Formation and development of osteopathy as a scientific discipline

2021 ◽  
pp. 8-19
Author(s):  
Yu. O. Novikov ◽  
D. E. Mokhov ◽  
E. S. Tregubova

The formation and development of osteopathy as a scientific discipline is considered. Despite its one and a half century history, osteopathy is a relatively young medical specialty. At the same time, throughout the history of the existence of osteopathy, its supporters carried out an active search for scientific evidence of its effectiveness. Currently, osteopathy is going through the stage of scientification, its formation as a scientific discipline. However, even now even the term osteopathy itself is often interpreted quite loosely and, in some cases, tendentiously. In this regard, the purpose of this work is to trace the development of osteopathy — from the earliest works of its founders to the latest stage of development, when osteopathy has become more and more consistent with the basic requirements of evidence-based medicine. To achieve this goal, much attention is paid to all stages of the formation and development of osteopathy, both abroad and in Russia. There are considered such problems as the formation of the basic terminology, the development and change of the basic concepts of osteopathy, including the concept of osteopathic lesion and the concept of somatic dysfunctions, the development of modern methods of evidence-based medicine, the dynamics of publication activity of osteopathic researchers. It concludes that new ways of obtaining the data about the health effects of osteopathy will continue to emerge, and the level of evidence and the number of quality clinical trials are likely to change.

2021 ◽  
Vol 15 (3) ◽  
pp. 201-204
Author(s):  
Mario Herrera-Perez ◽  
David González-Martín ◽  
Javier Ruiz-Escobar ◽  
Ramón Viladot-Pericé

This study proposes an update on conservative treatment of hallux rigidus based on scientific evidence. This is a narrative review of 19 articles that analyzed conservative treatment of hallux rigidus in its different modalities. Conservative treatment is effective in approximately half of the patients with hallux rigidus, and footwear modifications, use of insoles, and hyaluronic acid injections are the most effective treatments, according to evidence-based medicine. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.


2016 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Eduardo Rocha Dias ◽  
Geraldo Bezerra da Silva Junior

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.


2016 ◽  
Author(s):  
Emily R. Winslow

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


Author(s):  
Guido Paolini ◽  
Guido Firmani ◽  
Francesca Briganti ◽  
Michail Sorotos ◽  
Fabio Santanelli di Pompeo

Abstract Background Nipple-areola complex reconstruction (NAR) most commonly represents the finishing touch to breast reconstruction (BR). Nipple presence is particularly relevant to the patient’s psyche, beyond any shadow of doubt. Many reconstructive options have been described in time. Surgery is easy, but final result is often disappointing on the long run. Methods The goal of this manuscript is to analyze and classify knowledge concerning NAR techniques and the factors that influence success, and then to elaborate a practical evidence-based algorithm. Out of the 3136 available articles as of August 8th, 2020, we selected 172 manuscripts that met inclusion criteria, which we subdivided into 5 main topics of discussion, being the various NAR techniques; patient factors (including patient selection, timing and ideal position); dressings; potential complications and finally, outcomes/patient satisfaction. Results We found 92 articles describing NAR techniques, 41 addressing patient factors (out of which 17 discussed patient selection, 14 described ideal NAC location, 10 described appropriate timing), 10 comparing dressings, 7 studying NAR complications, and 22 addressing outcomes and patient satisfaction. We elaborated a comprehensive decision-making algorithm to help narrow down the choice among NAR techniques, and choose the correct strategy according to the various scenarios, and particularly the BR technique and skin envelope. Conclusions No single NAR technique provides definitive results, which is why we believe there is no “end-all be-all solution”. NAR must be approached as a case-by-case situation. Furthermore, despite NAR being such a widely discussed topic in scientific literature, we still found a lack of clinical trials to allow for more thorough recommendations to be elaborated. Level of Evidence III This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266


2020 ◽  
pp. 86-88
Author(s):  
Bishan Basu

Evidence-Based Medicine (EBM) came into fashion nearly three decades ago. However, over this short period, this system of medical philosophy has come to dominate the medical practice worldwide. Never in the history of medicine could a single way of medical practice could dominate the healthcare systems of diverse countries like EBM did, that too within such short time span. But, it is high time we should ponder over the pros and cons of EBM and if this way of medical practice is to be allowed to continue, we should consider integration of additional inputs from the traditional ways of medicine. Though article focusses upon the cancer care, the conclusions derived can be applied to any other disciplines of healthcare.


The pursuit of tests for therapeutic interventions has been a characteristic of Western medicine since ancient times. Historical accounts of the clinical trial are usually expressed through the lens of presentism: how the various components of the first modern randomized controlled trial-the comparison, blinding, and randomization-culminated in Austin Bradford Hill’s 1946 trial of streptomycin for tuberculosis. The factual context of the development of the randomized controlled trial is important if only to emphasize the historicity of contemporary research methodology. However, the adoption of the various components of the trial at any one time has as much to do with changing the socio-political and ethical contexts as the ‘objective’ scientific standards of evidence. Evidence is not just scientific data floating in some ethereal medium, but is also linked to facts and beliefs of the various members of diverse medical communities who interpret evidence and deploy it to legitimize various strategies. This introductory chapter aims to present the background and context through which evidence-based medicine has emerged.


2005 ◽  
Vol 33 (5) ◽  
pp. 567-570 ◽  
Author(s):  
C. R. Bain ◽  
P. S. Myles

Evidence-based medicine uses a hierarchy of publication types according to their vulnerability to bias. A widely used measure of journal “quality” is its impact factor, which describes the citation rate of its publications. We investigated the relationship between impact factor for eight anaesthesia journals and publication type with respect to their level of evidence 1-4 using Spearman rank correlation (rho). There were 1418 original publications during 2001 included in the analysis. The number (%) of publication types according to evidence-based medicine level were: level 1: 6 (0.4%), level 2: 533 (38%) level 3: 329 (23%), level 4: 550 (39%). There was no correlation between journal ranking according to impact factor and publication type (rho=–0.03, P=0.25). The correlation between journal rank and the proportion of publications that were randomized trials was –0.35 (P<0.001). The correlation between journal rank and number of publications was 0.65 (P<0.001). The correlation between journal rank and number of level 1 or 2 studies was 0.58 (P<0.001). The overall level of evidence published in anaesthesia journals was high. Journal rank according to impact factor is related to the number of publications, but not the proportion of publications that are evidence-based medicine level 1 or 2.


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