialties, and not enough high-quality evidence is available on which to base clinical practice. However, 84% of the respondents believed neurosurgery is amenable to evidence. Of the respondents, 59% considered the neurosurgical guidelines in their hospital to be based on high-quality evidence. Responders that did consider the neurosurgical guidelines in their hospital to be based on high-quality evidence did consider their own treatments more often as based on Level I and/or Level II (84% resp. 55%) (P < .001). Also, neurosurgeons with formal training believed they could understand, criticize and interpret statistical outcomes presented in journals better than those without formal training (93% resp. 68%) (P < .001). CONCLUSIONS According to the respondents, neurosurgery is based less often on high-quality evidence than other medical specialties. When looking at the results of the survey, formal training in EBM is desirable, so neurosurgeons can better understand, criticize and interpret statistical outcomes presented in journals.

scholarly journals Exploring How Evidence is Used in Care Through an Organizational Ethnography of Two Teaching Hospitals (Preprint)

2018 ◽  
Author(s):  
Bryn Lander ◽  
Ellen Balka
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
New Technologies ◽  
Medical Training ◽  
Advisory Council ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Sources Of Information ◽  
Web Based ◽  
Based Medicine

BACKGROUND Numerous published articles show that clinicians do not follow clinical practice guidelines (CPGs). However, a few studies explore what clinicians consider evidence and how they use different forms of evidence in their care decisions. Many of these existing studies occurred before the advent of smartphones and advanced Web-based information retrieval technologies. It is important to understand how these new technologies influence the ways clinicians use evidence in their clinical practice. Mindlines are a concept that explores how clinicians draw on different sources of information (including context, experience, medical training, and evidence) to develop collectively reinforced, internalized tacit guidelines. OBJECTIVE The aim of this paper was to explore how evidence is integrated into mindline development and the everyday use of mindlines and evidence in care. METHODS We draw on ethnographic data collected by shadowing internal medicine teams at 2 teaching hospitals. Fieldnotes were tagged by evidence category, teaching and care, and role of the person referencing evidence. Counts of these tags were integrated with fieldnote vignettes and memos. The findings were verified with an advisory council and through member checks. RESULTS CPGs represent just one of several sources of evidence used when making care decisions. Some forms of evidence were predominately invoked from mindlines, whereas other forms were read to supplement mindlines. The majority of scientific evidence was accessed on the Web, often through smartphones. How evidence was used varied by role. As team members gained experience, they increasingly incorporated evidence into their mindlines. Evidence was often blended together to arrive at shared understandings and approaches to patient care that included ways to filter evidence. CONCLUSIONS This paper outlines one way through which the ethos of evidence-based medicine has been incorporated into the daily work of care. Here, multiple Web-based forms of evidence were mixed with other information. This is different from the way that is often articulated by health administrators and policy makers whereby clinical practice guideline adherence is equated with practicing evidence-based medicine.

Location Choice of China′s ODI: Evidence Based on Panel Data

2013 ◽  
Vol 401-403 ◽  
pp. 2341-2344
Author(s):  
Xue Song Gu ◽  
Li Yan Han
Keyword(s):  
Developing Countries ◽  
Panel Data ◽  
Location Choice ◽  
Developed Countries ◽  
Evidence Based ◽  
Host Countries ◽  
Chow Test ◽  
Significant Difference

This paper empirically investigates the factors determining Chinas ODI location choice based on 105 host countries panel data over 2004 to 2009. The main contribution is using Chow test to reveal the significant difference in factors determining Chinas ODI towards developed and developing host countries. Chinas ODI demonstrates resource and efficiency seeking in developing countries, while does not exhibit technology seeking in developed countries.

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