scholarly journals Frailty, the determinants of health and the new evidence base

2018 ◽  
Vol 1 (1) ◽  
pp. 5-6
Author(s):  
Roman Romero-Ortuno ◽  
Duncan R. Forsyth
Keyword(s):  
Evidence Base ◽  
Determinants Of Health ◽  
New Evidence

Pharmacological management of acute severe behavioural disturbance: a survey of current protocols

2017 ◽  
Vol 25 (4) ◽  
pp. 395-398 ◽  
Author(s):  
Nick O’Connor ◽  
John Corish
Keyword(s):  
Clinical Decision Making ◽  
Relevant Literature ◽  
Clinical Decision ◽  
Evidence Base ◽  
Clinical Knowledge ◽  
Behavioural Disturbance ◽  
Treatment Protocols ◽  
Pharmacological Management ◽  
New Evidence ◽  
Careful Assessment

Objectives: The investigators reviewed protocols for the pharmacological management of acute severe behavioural disturbance (ASBD) used in Australasian psychiatric settings. Relevant literature was also examined, with a focus on Australian research. Methods: All Fellows of the RANZCP were emailed on two occasions in 2014 requesting a copy of the guidelines for pharmacological management of the ASBD patient used in their workplace. A literature search was also undertaken. Results: Thirty-six pharmacological management protocols for the ASBD patient were received. Twenty-six of these referred to patients aged 18–65 years and were selected for analysis. A number of recent publications provided new evidence in relation to the safe and effective management of patients with ASBD. Conclusions: ASBD is a heterogeneous, transnosological set of presentations requiring careful assessment and rational clinical decision making. Treatment protocols arising from an evolving evidence base provide safe and effective pathways for the majority of patients. However, sound clinical knowledge and a careful assessment of each presentation is required to enable the clinician to tailor treatment individually.

Is Health Made or Bought? New Evidence on the Roles of Work and Income as Determinants of Health

2008 ◽  
Author(s):  
Michael Wolfson ◽  
Philippe Fines ◽  
Geoff Rowe ◽  
Russell Wilkins
Keyword(s):  
Determinants Of Health ◽  
New Evidence

Voter Mobilization, Experimentation, and Translational Social Science

2016 ◽  
Vol 14 (3) ◽  
pp. 738-749 ◽  
Author(s):  
Donald P. Green ◽  
Alan S. Gerber
Keyword(s):  
Social Science ◽  
Voter Turnout ◽  
Field Experiments ◽  
Evidence Base ◽  
Research Literature ◽  
Public Knowledge ◽  
Voter Mobilization ◽  
Rapid Accumulation ◽  
New Evidence ◽  
Political Groups

Field experiments on voter mobilization enable researchers to test theoretical propositions while at the same time addressing practical questions that confront campaigns. This confluence of interests has led to increasing collaboration between researchers and campaign organizations, which in turn has produced a rapid accumulation of experiments on voting. This new evidence base makes possible translational works such as Get Out the Vote: How to Increase Voter Turnout that synthesize the burgeoning research literature and convey its conclusions to campaign practitioners. However, as political groups develop their own in-house capacity to conduct experiments whose results remain proprietary and may be reported selectively, the accumulation of an unbiased, public knowledge base is threatened. We discuss these challenges and the ways in which research that focuses on practical concerns may nonetheless speak to enduring theoretical questions.

scholarly journals Updating the Evidence Base for Suctioning Adult Patients: A Systematic Review

2009 ◽  
Vol 16 (3) ◽  
pp. e6-e17 ◽  
Author(s):  
Tom J Overend ◽  
Cathy M Anderson ◽  
Dina Brooks ◽  
Lisa Cicutto ◽  
Michael Keim ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Meta Analysis ◽  
Evidence Base ◽  
Health Care Team ◽  
Adult Patients ◽  
Cochrane Library ◽  
Open Versus ◽  
New Evidence

OBJECTIVES: To update a previous clinical practice guideline on suctioning in adult patients, published in theCanadian Respiratory Journalin 2001.METHODS: A primary search of the MEDLINE (from 1998), CINAHL, EMBASE and The Cochrane Library (all from 1996) databases up to November 2007, was conducted. These dates reflect the search limits reached in the previous clinical practice guideline. A secondary search of the reference lists of retrieved articles was also performed. Two reviewers independently appraised each study before meeting to reach consensus. Study quality was evaluated using the Jadad and PEDro scales. When sufficient data were available, a meta-analysis was conducted using a random effects model. Data are reported as ORs, weighted mean differences and 95% CIs. When no comparisons were possible, qualitative analyses of the data were completed.RESULTS: Eighty-one studies were critically appraised from a pool of 123. A total of 28 randomized controlled trials or randomized crossover studies were accepted for inclusion. Meta-analysis was possible for open versus closed suctioning only. Recommendations from 2001 with respect to hyperoxygenation, hyperinflation, use of a ventilator circuit adaptor and subglottic suctioning were confirmed. New evidence was identified with respect to indications for suctioning, open suction versus closed suction systems, use of medications and infection control.CONCLUSIONS: While new evidence continues to be varied in strength, and is still lacking in some areas of suctioning practice, the evidence base has improved since 2001. Members of the health care team should incorporate this evidence into their practice.

scholarly journals Value Assessment, Real World Evidence and Fundamental Measurement: Version 3.0 of the Minnesota Formulary Submission Guidelines

2020 ◽  
Vol 11 (4) ◽  
pp. 12
Author(s):  
Paul C. Langley
Keyword(s):  
Evidence Base ◽  
Pharmaceutical Products ◽  
Normal Science ◽  
Value Assessment ◽  
New Paradigm ◽  
Therapeutic Class ◽  
New Information ◽  
Real World Evidence ◽  
Fatal Flaw ◽  
New Evidence

This latest version of the Minnesota guidelines is intended to reassert the application of the standards of normal science in formulary submissions for new and existing pharmaceutical products and devices. This represents a paradigm shift from the existing value assessment standards which are focused on imaginary or I-QALY modeling of lifetime claims. The proposed new paradigm rejects this as pseudoscience; a failure to recognize the standards of normal science, in particular a failure to recognize the constraints of fundamental measurement. As a result, current health technology assessment is dominated by value assessments that create claims that are neither credible, nor empirically evaluable or replicable. The fatal flaw is the failure to recognize that QALYS are an impossible mathematical construct (hence the term I-QALY). The proposed paradigm recognizes that if there are claims for product value then, regardless of whether the claim is for clinical impact, quality of life or resource utilization, all claims must be empirically evaluable. If not, then they should be rejected. The Minnesota guidelines propose a new evidence based approach to formulary assessment, together with ongoing disease area and therapeutic class reviews. The focus is on claims that are specific to target patient populations that are claims for specific attributes and are consistent with the axioms of fundamental measurement. Manufacturers are asked to support claims assessment through protocols detailing the evidence base for claims assessment, the timelines for those assessments and the process by which claims assessments are reported back to formulary committees. Value assessment leads naturally to value contracting, revisiting provisional prices as new information is discovered and delivered to the formulary committee.    

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