scholarly journals Keeping up with Best Evidence: What Resources are Available?

2012 ◽  
Vol 46 (1) ◽  
pp. 4-7 ◽  
Author(s):  
Nasir Hussain ◽  
Mohit Bhandari ◽  
Sarah Turvey
Keyword(s):  
Evidence Based Medicine ◽  
Healthcare Professionals ◽  
Point Of Care ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Medical Journals ◽  
Orthopedic Surgeons ◽  
Allied Healthcare ◽  
Based Medicine ◽  
Quality Evidence

ABSTRACT Evidence-based medicine (EBM) teaches physicians to base their decisions and actions on the best available scientific evidence in conjunction with their own expertise and the patient's values and preferences; however, this can be very time consuming as a one has to stay current and up-to-date with the most recent evidence. Several point-of-care databases, such as Up To Date and Dynamed, have been developed that distill the contents of medical journals into summaries with guidelines for practice in order to aid in EBM approach, but these also come with various limitations. Due to this, tools specific to surgical specialties are now beginning to be developed that systematically collect, appraise and summarize top quality evidence. One such tool is Ortho Evidence, which is an openaccess tool for orthopedic surgeons, researchers and allied healthcare professionals. How to cite this article Hussain N, Turvey S, Bhandari M. Keeping up with Best Evidence: What Resources are Available? J Postgrad Med Edu Res 2012;46(1):4-7.

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.

scholarly journals Validity and reliability of the Noor Evidence-Based Medicine Questionnaire: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249660
Author(s):  
Mohd Noor Norhayati ◽  
Zanaridah Mat Nawi
Keyword(s):  
Evidence Based Medicine ◽  
Healthcare Professionals ◽  
High Reliability ◽  
Internal Consistency Reliability ◽  
Evidence Based ◽  
Validity And Reliability ◽  
Cronbach’S Alpha ◽  
Cross Sectional ◽  
Cronbach's Alpha ◽  
Based Medicine

Background Evidence-based medicine (EBM) is a widely accepted scientific advancement in clinical settings that helps achieve better, safer, and more cost-effective healthcare. However, presently, validated instruments to evaluate healthcare professionals’ attitude and practices toward implementing EBM are not widely available. Therefore, the present study aimed to determine the validity and reliability of a newly developed knowledge, attitude, and practice (KAP) questionnaire on EBM for use among healthcare professionals. Methods The Noor Evidence-Based Medicine Questionnaire was tested among physicians in a government hospital between July and August 2018. Exploratory factor analysis and internal consistency reliability-based Cronbach’s alpha statistic were conducted. Results The questionnaire was distributed among 94 physicians, and 90 responded (response rate of 95.7%). The initial number of items in the KAP domains of the Noor Evidence-Based Medicine Questionnaire were 15, 17, and 13, respectively; however, two items in the practice domain with communalities <0.25 and factor loadings <0.4 were removed. The factor structure accounted for 52.33%, 66.29%, and 55.39% of data variance in the KAP domains, respectively. Cronbach’s alpha values were 0.81, 0.81, and 0.84 for KAP domains, respectively, indicating high reliability. Conclusions This questionnaire can be used to evaluate the knowledge, attitudes, and behaviour of healthcare professionals toward EBM. Future testing of this questionnaire among other medical personnel groups will help expand the scope of this tool.

Evidence-Based Medicine for Orthopedic Surgeons

2010 ◽  
Vol 18 (01) ◽  
pp. 57-63 ◽  
Author(s):  
John Kuhn ◽  
Warren Dunn ◽  
Kurt Spindler
Keyword(s):  
Evidence Based Medicine ◽  
Evidence Based ◽  
Orthopedic Surgeons ◽  
Based Medicine

scholarly journals Nudging healthcare professionals towards evidence-based medicine: A systematic scoping review

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Rosanna Nagtegaal ◽  
Lars Tummers ◽  
Mirko Noordegraaf ◽  
Victor Bekkers
Keyword(s):  
Scoping Review ◽  
Evidence Based Medicine ◽  
Methodological Quality ◽  
Healthcare Professionals ◽  
Information Overload ◽  
Reference Points ◽  
Future Research ◽  
Evidence Based ◽  
Social Reference ◽  
Based Medicine

Translating medical evidence into practice is difficult. Key challenges in applying evidence-based medicine are information overload and that evidence needs to be used in context by healthcare professionals. Nudging (i.e. softly steering) healthcare professionals towards utilizing evidence-based medicine may be a feasible possibility. This systematic scoping review is the first overview of nudging healthcare professionals in relation to evidence-based medicine. We have investigated a) the distribution of studies on nudging healthcare professionals, b) the nudges tested and behaviors targeted, c) the methodological quality of studies and d) whether the success of nudges is related to context. In terms of distribution, we found a large but scattered field: 100 articles in over 60 different journals, including various types of nudges targeting different behaviors such as hand hygiene or prescribing drugs. Some nudges – especially reminders to deal with information overload – are often applied, while others - such as providing social reference points – are seldom used. The methodological quality is moderate. Success appears to vary in terms of three contextual characteristics: the task, organizational, and occupational contexts. Based on this review, we propose future research directions, particularly related to methods (preregistered research designs to reduce publication bias), nudges (using less-often applied nudges on less studied outcomes), and context (moving beyond one-size-fits-all approaches).

scholarly journals Understanding medical student evidence-based medicine information seeking in an authentic clinical simulation

2020 ◽  
Vol 108 (2) ◽  
Author(s):  
Joey Nicholson ◽  
Adina Kalet ◽  
Cees Van der Vleuten ◽  
Anique De Bruin
Keyword(s):  
Medical Students ◽  
Evidence Based Medicine ◽  
Information Seeking ◽  
Point Of Care ◽  
Evidence Based ◽  
Clinical Question ◽  
Common Information ◽  
Clinical Scenarios ◽  
Objective Evidence ◽  
Based Medicine

Objective: Evidence-based medicine practices of medical students in clinical scenarios are not well understood. Optimal foraging theory (OFT) is one framework that could be useful in breaking apart information-seeking patterns to determine effectiveness and efficiency of different methods of information seeking. The aims of this study were to use OFT to determine the number and type of resources used in information seeking when medical students answer a clinical question, to describe common information-seeking patterns, and identify patterns associated with higher quality answers to a clinical question.Methods: Medical students were observed via screen recordings while they sought evidence related to a clinical question and provided a written response for what they would do for that patient based on the evidence that they found.Results: Half (51%) of study participants used only 1 source before answering the clinical question. While the participants were able to successfully and efficiently navigate point-of-care tools and search engines, searching PubMed was not favored, with only half (48%) of PubMed searches being successful. There were no associations between information-seeking patterns and the quality of answers to the clinical question.Conclusion: Clinically experienced medical students most frequently relied on point-of-care tools alone or in combination with PubMed to answer a clinical question. OFT can be used as a framework to understand the information-seeking practices of medical students in clinical scenarios. This has implications for both teaching and assessment of evidence-based medicine in medical students.

Evidence-based medicine

2017 ◽  
Author(s):  
Philip Wiffen ◽  
Marc Mitchell ◽  
Melanie Snelling ◽  
Nicola Stoner
Keyword(s):  
Evidence Based Medicine ◽  
Binary Data ◽  
Statistical Significance ◽  
Number Needed To Treat ◽  
Evidence Based ◽  
High Quality ◽  
Relative Risks ◽  
High Quality Evidence ◽  
Based Medicine ◽  
Quality Evidence

This chapter provides a brief overview to the concept of evidence-based medicine (EBM) starting with a well-accepted definition. The importance of clinical significance over statistical significance is discussed. A number of useful tools are presented and described to enable the practitioner to become competent in recognizing high-quality evidence and to have the skills to critically appraise evidence that is potentially important to their practice. There is a brief description of some of the statistical tools commonly used in EBM including binary data tools such as odds ratios, number needed to treat, and relative risks.

Consensus on evidence-based medicine curriculum contents for healthcare schools in Brazil

2021 ◽  
pp. bmjebm-2020-111397
Author(s):  
Gabriela Andrade Araujo ◽  
Luis Claudio Lemos Correia ◽  
Julia Rodrigues Siqueira ◽  
Leandro Calazans Nogueira ◽  
Ney Meziat-Filho ◽  
...  
Keyword(s):  
Evidence Based Medicine ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Expert Panel ◽  
Evidence Based ◽  
Moderate Degree ◽  
Online Questionnaire ◽  
The Mean ◽  
Based Medicine ◽  
Total Workload

ObjectivesHealthcare professionals need to take into account their knowledge, skills and attitudes to develop a focused clinical question, perform an effective search of the literature, critically appraise the evidence, and apply to the clinical context and evaluate the effectiveness of the process. To date, there is a lack of consensus on evidence-based medicine (EBM) curriculum for undergraduate healthcare students in Brazil. The aim of this study was to develop a consensus on EBM curriculum contents for healthcare schools in Brazil considering expert opinion.DesignModified three-round Delphi methodology.SettingOnline survey.ParticipantsThe expert panel was composed of 40 healthcare professionals from different specialties. Most of the participants (n=24; 60%) were female with the age between 30 and 44 years. Participants were also experts in the field of epidemiology, biostatistics or public health. The mean experience of experts in teaching EBM was 9.5 years.Main outcome measuresAn online questionnaire consisting of 89 items related to EBM was sent to the experts. The experts ranked each item of EBM curriculum considering the importance of each item as omitted, mentioned, explained or practised. The last section of the questionnaire was composed of ‘additional content’ where the experts evaluated only if an item should be included or not, the form of offering the EBM contents and the total workload (in hours/semester). Open-ended questions were present in each section to give the opportunity to experts to insert suggestions. Items that reached values greater than or equal to 70% of agreement among experts was considered definitive for the curriculum. Items between 51% and 69% of agreement were included for the next round and those items with less than or equal to 50% of agreement were considered unnecessary and were excluded. In the third round, the EBM contents were classified according to the degree of consensus as follow: strong (≥70% of agreement), moderate (51%–69% of agreement) and weak (50% of agreement) based on the maximum consensus reached.ResultsOf the 89 initial contents, 32 (35.9%) reached a strong degree of consensus, 23 (25.8%) moderate degree of consensus, two (2.2%) weak degree of consensus and 35 items were not recommended (≤50% of agreement). The workload suggested by experts should be between 61 and 90 hour/semester and an EBM curriculum should be offered with epidemiology and biostatistics as prerequisites. Regarding the importance of each item, 29 (72.5%) should be explained and 25 (27.5%) should be practised with exercises.ConclusionsThe consensus on an EBM curriculum for Brazilian healthcare schools consists of 54 items. This EBM curriculum also presents the degree of consensus (strong, moderate and weak), the importance of each item (mentioned, explained and practised with exercises). A total workload of between 60 and 90 hours per semester was suggested and the EBM curriculum should be offered with epidemiology and biostatistics as prerequisites, but also EBM contents should be included within other disciplines throughout the entire undergraduate course.

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