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Dahm Philipp - - 2009
PURPOSE: We investigated the attitudes and opinions of urologists toward evidence-based medicine to help guide future efforts of the American Urological Association and other organizations vested in the education and training of urologists. MATERIALS AND METHODS: From August to November 2006 we performed a mail survey of a random sample ...
Curlin Farr A - - 2008
A growing literature on the religious characteristics of health care professionals raises questions about how clinicians' religious traditions and commitments shape their clinical practices. Because medicine is a moral practice, theological and philosophical ideas are operative in any self-conscious application of medical science. As such, disagreements about morally controversial medical ...
Bisson Jonathan I - - 2008
Despite ongoing gaps in our knowledge, there is now considerable research evidence available to inform clinical decisions and treatment plans shortly after traumatic events. The author uses two fictional cases to illustrate an evidence-based approach to clinical management following traumatic events. The importance of fully assessing individuals and tailoring management ...
Wing Deborah A - - 2008
OBJECTIVE: To estimate the current scope of practice and evaluate the experience in training of maternal-fetal medicine specialists in the United States. METHODS: We administered an Internet-based, 16-question survey of 1,764 members of the Society for Maternal-Fetal Medicine, inquiring about aspects of fellowship training and scope of practice after completion ...
Visser K - - 2009
To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders. 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007-8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in ...
Geltzer Anna - - 2009
This paper examines the uses of evidence-based medicine (EBM) in post-Soviet Russia through the use of semi-structured interviews. It asks what it means to talk about practicing evidence-based medicine in a setting where the context of practice presents considerable barriers to the implementation of EBM principles. Drawing on interviews with ...
Tabarin A - - 2008
The French Society of Endocrinology convened a multidisciplinary panel of endocrinologists, radiologists, nuclear physicians and surgeons to address the appropriate evaluation and treatment of adrenal incidentalomas. The panel conducted a systematic review of medical literature on the following issues: epidemiology, natural history, radiological and scintigraphic evaluation, endocrine assessment, surgical management ...
Brand Caroline A - - 2008
Osteoarthritis of the hip and knee is an increasingly common condition that is managed principally with lifestyle behaviour changes. Osteoarthritis management can be complex, as it typically affects older patients with multiple comorbidities. There is evidence that opportunities exist to improve uptake of evidence-based recommendations for care, especially for non-pharmacological ...
Shaw, G.M.
Invited commentary and debate
Khoury Muin J - - 2008
An ongoing dilemma in genomic medicine is balancing the need for scientific innovation with appropriate evidence thresholds for moving technology into practice. The current low threshold allows unsubstantiated technologies to enter into practice, with the potential to overwhelm the health system. Alternatively, establishing an excessively high threshold for evidence could ...
Mascola Anthony Joseph - - 2008
OBJECTIVE: Evidence-based medicine has been promoted to enhance clinical decision making and outcomes in psychiatry. Residency training programs do not routinely provide instruction in evidence-based medicine. Where instruction exists, it tends to occur in classroom settings divorced from the clinical decision-making process and is focused narrowly on appraisal of evidence ...
Murad M Hassan - - 2008
The Society for Vascular Surgery considers the placement and maintenance of arteriovenous hemodialysis access to be an important component of any vascular surgery practice. Therefore, the Society has long been involved in setting the standards for the management of arteriovenous access. Formulating clinical recommendations in this area is the latest ...
Srihari Vinod - - 2008
OBJECTIVE: Evidence-based medicine has an important place in the teaching and practice of psychiatry. Attempts to teach evidence-based medicine skills can be weakened by conceptual confusions feeding a false polarization between traditional clinical skills and evidence-based medicine. METHODS: The author develops a broader conception of clinical expertise consisting of three ...
D' Angelo S - - 2008
OBJECTIVE: The 3E (Evidence, Expertise, Exchange) Initiative is a multinational effort of rheumatologists aimed at developing evidence-based recommendations addressing specific questions relevant to clinical practice. The objective of the Italian part of the 3E Initiative was to develop new recommendations designed to help Italian rheumatologists in everyday clinical practice management ...
Morabia Alfredo - - 2009
Pierre Louis, in his 1836 publication, "Researches on the effects of bloodletting in some inflammatory diseases," concluded that there were "narrow limits to the utility" of bloodletting for the treatment of pneumonia. Louis's conclusions were based on an observed excess mortality of patients bled rapidly post disease onset compared with ...
Schutte-Rodin Sharon - - 2008
Insomnia is the most prevalent sleep disorder in the general population, and is commonly encountered in medical practices. Insomnia is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment.1 ...
Levy Susan E - - 2008
Complementary and alternative medical (CAM) treatments are commonly used for children with autism spectrum disorders. This review discusses the evidence supporting the most frequently used treatments, including categories of mind-body medicine, energy medicine, and biologically based, manipulative, and body-based practices, with the latter two treatments the most commonly selected by ...
Fuchs Eunice M - - 2008
Sedation management in the mechanically ventilated critically ill patient is a topic of continuing interest in the critical care literature. The wide variety of clinical practices described in the literature with regard to sedation management has limited the implementation of evidence-based practice guidelines. Common themes for a coherent sedation management ...
Hay M Cameron - - 2008
RATIONALE, AIMS AND OBJECTIVES: There is mounting evidence of a gap between Evidence-based Medicine (EBM) and physician clinical practice, in part because EBM is averaged global evidence gathered from exogenous populations which may not be relevant to local circumstances. Local endogenous evidence, collected in particular and 'real world' patient populations ...
Loughlin Michael - - 2008
Both defenders and certain critics of evidence-based medicine (EBM) share philosophical commitments - assumptions about the meaning of and relationship between such fundamental concepts as 'objectivity', 'subjectivity' and 'rationality'- that frame the debate between them. Critics need to be particularly careful in analysing their own philosophical commitments. Ironically, failure to ...
Kannan Anand - - 2008
Using heparinised saline as a flush to maintain the patency of arterial and central venous lines is a well-known practice. A literature search was undertaken but found no evidence to support the use of heparinised saline over normal saline. In addition, the use of heparinised saline may be associated with ...
Codyre David - - 2008
OBJECTIVE: The aim of this paper is to summarize information about the dissemination and implementation of the Royal Australian and New Zealand College of Psychiatrists' clinical practice guidelines (CPGs) since their completion in 2003, and assess the effectiveness of these activities. METHOD: The dissemination and implementation activities undertaken from 2003 ...
Cox John L - - 2008
The purpose of this essay is to outline how the conceptual and clinical approaches of psychiatry contribute to increased understanding about the nature of evidence, and the art and science of medicine. It is based on the author's search for a more integrative medicine, the influence of Paul Tournier's 'Medicine ...
Bernards Christopher M - - 2008
The American Society of Regional Anesthesia and Pain Medicine (ASRA) Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine includes an evidence- and expert opinion-based section on performing procedures on anesthetized or heavily sedated patients. This practice advisory is based on existing scientific literature, pathophysiological principles, and expert ...
Merijohn George K - - 2008
The study club model can be a highly effective method to advance the awareness, implementation, and dissemination of the evidence-based dental (EBD) practice approach. Three concepts for developing and facilitating a successful evidence-based study club are described. Simple approaches for study club development and management are introduced. The importance of ...
Campbell-Taylor Irene - - 2008
The assessment and management of patients in long-term care who have oropharyngeal dysphagia has developed into an apparently complex and distinct field of practice. It is unfortunate that it lacks an evidence base, the efficacy of treatment is not established, and many clinicians are unfamiliar with appropriate and effective interventions ...
Lobo Rogerio - - 2008
Although all clinicians should practice evidence-based medicine to assure the highest quality healthcare for our patients, there have been several misconceptions about what this really is, or what it should be. In some instances, the overreliance on a single randomized clinical trial (RCT), while ignoring a wealth of other literature ...
Phillips R - - 2008
This paper gives a practical account of why and how to learn to practise evidence based medicine while still in clinical training. It highlights practical benefits to learning the skills (such as passing exams, coping with information overload and helping patients), and explains how to manage each of the four ...
Gélis Anthony - - 2008
OBJECTIVE: To develop clinical practice guidelines for the use of foot orthotics (FO) in the treatment of knee and hip osteoarthritis. METHOD: The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating a systematic review of the literature, input from every day clinical practice and external review by a multidisciplinary ...
Salerian Alen J - - 2008
This paper proves that President Kennedy's postmortem examination is a sham. The sham nature of the presidential autopsy is based upon several findings incompatible with human anatomy, practice of medicine and Newton's second law "an object acted upon by a constant force will move with constant acceleration in the direction ...
Borland Ron - - 2008
BACKGROUND AND OBJECTIVE: GPs are an important source of smoking cessation advice. This research examined whether a model encouraging GP referral of patients who smoke to a specialist service would be acceptable and effective for increased smoking cessation when compared with a model of in-practice management. METHODS: The study design ...
Kerfoot Karlene M - - 2008
The successful leader must first make the commitment to practice evidence-based leadership by examining best practices and modeling her/his leadership practice after these models. We know from a plethora of evidence that the relationship-based leader who is also grounded in good operational abilities and can paint the picture of a ...
Kinirons Peter - - 2008
Status epilepticus (SE) is a common medical emergency. Two problems continue to militate against improved outcome in SE, namely, failure to recognize the wide spectrum of clinical presentation and failure to treat in an appropriately aggressive and timely manner. In this study, we aim to provide a clear understanding of ...
Walsh Anne - - 2008
AIM: This paper is a report of a study to explore Australian parents' knowledge, beliefs, practices and information sources about fever management and develop a scale to measure parents' fever management practices. BACKGROUND: Parental fever phobia and overuse of antipyretics to reduce fever continue. No scales to measure parents' fever ...
Heffernan Eric J - - 2008
The "bottom-up" model of evidence-based practice (EBP) emphasizes the principles of integrating best research evidence with clinical expertise and patient values. It is derived from multidisciplinary sources, including clinical medicine, epidemiology, and adult learning theory, and has been applied to many medical disciplines, including radiology. Central to its implementation in ...
Varkey Prathibha - - 2008
PURPOSE: To determine the psychometric properties and validity of an OSCE to assess the competencies of Practice-Based Learning and Improvement (PBLI) and Systems-Based Practice (SBP) in graduate medical education. METHOD: An eight-station OSCE was piloted at the end of a three-week Quality Improvement elective for nine preventive medicine and endocrinology ...
Reichmann James P - - 2008
The current paradigm in obstetrics has shifted toward evidence-based medicine, and yet in clinical practice physicians continue to use interventions for which there exists no credible evidence. This article examines the U.S. Food and Drug Administration (FDA) status of home uterine activity monitoring (HUAM) and the published clinical trials examining ...
McAvoy Brian R - - 2008
Addiction medicine deals with problems arising from the use of psychoactive substances, and encompasses the disciplines of general practice and primary care, psychiatry, psychology, internal medicine, public health, pharmacology and sociology. Addiction is a chronic, relapsing illness that is difficult to cure. There are now effective, evidence-based interventions for the ...
'Evidence-Based Nursing: A Guide to Clinical Practice' aims to enable nurses to: frame their clinical questions to find the evidence to support their opinions; distinguish between strong and weak evidence; clearly understand study results; weigh the risks and benefits of management options; and apply the evidence to their individual patients. ...
Narahari Saravu R - - 2008
This paper considers the problem of evaluating multimodal integrative medicine treatments for complex pathologic conditions. The example is given of evaluation of highly successful treatments of lymphedema using Ayurvedic and Yoga medicine practices together with modern medicine. For a framework to evaluate such a complex intervention, we base our proposal ...
Sannes Timothy S - - 2008
The rise in popularity of complementary and alternative medicine (CAM) in the United States has stimulated increasing interest in researching CAM. One challenge to this research is determining the optimal dose of a CAM intervention. T'ai Chi Chuan (TCC) has received considerable attention as a mind-body practice; however, it remains ...
Mathews Catherine J - - 2008
PURPOSE OF REVIEW: To propose and discuss an evidence-based algorithm for the diagnosis and treatment of bacterial septic arthritis. Also, to review the recent literature on emerging management strategies and discuss the potential impact of these developments on clinical practice. RECENT FINDINGS: Evidence-based guidelines have recently been published to assist ...
Putukian Margot - - 2008
Infectious mononucleosis (IM) is a common medical condition that afflicts thousands of young athletes each year. Despite the self-limited nature of this disorder, the variability of the clinical presentation and the rare risk of splenic rupture routinely present sports medicine clinicians with difficult return-to-play decisions. Currently there are no evidence-based ...
Porter-O'Grady Tim - - 2008
Leaders must understand the essential characteristics and realities of creating an evidence-driven organization. It is especially important to comprehend and apply sound leadership and management of infrastructure, processes, and behaviors that incorporate evidence in every aspect of clinical practice. Evidence-driven practice is no longer optional and is now a fundamental ...
Relton Clare - - 2008
There are active public campaigns both for and against homeopathy, and its continuing availability in the NHS is debated in the medical, scientific and popular press. However, there is a lack of clarity in key terms used in the debate, and in how the evidence base of homeopathy is described ...
Moussa Issam D - - 2008
Evidence-based medicine has emerged in response to empiric clinical decision-making with the quest of infusing more "science" into the process of caring for the sick. Yet, evidence-based medicine today is being applied to clinical practice in a rigid and, paradoxically, unscientific manner. The perception that evidence-based medicine is the "ultimate ...
Eventov-Friedman S - - 2008
Few therapies in perinatal medicine have created as much controversy as corticosteroids. Despite five decades of extensive research and practice, major areas of uncertainty remain. In this article, we review the most current evidence on both antenatal and postnatal therapy. Overall, it is clear that we must continue to investigate ...
Kara N - - 2009
INTRODUCTION: The use of nasal creams and ointments in the conservative management of anterior epistaxis is well documented and supported. This study set out to obtain a national opinion, in order to establish current practice. DESIGN: A survey of all Scotland-based otolaryngology clinicians was conducted. Participants were asked which topical ...
Caldwell Elizabeth - - 2008
Evidence-based practice is an approach that has gained recognition for facilitating the transfer of evidence into quality clinical practice. While occupational therapy clinicians have a professional responsibility to ensure that their practice is effective, managers also have a responsibility to implement structures and systems that will support therapists in doing ...
Evans Suzanne B - - 2008
Axillary lymph node dissection after the finding of a positive sentinel lymph node is a common clinical practice. A review is performed for the efficacy and morbidity of axillary lymph node dissection, the rationale for nonsurgical management of the axilla, and the efficacy, technical limitations, and toxicity of axillary radiation ...
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