The document discusses evidence-based medicine (EBM), which involves using the best current evidence from clinical research in medical decision making. It provides definitions of EBM and outlines its benefits, such as better patient outcomes and generalizable information. However, some criticisms of EBM are that it can promote a "cookbook" approach and ignore patient values. The key steps in EBM are formulating a clear clinical question, searching for evidence, appraising the evidence, and applying it to patients. Questions are structured using PICO (patient/problem, intervention, comparison, outcome). While EBM aims to use high-quality evidence, the document notes that for many treatments, there is little or poor quality evidence to guide decisions.
Prof. Todor (Ted) A. Popov - 6th Clinical Research ConferenceStarttech Ventures
Ομιλία - Παρουσίαση: Prof. Todor (Ted) A. Popov, Professor of Medicine, Medical University in Sofia, Chairman of the Bulgarian Ethics Committee for Multicenter Studies
Τίτλος Παρουσίασης: «Do databases around the world speak the same language?»
a brief overview about how and why to practice evidence based medicine, its clinical application, what it is and what it is not? benefits and challenges
Prof. Todor (Ted) A. Popov - 6th Clinical Research ConferenceStarttech Ventures
Ομιλία - Παρουσίαση: Prof. Todor (Ted) A. Popov, Professor of Medicine, Medical University in Sofia, Chairman of the Bulgarian Ethics Committee for Multicenter Studies
Τίτλος Παρουσίασης: «Do databases around the world speak the same language?»
a brief overview about how and why to practice evidence based medicine, its clinical application, what it is and what it is not? benefits and challenges
This topic is very essential for Pharm.D students. It includes application, benefits, limitations of EBM. It also includes EBM history and background which helps you for examinations. EBM is very important topic in Pharmacotherapeutics-III so you may find this needful.
All the best!!!
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Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
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Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
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Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
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Public Education: Open discussions ensure informed decisions about CRISPR.
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2. One of the major changes in the teaching and practice of medicine has been
the rapid growth in evidence-based medicine (EBM), which is reflected in
this new edition by now having its own subsection. As Paul Glasziou and
colleagues have argued ‘a 21st century clinician who cannot critically read a
study is as unprepared as one who cannot take blood pressure or examine
the cardiovascular system. Evidencebased medicine, previously referred to
as clinical epidemiology, has grown rapidly over the last 20 years, partially as
a result of better-quality research, systematic methods to accumulate and
summarise these data, and easy access to highquality databases such as the
Cochrane collaboration or EBM-based guidelines that allow health
professionals to quickly access evidence when considering patient
management.
3. ‘the conscientious, explicit and judicious use of current best evidence
in making decisions about the care of individual patients and
improving the health of populations
4. PROVIDE BETTER INFORMATION.
BETTER PATIENT OUTCOME.
GENERALIZE INFORMATION.
IT IMPROVES THE EFFECTIVENESS IN THE CLINICAL PRACTICE.
IT INVOLVES IN THE EVIDENCE FOR BETTER DECISION MAKER.
5. EBM denigrates clinical experience.
Ignores patient values.
Promotes an unthinking cookbook approach to medicine .
A cost-cutting tool .
An ivory tower research exercise not suited to everyday clinical
practice.
Leads to therapeutic nihilism in the absence of evidence from
randomised controlled trials Source: Modified from Straus SE,
McAlister FA (2000) Evidence-based medicine: a commentary on
common criticisms
6. Patient or commissioner/ policy-maker EBM domain
What is making me feel unwell? Diagnosis
Will this have any long term consequences? Prognosis
Why did I get ill? etiology What can you do to help me? Treatment
Are any interventions worth paying for? (commissioners,
policymakers) Cost-effectiveness
7. There are several steps in being a EBM practitioner. These are
(a) formulate a clear question,
(b) search for the evidence,
(c) critically appraise the evidence,
(d) apply the evidence (or not) to the individual patient or population
as appropriate
8. Study designs should be evaluated according to the hierarchy of
evidence EBM tries to use evidence in an explicit fashion by
quantifying benefits and harms using concepts such as the numbers
need to treat The five EBM domains are diagnosis, prognosis,
aetiology, treatment and cost-effectiveness PICO is a useful acronym to
help formulate clear EBM questions EBM is undertaken according to
the following stages: formulating a question, search for evidence,
appraising evidence and applying the evidence, if appropriate
Generalisability of evidence as well as considering patients’
preferences is important in applying evidence to individuals
9. Two examples of EBM questions.
Prognostic question
Patient A 77-year-old woman with hypertension, and moderate left
ventricular enlargement
Intervention Presence of nonrheumatic atrial fibrillation
Comparator Absence of nonrheumatic atrial fibrillation
Outcomes Risk of stroke risk over a specific time period (5 or 10 years)
(both as relative risk and absolute risk difference)
Therapy question Patient A 77-year-old woman with nonrheumatic atrial
fibrillation, hypertension, and moderate left ventricular enlargement
Intervention Warfarin therapy Comparator No therapy or aspirin Outcomes
Reduction in stroke risk versus increase in bleeding complications (relative
and absolute risks)
10. The absence of evidence or only the presence of poor quality
evidence. For example a review of 109 inpatients seen in Oxford for
one month found that for 53% of primary treatments there was trial
evidence to support therapy. In an additional 29% there was
convincing nonexperimental evidence and in 18% there was no
evidence that therapy was better than no therapy (Ellis et al., 1995).
This figure is likely to be less good for some other specialties e.g.
primary care. Such absence of evidence does not mean evidence of
absence and should act as a stimulus for future research to help fill
such evidence-based gaps.