scholarly journals Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

2010 ◽  
Vol 10 ◽  
pp. 2228-2237 ◽  
Author(s):  
William T. Lowrance ◽  
Tatum V. Tarin ◽  
Shahrokh F. Shariat
Keyword(s):  
Cost Effectiveness ◽  
Radical Prostatectomy ◽  
Radical Retropubic Prostatectomy ◽  
Evidence Based ◽  
High Quality ◽  
Robotic Assisted ◽  
Retropubic Prostatectomy ◽  
Open Radical Prostatectomy ◽  
High Quality Evidence ◽  
Quality Evidence

The rapid adoption of robotic-assisted laparoscopic radical prostatectomy (RALP) has occurred despite a lack of high-quality evidence demonstrating its oncologic advantages, safety, or cost effectiveness compared with open radical retropubic prostatectomy (ORP). This review examines the current literature comparing ORP and RALP, focusing on perioperative, oncologic, functional, and economic outcomes.

Robotic-Assisted Laparoscopic Prostatectomy: Do Minimally Invasive Approaches Offer Significant Advantages?

2005 ◽  
Vol 23 (32) ◽  
pp. 8170-8175 ◽  
Author(s):  
Joseph A. Smith ◽  
S. Duke Herrell
Keyword(s):  
Radical Prostatectomy ◽  
Open Surgery ◽  
Radical Retropubic Prostatectomy ◽  
Robotic Assisted ◽  
Laparoscopic Prostatectomy ◽  
Retropubic Prostatectomy ◽  
Experienced Surgeon ◽  
Open Radical Prostatectomy ◽  
Postoperative Continence ◽  
Invasive Surgical Approach

Radical prostatectomy has maintained a cardinal role in the treatment of localized prostate cancer. Robotic-assisted laparoscopic prostatectomy (RALP) has been introduced as a less invasive surgical approach. Available data on RALP versus open approaches were reviewed for surgical and cancer related outcomes. RALP is consistently associated with decreased blood loss and limited postoperative pain and hospital stay. Surgical margins seem similar between most reported series of RALP or open radical prostatectomy. Most intrainstitutional comparisons demonstrate better postoperative continence and potency with RALP, but there is still debate about whether results are superior to radical retropubic prostatectomy in the hands of a highly experienced surgeon. RALP provides outcomes at least comparable, and, in some measures, superior to open surgery. Refinements of instrumentation may provide even better results in the future.

scholarly journals TRADE-OFFS BETWEEN EPISTEMIC AND MORAL VALUES IN EVIDENCE-BASED POLICY

2018 ◽  
Vol 35 (1) ◽  
pp. 49-78 ◽  
Author(s):  
Donal Khosrowi
Keyword(s):  
Controlled Trials ◽  
Evidence Based ◽  
Epistemic Values ◽  
High Quality ◽  
Political Values ◽  
Randomized Controlled ◽  
High Quality Evidence ◽  
Evidence Based Policy ◽  
Trade Offs ◽  
Quality Evidence

Abstract:Proponents of evidence-based policy (EBP) call for public policy to be informed by high-quality evidence from randomized controlled trials. This methodological preference aims to promote several epistemic values, e.g. rigour, unbiasedness, precision, and the ability to obtain causal conclusions. I argue that there is a trade-off between these epistemic values and several non-epistemic, moral and political values. This is because the evidence afforded by standard EBP methods is differentially useful for pursuing different moral and political values. I expand on how this challenges ideals of value-freedom and -neutrality in EBP, and offer suggestions for how EBP methodology might be revised.

Clinical studies of incidental intracranial meningiomas—towards high-quality evidence-based practice

2020 ◽  
Vol 162 (3) ◽  
pp. 673-674
Author(s):  
Abdurrahman I. Islim ◽  
Christopher P. Millward ◽  
Kirsty J. Martin-McGill ◽  
Ruwanthi Kolamunnage-Dona ◽  
Thomas Santarius ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Intracranial Meningiomas ◽  
Quality Evidence

Addressing the information needs of older patients

2002 ◽  
Vol 12 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Matthew Harris ◽  
Antony Bayer ◽  
Win Tadd
Keyword(s):  
Therapeutic Intervention ◽  
Older Patients ◽  
Information Needs ◽  
Clinical Governance ◽  
Reliable Information ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Risk Framework ◽  
Quality Evidence

The availability of high-quality, evidence-based, clearly communicated, user-focused information is central to the new NHS. Reliable information empowers patients and their families and enables them to become more knowledgeable about their care and condition following consultation and diagnosis or before a therapeutic intervention. It is an integral part of clinical governance and the clinical risk framework.

Organizing and delivering treatment for ADHD

2018 ◽  
Author(s):  
David Coghill ◽  
Marina Danckaerts
Keyword(s):  
Treatment Initiation ◽  
Careful Consideration ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
High Quality ◽  
Children With Adhd ◽  
High Quality Evidence ◽  
Ongoing Care ◽  
Evidence Based Guidelines ◽  
Quality Evidence

Following diagnosis, all children with ADHD will require some form of intervention, and most will require treatment over a relatively prolonged period of time. Whilst there are now several high-quality evidence-based guidelines for the management of ADHD, these are often difficult to operationalize into routine clinical practice and as a consequence studies report considerable variations in care at local, national, and international levels. We describe a structured, but flexible, approach to the organization and delivery of ADHD treatments that aims to optimize care and reduce variation in practice. This pathway pays particular attention to optimizing care through careful consideration of the initial targets for treatment and choice of first treatment, initiation and titration of medication treatments, monitoring ongoing care and identifying adverse events, and the adjustment and switching of treatments when outcomes are not optimal.

Asthma guidelines: which is the best of three?

2020 ◽  
Vol 31 (8) ◽  
pp. 344-351
Author(s):  
Andrew Booth
Keyword(s):  
Health Professional ◽  
Evidence Based ◽  
High Quality ◽  
Pharmacological Management ◽  
International Guidelines ◽  
Diagnosis And Management ◽  
Asthma Guideline ◽  
High Quality Evidence ◽  
The Uk ◽  
Quality Evidence

Andrew Booth offers a comprehensive look into national and international guidelines surrounding the diagnosis and management of asthma National and international guidelines provide evidence-based advice on the diagnosis and management of asthma. There are now three potential asthma guidelines to follow, each taking its own unique, and sometimes conflicting direction, creating a total of over 700 pages of high-quality evidence. A puzzle is thus presented to the busy health professional: which guideline do I follow? This article compares and contrasts two national and one international asthma guideline, focusing particularly on diagnosis and pharmacological management. Mortality from asthma is increasing in the UK, making the need for a conjoined guideline more urgent than ever.

Formative Evaluation of a Framework for High Quality, Evidence-Based Services in School Mental Health

2009 ◽  
Vol 1 (4) ◽  
pp. 196-211 ◽  
Author(s):  
Mark Weist ◽  
Nancy Lever ◽  
Sharon Stephan ◽  
Eric Youngstrom ◽  
Elizabeth Moore ◽  
...  
Keyword(s):  
Mental Health ◽  
Formative Evaluation ◽  
School Mental Health ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Quality Evidence

scholarly journals Ankyloglossia and Its Management- Need for Standardised Guidelines

2020 ◽  
pp. 36-41
Author(s):  
Hemanth Kowdley Subrahmanyam
Keyword(s):  
Decision Making ◽  
Diagnostic Criteria ◽  
Breast Feeding ◽  
Healthcare Providers ◽  
Treatment Decisions ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Evidence ◽  
Quality Evidence

With increasing diagnosis of ankyloglossia, the need for uniformity in diagnostic criteria and treatment decisions like frenotomy or frenuloplasty has come to the fore. Involvement of multidisciplinary healthcare providers who use various non-standardised resources and tools in the assessment and decision making is debatable. Effects of ankyloglossia on breast feeding, speech and sleep are discussed in this article following review of available high quality evidence based literature.

Evidence-based medicine

2017 ◽  
Author(s):  
Philip Wiffen ◽  
Marc Mitchell ◽  
Melanie Snelling ◽  
Nicola Stoner
Keyword(s):  
Evidence Based Medicine ◽  
Binary Data ◽  
Statistical Significance ◽  
Number Needed To Treat ◽  
Evidence Based ◽  
High Quality ◽  
Relative Risks ◽  
High Quality Evidence ◽  
Based Medicine ◽  
Quality Evidence

This chapter provides a brief overview to the concept of evidence-based medicine (EBM) starting with a well-accepted definition. The importance of clinical significance over statistical significance is discussed. A number of useful tools are presented and described to enable the practitioner to become competent in recognizing high-quality evidence and to have the skills to critically appraise evidence that is potentially important to their practice. There is a brief description of some of the statistical tools commonly used in EBM including binary data tools such as odds ratios, number needed to treat, and relative risks.

Biliary Dyskinesia: Current Perspectives and Future Directions

2020 ◽  
pp. 000313482097161
Author(s):  
Bryan K. Richmond ◽  
Andrew Walker
Keyword(s):  
Biliary Dyskinesia ◽  
Special Populations ◽  
Evidence Based ◽  
High Quality ◽  
Biliary Pain ◽  
Future Directions ◽  
Gallbladder Ejection Fraction ◽  
Diagnostic Strategies ◽  
High Quality Evidence ◽  
Quality Evidence

Biliary dyskinesia (BD) is a disorder characterized by functional biliary pain, the absence of gallstones on ultrasound, and the finding of a reduced gallbladder ejection fraction on a cholecystokinin-cholescintigraphic scan. Cholecystectomy remains a commonly applied treatment for BD, despite a lack of high-quality evidence supporting the practice. The following article provides an overview of the current diagnostic strategies, treatment outcomes with both surgical and nonsurgical treatment, emerging considerations related to special populations, and suggestions for addressing the identified knowledge gaps, moving forward in an effort to develop stronger, more evidence-based practice guidelines for treating this poorly understood and poorly studied condition.

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