Contemporary Approaches for Evidence-Based Pharmacotherapy

2013 ◽  
Vol 26 (2) ◽  
pp. 95-102
Author(s):  
Suzanna Gim ◽  
William R. Vincent
Keyword(s):  
Evidence Based Medicine ◽  
Patient Specific ◽  
Evidence Based ◽  
Valid Evidence ◽  
Clinical Questions ◽  
Based Medicine

Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. This article provides simple ways to practice everyday EBM by (1) asking patient-specific clinical questions, (2) finding the most relevant, best evidence, (3) critically appraising evidence to ensure validity, (4) applying evidence to practice, and (5) using available tools to stay abreast of relevant and valid evidence as it becomes available.

An overview of study designs

2020 ◽  
Vol 81 (5) ◽  
pp. 1-6
Author(s):  
Julian Aquilina ◽  
Joana B Neves ◽  
Maxine GB Tran
Keyword(s):  
Clinical Trials ◽  
Study Design ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Advantages And Disadvantages ◽  
Valid Evidence ◽  
Study Designs ◽  
Based Medicine

The numbers of clinical trials have increased exponentially over the last decade, amplifying the pressure to select an appropriate study design to obtain reliable and valid evidence. The ability to find, critically appraise and use evidence to develop new interventions is fundamental to evidence-based medicine. Different study designs have their own advantages and disadvantages, and provide different evidentiary value. This article provides an overview of clinical trials, illustrating that, ultimately, the study design chosen needs to meet experimental and funding limitations, while minimising error.

scholarly journals Answering Clinical Questions with Knowledge-Based and Statistical Techniques

2007 ◽  
Vol 33 (1) ◽  
pp. 63-103 ◽  
Author(s):  
Dina Demner-Fushman ◽  
Jimmy Lin
Keyword(s):  
Evidence Based Medicine ◽  
Information Needs ◽  
Semantic Processing ◽  
Question Answering ◽  
Clinical Medicine ◽  
Statistical Techniques ◽  
Evidence Based ◽  
Knowledge Based ◽  
Clinical Questions ◽  
Based Medicine

The combination of recent developments in question-answering research and the availability of unparalleled resources developed specifically for automatic semantic processing of text in the medical domain provides a unique opportunity to explore complex question answering in the domain of clinical medicine. This article presents a system designed to satisfy the information needs of physicians practicing evidence-based medicine. We have developed a series of knowledge extractors, which employ a combination of knowledge-based and statistical techniques, for automatically identifying clinically relevant aspects of MEDLINE abstracts. These extracted elements serve as the input to an algorithm that scores the relevance of citations with respect to structured representations of information needs, in accordance with the principles of evidence-based medicine. Starting with an initial list of citations retrieved by PubMed, our system can bring relevant abstracts into higher ranking positions, and from these abstracts generate responses that directly answer physicians' questions. We describe three separate evaluations: one focused on the accuracy of the knowledge extractors, one conceptualized as a document reranking task, and finally, an evaluation of answers by two physicians. Experiments on a collection of real-world clinical questions show that our approach significantly outperforms the already competitive PubMed baseline.

scholarly journals Bipolar disorder: clinical uncertainty, evidence-based medicine and large-scale randomised trials

2001 ◽  
Vol 178 (S41) ◽  
pp. s191-s194 ◽  
Author(s):  
John Geddes ◽  
Guy Goodwin
Keyword(s):  
Bipolar Disorder ◽  
Evidence Based Medicine ◽  
Large Scale ◽  
Bipolar Affective Disorder ◽  
Research Literature ◽  
Evidence Based ◽  
Drug Treatments ◽  
Clinical Questions ◽  
Collaborative Ventures ◽  
Based Medicine

BackgroundThe increasing use of the methods of evidence-based medicine to keep up-to-date with the research literature highlights the absence of high-quality evidence in many areas in psychiatry.AimsTo outline current uncertainties in the maintenance treatment of bipolar disorder and to describe some of the decisions involved in designing a large simple trial.MethodWe describe some of the strategies of evidence-based medicine, and how they can be applied in practice, focusing specifically on the area of bipolar disorder.ResultsOne of the key clinical uncertainties in the treatment of bipolar disorder is the place of maintenance drug treatments and their relative efficacy. A large-scale study, the Bipolar Affective Disorder: Lithium Anticonvulsant Evaluation (BALANCE) trial, is proposed to compare the effectiveness of lithium, valproate and the combination of lithium and valproate.ConclusionsProviding reliable answers to key clinical questions in psychiatry will require new approaches to clinical trials. These will need to be far larger than previously appreciated and will therefore need to be collaborative ventures involving front-line clinicians.

Parkinson disease: A summary of recent evidence-based medicine reviews

2012 ◽  
Vol 2 (2) ◽  
pp. 25-31 ◽  
Author(s):  
Jack J. Chen
Keyword(s):  
Parkinson Disease ◽  
Evidence Based Medicine ◽  
Patient Specific ◽  
Evidence Based ◽  
Motor Symptoms ◽  
Expert Opinions ◽  
Practice Parameters ◽  
Specific Factors ◽  
Economic Constraints ◽  
Based Medicine

ABSTRACT Parkinson disease (PD) is a complex movement disorder in which the symptomatology, severity and progression vary substantially among patients. Therefore, there is a need to individualize patient therapy. Factors that should be considered when individualizing therapy include published guidelines, practice parameters, and Evidence Based Medicine (EBM) reviews, as well as clinical experience and judgment, patient specific factors and preferences, consensus and expert opinions, and health economic constraints. This article discusses EBM findings regarding treatment of the motor symptoms and the non-motor symptoms associated with PD.

The Challenge of Evidence-Based Migraine Therapy

Cephalalgia ◽  
2000 ◽  
Vol 20 (2_suppl) ◽  
pp. 1-4 ◽  
Author(s):  
WJ Becker
Keyword(s):  
Clinical Trials ◽  
Clinical Experience ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Academic Health ◽  
Migraine Therapy ◽  
Research Challenges ◽  
Health Centres ◽  
Clinical Questions ◽  
Based Medicine

It is important that physicians practise evidence-based medicine. Clinical experience is important, but there are a number of reasons why clinical experience can lead to the impression that ineffective treatments are effective. There are major educational and research challenges which must be met before clinicians can practice evidence-based migraine therapy more extensively than at present. Treating physicians will need to learn more about the principles of evidence-based medicine. Researchers will need to produce more and better clinical trials that address important clinical questions. The results of these trials will need to be reported clearly, and we need to improve the efficiency with which these results can be accessed. It is important that the pharmaceutical industry, clinicians, and academic health centres work together to meet these challenges.

Medical Search Engines

2008 ◽  
pp. 873-881
Author(s):  
Bob Badgett ◽  
Suresh Chalasani ◽  
Rajendra V. Boppana ◽  
Jacqueline A. Pugh
Keyword(s):  
Biomedical Research ◽  
Evidence Based Medicine ◽  
Clinical Care ◽  
National Institutes Of Health ◽  
Research Articles ◽  
The Internet ◽  
Free Access ◽  
Evidence Based ◽  
Clinical Questions ◽  
Based Medicine

Twenty years ago, researchers identified the difficulties physicians have in answering the clinical questions that arise during medical care (Covell, Uman, & Manning, 1985). Fifteen years ago, the “Evidence-based medicine” movement arose (Cohen, 2001) and exhorted clinicians to use computers to look up the answers to questions as they arise during clinical care. Fortuitously for the proponents of evidence-based medicine the Internet matured in the 1990s{Hersh 1996 #3370}, epitomized by the launching of PubMed by Al Gore in June, 1997. PubMed, developed by the National Institutes of Health, provided the first free access to millions of biomedical research articles at MEDLINE. Unfortunately, the Internet has not fulfilled its potential to assist physicians in answering clinical questions. A recent study found that physicians obtain answers to only 40% of questions that arise during patient care (Ely, Osheroff, Chambliss, Ebell, & Rosenbaum, 2004); this rate is not much different than the rate of 30% reported 20 years ago (Covell et al., 1985).

scholarly journals The Evidence-based Medicine Paradigm: Where are We 20 Years Later? Part 2

2013 ◽  
Vol 40 (4) ◽  
pp. 475-481 ◽  
Author(s):  
Shashi S. Seshia ◽  
G. Bryan Young
Keyword(s):  
Cognitive Processes ◽  
Emerging Economies ◽  
Evidence Based Medicine ◽  
Statistical Tests ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Core Elements ◽  
Literature Evidence ◽  
Clinical Questions ◽  
Based Medicine

AbstractIn Part 2, we discuss the challenges of keeping up with the ‘literature,’ evidence-based medicine (EBM) in emerging economies and the Neurosciences, and two recent approaches to classifying evidence. We conclude by summarizing information from Parts 1 and 2 which suggest the need to critically re-appraise core elements of the EBM paradigm: (1) the hierarchical ranking of evidence, (2) randomized controlled trials or systematic reviews as the gold standard for all clinical questions or situations, (3) the statistical tests that have become integral to the ‘measurements’ for analyzing evidence, and (4) re-incorporating a role for evidence from basic sciences and pathophysiology. An understanding of how cognitive processes influence clinical decisions is also necessary to improve evidence-based practice. Emerging economies may have to modify the design and conduct of clinical research to their settings. Like all paradigms, EBM must keep improving with input from the grassroots to remain beneficial.

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