scholarly journals Is There a Consensus when Physicians Evaluate the Relevance of Retrieved Systematic Reviews?

2016 ◽  
Vol 55 (03) ◽  
pp. 292-298 ◽  
Author(s):  
Dympna O’Sullivan ◽  
Craig Kuziemsky ◽  
Wojtek Michalowski ◽  
Ken Farion ◽  
Bartosz Kukawka ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Clinical Setting ◽  
Contextual Factors ◽  
Clinical Information ◽  
Pediatric Emergency ◽  
Emergency Physicians ◽  
Web Based ◽  
Case Vignettes ◽  
Study Participants ◽  
Based Medicine

SummaryBackground: A significant challenge associated with practicing evidence-based medicine is to provide physicians with relevant clinical information when it is needed. At the same time it appears that the notion of relevance is subjective and its perception is affected by a number of contextual factors.Objectives: To assess to what extent physi -cians agree on the relevance of evidence in the form of systematic reviews for a common set of patient cases, and to identify possible contextual factors that influence their perception of relevance.Methods: A web-based survey was used where pediatric emergency physicians from multiple academic centers across Canada were asked to evaluate the relevance of systematic reviews retrieved automatically for 14 written case vignettes (paper patients). The vignettes were derived from prospective data describing pediatric patients with asthma exacerbations presenting at the emer gency department. To limit the cognitive burden on respondents, the number of reviews associated with each vignette was limited to three.Results: Twenty-two academic emergency physicians with varying years of clinical practice completed the survey. There was no consensus in their evaluation of relevance of the retrieved reviews and physicians’ assessments ranged from very relevant to irrelevant evidence, with the majority of evaluations being somewhere in the middle. This indicates that the study participants did not share a notion of relevance uniformly. Further analysis of commentaries provided by the physicians allowed identifying three possible contextual factors: expected speci ficity of evidence (acute vs chronic condition), the terminology used in the systematic reviews, and the micro environment of clinical setting.Conclusions: There is no consensus among physicians with regards to what constitutes relevant clinical evidence for a given patient case. Subsequently, this finding suggests that evidence retrieval systems should allow for deep customization with regards to physi -cian’s preferences and contextual factors, including differences in the micro environment of each clinical setting.

scholarly journals Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

2021 ◽  
pp. 153473462110118
Author(s):  
Anna Eleftheriou ◽  
Aikaterini Rokou ◽  
Christos Argyriou ◽  
Nikolaos Papanas ◽  
George S. Georgiadis
Keyword(s):  
Medical Education ◽  
Clinical Training ◽  
Medical Training ◽  
Medical Schools ◽  
Web Based ◽  
Clinical Exposure ◽  
Virtual Teaching ◽  
Based Medicine ◽  
The Impact

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

scholarly journals Heart rate variability as a strain indicator for psychological stress for emergency physicians during work and alert intervention: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Beatrice Thielmann ◽  
Robert Pohl ◽  
Irina Böckelmann
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Systematic Reviews ◽  
Web Of Science ◽  
Meta Analysis ◽  
Emergency Physicians ◽  
Inclusion Criteria ◽  
Objective Monitoring ◽  
Prisma Statement ◽  
Health Studies

Abstract Background The workloads of emergency physicians are severe. The prevalence of burnout among emergency physicians is higher than with other physicians or compared to the general population. The analysis of heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this paper is to systematically evaluate the literature on heart rate variability as an objective indicator for mental stress of emergency physicians. Methods A systematic literature review examining heart rate variability of emergency physicians in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. PubMed, Ovid, Cochrane Libary, Scopus, and Web of Science electronic databases were used. The methodological quality was evaluated by using a modified STARD for HRV. Results Two studies matched the inclusion criteria by using HRV between alert intervention and two other studies were considered that used HRV in other question areas. It showed an adaptation of HRV under stress. The studies were not comparable. Conclusions There is a need for occupational health studies that examine strains and stress of emergency physicians. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress.

Thoth: A Web-based Tool to Support Systematic Reviews

2019 ◽  
Author(s):  
Luciano Marchezan ◽  
Guilherme Bolfe ◽  
Elder Rodrigues ◽  
Maicon Bernardino ◽  
Fabio Paulo Basso
Keyword(s):  
Systematic Reviews ◽  
Web Based

scholarly journals Emergency physicians’ attitudes and perceived barriers to the implementation of take-home naloxone programs in Canadian emergency departments

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Lauren Lacroix ◽  
Lisa Thurgur ◽  
Aaron M. Orkin ◽  
Jeffrey J. Perry ◽  
Ian G. Stiell
Keyword(s):  
At Risk ◽  
Perceived Barriers ◽  
Face Validity ◽  
Opioid Overdose ◽  
Emergency Physicians ◽  
Web Based ◽  
Health Crisis ◽  
Canadian Association ◽  
National Public Health

AbstractObjectivesRates of opioid-related deaths have reached the level of national public health crisis in Canada. Community-based opioid overdose education and naloxone distribution (OEND) programs distribute naloxone to people at risk, and the emergency department (ED) may be an underutilized setting to deliver naloxone to these people. The goal of this study was to identify Canadian emergency physicians’ attitudes and perceived barriers to the implementation of take-home naloxone programs.MethodsThis was an anonymous Web-based survey of members of the Canadian Association of Emergency Physicians. Survey questions were developed by the research team and piloted for face validity and clarity. Two reminder emails were sent to non-responders at 2-week intervals. Respondent demographics were collected, and Likert scales were used to assess attitudes and barriers to the prescription of naloxone from the ED.ResultsA total of 459 physicians responded. The majority of respondents were male (64%), worked in urban tertiary centres (58.3%), and lived in Ontario (50.6%). Overall, attitudes to OEND were strongly positive; 86% identified a willingness to prescribe naloxone from the ED. Perceived barriers included support for patient education (57%), access to follow-up (44%), and inadequate time (37%). In addition to people at risk of overdose, 77% of respondents identified that friends and family members may also benefit.ConclusionsCanadian emergency physicians are willing to distribute take-home naloxone, but thoughtful systems are required to facilitate opioid OEND implementation. These data will inform the development of these programs, with emphasis on multidisciplinary training and education.

The Usage of Evidence-Based Dentistry among Postgraduate Student of Isfahan University of Medical Sciences

2021 ◽  
Author(s):  
Firoozeh Nilchian ◽  
Reza Rezaee
Keyword(s):  
Personal Characteristics ◽  
Evidence Based ◽  
Medical Sciences ◽  
Clinical Teachers ◽  
Good Opportunity ◽  
Distribution Of Resources ◽  
Information Exploration ◽  
Study Participants ◽  
Based Medicine ◽  
Evidence Based Dentistry

Introduction: Our current era is the age of information exploration and innovation that has given us a good opportunity to use evidence-based information, so this study aimed to evaluate the use of Evidence-Based Dentistry in Isfahan Dental School in 2018. Materials & Methods: The sampling method of this study was census and, the number of faculty assistants was 50. The method of collecting this information was through a questionnaire Regarding fulfillment of ethical manners in this study, participants were not required to mention their names and personal characteristics, and only if they consented participate in the study, a questionnaire was provided to them. Man withny analysis and Spear man correlation were used to evaluate the relation between EBD (Evidence Based Dentistry) according to their gender. Results: In the current evaluation, it was observed that 19 dentists (36.5%) were female and 33 (63.5%) were male. Most residents (63.5%) sometimes use evidence-based dentistry, 11 cases (21.2%) rarely and 8 cases (15.3%) using this technique always. About the frequency distribution of resources used by residents to answer questions in dealing with patients, the highest frequency (65.4%) was related to “textbooks or questions from clinical teachers” as well as “translated reference books” and the least Frequency (13.5%) was related to “Search other databases”. Conclusion: Based on the findings in this section, the use of evidence-based medicine among residents is low.

Towards systematic reviews that inform health care management and policy-making

2005 ◽  
Vol 10 (1_suppl) ◽  
pp. 35-48 ◽  
Author(s):  
John Lavis ◽  
Huw Davies ◽  
Andy Oxman ◽  
Jean-Louis Denis ◽  
Karen Golden-Biddle ◽  
...  
Keyword(s):  
Health Care ◽  
Systematic Reviews ◽  
Policy Making ◽  
Care Management ◽  
Contextual Factors ◽  
Health Care Management ◽  
Health Care Managers ◽  
Executive Summary ◽  
Policy Makers ◽  
Care Managers

Objectives To identify ways to improve the usefulness of systematic reviews for health care managers and policy-makers that could then be evaluated prospectively. Methods We systematically reviewed studies of decision-making by health care managers and policy-makers, conducted interviews with a purposive sample of them in Canada and the United Kingdom (n=29), and reviewed the websites of research funders, producers/purveyors of research, and journals that include them among their target audiences (n=45). Results Our systematic review identified that factors such as interactions between researchers and health care policy-makers and timing/timeliness appear to increase the prospects for research use among policy-makers. Our interviews with health care managers and policy-makers suggest that they would benefit from having information that is relevant for decisions highlighted for them (e.g. contextual factors that affect a review's local applicability and information about the benefits, harms/risks and costs of interventions) and having reviews presented in a way that allows for rapid scanning for relevance and then graded entry (such as one page of take-home messages, a three-page executive summary and a 25-page report). Managers and policy-makers have mixed views about the helpfulness of recommendations. Our analysis of websites found that contextual factors were rarely highlighted, recommendations were often provided and graded entry formats were rarely used. Conclusions Researchers could help to ensure that the future flow of systematic reviews will better inform health care management and policy-making by involving health care managers and policy-makers in their production and better highlighting information that is relevant for decisions. Research funders could help to ensure that the global stock of systematic reviews will better inform health care management and policy-making by supporting and evaluating local adaptation processes such as developing and making available online more user-friendly ‘front ends’ for potentially relevant systematic reviews.

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