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So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
So much evidence : initiating EBWH society
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So much evidence : initiating EBWH society

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Evidence based women's health society is a new emerging society in the field of women's health. Why there is a need for such society? this talk highlights this issue

Evidence based women's health society is a new emerging society in the field of women's health. Why there is a need for such society? this talk highlights this issue

Published in: Health & Medicine, Education
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  • 1. So Much Evidence What is Next
  • 2. Process of Randomisation Participants RandomlyAssigned Intervention Group Control Group Follow-up Follow-up Intervention Group Control Group OutcomeCompared
  • 3. Assessed for eligibility (n= 245) Excluded (n= 15) Not meeting inclusion criteria (n=7) Refused to participate (n=5) Social reasons (n=3) Received IUI (110) Analyzed (n=110) Cycles cancelled (n=5) Inadequate response (n=4) Hyper-response (n=1) Group I (n=115) received Merional + CC Cycles cancelled (n=8) Inadequate response (n=6) Hyper-response (n=2) Group II (n=115) received Merional alone Received IUI (107) Analyzed (n=107) Allocation Analysis Follow-Up Enrollment Randomized (n=230)
  • 4. The best evidence for different types of question Level Treatment Prognosis Diagnosis I Systematic Review of … Systematic Review of … Systematic Review of … II Randomised trial Cohort Cross sectional III
  • 5. systematic reviews 0 200 400 600 800 1000 1200 1400 1600 1800 2000 2200 2400 2600 2800 3000 3200 3400 3600 3800 4000 1995/1 1995/2 1996/1 1996/2 1996/3 1997/1 1997/2 1997/3 1997/4 1998/1 1998/2 1998/3 1998/4 1999/1 1999/2 1999/3 1999/4 2000/1 2000/2 2000/3 2000/4 2001/1 2001/2 2001/3 2001/4 2002/1 2002/2 2002/3 2002/4 2003/1 2003/2 2003/3 2003/4 2004/1 2004/2 2004/3 New protocols Existing protocols New reviews Updated reviews Existing reviews, not incl updates Reviews and protocols for reviews on The Cochrane Database of Systematic Reviews Issue 1/2005 Alderson, 2005
  • 6. Too much information 0 500000 1000000 1500000 2000000 2500000 Biomedical MEDLINE Trials Diagnostic? MedicalArticlesperYear 5,000? per day 1,500 per day 55 per day
  • 7. OBGYN in Pubmed • 563 meta-analysis • 7184 RCT
  • 8. Ready Made EBOG • RCOG • SOGC • Cochrane Library • UpTodate
  • 9. “I don’t know…” “I don’t really care about all of this research stuff…” “I just want to take care of patients…” Unnamed Ob-Gyn Resident Still There is a Problem
  • 10. Many “Leaks” from research to practice Aware Accept Target Able Recall Agree Done Valid Research If 80% achieved at each stage then 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 = 0.21
  • 11. (a*+) (b+) (c*) (d) Minimum clinical Important difference No difference Another Problem : Which are (i) statistically significant * and (ii) Clinically significant +?
  • 12. So • Too many information • Little applied
  • 13. Read EBM sources Start Journal club Engage colleagues Record ur practice Write a Letter to BMJ Individual
  • 14. EBP The EBM Model Best Evidence Client Values and Expectations Practitioner’s Individual Expertise Sackett et al., 1997
  • 15. EBP Model Institution state and circumstances Clinical Expertise Client Preferences and actions Research Evidence
  • 16. But still Knowledge needs to be managed much more effectively than it has been in the past
  • 17. “Evidence Base” Community • “The purchase of treatments and services that have been scientifically confirmed to improve outcomes.” (Lehman et al, 2004)
  • 18. “Evidence Base” Community • Evidence mapping • Mining the Research • Missing Pieces: Identifying the Gaps in Evidence
  • 19. Unexplained Infertility IUI alone IUI + O.I Timed intercourse O.I alone Spontaneous intercourse??
  • 20. Ines Trial IUI + O.I IVF + sET NC IVF
  • 21. “Evidence Base” Community • engaging patients in research • working with guideline developers • Reporting and discussing practice guidelines • Podcasting as a Dissemination Strategy • funding for Knowledge Translation and Dissemination
  • 22. Steps For Evidence Base Community Implementation Information sharing with decision Makers Organization & Fund raising Clinical Care Improvement Training on EBP’s, supervision, consultation and support Engagement Strategic plan Focus on outcomes that clients value. Improved Women Health Clinicians, consumers, Stakeholers Feedback :Efficiency & Effectiveness
  • 23. Elements Important (Fixsen et al, 2005) • Commitment of leadership to the implementation process. • “unfreezing” current organizational practices. • Resources for extra costs, effort, materials, recruiting, access to expertise, retraining.
  • 24. So • There is a need for an authorised body to handle these tasks • To communicate with decision makers • To cooperate with existing societies • To gather interested people: doctors and consumers
  • 25. Hence
  • 26. • International society • Open to every one • Starting activity from September 2010 • Cooperate with different societies involved in women health

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