| Evidence-based medicine, clinical practice guidelines, and common sense in the management of osteoporosis. | |
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MedLine Citation:
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PMID: 19491062 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the benefits and limitations of randomized controlled trials (RCTs), clinical practice guidelines (CPGs), and clinical judgment in the management of osteoporosis. METHODS: A review was conducted of the English-language literature on the origins and applications of RCTs, CPGs, evidence-based medicine, and clinical judgment in the management of osteoporosis. RESULTS: Evidence-based medicine is use of the currently available best evidence in making clinical decisions for individual patients. CPGs are recommendations for making clinical decisions based on research evidence, sometimes with consideration of expert opinion, health care policy, and costs of care. The highest levels of medical evidence are usually thought to be RCTs and meta-analyses of high-quality RCTs. Although it is desirable and appropriate for clinicians to consider research evidence from RCTs and recommendations presented in CPGs in making clinical decisions, other factors-such as patient preference, comorbidities, affordability, and availability of care-are important for the actual implementation of evidence-based medicine. CONCLUSION: Decisions about who to treat, which drug to use, how best to monitor, and how long to treat require clinical skills in addition to knowledge of medical research. The necessity of integrating common sense and clinical judgment is highlighted by the fact that many patients treated for osteoporosis in clinical practice would not qualify for participation in the pivotal clinical trials that demonstrated efficacy and safety of the drugs used to treat them. |
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Authors:
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E Michael Lewiecki; Neil Binkley |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists Volume: 15 ISSN: 1934-2403 ISO Abbreviation: Endocr Pract Publication Date: 2009 Sep-Oct |
Date Detail:
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Created Date: 2009-10-27 Completed Date: 2010-01-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607439 Medline TA: Endocr Pract Country: United States |
Other Details:
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Languages: eng Pagination: 573-9 Citation Subset: IM |
Affiliation:
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New Mexico Clinical Research and Osteoporosis Center, 300 Oak Street Northeast, Albuquerque, NM 87106. LEWIECKI@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Evidence-Based Medicine Female Humans Male Meta-Analysis as Topic Osteoporosis / therapy* Practice Guidelines as Topic Professional Practice Randomized Controlled Trials as Topic Risk Assessment |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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