RCT less than 24 months old.
--
Preston H. Long
> From: "Djulbegovic, Benjamin" <[log in to unmask]>
> Reply-To: "Djulbegovic, Benjamin" <[log in to unmask]>
> Date: Tue, 5 Jun 2001 08:41:27 -0400
> To: [log in to unmask]
> Subject: Re: Is EBM Effective?
>
> But, how do you define "the most current and up to date info"?
> ben
>
>
> -----Original Message-----
> From: preston [mailto:[log in to unmask]]
> Sent: Tuesday, June 05, 2001 8:32 AM
> To: Djulbegovic, Benjamin; [log in to unmask]
> Subject: Re: Is EBM Effective?
>
>
> To me an EBM provider uses the most current and up to date info in his
> practice. I find reasons why providers don't use EBM far more interesting.
> Some reasons offered have been ignorance, peer pressure, financial incentive
> and reward. William J. Mayo said,"The best interest of the patient is the
> only interest to be considered." I am currently involved in a study
> comparing EBM to placebo and conventional treatments of a condition.
> --
> Preston H. Long
>
>> From: "Djulbegovic, Benjamin" <[log in to unmask]>
>> Reply-To: "Djulbegovic, Benjamin" <[log in to unmask]>
>> Date: Tue, 5 Jun 2001 08:22:13 -0400
>> To: [log in to unmask]
>> Subject: Re: Is EBM Effective?
>>
>> Since there has been some lamenting recently about the lack of activity on
>> this group, to add some "fuel" (pointing to the difficulties if not
>> impossibility of conducting a study proposed below), I would just like to
>> ask:
>> "how would one define an "EBM doctor"? Let's say someone would like to
> fund
>> such a study: What definitions of EBM vs. non-EBM doctors would you use?
>> (Actually, I am not trying to be a provocative here. It is just after many
>> years of teaching and hopefully practicing EBM, I came to conclusion that
>> the value of EBM should not be evaluated against non-EBM, but should be
>> sought in the understanding of the quality of our knowledge, as I
> described
>> in my message from yesterday).
>>
>> hope we can get some stimulating discussion going...
>>
>> ben
>>
>> -----Original Message-----
>> From: jordanra [mailto:[log in to unmask]]
>> Sent: Tuesday, June 05, 2001 7:01 AM
>> To: [log in to unmask]
>> Subject: Re: Is EBM Effective?
>>
>>
>> Agree with what has been said, but would add, that EBM might also assist
> in
>> building more realistic expectations into the physician/patient
> relationship
>> and medical science. A major challange however, is for physicians to
>> develop the necessary communication skills. (And to some degree, for the
>> average patient to develop some educated listening skills).
>>
>> R. Jordan
>> LTC, MC
>> Commander
>> U. S. Army Medical Activity, Japan
>>
>> ----- Original Message -----
>> From: "Marjan Kljakovic" <[log in to unmask]>
>> To: <[log in to unmask]>
>> Sent: Tuesday, June 05, 2001 7:01 AM
>> Subject: Re: Is EBM Effective?
>>
>>
>>> I read with interest the angst around trying to see whether teaching
>>> EBM is effective on patient outcomes. I think Toby Lipman hit the nail
>>> on the head when he wrote
>>> "Surely using patient outcomes is a far too complex end-point for a
>>> study of the effectiveness of EBM?"
>>>
>>> The issue of compexity is pivotal in understanding why the
>>> effectiveness of EBM teaching will be ellusive.
>>>
>>> The core of activity in general practice (for doctors) is the doctor /
>>> patient / illness relationship. EBM is a technique used by the doctor to
>>> try and influence that relationship so that a desired outcome might be
>>> achieved with respect to an illness.
>>>
>>> As a teacher of EBM with undergraduate and post graduate medical
>>> students, I live in the hope that I have an effect on patient outcomes
>>> which those students will create with their future patients. I use the
>>> word "hope" because I am sure that what I teach is at least two steps
>>> back from any patient outcome:
>>>
>>> I would encourage research into the various relationships that are
>>> inherent in the steps between the teacher of EBM and the desired
>>> outcomes. We need more qualitative research to answer questions
>>> on relationship issues such as
>>> "How can teachers influence students to take EBM seriously?"
>>> "How do student carry EBM teaching into clinical practice?"
>>> "How do patients perceive the "EBM" doctor" compared to the
>>> "non-EBM doctor?"
>>> Cheers
>>> Marjan
>>>
>>>
>>> The whole matter is complex because we need to understand that
>>> there is
>>>
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