Dear John
Just a brief comment on the role of NICE. it is an NHS organisation. it is
asked to comment on technologies or to provide guidelines by the Department of
Health/Welsh Assembly Government. it provides the scientific background to its
work, including the cost-effectiveness of technologies and, as a separate but
obviously related exercise decides if the figures on cost effectiveness are
sufficient to make it useful in the NHS.
The first is a scientific exercise, the second a judgement based on expert
opinion about whether it provides value for money for the NHS in relation to the
other things that the NHS has to provide and its finite budget.
Norman Vetter
Dr Norman J Vetter
Department of Epidemiology
UWCM
Heath Park
Cardiff, CF14 4XN
UK
Tel: +44 (0)29 20 744196
Web: www.normanvetter.com
>>> John Barclay <[log in to unmask]> 16/09/2004 22:21:19 >>>
Dear James Osborne
Thank you for clarifying the origin of the acronym "EBM".
Are you sure it is still the same today?
I would have thought "EBM" as meaning "Empirically Biased Medicine". This
seems a more appropriate translation of the acronym, given the role of NICE in
the UK (and also some European institutions) in providing practice guidelines
and recommendations which appear to be driven more by the limitation of costs to
political entities than by improving outcomes for individual patients...
Sincerely.
Dr John Barclay.
----- Original Message -----
From: Osborne, James
To: [log in to unmask]
Sent: Thursday, September 16, 2004 7:10 PM
Subject: Re: evidence based medicine [MeSH]
Jon
The quick (but maybe not that explanatory) answer is as follows;
----------------------------
EVIDENCE-BASED-MEDICINE
Scope Note
The process of systematically finding, appraising, and using contemporaneous
research findings as the basis for clinical decisions. Evidence-based
medicine asks questions, finds and appraises the relevant data, and
harnesses that information for everyday clinical practice. Evidence-based
medicine follows four steps: formulate a clear clinical question from a
patient's problem; search the literature for relevant clinical articles;
evaluate ( critically appraise) the evidence for its validity and
usefulness; implement useful findings in clinical practice. The term
"evidence based medicine" (no hyphen) was coined at McMaster Medical School
in Canada in the 1980's to label this clinical learning strategy, which
people at the school had been developing for over a decade. (From BMJ 1995;
310:1122).
----------------------------
This information is taken from the expansion note attached to the MESH
Heading taken from the NHS-Dialog system. The MESH term was introduced in
1997.
Also of interest is how the other bibliographic databases handle the term.
For example, Cinahl had a term PROFESSIONAL-PRACTICE-RESEARCH-BASED used
from 1997 to 2000, then replaced by the term
PROFESSIONAL-PRACTICE-EVIDENCE-BASED from 2000 to 2002, when they split the
terms into MEDICAL-PRACTICE-EVIDENCE-BASED and
NURSING-PRACTICE-EVIDENCE-BASED. Cinahl's 'definition' of
MEDICAL-PRACTICE-EVIDENCE-BASED is 'Medical practice that bases clinical
decisions on research, clinical expertise, patient choices, and critical
evaluation of the literature'.
Whatever the bibliographic database, because we know (anectodatally?) that
the practice of MESH mapping and similar can occasionally be less than
perfect, that's why good searchers will complement their use with sensible
text-word searching.
To really answer your question, I suspect you'll need to tap a NLM
librarian.
James Osborne
Clinical Effectiveness Coordinator
United Bristol Healthcare NHS Trust
Bristol
-----Original Message-----
From: Jon Brassey [mailto:[log in to unmask]]
Sent: 16 September 2004 17:31
To: [log in to unmask]
Subject: evidence based medicine [MeSH]
Does anyone know the criteria that the NLM uses to assign the "evidence
based medicine" MeSH term?
Best wishes
jon
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