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Evidence Based Medicine:
Wouldn’t It Be Nice…?
Chris E. Stout, PsyD
Department of Research, ATI
College of Medicine, University of Illinois,
Chicago
It’s nice to work with workers’ comp
outcomes because…
Outcomes are VERY Quantified
– RTW at the same job description and PDL
or not?
– How many days passed before RTW?
– Nice, clean, and tidy!
Surgeon’s Perspective on a
Good Outcome
• No anesthesia issues
• No surprises during or after
• No complications
• Good wound healing
• No post-op infection
But how does the story end?
Is the patient back at work?
Quickly?
At the same PDL as prior to injury?
With the same job classification?
Just the facts, er,
evidence…
Evidence is predicated on
clinical outcomes
So, evidence-based practice ROCKs!
Right…?
Half of what you are taught in medical school
will be wrong in 10 years’ time,
the problem is you don’t know which half.
- Sydney Burwell, MD, former Dean,
Harvard Medical School
It took an
average of 17
years for new
knowledge
generated by
RCTs to be
incorporated
into practice.
–IOM
Not a problem of too little,
but too much
• 3600 statistical articles are published
on average each year
• Do you know how long it would
take you to keep up…?
Just for Coronary Heart Disease…
If you read 1 article/15 minutes
You would have to read >10
articles
7 days/week
Forever…
In addition, too often there is a
disconnect between actual practice
and the evidence
OK,
So,
now
WHAT?
It’s about
tools…
Onset
Location
Duration
Character
Aggravating/Alleviating
Relieving factors
Timing & severity
Got an image?
Onset
Location
Duration
Character
Aggravating/Alleviating
Relieving factors
Timing & severity
• 75% hit rate for NEJM’s
weekly puzzler via
cut-and-paste
• 96% if fill in the fields
There are a number of resources
available
EvidenceUpdates
• A joint collaboration of
BMJ Group and the
Health Information
Research Unit at
McMaster University
• Best new evidence
tailored to your interests.
• 2-step process shrinks
~50,000 articles/year
(from >140 clinical
journals) down to the
most important 1 - 2
articles per month
= "noise reduction" of
over 99.9%.
And, wouldn’t it be cool if you could have
your latest post-op protocol available
to your rehab-referrals?
You already do, and for free.
I have been experimenting with a
number of online tools….
Tutorials on Information Mastery and EBPs
Evidence-based Medicine Resource Center
Group That Grade the Evidence For You
Curated Library
Please be in touch
Chris.Stout@ATIPT.com
and get these slides
(and more) via
DrChrisStout.com

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