Achieving Evidence-Based Practices in Colorectal Surgery

2014 ◽  
Author(s):  
Imran Hassan
Keyword(s):  
Colorectal Surgery ◽  
Evidence Based Medicine ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
The Past ◽  
Hierarchy Of Evidence ◽  
Evidence Based Surgery ◽  
Key Resources ◽  
Based Medicine

The concept of evidence-based medicine (EBM) and evidence-based surgery (EBS) involves combining the best scientific evidence available with the clinician’s judgment while also considering the patient’s needs and preferences. In the past, the practice of colorectal surgery was based on tradition and anecdotal experience from experts rather than scientific rationale. However, the rise of EBM has led to changes in how colorectal surgery is performed. This review discusses the hierarchy of evidence, fundamental principles of EBS, and practicing evidence-based colorectal surgery. Tables review the Oxford Centre for Evidence-Based Medicine revised levels of evidence, four steps of evidence-based surgery, key resources for evidence-based surgery, the “PICO” technique, and the Dindo-Clavien classification system. This review contains 5 tables and 69 references.

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

Evidence-Based Medicine

2015 ◽  
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

scholarly journals Evidence-Based Medicine in judicial decisions concerning right to healthcare

2016 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Eduardo Rocha Dias ◽  
Geraldo Bezerra da Silva Junior
Keyword(s):  
Health Insurance ◽  
Evidence Based Medicine ◽  
Private Health Insurance ◽  
Scientific Evidence ◽  
Federal Court ◽  
Public Healthcare ◽  
Evidence Based ◽  
Unified Health System ◽  
The Individual ◽  
Based Medicine

ABSTRACT Objective To analyze, from the examination of decisions issued by Brazilian courts, how Evidence-Based Medicine was applied and if it led to well-founded decisions, searching the best scientific knowledge. Methods The decisions made by the Federal Courts were searched, with no time limits, at the website of the Federal Court Council, using the expression “Evidence-Based Medicine”. With regard to decisions issued by the court of the State of São Paulo, the search was done at the webpage and applying the same terms and criterion as to time. Next, a qualitative analysis of the decisions was conducted for each action, to verify if the patient/plaintiff’s situation, as well as the efficacy or inefficacy of treatments or drugs addressed in existing protocols were considered before the court granted the provision claimed by the plaintiff. Results In less than one-third of the decisions there was an appropriate discussion about efficacy of the procedure sought in court, in comparison to other procedures available in clinical guidelines adopted by the Brazilian Unified Health System (Sistema Único de Saúde) or by private health insurance plans, considering the individual situation. The majority of the decisions involved private health insurance plans (n=13, 68%). Conclusion The number of decisions that did consider scientific evidence and the peculiarities of each patient was a concern. Further discussion on Evidence-Based Medicine in judgments involving public healthcare are required.

Unhealthy Politics

2020 ◽  
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
United States ◽  
Health Care ◽  
Scientific Evidence ◽  
The United States ◽  
Evidence Base ◽  
Medical Industry ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Delivery Of Medical Care ◽  
Based Medicine

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. This book sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. The book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor's orders.” It offers vital insights into the limits of science, expertise, and professionalism in American politics. The book explains why evidence-based medicine is important. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.

Using Science-Based Guidelines to Shape Public Health Law

2003 ◽  
Vol 31 (S4) ◽  
pp. 65-67 ◽  
Author(s):  
Stephanie Zaza ◽  
John Clymer ◽  
Linda Upmeyer ◽  
Stephen B. Thacker
Keyword(s):  
Public Health ◽  
Evidence Based Medicine ◽  
Scientific Literature ◽  
Scientific Information ◽  
Scientific Article ◽  
Evidence Based ◽  
Health Law ◽  
The Past ◽  
Different Types ◽  
Based Medicine

Compared to evidence-based public health, evidence-based medicine is a more familiar phrase. Evidence-based medicine has become increasingly popular in the past decade, due in large part to the emergence of computerized database search technology and advanced statistical tools which allow researchers to quickly identify and summarize vast amounts of scientific information.Today, the concept of evidence-based public health is gaining momentum and has grown in popularity. However, the term “evidence-based” lacks clarification and is subject to a variety of interpretations. The evidence that supports evidence-based medicine or public health may include individual experience, anecdotal information, the content of a single scientific article, or the results of a sophisticated systematic review of scientific literature. The imprecise language used to describe evidence leads to confusion over what types of evidence are most appropriate in answering different types of questions.

scholarly journals COVID-19: The Impact on Cardiovascular System

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1691
Author(s):  
Jozica Šikić ◽  
Zrinka Planinić ◽  
Vid Matišić ◽  
Tea Friščić ◽  
Vilim Molnar ◽  
...  
Keyword(s):  
Cardiovascular System ◽  
Evidence Based Medicine ◽  
Patient Monitoring ◽  
Scientific Literature ◽  
Careful Consideration ◽  
Evidence Based ◽  
The Past ◽  
Multidisciplinary Nature ◽  
Based Medicine ◽  
The Impact

SARS-CoV-2 has been circulating in population worldwide for the past year and a half, and thus a vast amount of scientific literature has been produced in order to study the biology of the virus and the pathophysiology of COVID-19, as well as to determine the best way to prevent infection, treat the patients and eliminate the virus. SARS-CoV-2 binding to the ACE2 receptor is the key initiator of COVID-19. The ability of SARS-CoV-2 to infect various types of cells requires special attention to be given to the cardiovascular system, as it is commonly affected. Thorough diagnostics and patient monitoring are beneficial in reducing the risk of cardiovascular morbidity and to ensure the most favorable outcomes for the infected patients, even after they are cured of the acute disease. The multidisciplinary nature of the fight against the COVID-19 pandemic requires careful consideration from the attending clinicians, in order to provide fast and reliable treatment to their patients in accordance with evidence-based medicine principles. In this narrative review, we reviewed the available literature on cardiovascular implications of COVID-19; both the acute and the chronic.

Introduction

2020 ◽  
pp. 1-20
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
United States ◽  
Health Care ◽  
Resource Allocation ◽  
Scientific Evidence ◽  
The United States ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Delivery Of Medical Care ◽  
Based Medicine

This introductory chapter explains why evidence-based medicine is important. The sluggish incorporation of medical evidence into clinical practice is a concern for three key reasons: safety, quality, and the efficiency of resource allocation. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.

Adoption of Evidence-Based Medicine in Clinical Laboratory Science: A Survey of the Prevalence of Systematic and Narrative Reviews

2018 ◽  
Vol 50 (3) ◽  
pp. 223-228
Author(s):  
Lauren N Pearson ◽  
Robert L Schmidt
Keyword(s):  
Evidence Based Medicine ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Critical Role ◽  
Publication Rate ◽  
Evidence Based ◽  
Clinical Laboratory Science ◽  
Laboratory Science ◽  
The Past ◽  
Based Medicine

Abstract Background Systematic reviews (SRs) play a critical role in evidence-based medicine. Objective To determine the publication trends of SRs in clinical laboratory science (CLS). Methods We searched Scopus to identify all reviews published in the top 20 CLS journals during the past 10 years (2008–2017). We determined year of publication, review type (systematic vs narrative), citations, and whether the review was accompanied by a meta-analysis (MA). Results We identified 2934 reviews. Of these, 2833 (96.6%) were narrative reviews, and 98 (3.3%) were SRs. A total of 67 (66.3%) of the SRs were accompanied by a MA. Three journals accounted for 68 of 98 (69.4%) SRs. The percentage of SRs (relative to all reviews) has increased during the past decade (P = .01). SRs were more frequently published in high-impact journals (P <.001). Conclusion The publication rate of SRs in CLS journals has increased during the past decade.

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