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.

Comparatively Ineffective? PCORI and the Uphill Battle to Make Evidence Count in US Medicine

2020 ◽  
Vol 45 (5) ◽  
pp. 787-800
Author(s):  
Eric M. Patashnik
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Treatment Options ◽  
Cultural Barriers ◽  
Health Care Spending ◽  
Evidence Based ◽  
Medical Evidence ◽  
Patient Centered ◽  
The Us ◽  
Based Medicine

Abstract The Patient-Centered Outcomes Research Institute (PCORI) was established as part of the Affordable Care Act to promote research on the comparative effectiveness of treatment options. Advocates hoped this information would help reduce wasteful spending by identifying low-value treatments, but many conservatives and industry groups feared PCORI would ration care and threaten physicians' autonomy. PCORI faced three challenges during its first decade of operation: overcoming the controversy of its birth and escaping early termination, shaping medical practice, and building a public reputation for relevance. While PCORI has won reauthorization, it has not yet had a major impact on the decisions of clinicians or payers. PCORI's modest footprint reflects not only the challenges of getting a new organization off the ground but also the larger political, financial, and cultural barriers to the uptake of medical evidence in the US health care system. The growing attention among policymakers and researchers to provider prices (rather than utilization) as the driver of health care spending could be helpful to the political prospects of the evidence-based medicine project by making it appear to be less as rationing driven by costs and more as an effort to improve quality and uphold medical professionalism.

Será que estamos precisando de uma lava jato científica?

2019 ◽  
Vol 18 (1) ◽  
pp. 1
Author(s):  
Antonio Marcos Andrade
Keyword(s):  
Health Care ◽  
Medical Journal ◽  
British Medical Journal ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Plos Medicine ◽  
De Se ◽  
Research Findings ◽  
Based Medicine ◽  
Published Research

Em 2005, o grego John Loannidis, professor da Universidade de Stanford, publicou um artigo na PLOS Medicine intitulado “Why most published research findings are false” [1]. Ele que é dos pioneiros da chamada “meta-ciência”, disciplina que analisa o trabalho de outros cientistas, avaliou se estão respeitando as regras fundamentais que definem a boa ciência. Esse trabalho foi visto com muito espanto e indignação por parte dos pesquisadores na época, pois colocava em xeque a credibilidade da ciência.Para muitos cientistas, isso acontece porque a forma de se produzir conhecimento ficou diferente, ao ponto que seria quase irreconhecível para os grandes gênios dos séculos passados. Antigamente, se analisavam os dados em estado bruto, os autores iam às academias reproduzir suas experiências diante de todos, mas agora isso se perdeu porque os estudos são baseados em seis milhões de folhas de dados. Outra questão importante que garantia a confiabilidade dos achados era que os cientistas, independentemente de suas titulações e da relevância de suas descobertas anteriores, tinham que demonstrar seus novos achados diante de seus pares que, por sua vez, as replicavam em seus laboratórios antes de dar credibilidade à nova descoberta. Contudo, na atualidade, essas garantias veem sendo esquecidas e com isso colocando em xeque a validade de muitos estudos na área de saúde.Preocupados com a baixa qualidade dos trabalhos atuais, um grupo de pesquisadores se reuniram em 2017 e construíram um documento manifesto que acabou de ser publicado no British Medical Journal “Evidence Based Medicine Manifesto for Better Health Care” [2]. O Documento é uma iniciativa para a melhoria da qualidade das evidências em saúde. Nele se discute as possíveis causas da pouca confiabilidade científica e são apresentadas algumas alternativas para a correção do atual cenário. Segundo seus autores, os problemas estão presentes nas diferentes fases da pesquisa:Fases da elaboração dos objetivos - Objetivos inúteis. Muito do que é produzido não tem impacto científico nem clínico. Isso porque os pesquisadores estão mais interessados em produzir um número grande de artigos do que gerar conhecimento. Quase 85% dos trabalhos não geram nenhum benefício direto a humanidade.Fase do delineamento do estudo - Estudos com amostras subdimensionados, que não previnem erros aleatórios. Métodos que não previnem erros sistemáticos (viés na escolha das amostras, falta de randomização correta, viés de confusão, desfechos muito abertos). Em torno de 35% dos pesquisadores assumem terem construídos seus métodos de maneira enviesada.Fase de análise dos dados - Trinta e cinco por cento dos pesquisadores assumem práticas inadequadas no momento de análise dos dados. Muitos assumem que durante esse processo realizam várias análises simultaneamente, e as que apresentam significância estatística são transformadas em objetivos no trabalho. As revistas também têm sua parcela de culpa nesse processo já que os trabalhos com resultados positivos são mais aceitos (2x mais) que trabalhos com resultados negativos.Fase de revisão do trabalho - Muitos revisores de saúde não foram treinados para reconhecer potenciais erros sistemáticos e aleatórios nos trabalhos.Em suma é necessário que pesquisadores e revistas científicas pensem nisso. Só assim, teremos evidências de maior qualidade, estimativas estatísticas adequadas, pensamento crítico e analítico desenvolvido e prevenção dos mais comuns vieses cognitivos do pensamento.

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 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.

scholarly journals INTERNATIONAL EXPERIENCE OF PUBLIC ADMINISTRATION OF PRODUCTION AND TURNOVER OF MEDICINES IN UKRAINE

2020 ◽  
pp. 151-159
Author(s):  
Л. В. Котенко
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Public Administration ◽  
International Cooperation ◽  
International Organizations ◽  
Good Manufacturing Practice ◽  
International Experience ◽  
Iso 9001 ◽  
Regulatory Bodies

The article forms the international experience of public administration of production and circulation of medicines in Ukraine. The role of international organizations in maintaining the health of the nation, increasing the level of labor productivity, as well as the quality and life expectancy of people is studied. The leaders of the European market of drug manufacturers have been identified. The international standard ISO 9001 and features of introduction of good manufacturing practice (GMP) are analyzed. The international cooperation for the regulatory bodies of the WHO member states is described in order to discuss ways to strengthen cooperation in the field of health care.

scholarly journals EVIDENCE-BASED MEDICINE AS A MODERN METHODOLOGY IN HEALTH CARE

2018 ◽  
Vol 4 ◽  
pp. 160 ◽  
Author(s):  
H. Yu. Morokhovets ◽  
Yu. V. Lysanets ◽  
O. V. Silkova ◽  
L. Y. Ostrovska ◽  
T. Y. Purdenko
Keyword(s):  
Health Care ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Based Medicine
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