JiscMail Logo
Email discussion lists for the UK Education and Research communities

Help for EVIDENCE-BASED-HEALTH Archives


EVIDENCE-BASED-HEALTH Archives

EVIDENCE-BASED-HEALTH Archives


EVIDENCE-BASED-HEALTH@JISCMAIL.AC.UK


View:

Message:

[

First

|

Previous

|

Next

|

Last

]

By Topic:

[

First

|

Previous

|

Next

|

Last

]

By Author:

[

First

|

Previous

|

Next

|

Last

]

Font:

Proportional Font

LISTSERV Archives

LISTSERV Archives

EVIDENCE-BASED-HEALTH Home

EVIDENCE-BASED-HEALTH Home

EVIDENCE-BASED-HEALTH  April 2012

EVIDENCE-BASED-HEALTH April 2012

Options

Subscribe or Unsubscribe

Subscribe or Unsubscribe

Log In

Log In

Get Password

Get Password

Subject:

Re: Definitions of EBM/EBP

From:

"Ahmed Abou-Setta, M.D." <[log in to unmask]>

Reply-To:

Ahmed Abou-Setta, M.D.

Date:

Thu, 12 Apr 2012 14:33:58 -0500

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (179 lines)

Well Amy (and others), it's just a shift in the language used to describe
research (in order to get it recognized and published). No one really writes
narrative reviews, they are all now "systematic reviews", even if they are
not systematic... but that's what the consumers want to read. Researchers
are marketing their products (publications) to unfortunately unaware
population of physicians who don't have time to critically appraise
evidence. Most trials I review on a daily basis do not describe their
methods in any real way to allow for a proper appraisal. They use big words
like "random" and "double-blind" and the reader is expected to bow down to
their highnesses and accept that they even know what the meaning of random
is or how to properly blind participants/ investigators/ assessors. In the
medical literature, researchers have to market their results so they can
ride the publication bias wave and get published in top journals. Clinicians
(like all humans) by nurture have been taught to be look for associations
between objects. In this case, we associate 'good evidence' with top
journals, systematic reviews, and 'level I evidence' even if we don't
understand why one trial publication falls under one category versus
another. My statements are general, and I know that there are some
exceptional clinicians/researchers out there, but unfortunately the majority
of clinicians don't have the protected time to do research or evaluate
published research. I know of people who actually come into work an hour or
two before everyone else just to have some quiet time for catching up on new
research. Of course that's time away from the rest of their lives. It's a
tough balance, but there has to be a better plan for teaching clinicians
about what EBM/EBHC is, and how to incorporate this in their everyday
practice.

Ahmed

-----Original Message-----
From: Evidence based health (EBH)
[mailto:[log in to unmask]] On Behalf Of Amy Price
Sent: Thursday, April 12, 2012 1:10 PM
To: [log in to unmask]
Subject: Re: Definitions of EBM/EBP

In the USA many I associate with or know from groups either make the false
assumption that EBM EBHC is RCT level 1A or nothing. Or they call anything
they produce evidence and say because we produced a study the product is
evidence based. Finding evidence takes them weeks unless it is their
specific topic and then they know this because they review for major
journals. Expert, disciplined, accountable selection is the keyŠ

Amy Price

On 4/12/12 1:38 PM, "Djulbegovic, Benjamin" <[log in to unmask]>
wrote:

>
>I was really referring to CONSCIOUS selection of evidence (obviously in 
>support of particular view, which is the main reason for such massive 
>overuse of treatments and tests)...
>
>
>-----Original Message-----
>From: Jim Walker [mailto:[log in to unmask]]
>Sent: Thursday, April 12, 2012 1:33 PM
>To: Djulbegovic, Benjamin; [log in to unmask]
>Subject: Re: Definitions of EBM/EBP
>
>Although a cognitive psychologist or behavioral economist might point 
>to evidence that no practice or other thought is possible without 
>selection (both pre-conscious and conscious) from among the information
available.
>
>
>Perhaps the relevant distinction is between relatively expert, 
>disciplined, accountable selection and relatively naive, ad hoc, 
>implicit selection.
>
>
>See Norretranders (1991) The User Illusion, which focuses on selection 
>directly or Kahneman (2012) Thinking, Fast and Slow for a more recent 
>and authoritative summary of the literature.
>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
>>>> "Djulbegovic, Benjamin"  04/12/12 1:18 PM >>>
>
>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/EducationStrategiesToReduceDiagnost
>icE
>rror.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 patient¹s 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 patient¹s 
>problems and decisions for review and improvement.
>
>Leo Leonidas MD (Pediatrics, Maine)
>Ref:
>Trowbridge, R. (2008). Twelve tips for teaching avoidance of diagnostic 
>errors. Medical Teacher, 30, 496­500.
>
>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
>
>
>
>
>IMPORTANT WARNING: The information in this message (and the documents 
>attached to it, if any) is confidential and may be legally privileged. 
>It is intended solely for the addressee. Access to this message by 
>anyone else is unauthorized. If you are not the intended recipient, any 
>disclosure, copying, distribution or any action taken, or omitted to be 
>taken, in reliance on it is prohibited and may be unlawful. If you have 
>received this message in error, please delete all electronic copies of 
>this message (and the documents attached to it, if any), destroy any 
>hard copies you may have created and notify me immediately by replying 
>to this email. Thank you.
>
>Geisinger Health System utilizes an encryption process to safeguard 
>Protected Health Information and other confidential data contained in 
>external e-mail messages. If email is encrypted, the recipient will 
>receive an e-mail instructing them to sign on to the Geisinger Health 
>System Secure E-mail Message Center to retrieve the encrypted e-mail.

Top of Message | Previous Page | Permalink

JISCMail Tools


RSS Feeds and Sharing


Advanced Options


Archives

April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004
September 2004
August 2004
July 2004
June 2004
May 2004
April 2004
March 2004
February 2004
January 2004
December 2003
November 2003
October 2003
September 2003
August 2003
July 2003
June 2003
May 2003
April 2003
March 2003
February 2003
January 2003
December 2002
November 2002
October 2002
September 2002
August 2002
July 2002
June 2002
May 2002
April 2002
March 2002
February 2002
January 2002
December 2001
November 2001
October 2001
September 2001
August 2001
July 2001
June 2001
May 2001
April 2001
March 2001
February 2001
January 2001
December 2000
November 2000
October 2000
September 2000
August 2000
July 2000
June 2000
May 2000
April 2000
March 2000
February 2000
January 2000
December 1999
November 1999
October 1999
September 1999
August 1999
July 1999
June 1999
May 1999
April 1999
March 1999
February 1999
January 1999
December 1998
November 1998
October 1998
September 1998


WWW.JISCMAIL.AC.UK

Secured by F-Secure Anti-Virus CataList Email List Search Powered by the LISTSERV Email List Manager