Language-use Suggestion:
Types of information selection
a. System 1 (pre-conscious) This is cognitively necessary and is can be
modified to some extent by learning (expertise).
b. System 2 (conscious)
i. Relatively careful
ii. Relatively careless
iii. Intentionally Deceptive, Tendentious, Invidious, Nefarious, or
whatever
Jim
James M. Walker, MD, FACP
Chief Medical Information Officer
Geisinger Health System
The best way to predict the future is to invent it.
- Alan Kay
>>> Jordan Panayotov 04/14/12 9:22 AM >>>
Dear All,
May I add an important detail that is missing in the discussion about
EBP/EBM/EIP/EIM/EIDM.
How reliable is the Evidence? What happens with the Evidence when, for
example, 193 (one hundred ninety three) papers are RETRACTED?
See Retraction Watch here
http://retractionwatch.wordpress.com/2012/04/10/193-papers-could-be-retracted-journal-consortium-issues-ultimatum-in-fujii-case/
Countless number of practitioners and decision-makers around the world
try to adhere to Evidence-Based Practice which is based on evidence,
which is based on systematic reviews, which are based on peer reviewed
publications (like Fujii’s papers).
According to Microsoft Academic Search
http://65.54.113.26/Author/54367026/yoshitaka-fujii Fujii has been cited
5,735 times! Y. Fujii has collaborated with 512 co-authors from 1991 to
2011; Cited by 18,519 authors!
What is the VALUE of such Evidence? What is the impact of such
"Evidence" on EBP/EBM?
All the best,
Jordan
----- Original Message -----
From: Djulbegovic, Benjamin
To: [log in to unmask]
Sent: Friday, April 13, 2012 3:17 AM
Subject: Re: Definitions of EBM/EBP
Indeed, SELECTIVE use of evidence is greater threat to the practice of
medicine than not consulting evidence resources at all!
bd
From: Evidence based health (EBH)
[mailto:[log in to unmask]] On Behalf Of Ash Paul
Sent: Thursday, April 12, 2012 1:13 PM
To: [log in to unmask]
Subject: Re: Definitions of EBM/EBP
Dear Rakesh,
Your comment 'Is it possible that most practitioners would love to
understand EIP as (B) practice informed on the cumulation/totality of
research but unfortunately often end up with (A) practice informed by
any piece (or pieces) of evidence' is not only very interesting but also
very relevant, especially for healthcare commissioners.
You might find this 2009 article published in the 'Journal of Health
Sceinces Education' interesting:
Educational strategies to reduce diagnostic error: can you teach the
stuff?
http://www.isabelhealthcare.com/pdf/EducationStrategiesToReduceDiagnosticError.pdf
The author Mark Graber refers to (here we go again, I'm wading into
Biblical controversy once more!) The 10 Commandments To Reduce Cognitive
Errors
1. Thou shalt reflect on how you think and decide.
2. Thou shalt not rely on your memory when making critical decisions.
3. Thou shalt make your working environment information-friendly by
using the latest wireless technology such as the Tablet PC and PDA.
4. Thou shalt consider other possibilities even though you are sure of
your first diagnosis.
5. Thou shalt know Bayesian probability and the epidemiology of the
diseases in your differential diagnosis.
6. Thou shalt mentally rehearse common and serious conditions that you
expect to see in your specialty.
7. Thou shalt ask yourself if you are the right person to make the
final decision or a specialist after considering the patient’s values
and wishes.
8. Thou shalt take time to decide and not be pressured by anyone.
9. Thou shalt create accountability procedures and follow up for
decisions made.
10. Thou shalt record in a relational data base software your
patient’s problems and decisions for review and improvement.
Leo Leonidas MD (Pediatrics,
Regards,
Ash
From: Rakesh Biswas
To: [log in to unmask]
Sent: Thursday, 12 April 2012, 15:34
Subject: Re: Definitions of EBM/EBP
Thanks Neil for this great discussion.
Is it possible that most practitioners would love to understand EIP as
(B) practice informed on the cumulation/totality of research but
unfortunately often end up with (A) practice informed by any piece (or
pieces) of evidence.
This is again possibly due to the fact that cumulation/totality of
research depends on 'as far as such cumulation exists' and is accessible
to the practitioner?
regards, rakesh
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