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Mäkelä Marjukka - - 2004
This article is based on a keynote presentation at the 13th Nordic Congress in General Practice in Helsinki, Finland in September 2003. The aim was to demonstrate the strengths and limitations of evidence-based medicine (EBM) in a primary healthcare setting, and to show how and why it also can represent ...
Sinclair J C - - 2004
Three aspects of the role of clinical evidence in guiding therapy in the field of neonatology are presented: 1) what is embodied in the concept "evidence-based medicine"? 2) the contribution of the Cochrane Collaboration and its Neonatal Review Group in summarizing and disseminating evidence, in the form of systematic reviews ...
Sams Lisa - - 2004
Establishing evidence-based practice is a difficult process. The authors describe an innovative collaborative project for establishing evidence-based practice in managing pain in pediatric oncology patients. Using the project as an example, they address the theoretical foundation to support evidence-based practice, barriers to adopting evidence, and strategies for overcoming barriers.
Meeran Hanif - - 2005
The present article outlines the basic principles of Evidence Based Medicine (EBM) and how they should guide clinical practice. The evidence supporting a selection of perioperative interventions is assessed against objective criteria. Many of the perioperative interventions that have been widely adopted into clinical practice are supported by very limited ...
Elstein A S - - 2004
The aims of this paper are to identify the issues and forces that were the impetus for two recent developments in academic medicine, evidence-based medicine (EBM) and medical decision making (MDM); to make explicit their underlying similarities and differences; and to relate them to the fates of these innovations. Both ...
Schaafsma Frederieke - - 2004
OBJECTIVES: This study assessed the extent and nature of information demands among occupational health physicians and their attitude towards the application of evidence-based medicine in occupational health. METHODS: A questionnaire survey was carried out among a random sample of 159 physicians practicing occupational medicine in The Netherlands. The questionnaire investigated ...
Anderson Tanya R - - 2004
Managing violent patients is a dilemma that every clinician faces. This article reviews the current literature and assesses the evidence on the management of violent patients in the clinical setting. Risk factors (dispositional, historical, contextual and clinical) and early warning signs of violence will be outlined. Understanding these issues will ...
Viira D - - 2004
Use of the laryngeal mask airway in gynaecological laparoscopy is controversial, largely because of a concern about increased risk of regurgitation and pulmonary aspiration. The practice of evidence-based medicine provides a recommended strategy to resolve such an issue. We did a literature search and found limited evidence to support or ...
Guest J F - - 2004
In the UK, some 2.3 million people suffer cerumen ('ear wax') problems serious enough to warrant management, with approximately 4 million ears syringed annually. Impacted cerumen is a major cause of primary care consultation, and a common comorbidity in ENT patients, the elderly, infirm and people with mental retardation. Despite ...
Michie Susan - - 2004
RATIONALE, AIMS AND OBJECTIVES: This study investigates reasons why general practices achieve nationally set milestones to different extents. It compares the beliefs, self-reported behaviours and organizational context of general practitioners (GPs) who have been successful in achieving milestones set out in the UK's National Service Framework (NSF) for Coronary Heart ...
Amy R. Willis
This paper explores what, if any, identifiable differences exist in the way health care professionals and library professionals perceive the potential contributions of librarians to the practice of evidence-based medicine. The question this paper seeks to answer is: Are the actions performed by health science librarians in supporting the practice ...
Gronseth Gary S - - 2004
Despite the availability of vast quantities of evidence from basic biomedical and clinical studies, a gap often exists between the optimal practice suggested by the evidence and actual practice. For many clinical situations, however, evidence is unavailable, of poor quality or contradictory. Out of necessity, clinicians have become accustomed to ...
Hatzichristou Dimitrios - - 2004
INTRODUCTION: The optimal approach for identification and evaluation of the sexual problems in men and women in primary care or general medicine practice has not been consensed. AIM: To provide recommendations/guidelines concerning state-of-the-art knowledge for clinical evaluation and management strategies in the evaluation and treatment of sexual dysfunction in men ...
Hess Dean R - - 2004
The principles of evidence-based medicine provide the tools to incorporate the best evidence into everyday practice. Evidence-based medicine is the integration of individual clinical expertise with the best available research evidence from systematic research and the patient's values and expectations. A hierarchy of evidence can be used to assess the ...
Mulcahy John J - - 2004
INTRODUCTION: Penile prostheses, introduced as the first effective organic treatment for erectile dysfunction over three decades ago, have an important role in the treatment of erectile dysfunction when other nonprosthetic treatment options have proven unsatisfactory. Although they are the least chosen and most invasive treatment option, they have the highest ...
Manske Steve - - 2004
OBJECTIVE: Apply a "best practices" model to evidence regarding group smoking cessation to inform organizational decisions about adopting such programs. The best-practices model attempts to integrate rigorous review of evidence with context and practical considerations important to organizations contemplating adoption. DATA SOURCES: First, we identified effective practices by systematic literature ...
Ventegodt Søren - - 2004
Biomedicine focuses on the biochemistry of the body, while consciousness-based medicine--holistic medicine--focuses on the individual"s experiences and conscious whole (Greek: holos, whole). Biomedicine perceives diseases as mechanical errors at the micro level, while consciousness-based medicine perceives diseases as disturbances in attitudes, perceptions, and experiences at the macro level--in the organism ...
Meyers Wendy C - - 2004
Current health care trends and pressures have strained clinical decision making and practice patterns of practitioners. Evidence-based practice has evolved in response to these trends. Evidence-based practice requires providers to be proficient in statistical analysis and critique of the evidence. This article uses a hypothetical patient's prognostic concerns to depict ...
Michelson James - - 2004
While the goal of evidence-based medicine (EBM) is certainly laudable, it is completely based on the proposition that 'truth' can be gleaned exclusively from statistical studies. In many instances, the complexity of human physiology and pathophysiology makes this a reasonable, if not necessary, assumption. However, there are two additional large ...
Oliveri Roberto S - - 2004
RATIONALE, AIMS AND OBJECTIVES: Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM into clinical practice. METHODS: ...
Porta Massimo - - 2004
Recent years have witnessed the rising star of evidence-based medicine (EBM) as an approach towards rationalizing clinical practice in the face of an exponentially growing body of knowledge. Along with it, however, a sense of unease is rising among practising doctors, as they feel that well-intentioned principles may be increasingly ...
Vineis P - - 2004
The clinical decision is supposed to be based on evidence. In fact, what counts as evidence is far from being established. Some definition of "proof" is needed to distinguish between scientific medicine and charlatanism. My thesis is that unfortunately a clear-cut boundary between evidence and lack of evidence cannot be ...
Patterson Jo Ellen - - 2004
The purpose of this article is to integrate science into clinical practice by introducing marriage and family therapists to the ideas of evidence-based practice (EBP). Evidence-based practice, which originated in the medical field, refers to the process of using research to make clinical decisions that best meet the needs of ...
Rawlinson Mark - - 2004
Best practice in the management of indwelling catheters has been debated for many years. Proactive preventative strategies are widely considered favourable, but inevitably patients are referred with sudden, acute or unexpected non-draining catheters requiring a reactive or problem-solving response. This article considers the lack of comprehensive evidence on which nurses ...
Alberts Mark J - - 2004
Reducing the high morbidity and mortality associated with stroke continues to be a major healthcare challenge in the United States. Recent advances in the management and prevention of atherothrombotic events are significant; however, the clinical application of evidence-based "best practices" is lagging in many hospitals across the country. The "Stroke ...
Hall John - - 2004
The purpose of this paper is to enable general dental practitioners to understand how to compile an evidence-based portfolio for the MFGDP(UK) examination. The principles of evidence-based portfolios are outlined. There are six key skills that a candidate needs to understand in order to complete this portfolio. The six Key ...
Parsons Myra - - 2004
OBJECTIVE: to assess the views and practices of midwives regarding oral intake in labour for women with low-risk pregnancies. DESIGN: an exploratory survey design including open- and closed-ended questions. SETTING: four hospitals in Sydney, Australia. PARTICIPANTS: 89 practising midwives who provided care for labouring women. FINDINGS: midwives were divided on ...
Nickinovich David G - - 2004
Since 1992, the American Society of Anesthesiologists has produced 12 evidence-based practice guidelines, 2 practice advisories, and 3 guideline updates. These documents have assisted anesthesiologists and practitioners in many other specialties. Their brevity, practicality, and ease of use, coupled with a thorough and systematic evaluation of the evidence have been ...
Bernstein Joseph - - 2004
Evidence-based medicine refers to an explicit process of using and evaluating information to make medical decisions. Evidence-based medicine, perhaps contrary to popular perception, requires its users to embrace uncertainty in medical decision making because information that is simultaneously true and complete cannot be attained. Recognizing medicine's inherent uncertainty, proponents of ...
Usher Kim - - 2004
PRN, or 'as needed', medications are administered frequently by mental health nurses in psychiatric inpatient settings to manage difficult and disturbed behaviour when other strategies fail. Research indicates that approximately 50% of psychiatric inpatients receive a PRN medication at some stage of their treatment. Although evidence indicates that traditional antipsychotics ...
Steves Russell - - 2004
OBJECTIVE: To introduce the concept of evidence-based medicine (EBM) to athletic trainers. This overview provides information on how EBM can affect the clinical practice of athletic training and enhance the care given to patients. DATA SOURCES: We searched the MEDLINE and CINHAL bibliographic databases using the terms evidence-based medicine and ...
Helgason Cathy M - - 2004
The current scientific model for clinical decision-making is founded on binary or Aristotelian logic, classical set theory and probability-based statistics. Evidence-based medicine has been established as the basis for clinical recommendations. There is a problem with this scientific model when the physician must diagnose and treat the individual patient. The ...
Ownby Raymond L - - 2004
The vast amount of clinical information available today and the difficulties that clinicians have in applying this information have given rise to interest in evidence-based medicine. An additional impetus for the development of the evidence-based medicine movement has been the increasing recognition that much of medical practice is not evidence-based. ...
Johnson Gina - - 2004
BACKGROUND: Over 500 million is spent in the United Kingdom every year on over-the-counter medicines for coughs and colds. Evidence for their pharmacological efficacy is lacking. AIM: To examine lay beliefs about over-the-counter medicines for coughs and colds. To explore whether the distinction between symptom relief and cure has the ...
Rubenfeld Gordon D - - 2004
New data on the efficacy of low tidal volume ventilation for acute lung injury, noninvasive ventilation for chronic obstructive pulmonary disease exacerbation, weaning from mechanical ventilation, and prevention of ventilator-associated pneumonia provide, for perhaps the first time in respiratory care, compelling evidence for clinicians to change practice. However, experience from ...
Amarilys Zaldúa Triana
&lt;p&gt;The author analysis the current semiothic concepts of Occidental Medicine, that culminated in the idea of Medicine Based on Evidences, demonstrating that this practice improves the distance between doctor and patient. The author also recovers the concept of interview to demonstrate the importance of interaction doctor-patient.&lt;/p&gt;
Lui Hoi-Shun - - 2004
Ultra wideband (UWB) radar has been extensively investigated both theoretically and practically for the identification buried artifacts. Ground probe radar (GPR) concentrates on the identification of lightly buried land mines, unexploded ordnance (UXO) and archeological targets. The same technology is proposed in a similar context for the rapid identification of ...
Mardle Simon - - 2004
In determining the importance of criteria in the management of fisheries, two key issues stand out-the definition of a succinct set of criteria and the determination of which interest groups play a defining role in the management development process. This is indeed the case for all natural resource management problems, ...
Rycroft-Malone Joanne - - 2004
Objective: Evidence-based practice has emerged as the dominant theme of practice, policy, management, and education within the United Kingdom's National Health Service (NHS). Policy frameworks typically indicate that the implementation of evidence into practice follows a logical and rational model from production, to dissemination, and then implementation, audit, and improvement. ...
Heufelder A - - 2004
In recent years, medical practice has evolved towards greater reliance on evidence-based medicine. Societies and reimbursement agencies often publish recommendations for treatment based on literature review and trial data. Despite this, growth hormone (GH) replacement therapy in adults varies substantially from region to region. The reasons for this include differing ...
Geller M J - - 2004
Studies of Greek medicine and Babylonian medicine usually show little awareness of the richness of source material in the other discipline. The present study attempts to begin bridging the gap by showing that early Greek medicine and late Babylonian medicine had much in common, to a surprising extent. Certain early ...
Sinclair Simon - - 2004
Western medicine is a diverse social and cultural system which responds in different ways to internal and external pressures. The Evidence-Based Medicine (EBM) movement has, despite some resistance from the rofession, led to the introduction of EBM into many areas of medicine, including medical training. Using material from teaching sessions ...
Pelletier Kenneth R - - 2004
Ambulatory medicine is a frequent clinical setting where practitioners can effectively apply Mind-body interventions ranging from basic stress management therapies to the sophisticated biomedical instrumentation of clinical biofeedback. Given the rather extensive and growing body of clinical research in this area, the intent of this article is to provide an ...
Rosen Clifford J - - 2004
The diagnosis and management of osteoporosis have become increasingly more complex as new drugs enter the marketplace and meta-analyses of randomized trials with "other" agents become more prolific. We describe five common clinical scenarios encountered in the practice of osteoporosis medicine and various road maps that could lead to successful ...
Rosenthal Robert C - - 2004
Today, the busy clinician benefits from a philosophy of practice that brings together the best applicable evidence and the experiences of clinical work in an effort to provide the best care for individual patients. EBM provides a structured approach that recognizes the contributions of evidence and clinical experience. An EBM ...
Pisanelli Domenico M - - 2004
In this paper we show the usefulness of an ontological approach for solving some problems arising in medicine. We point out the relevance of terminological ontologies for disambiguating polysemous terms, for re-organizing very large corpora and detecting possible inconsistencies and for managing a catalog of bio-medical equipments. We also put ...
Dowson C A - - 2004
A considerable amount of literature has described the prevalence of anxiety in patients with the lung condition chronic obstructive pulmonary disease (COPD). Few, if any, papers have reviewed the interrelationship between anxiety symptoms and self-management interventions in this population. This is the aim of the current review. First, the review ...
Manikandan R - - 2004
OBJECTIVE: To analyse current practice in the management of acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH) in the UK, and to assess how much of this is evidence-based. METHODS: In all, 410 consultant urologists practising in UK hospitals were sent a questionnaire about the management of AUR ...
Dvorkin Lana - - 2004
Due to the growing use of herbs and dietary supplements by consumers, pharmacists now need a basic knowledge of this topic for their professional practices. To meet this need, an elective course on herbs and dietary supplements is being taught at the Massachusetts College of Pharmacy and Health Science. The ...
Yadao Melissa A - - 2004
Osteochondritis dissecans of the elbow is a localized condition of the articular surface that is commonly seen in the young athlete. This disorder refers primarily to lesions of the capitellum and can be difficult to treat. Although trauma and ischemia play significant roles, the exact etiology remains unknown. The natural ...
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