Many procedures performed as part of routine broodmare practice are based on sound clinical judgment and experience or scientific evidence; however, others are based on perceived problems and needs to address them. This article presents four procedures commonly used in broodmare practice, for which there is questionable evidence to substantiate ...

Cryptococcus neoformans var. grubii and C. gattii were repeatedly isolated from decaying wood of trunk hollows in living trees growing in Jabalpur City in Central India. The isolation of C. gattii has been reported from decayed wood inside trunk hollow of Tamarindus indica (15.6%), Mangifera indica (2.2%), Pithecolobium dulce (12.5%), ...

PURPOSE: Evidence based clinical practice has been defined as the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients. It refers to a broad set of principles and methods intended to ensure that medical decisions, guidelines and health policy are ...

Data collection in the field of medicine is extremely important for patient safety. It is viewed as a quality issue in several countries around the world. In order to achieve this goal, nationwide apheresis registries were planned. In 2003, World Apheresis Association (WAA) decided to establish a world-wide apheresis registry. ...

There are an increasing number of our patients on antiplatelet and anticoagulant medications. In the absence of clear guidelines for the perioperative management of these patients presenting for operative dermatological procedures, we undertook a pilot survey of the current practices of dermatologists in the United Kingdom. The aims of our ...

Management of petrous apex pathology poses a unique challenge even to the most seasoned skull base surgeons. The central location in the skull base with adjacent critical neurovascular structures makes access to this region more than a trivial matter. Significant advances in diagnostic imaging have greatly facilitated the diagnosis of ...

There is an international focus on improving the quality of care for people with chronic conditions, including those with chronic rheumatic conditions such as osteoarthritis (OA). A number of evidence-based clinical practice guidelines exist to guide clinician management of OA of the hip and knee. However, gaps and delays in ...

Evidence-based medicine (EBM) is a paradigm for systematically collecting, evaluating, and applying the best information currently available to improve patient outcomes. Effective evidence-based practice requires defining an answerable, well-built question, systematically searching for the best current evidence, and appraising that evidence for validity. Essential components of EBM also require using ...

CONTEXT: Workload pressures may lead pre-registration house officers (PRHOs) to undervalue critical appraisal and thinking skills. This study aimed to explore Mersey Deanery PRHOs' attitudes, experiences and perceived readiness for practising evidence-based medicine with critical appraisal skills. METHODS: A cross-sectional survey of 157 PRHOs from 5 postgraduate centres in the ...

In the United States, access to qualified homebirth providers varies by state, city, and community, and consistent, evidence-based guidelines for intrapartum management at home are not available. This article examines the similarities and differences in midwifery management of the intrapartum, postpartum, and neonatal course between planned homebirths and planned hospital ...

Over time, evidence-based veterinary medicine (EBVM) should integrate with normal clinical practice. Also, clinical knowledge increases with EBVM, reducing the need for information in one area and allowing veterinarians to explore new areas of specialty or cutting-edge advances in the profession. Textbooks, journals, veterinary conferences, and web sites provide nearly ...

So far, this series has described and illustrated the first four steps of the five-step evidence-based practice (EBP) process that was originally designed and taught by the medical epidemiologists of McMaster University (Hamilton, Ontario, Canada) and the National Health Service Centre for Evidence-Based Medicine (University of Oxford, Oxford, England). This ...

AIM: This paper examines the evidence-based practice movement, the hierarchy of evidence and the relationship between evidence-based practice and reflective practice. BACKGROUND: Evidence-based practice is equated with effective decision making, with avoidance of habitual practice and with enhanced clinical performance. The hierarchy of evidence has promoted randomized control trials as ...

Canada's per capita use of intravenous immune globulin (IVIG) grew by approximately 115% between 1998 and 2006, making Canada one of the world's highest per capita users of IVIG. It is believed that most of this growth is attributable to off-label usage. To help ensure IVIG use is in keeping ...

This paper briefly surveys the trend of and controversy surrounding empirical validation in psychotherapy. Empirical validation of hypnotherapy has paralleled the practice of validation in psychotherapy and the professionalization of clinical psychology, in general. This evolution in determining what counts as evidence for bona fide clinical practice has gone from ...

The acquisition of expertise is an area of controversy between those who lean more toward learning and those who lean more toward talent. Because the genetics and early life experiences of humans are not open to direct manipulation, human studies are of limited use in this debate. Studies using nonhumans ...

Acupuncture and other types of 'complementary and alternative medicine' (CAM) are proving increasingly popular in the UK. As attempts to incorporate acupuncture into allopathic medicine have grown in number, the issue of assessing its effectiveness in ways consistent with the concept of evidence-based medicine has become more urgent. The nature, ...

BACKGROUND: Within surgery the debate about the place of evidence-based medicine (EBM) has focused on the nature and compatibility of EBM with surgical practice with an inevitable polarization of opinion. However, EBM techniques are being embedded into undergraduate medical curricula and surgical training programs across Australia. The Monash University Department ...

OBJECTIVE: The present paper examines the experience of establishing a center for evidence-based complementary and alternative medicine (EBCAM) practice. It examines both the difficulties and the challenges of doing research to establish EBCAM. The paper also examines the political context of the demand for evidence- based practice (EBP) for CAM. ...

PURPOSE: To characterise the therapeutic profile of orphan medicines. MATERIALS AND METHODS: A cross-sectional study was performed during 2 months in a convenience sample of seven hospital pharmacy services, in the region of Lisbon. Data were collected, from pharmaceutical service's records. RESULTS: A total of 18 orphan medicines, were dispensed ...

The objective of this survey is to provide an insight into the knowledge and attitude of the higher surgical trainees in Otolaryngology towards evidence based medicine and evaluate their understanding of medical statistics and use of evidence based medicine in patient management. A self administered anonymous questionnaire was distributed to ...

The stimulus inciting Archie Cochrane's interest in scientific medicine was his own ill health and the inability of psychoanalysis to cure his problem of sexual dysfunction. The aetiology and modern management of anejaculation will be considered. The treatment undertaken by Cochrane failed because his condition was organic. Evidence-based medicine was ...

The evidence-based medicine movement has remained both well known and controversial since its inception. The authors reframe the evidence-based medicine debate by pointing out an underappreciated epistemological deficiency: evidence-based medicine as currently conceptualized cannot accommodate concepts that resist quantitative analysis and therefore cannot logically differentiate human beings from complex machines. ...

PURPOSE: We undertook a study to assess the impact of comparative feedback vs general reminders on practice-based referrals to a tobacco cessation quit line and estimated costs for projected quit responses. METHODS: We conducted a group-randomized clinical trial comparing the impact of 6 quarterly (18 months) feedback reports (intervention) with ...

Evidence-based practice (EBP) requires a shift from the traditional paradigm of clinical practice grounded in intuition, clinical experience, and pathophysiological rationale. In the EBP paradigm, clinical expertise is combined with integration of best scientific evidence, patient values and preferences, and the clinical circumstances. This primer article provides a summary of ...

A questionnaire survey was made of primary health care physicians in Asir region, Saudi Arabia in 1999 to explore their awareness of and attitude towards evidence-based medicine. The 272 respondents welcomed the principles of evidence-based medicine. Awareness and use of extracting journals, review publications and databases was low. Pharmaceutical company ...

OBJECTIVE: This study surveyed the practice patterns of behavioral health providers to determine the degree to which providers in this study utilized evidence-based approaches when dealing with traumatized individuals and the extent to which these practice methods vary as a result of population density or provider characteristics. METHOD: A survey ...

Homeopathy has been the cause of much debate in the scientific literature with respect to the plausibility and efficacy of homeopathic preparations and practice. Nonetheless, many consumers, pharmacists, physicians, and other health care providers continue to use or practice homeopathic medicine and advocate its safety and efficacy. As drug experts, ...

Although the role of nutrition as a therapy for the sick has been recognized for centuries, the science of nutrition is a relatively young discipline. The first modern attempt to document and standardize appropriate nutrition care was the diet manual. The evolution from "diet manual" to "practice manual" is less ...

Physicians' treatment choices are influenced by a number of factors, including guidelines, evidence-based medicine, past experience and, to a certain extent, habit. Evidence-based medicine is the foundation of clinical practice guidelines. This article reviews the influence of evidence and guidelines on physicians' treatment choices. As examples, the role of evidence ...

This ninth best-practice review examines two series of common primary care questions in laboratory medicine: (i) potassium abnormalities and (ii) venous leg ulcer microbiology. The review is presented in question-and-answer format, referenced for each question series. The recommendations represent a précis of guidance found using a standardised literature search of ...

Evidence-based medicine (EBM) is a rapidly expanding subject. The aim of this editorial is to give an overview and address some of the practical issues relevant to the developing world. EBM may be defined as the conscientious, explicit and judicious use of current best evidence in making decisions about the ...

There are no evidence-based-criteria for the diagnosis, severity assessment, of treatment of acute cholecystitis or acute cholangitis. For example, the full complement of symptoms and signs described as Charcot's triad and as Reynolds' pentad are infrequent and as such do not really assist the clinician with planning management strategies. In ...

The purpose of this article is to present activities that can be used to integrate evidence-based practice (EBP) into clinicians' daily work so that they may be better informed when planning intervention with their clients. The article includes a short history of EBP, a description of an eight-step EBP process ...

The development of evidence-based guidelines has gained popularity as a strategy to reduce variation in practice and to orient clinical care around documentable best practices. Based on available data, the new European guidelines for the management of bleeding in the trauma patient do deliver a number of sound recommendations. However, ...

The concept of 'evidence-based medicine' dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal 'evidence' in approving any form of health care provision. Essentially 'evidence-based medicine' ...

Evidence-based medicine (EBM) is a fashionable and an extremely hot topic for clinicians, patients and the health service planners. Evidence-based cytology (EBC) is an offshoot of EBM. The EBC is concerned with generating a reproducible, high quality and clinically relevant test result in the field of cytology. This is a ...

Implementation of best care practices is difficult because the status quo is often perpetuated; many providers treat patients based on anecdotal experience rather than evidence-based medicine. Our goal was to develop and evaluate an electronic feedback system that feeds back practice and outcome data combined with educational material to anesthesiologists. ...

Atrial fibrillation (AF) is a condition of genuine clinical concern. This arrhythmia increases patient morbidity and mortality, most notably due to stroke, thromboembolism and heart failure. Consequentially, there is a strong impetus to acquire a greater understanding of its natural history and course in order to provide crucial evidence-based treatment ...

This article addresses the advantages, disadvantages, and traps to which evidence-based medicine (EBM) may lead and suggests that, to be ethically valid, EBM must be aimed at the patient's best interests and not at the financial interests of others. While financial considerations are by no means trivial, it is hypocritical ...

Evidence-based medicine--the use of "current best evidence" in making medical decisions--is becoming the standard system for health care delivery. In applying evidence-based medicine, the podiatric profession lags behind in several key ways. Major problems include a scarcity of high-level evidence for most podiatric issues and a lack of database resources ...

At least 661 unique patent medicine manufacturers promoted their nostrums in Baltimore from 1863 to 1930. The industry saw its greatest growth from 1880 to 1900 and peaked in 1907. Overall, about 7% of these companies were owned by women and 4% by African-Americans. Based on the short life span ...

An avulsion injury is a challenge to manage, and there are many factors to consider to obtain the best prognosis in each scenario. In 2001, Lee and colleagues published decision analysis paradigms for the management of avulsed permanent teeth for the purpose of providing busy clinicians with user-friendly, reference-based flow-charts ...

Deciding the best option for your practice is by no means straightforward. It would be easy to look at the financial effects and simply decide to withdraw from the DTSS; however, consideration should be given to other factors such as the dentist's duty of care to patients, whether the practice ...

PURPOSE OF REVIEW: The aim of this article is to provide new clinical data on transurethral microwave thermotherapy, evaluate it in the perspective of evidence-based guidelines and daily practice and investigate the driving forces that determine the current position of thermotherapy for the management of benign prostatic obstruction. RECENT FINDINGS: ...

This article examines evidence-based practice (EBP) and emphasizes how the case manager can find and use research about best practices. EBP should be a mainstay of care but fear about accessing and lack of time to purse EBP material may deter many case managers from integrating best practices into their ...

AIMS: To summarise evidence and key recommendations for general practitioner diagnosis and management of acute soft-tissue knee injuries, based on the New Zealand guideline. METHODS: A multidisciplinary team developed the guideline by critically appraising and grading retrieved literature using the Graphic Appraisal Tools for Epidemiology, Clinical decision rules and the ...

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death not only in Japan but worldwide. Clinical Practice Guidelines for HCC were published in 2001 by the European Society of Study of the Liver (EASL) and in 2005 by the American Association for the Study of Liver Disease ...

BACKGROUND: The Journal of Bone and Joint Surgery, American Volume (The Journal) recently initiated a section called "Evidence-Based Orthopaedics." Furthermore, a level-of-evidence rating is now used in The Journal to help readers in clinical decision-making. Little is known about whether this recent emphasis has influenced surgeons' perceptions about and competence ...

Speech-language pathologists are increasingly required to demonstrate that their practice is based on evidence. While the concept of evidence-based practice has strengths, there have been some weaknesses in its application in speech-language pathology. Nevertheless, since current health care demands compliance, the profession must consider the opportunities and threats that evidence-based ...