Published Research, Flawed, Misleading, Nefarious - Use of Reporting Guidelin...John Hoey
Much published health sciences literature is misleading and biased
Efforts to correct this include use of reporting guidelines- criteria for doing science and reporting the results properly
Also discussion of conflicts of interest - how to report them.
Concise explaining of Evidence-Based Medicine and discussing the following: 1-What is Evidence-Based Medicine?
2-Why Evidence-based Medicine?
3-Options for changing clinicians' practice behaviour
4- EBM Process- Five Steps
5-Seven alternatives to evidence-based medicine
Published Research, Flawed, Misleading, Nefarious - Use of Reporting Guidelin...John Hoey
Much published health sciences literature is misleading and biased
Efforts to correct this include use of reporting guidelines- criteria for doing science and reporting the results properly
Also discussion of conflicts of interest - how to report them.
Concise explaining of Evidence-Based Medicine and discussing the following: 1-What is Evidence-Based Medicine?
2-Why Evidence-based Medicine?
3-Options for changing clinicians' practice behaviour
4- EBM Process- Five Steps
5-Seven alternatives to evidence-based medicine
Are Most Positive Findings False? Confirmatory Bias in the Evaluation of Psyc...James Coyne
I was tired of this 2007 presentation being plagiarized and so i am making it available. The time stamp for the file on a hard drive for it is 3.20.2007. An old cv I retrieved indicates that I gave a talk at Catholic University of America and at University of Gronigen with this title in 2007. I recycled some of the slides since and slides 48-50 have been quite popular as seen in some persons using them in publications without appropriate attribution.
Regardless, you should be amazed how prescient this presentation now seems, over a decade later, and how much things have not changed.
SLC CME- Evidence based medicine 07/27/2007cddirks
Saint Luke's Care, a quality improvement organization within Saint Luke's Health System, presents a CME presentation by Dr. Brent Beasley on Evidence Based Medical Care.
Evidence based medicine, by prof Badr Mesbah. Professor of pediatric, Suez canal university
Lecture presented in Port said fourth neonatology conference, 24-25 October 2013, Port said, Egypt
A great presentation from a well versed friend in research and EBM, Dr Yaser Faden.
This is a simple introduction to study design with an accompanying workshop to simplify the different types of research study designs.
Are Most Positive Findings False? Confirmatory Bias in the Evaluation of Psyc...James Coyne
I was tired of this 2007 presentation being plagiarized and so i am making it available. The time stamp for the file on a hard drive for it is 3.20.2007. An old cv I retrieved indicates that I gave a talk at Catholic University of America and at University of Gronigen with this title in 2007. I recycled some of the slides since and slides 48-50 have been quite popular as seen in some persons using them in publications without appropriate attribution.
Regardless, you should be amazed how prescient this presentation now seems, over a decade later, and how much things have not changed.
SLC CME- Evidence based medicine 07/27/2007cddirks
Saint Luke's Care, a quality improvement organization within Saint Luke's Health System, presents a CME presentation by Dr. Brent Beasley on Evidence Based Medical Care.
Evidence based medicine, by prof Badr Mesbah. Professor of pediatric, Suez canal university
Lecture presented in Port said fourth neonatology conference, 24-25 October 2013, Port said, Egypt
A great presentation from a well versed friend in research and EBM, Dr Yaser Faden.
This is a simple introduction to study design with an accompanying workshop to simplify the different types of research study designs.
EBM Is the ability to access, asses and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This ppt will help dentists in taking Evidence Based decision in daily practice and will also help researchers to categorized result of research on the basis of hierarchy of Evidence Based Dentistry
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Evidence and Science Based Medicine A Primer.pptxKaushik Banerjee
A Starter pack to understand what is Evidence-Based Medicine and how it works, provides a historical perspective (Homeopathy, Allopathy, etc.), discusses levels of evidence, methods to generate evidence etc.
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
How evidence affects clinical practice in egyptWafaa Benjamin
Evidence based medicine is the gold standard for clinical care.
It implies the integration of best research evidence with clinical expertise and patient values.
There is still a wide gap between availability of evidence and its incorporation into routine practice in our country.
Barriers to implementation could be personal, social, institutional, financial and legal barriers.
True practice of evidence based care can only occur where evidence based decisions coincide with patients’ beliefs and clinicians’ preferences.
Continuing medical education programs should be set with integrating evidence based medicine teaching and learning within clinical training.
The importance of presence of local national guidelines which need to take into account variation in expertise, resources and patient preferences across our geographical and cultural contexts .
Customisation of a guideline to meet the local needs of a target patient population is critical to successful implementation.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
Under Pressure : Kenneth Kruk's StrategyKenneth Kruk
Kenneth Kruk's story of transforming challenges into opportunities by leading successful medical record transitions and bridging scientific knowledge gaps during COVID-19.
Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...IMARC Group
The global veterinary diagnostics market size reached US$ 6.6 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 12.6 Billion by 2032, exhibiting a growth rate (CAGR) of 7.3% during 2024-2032.
More Info:- https://www.imarcgroup.com/veterinary-diagnostics-market
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Feeding plate for a newborn with Cleft Palate.pptxSatvikaPrasad
A feeding plate is a prosthetic device used for newborns with a cleft palate to assist in feeding and improve nutrition intake. From a prosthodontic perspective, this plate acts as a barrier between the oral and nasal cavities, facilitating effective sucking and swallowing by providing a more normal anatomical structure. It helps to prevent milk from entering the nasal passage, thereby reducing the risk of aspiration and enhancing the infant's ability to feed efficiently. The feeding plate also aids in the development of the oral muscles and can contribute to better growth and weight gain. Its custom fabrication and proper fitting by a prosthodontist are crucial for ensuring comfort and functionality, as well as for minimizing potential complications. Early intervention with a feeding plate can significantly improve the quality of life for both the infant and the parents.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
2. Outline of TalkOutline of Talk
Definition of EBMDefinition of EBM
History of EBMHistory of EBM
Obstacles of EBMObstacles of EBM
How to practice EBM (How to practice EBM ( The Five A’s )The Five A’s )
3. What is EBM?What is EBM?
Evidence-based medicine (EBM) is the integration of bestEvidence-based medicine (EBM) is the integration of best
research evidence with clinical expertise and patient values.research evidence with clinical expertise and patient values.
Elements of EBM:Elements of EBM:
1- Best research evidence: clinically relevant research that has been1- Best research evidence: clinically relevant research that has been
conducted using sound methodologyconducted using sound methodology
2- Clinical expertise: the clinician's cumulated experience, education2- Clinical expertise: the clinician's cumulated experience, education
and clinical skills.and clinical skills.
3- Patient values: the unique preferences, concerns, and3- Patient values: the unique preferences, concerns, and
expectations each patient brings into a clinical encounter.expectations each patient brings into a clinical encounter.
4. How did it start?How did it start?
Late 1970’s clinical epidemiologists at McMasterLate 1970’s clinical epidemiologists at McMaster
University wrote a series of articles on how to readUniversity wrote a series of articles on how to read
clinical journals calledclinical journals called critical appraisalcritical appraisal that werethat were
published in 1981 in Canadian Medical Associationpublished in 1981 in Canadian Medical Association
Journal.Journal.
This team started teaching the practice at the UniversityThis team started teaching the practice at the University
and the term changed to EBM in a document forand the term changed to EBM in a document for
resident applicants in 1990.resident applicants in 1990.
In 1991 the term EBM appeared in ACP JC.In 1991 the term EBM appeared in ACP JC.
5. Why EBM?Why EBM?
Daily need for valid information.Daily need for valid information.
Inadequacy of traditional textbooks – out of date,Inadequacy of traditional textbooks – out of date,
ineffective, overwhelming.ineffective, overwhelming.
Disparity between our diagnostic skills and clinicalDisparity between our diagnostic skills and clinical
judgment – and up to date knowledge and clinicaljudgment – and up to date knowledge and clinical
performance.performance.
The EBM process aims to make it easier to apply currentThe EBM process aims to make it easier to apply current
quality evidence from research in clinical and healthcarequality evidence from research in clinical and healthcare
decisions.decisions.
6. Obstacles to EBMObstacles to EBM
Shortage of coherent consistent scientific evidence.Shortage of coherent consistent scientific evidence.
Difficulty applying to my patient population.Difficulty applying to my patient population.
Developing skills for searching and appraising.Developing skills for searching and appraising.
TimeTime
Limited number of studies that show “EBM” works.Limited number of studies that show “EBM” works.
7. EBM - How to practice:EBM - How to practice:
The 5 A’sThe 5 A’s
AAsk – formulated clinical questionsk – formulated clinical question
AAcquire – best evidence to answer a questioncquire – best evidence to answer a question
AAppraise – evidence for validity, impact and applicabilityppraise – evidence for validity, impact and applicability
AApply – to our patientpply – to our patient
AAssess – effectivenessssess – effectiveness
8. AAsksk
Formulate the clinical question :Formulate the clinical question :
PICOPICO
PPatient’s problem and problem of interest;atient’s problem and problem of interest;
IIntervention, prognostic factor or exposure of interestntervention, prognostic factor or exposure of interest
CComparison interventionomparison intervention
OOutcomes of interestutcomes of interest
The question needs to be focused and searchable.The question needs to be focused and searchable.
9. Patient population and problem ofPatient population and problem of
interestinterest
How would you describe a group of patients similar to yours?How would you describe a group of patients similar to yours?
What are the most important characteristics of the patient?What are the most important characteristics of the patient?
Patient populationPatient population :: e.g. sex, age or race of the patiente.g. sex, age or race of the patient
Problem of interest : the primary problem, disease, or co-Problem of interest : the primary problem, disease, or co-
existing conditions.existing conditions.
10. Intervention, prognostic factor, orIntervention, prognostic factor, or
exposureexposure
Which main intervention, prognostic factor, or exposureWhich main intervention, prognostic factor, or exposure
are you considering?are you considering?
What do you want to do for the patient? Prescribe aWhat do you want to do for the patient? Prescribe a
drug? Order a test? Order surgery?drug? Order a test? Order surgery?
What factor may influence the prognosis of the patient?What factor may influence the prognosis of the patient?
Age? Co-existing problems?Age? Co-existing problems?
What was the patient exposed to? Asbestos? CigaretteWhat was the patient exposed to? Asbestos? Cigarette
smoke?smoke?
11. ComparisonComparison
What is the main alternative to compare with theWhat is the main alternative to compare with the
intervention?intervention?
Are you trying to decide between two drugs, a drug andAre you trying to decide between two drugs, a drug and
no medication or placebo, or two diagnostic tests?no medication or placebo, or two diagnostic tests?
Your clinical question does not always need a specificYour clinical question does not always need a specific
comparison.comparison.
12. OutcomesOutcomes
What can you hope to accomplish, measure,What can you hope to accomplish, measure,
improve or affect?improve or affect?
What are you trying to do for the patient?What are you trying to do for the patient?
Relieve or eliminate the symptoms?Relieve or eliminate the symptoms?
Reduce the number of adverse events?Reduce the number of adverse events?
Improve function or test scores?Improve function or test scores?
13. CaseCase
Zahra is 67 years old and has a history of congestive heart failureZahra is 67 years old and has a history of congestive heart failure
brought on by several myocardial infarctionsbrought on by several myocardial infarctions..
She has been hospitalized twice within the last 6 months forShe has been hospitalized twice within the last 6 months for
worsening of heart failure. At the present time she remains inworsening of heart failure. At the present time she remains in
normal sinus rhythm. She is extremely diligent about taking hernormal sinus rhythm. She is extremely diligent about taking her
medications (enalapril, aspirin and simvastatin) and wantsmedications (enalapril, aspirin and simvastatin) and wants
desperately to stay out of the hospital.desperately to stay out of the hospital.
You think she should also be taking digoxin but you are notYou think she should also be taking digoxin but you are not
certain if this will help keep her out of the hospital. You decidecertain if this will help keep her out of the hospital. You decide
to research this question before her next visit.to research this question before her next visit.
Formulate answerable focused clinical question?Formulate answerable focused clinical question?
14. PICO QUESTIONPICO QUESTION
PPatients: congestive heart failure, elderlyatients: congestive heart failure, elderly
IIntervention: digoxinntervention: digoxin
CComparison:omparison: none, placebonone, placebo
OOutcomes: primary (reduce need for hospitalization)utcomes: primary (reduce need for hospitalization)
secondary (reduce mortality)secondary (reduce mortality)
In elderly patients with congestive heart failure, is digoxinIn elderly patients with congestive heart failure, is digoxin
effective in reducing the need for re-hospitalization?effective in reducing the need for re-hospitalization?
15. Type of questionType of question
DiagnosisDiagnosis
TherapyTherapy
PrognosisPrognosis
Harm/EtiologyHarm/Etiology
16. Type of studyType of study
DiagnosisDiagnosis
prospective, blind comparison toprospective, blind comparison to
a gold standarda gold standard
HarmHarm
RCT > cohort > case control >RCT > cohort > case control >
case seriescase series
PrognosisPrognosis
cohort study > case control >cohort study > case control >
case seriescase series
TreatmentTreatment
RCT>cohort > case control >RCT>cohort > case control >
case seriescase series
18. AAppraiseppraise
Appraise the EvidenceAppraise the Evidence
Once an article is located, it is necessary to appraise its validity andOnce an article is located, it is necessary to appraise its validity and
importance before applying the results.importance before applying the results.
The specific analysis of the paper, regarding validity and importance etc,The specific analysis of the paper, regarding validity and importance etc,
depend on the type of study design and the nature of the question.depend on the type of study design and the nature of the question.
User’s Guide to the Medical Literature, JAMA 2002User’s Guide to the Medical Literature, JAMA 2002
1. Are the results valid?
2. What are the results?
3. How will these results help me work with my patients?
19. AApplypply
Apply the Results to Your PatientApply the Results to Your Patient
Is the evidence applicable to your patient, andIs the evidence applicable to your patient, and feasiblefeasible in yourin your
setting?setting?
Would your patient fit inclusion and not exclusion criteria?Would your patient fit inclusion and not exclusion criteria?
Were all clinically important outcomes considered?Were all clinically important outcomes considered?
Are costs and risks acceptable?Are costs and risks acceptable?
Are patients values/expectations considered?Are patients values/expectations considered?
20. AAssessssess
Assess the OutcomeAssess the Outcome
The final step includes an evaluation of yourThe final step includes an evaluation of your
performance in searching the literature, as well as anperformance in searching the literature, as well as an
assessment of the patient’s response.assessment of the patient’s response.
Perform self evaluations to improve your skills inPerform self evaluations to improve your skills in
using EBM.using EBM.
21. Self EvaluationSelf Evaluation
Are my questions well formulated?Are my questions well formulated?
Am I effectively/efficiently searching?Am I effectively/efficiently searching?
How am I doing with critical appraisal?How am I doing with critical appraisal?
Am I integrating what I have learned into clinicalAm I integrating what I have learned into clinical
practice?practice?
Are patients benefiting?Are patients benefiting?
22. EBM conclusionEBM conclusion
The use of current best available evidence inThe use of current best available evidence in
making decisions about patient care whilemaking decisions about patient care while
considering patient values.considering patient values.
Requires skills for critical appraisal as well asRequires skills for critical appraisal as well as
skills for applying evidence appropriately toskills for applying evidence appropriately to
individual patients.individual patients.
Lifelong process of learning enhanced by self-Lifelong process of learning enhanced by self-
evaluation.evaluation.