scholarly journals Epidemiology, Evidenced-Based Medicine, and Evidence-Based Public Health

1997 ◽  
Vol 7 (4) ◽  
pp. 187-197 ◽  
Author(s):  
Milos Jenicek
2017 ◽  
Vol 8 (3) ◽  
pp. 15
Author(s):  
Valerie Coppenrath

Background: An experience serving jury duty prompted reflection on the parallels between evidenced based medicine and our legal system. Findings: The steps of the legal system can be tied to each step of the practice of evidenced based medicine. Implications: Patients should be included in evidence based decisions. Pharmacists can act as resources for other providers practicing evidenced based medicine. Educators can use this analogy to teach evidence based medicine. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Commentary


2006 ◽  
Vol 25 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Isabell Purdy

Ethical treatment dilemmas are not new to the NICU. With technologic advances over the past 20 years, NICU care has developed rapidly, and survival rates have improved for some of the tiniest and most critically ill infants. In guiding clinical practice, however, standards in evidenced-based medicine have often superseded standards in evidence-based ethics. Part I of this article presents a historical review of neonatal care and an overview of cases that have set precedents in neonatal ethical debate. It also includes recommendations for enhancing the skills of neonatal nurses as patient advocates in NICU ethical issues, an area that is, at times, controversial and baffling to clinicians.


2006 ◽  
Vol 25 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Isabell Purdy ◽  
Rita Wadhwani

Ethical treatment dilemmas are not new to the NICU. With technologic advances over the past 20 years, NICU care has developed rapidly, and survival rates have improved for some of the tiniest and most critically ill infants. In guiding clinical practice, however, standards in evidenced-based medicine have often superseded standards in evidence-based ethics. Neonatal nurses attain a more in-depth understanding of the clinical significance of the four principles of bioethics: autonomy, nonmaleficence, beneficence, and justice. Case studies illustrate the principles discussed.


2021 ◽  
Author(s):  
Nobuhiro Asai ◽  
Yuichi Shibata ◽  
Daisuke Sakanashi ◽  
Arufumi Shiota ◽  
Hideo Kato ◽  
...  

Abstract BackgroundEvidenced based medicine (EBM) is necessary to standardize treatments for infections because EBM has been established based on the results of clinical trials. Since entry criteria for clinical trials are very strict, it ​may cause skepticism or question whether the results of clinical trials reflect the real world ​of medical practice.MethodsTo examine how many patients could join any randomized clinical trials for the treatment of community-onset pneumonia, we reviewed all the pneumonia patients in our institute during 2014-2017. The patients were divided into two groups: patients who were eligible for clinical trials (participation possible group), and those who were not (participation impossible group). Exclusion criteria for clinical trials were set based on previous clinical trials.ResultsA total of 406 patients were enrolled in the present study. Fifty-seven (14%) patients were categorized into the participation possible group, while 86% ​of patients belonged to the participation impossible group. Patients in the participation possible group had less comorbidities and ​more favorable outcomes than those with the participation impossible group. As for the outcomes, there were significant differences in the 30-day and in-hospital mortality rates between the two groups. In addition, the participation possible group showed a longer overall survival time than the participation impossible group (p<0.001 by Log-Rank test).ConclusionThere is a difference in patients’ profile and outcomes between clinical trials and the real world. Though EBM is essential to advance ​medicine, we should acknowledge the fact​s and the limit​s of the clinical trial.


Author(s):  
Blánaid Daly ◽  
Paul Batchelor ◽  
Elizabeth Treasure ◽  
Richard Watt

Public health is a key concern of modern dental practitioners as they continue to play a vital role in the health of populations across the world. The second edition of Essential Dental Public Health identifies the links between clinical practice and public health with a strong emphasis on evidence-based medicine. Fully revised and updated for a second edition, this textbook is split into four parts covering all the need-to-know aspects of the subject: the principles of dental public health, oral epidemiology, prevention and oral health promotion, and the governance and organization of health services. Essential Dental Public Health is an ideal introduction to the field for dentistry undergraduates, as well as being a helpful reference for postgraduates and practitioners.


2009 ◽  
Vol 24 (4) ◽  
pp. 298-305 ◽  
Author(s):  
David A. Bradt

AbstractEvidence is defined as data on which a judgment or conclusion may be based. In the early 1990s, medical clinicians pioneered evidence-based decision-making. The discipline emerged as the use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine required the integration of individual clinical expertise with the best available, external clinical evidence from systematic research and the patient's unique values and circumstances. In this context, evidence acquired a hierarchy of strength based upon the method of data acquisition.Subsequently, evidence-based decision-making expanded throughout the allied health field. In public health, and particularly for populations in crisis, three major data-gathering tools now dominate: (1) rapid health assessments; (2) population based surveys; and (3) disease surveillance. Unfortunately, the strength of evidence obtained by these tools is not easily measured by the grading scales of evidence-based medicine. This is complicated by the many purposes for which evidence can be applied in public health—strategic decision-making, program implementation, monitoring, and evaluation. Different applications have different requirements for strength of evidence as well as different time frames for decision-making. Given the challenges of integrating data from multiple sources that are collected by different methods, public health experts have defined best available evidence as the use of all available sources used to provide relevant inputs for decision-making.


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