scholarly journals Orthopaedic Surgical Content Associated with Resources for Clinical Evidence

2014 ◽  
Vol 34 (1) ◽  
pp. 17
Author(s):  
Sarah L Turvey ◽  
Nasir Hussain ◽  
Laura Banfield ◽  
Mohit Bhandari
Keyword(s):  
Evidence Based Medicine ◽  
Clinical Evidence ◽  
Medical Literature ◽  
Evidence Based ◽  
Surgical Interventions ◽  
Surgical Practice ◽  
Large Scope ◽  
Clinical Questions ◽  
Based Medicine ◽  
Database Content

Introduction: As evidence-based medicine is increasingly being adopted in medical and surgical practice, effective processing and interpretation of medical literature is imperative. Databases presenting the contents of medical literature have been developed; however, their efficacy merits investigation. The objective of this study was to quantify surgical and orthopaedic content within five evidence-based medicine resources: DynaMed, Clinical Evidence, UpToDate, PIER, and First Consult. Methods: We abstracted surgical and orthopaedic content from UpToDate, DynaMed, PIER, First Consult, and Clinical Evidence. We defined surgical content as that which involved surgical interventions. We classified surgical content by specialty and, for orthopaedics, by subspecialty. The amount of surgical content, as measured by the number of relevant reviews, was compared with the total number of reviews in each database. Likewise, the amount of orthopaedic content, as measured by the number of relevant reviews, was compared with the total number of reviews and the total number of surgical reviews in each database. Results: Across all databases containing a total of 13268 reviews, we identified an average of 18% surgical content. Specifically, First Consult and PIER contained 28% surgical content as a percentage of the total database content. DynaMed contained 14% and Clinical Evidence 11%, whereas UpToDate contained only 9.5% surgical content. Overall, general surgery, pediatrics, and oncology were the most common specialty areas in all databases. Discussion: Our findings suggest that the limited surgical content within these large scope resources poses difficulties for physicians and surgeons seeking answers to complex clinical questions, specifically within the field of orthopaedics. This study therefore demonstrates the potential need for, and benefit of, surgery-specific or even specialty-specific tools.

scholarly journals Answering Clinical Questions with Knowledge-Based and Statistical Techniques

2007 ◽  
Vol 33 (1) ◽  
pp. 63-103 ◽  
Author(s):  
Dina Demner-Fushman ◽  
Jimmy Lin
Keyword(s):  
Evidence Based Medicine ◽  
Information Needs ◽  
Semantic Processing ◽  
Question Answering ◽  
Clinical Medicine ◽  
Statistical Techniques ◽  
Evidence Based ◽  
Knowledge Based ◽  
Clinical Questions ◽  
Based Medicine

The combination of recent developments in question-answering research and the availability of unparalleled resources developed specifically for automatic semantic processing of text in the medical domain provides a unique opportunity to explore complex question answering in the domain of clinical medicine. This article presents a system designed to satisfy the information needs of physicians practicing evidence-based medicine. We have developed a series of knowledge extractors, which employ a combination of knowledge-based and statistical techniques, for automatically identifying clinically relevant aspects of MEDLINE abstracts. These extracted elements serve as the input to an algorithm that scores the relevance of citations with respect to structured representations of information needs, in accordance with the principles of evidence-based medicine. Starting with an initial list of citations retrieved by PubMed, our system can bring relevant abstracts into higher ranking positions, and from these abstracts generate responses that directly answer physicians' questions. We describe three separate evaluations: one focused on the accuracy of the knowledge extractors, one conceptualized as a document reranking task, and finally, an evaluation of answers by two physicians. Experiments on a collection of real-world clinical questions show that our approach significantly outperforms the already competitive PubMed baseline.

Oxford Handbook of Key Clinical Evidence

2016 ◽  
Keyword(s):  
Clinical Practice ◽  
Statistical Methods ◽  
Clinical Evidence ◽  
Trial Data ◽  
Evidence Based ◽  
Medical Studies ◽  
Surgical Practice ◽  
One Stop ◽  
Based Medicine ◽  
Selection Of

Key trials have been selected for their relevance to clinical practice, allowing the reader to quickly access some of the most fundamental issues that influence their day-to-day activities. The Handbook covers all major medical and surgical specialties, with a new section on paediatrics added for the second edition. Introductory chapters have been included on the development of evidence-based medicine, giving uninitiated readers the tools required to critically analyse and understand medical studies. Complex trials have been distilled to key relevant facts, for quick reference and understanding. This is a comprehensive one-stop shop for medical students, trainees, and clinicians of all levels that presents key information for a selection of seminal evidence that has informed medical and surgical practice. Readers are introduced to the statistical methods and tools needed to critically analyse trial data, providing a key for the terms and statistical methods encountered in the book and within clinical research as a whole. Leading figures in the major specialties have selected and summarized some of the most important trials, while analysis of the key message and impact of the trial firmly places the evidence into a practical setting for the reader. Key study features and results are examined, while the difficulties or problems associated with the trials are outlined.

scholarly journals Bipolar disorder: clinical uncertainty, evidence-based medicine and large-scale randomised trials

2001 ◽  
Vol 178 (S41) ◽  
pp. s191-s194 ◽  
Author(s):  
John Geddes ◽  
Guy Goodwin
Keyword(s):  
Bipolar Disorder ◽  
Evidence Based Medicine ◽  
Large Scale ◽  
Bipolar Affective Disorder ◽  
Research Literature ◽  
Evidence Based ◽  
Drug Treatments ◽  
Clinical Questions ◽  
Collaborative Ventures ◽  
Based Medicine

BackgroundThe increasing use of the methods of evidence-based medicine to keep up-to-date with the research literature highlights the absence of high-quality evidence in many areas in psychiatry.AimsTo outline current uncertainties in the maintenance treatment of bipolar disorder and to describe some of the decisions involved in designing a large simple trial.MethodWe describe some of the strategies of evidence-based medicine, and how they can be applied in practice, focusing specifically on the area of bipolar disorder.ResultsOne of the key clinical uncertainties in the treatment of bipolar disorder is the place of maintenance drug treatments and their relative efficacy. A large-scale study, the Bipolar Affective Disorder: Lithium Anticonvulsant Evaluation (BALANCE) trial, is proposed to compare the effectiveness of lithium, valproate and the combination of lithium and valproate.ConclusionsProviding reliable answers to key clinical questions in psychiatry will require new approaches to clinical trials. These will need to be far larger than previously appreciated and will therefore need to be collaborative ventures involving front-line clinicians.

scholarly journals EVIDENCE-BASED MEDICINE IN THE TIMES OF COVID-19: A CROSS-SECTIONAL SURVEY TO UNDERSTAND THE INDIAN PERSPECTIVE

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Karan B. Bhanushali ◽  
Nikita Gupta ◽  
Vinayak Mishra ◽  
Heena Asnani
Keyword(s):  
Decision Making ◽  
Clinical Experience ◽  
Evidence Based Medicine ◽  
Online Survey ◽  
Medical Literature ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Based Medicine

Introduction: During the COVID-19 pandemic, there is a tremendous amount of literature published regularly. In a country like India, historically, where there is a paternalistic approach to practicing medicine, there is a lot of hindrance to evidence-based medicine (EBM). Doctors have always weighed one's clinical experience superior over any other form of decision-making. This system of practice has made decision-making difficult for the physicians during this pandemic as COVID-19 is a reasonably new disease entity and the physicians lack enough 'prior experience' dealing with such a situation. Our survey tries to address the common barriers to evidence-based medical practices especially during the COVID-19 pandemic in India. We also try to explore the various source of information used by the doctors. Methods: It is a descriptive cross-sectional survey. The questions were provided in multiple-choice question format. An online survey comprising of 10 questions entitled “Hurdles faced by physicians to assimilate evidence-based guidelines on COVID-19” was made using Google Forms (Google Inc, California, US) and circulated through email to medical practitioners in the Ghatkopar (Mumbai, India) Medical Association's register from 17th June 2020 to 1st September 2020. Results: Our survey collected 213 responses, out of which 80.3% (n=171) of doctors were involved in care, counseling, or management of COVID-19 patients. The most opted primary sources for evidence-based information during this pandemic were teachings of/discussions with medical colleagues (71.4%, n=152), followed by online webinars (59.6%, n= 127) and social media (41.8%, n=89). When questioned about the main obstacles faced by them to obtain evidence-based information, the responses were as follows: Overload of medical literature (53.5%, n=114), limited access to quality resources (40.8%, n=87), unfamiliarity with the bio-statistics analysis (39%, n= 83), difficulty in locating relevant medical literature (38%, n=81), unfamiliarity with the research methodology (37.1%, n=79), lack of time (30%, n=64).  Our respondents' perspective concerning EBM attributes: 57.3% (n=122) think evidence-based practice takes their clinical experience into account. 93.4% (n=199) of them have shown an interest in broadening their skills. There was no significant difference between doctors' attitudes with less than 10 years and more than 10 years of experience (chi-square value = 0.857, p = 0.65). Conclusion: Our survey results highlight the balance maintained between evidence-based medicine and experience-based medicine by Indian physicians. They identify the importance of EBM while acknowledging its shortcomings. They realize the significance of developing their repertoire to understand, appraise, and practice EBM. Keywords: EBM, COVID-19

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