Methods Of Evidence-based Medicine Research Articles

Tuina therapy for temporomandibular joint disorder syndrome: A protocol for systematic review and meta-analysis.

Background:Temporomandibular joint disorders (TMD) is common in clinic at present, which seriously affects the mental health and quality of life of patients. With the development of society, the incidence of TMD is gradually increasing. At present, there are many treatment methods, Tuina as a characteristic traditional Chinese medicine therapy, clinical treatment of TMD has a significant effect. In recent years, there are many clinical studies on Tuina in the treatment of TMD, but the clinical efficacy of Tuina in the treatment of TMD has not been systematically evaluated. In this study, we systematically evaluated the relevant literature of Tuina in the treatment of TMD by using the method of evidence-based medicine, in order to provide reference for clinical research in this direction in the future.Methods:VIP Chinese database, China knowledge Network, Wanfang, China Biomedical Database, PubMed, Embase, Cochrane Library and Web of Science were searched for clinical randomized controlled trials of Tuina in the treatment of TMD from the establishment of the database to December 2020. The 2 researchers independently screened the literature and carried out quality assessment and data extraction for the included study, and used RevMan5.3 software for risk assessment and Meta analysis.Results:In this study, the efficacy and safety of Tuina in the treatment of TMD were evaluated by effective rate, visual analog score (VAS) of temporomandibular joint pain, dysfunction index ((DI), palpation index (PI), craniomandibular index (CMI), maximum mouth opening (MMO), incidence of adverse reactions and so on.Conclusion:This protocol can provide evidence-based basis for the treatment of TMD, with Tuina to significantly improve the symptoms and function of patients with TMD.OSF Registration number:DOI 10.17605/OSF.IO/J75A8.

The effectiveness and safety of nicorandil in the treatment of patients with microvascular angina: A protocol for systematic review and meta-analysis.

Background:Microvascular angina has become a clinical and frequent cardiovascular disease in recent years, which is complicated and there is no clear treatment. Today, Western medicine still deals with microvascular angina with standardized treatment based on the stable angina. Firstly, it is to control the risk factors of atherosclerosis, and the second is to reduce the oxygen consumption of the patient's heart muscle. In the previous randomized controlled clinical trials, it has shown that nicorandil can improve the symptoms of angina for the treatment of microvascular angina, but there is a lack of high-quality randomized controlled trials on the clinical effectiveness and safety of nicorandil in the treatment of microvascular angina, and the lack of evaluation of its effectiveness and safety. Therefore, this paper aims to understand whether nicorandil can further improve the prognosis of patients with microvascular angina and the safety of the drug through the method of systematic evaluation.Methods:Retrieval of relevant network electronic databases by computer: SinoMed, CNKI, WanFang Data, VIP, PubMed, EMbase and The Cochrane Library, the retrieval time is from the establishment of each database to December 2017, to collect randomized controlled studies of nicorandil in the treatment of microvascular angina. At the same time, it is supplemented by manual search of the included literature references, as far as possible to increase the included literature imformation. Two researchers independently browse the topics and abstracts, and select, find, read the full text of the relevant literature, and screen the literature according to the criteria for inclusion and exclusion established in advance, then extract the data, and cross-check, and resolve the differences through multi-person discussion. Data analysis of collected information is performed by using RevMan 5.3 software.Results:The data of the included literature are statistically analyzed by meta-analysis, and the key outcome indicators are used to determine whether nicorandil can further improve the prognosis of patients with microvascular angina and the safety of the drug.Conclusion:Through the method of evidence-based medicine, this study finds the existing problems and defects in the current research, which will provide high-quality evidence-based medical evidence for nicorandil's treatment of microvascular angina, and it help the clinical treatment and further research.OSF registration number:DOI 10.17605/OSF.IO/DSQG9.

Characteristics of Sleep Structure Assessed by Objective Measurements in Patients With Amnestic Mild Cognitive Impairment: A Meta-Analysis

Objectives: This study aims to explore the differences of sleep structure between patients with amnestic mild cognitive impairment (aMCI) and elderly people with normal cognition, which will help to provide evidence for the relationship between sleep disturbances and cognitive impairment.Methods: A systematic review and meta-analysis were conducted on the literature on sleep parameters obtained by polysomnography or actigraphy in patients with aMCI. The PubMed and EMBASE databases were searched up to April 2020. Inclusion and exclusion criteria were established according to evidence-based medicine methods, and data of all eligible studies were meta-analyzed using the Review Manager 5.3 software.Results: Among the 1,171 literature articles on sleep structure of patients with MCI, eight case-control studies met the inclusion criteria and were included in this meta-analysis. A total of 278 subjects were included, of which 103 were patients with aMCI and 175 were elderly people with normal cognition. The results showed that sleep efficiency (SE) and slow wave sleep (SWS) of patients with aMCI were significantly lower than those of healthy elderly people. Compared with the control group, the percentage of stage 1 of non-rapid eye movement (N1%) in the aMCI patients group increased, and the percentage of stage 2 of non-rapid eye movement (N2%) decreased.Conclusions: Patients with aMCI may experience more severe sleep disturbances than normal cognitive elderly people. There were specific changes, especially in SE and SWS, in the sleep structure of patients with aMCI when compared to those with normal cognition.

Clinical practice guideline for migraine with traditional Chinese medicine(draft version for comments)

The present clinical practice guideline was written by experts organized by the special group of key projects in the 13 th five-year plan period of the China Academy of Chinese Medical Sciences based on the standards and procedures of World Health Orga-nization Handbook for Guideline Development, with "evidence-based, consensus-based, and experience-based principle" as a guide. On the basis of practice in traditional Chinese medicine(TCM) and clinical research for migraine, following the idea and method of evidence-based medicine, as well as the expert experience, the current best evidence and patients' values, the internationally recognized evidence quality evaluation methods and recommendation grading system were combined with the prescription record of classical TCM, TCM expert experience, and modern clinical research evidences. The acupuncture therapy, classic prescriptions and Chinese patent medicines used in the treatment of migraine in acute stage and preventive treatment were summarized to obtain five classic prescriptions(Chuanxiong Chatiao Powder, Chuanxiong Dingtong Yin, Sanpian Decoction, Xuefu Zhuyu Decoction, and Tongqiao Huoxue Decoction), and four Chinese patent medicines(Zhengtian Pills, Toutongning Capsules, Tongtian Oral Liquid, and Yangxue Qingnao Granules/Pills), and the common problems in their clinical application were analyzed. The purpose of this guideline is to standardize the treatment of migraine with TCM, reduce the frequency and severity of migraine attacks, and improve the patients' quality of life. It provides the clinical basis for the TCM treatment of migraine, and ensures the safety, effectiveness, practicability and scientificity of the treatment, so as to promote the TCM treatment of migraine. Due to the influence of region, nationality, race and other factors of the users, the detailed implementation of the guideline should be determined according to the actual situation.

Consequences of holocaust on physical health of survivors: bibliography review.

Period of elderly age preordains the occurrence of many health issues. People deported during World War II to concentration camps suffered from malnutrition, lack of sleep, physical and mental exhaustion. Recently, the health condition of Holocaust survivors is often complicated as a result of physical punishments and different torture methods as well as mental hardships which they had suffered during deportation. The consequences often have psychosomatic nature thus the survivors are often receivers of health care. The topic of bibliography review is based on the need to objectivize and systematically evaluate subjective health issues of Holocaust survivors in connection with trauma related to the stay in a concentration camp. The aim is to offer a review of effects of the Holocaust on health of different body systems for survivors in concentration camps and Jewish ghettos in the course of World War II. To map the subjective problems of Holocaust survivors, evidence-based medicine (EBM) method has been used with the help of scientific database PubMed, CINAHL Plus with full text, ProQuest and other sources with specific key words and Boole operators. Prognostic type of clinical/review questions has been selected for the bibliography review, which is trying to predict the probability of relation or output of illness/condition and based on diseases or symptoms seriousness to find out expectancy for treatment/improvement of care. 175 studies have been found in basic search with the use of key words both in English and in Czech language. The search has not been time-limited. The advanced search has focused on different body systems and health damage due to Nazi experiments. Fourteen studies have been used to complete the study. The research results have confirmed the significant effect of Holocaust trauma on body condition of the survivors. The reasons of this condition were insufficient nutrition, unsuitable and harmful hygienic, living and working conditions and brutality of the guards. According to the research, these factors have impacted all organ systems, mainly locomotion and cardiovascular ones. The results have shown a more frequent occurrence of osteoporosis, fractures of long bones and corresponding chronical pain of people of Jewish origin who had gone through different forms of torture during World War II. Other present symptoms include gastrointestinal problems, tumors mainly in the area of colorectum and lungs. Moreover, the stay in concentration camps had influence on women's menstrual cycle. The studies of Holocaust effects are an example of the influence of an extreme mental and physical burden on the body condition of the survivors' health. The results of the studies have shown a wide range of the effects also in mental and social areas.

The German Standing Committee on Vaccination: organization and mode of functioning

By law the Standing Committee on Vaccination (STIKO) has the mandate to develop recommendations for carrying out vaccinations and other measures of specific prophylaxis of communicable diseases. Currently, the committee has 18members who meet 3 times per year to discuss and vote on recommendations. The secretariat of STIKO is located at the Immunization Unit of the Robert Koch Institute (RKI). In 2011 the STIKO adopted anew standard operating procedure (SOP) for the development of evidence-based vaccination recommendations. Using methods of evidence-based medicine, the respective STIKO working group, comprised of STIKO members, RKI staff and external experts, develops adraft recommendation on which the commission votes. After conclusion of the external consultation procedure the vaccination recommendation is considered by the Federal Joint Committee and in the case of a positive vote, is incorporated into the guidelines for protective vaccination and therefore becomes a mandatory service of the statutory health insurance. This article provides an overview on the organization and modes of functioning of the STIKO.

Suggestions on design of evidence-based traditional Chinese medicine clinical study for new public health emergencies

2019 novel coronavirus(2019-nCoV) has occurred for 2 months, and seriously affected the people's health in the world. Therefore, scientific prevention and control strategies and effective intervention measures are the only ways to solve the world problem. In the determination of intervention measures, not only the effectiveness evaluation, but also accessibility, treatment cost, inventory and production capacity and other relevant sociological issues shall be considered, especially in low and middle-income countries and regions. With the introduction of clinical epidemiological experiment design and evidence-based medicine evidence evaluation into the evaluation of curative effect of traditional Chinese medicine(TCM), TCM has officially entered the studies of syndrome regularity of new public health emergencies(such as SARS and influenza) clearly diagnosed by modern medicine for many years, as well as the development of relevant guidelines, consensus and paths. The results of curative effect show that TCM could significantly alleviate symptoms, control disease and tendency, reduce the occurrence of critical illness, and improve the clinical efficacy and the prognosis and quality of life of patients, which fully reflects the consciousness and self-confidence of traditional Chinese medicine workers. For the evidence-based evaluation of TCM intervention in new public health emergencies, the basic principles and general methods of clinical epidemiology and evidence-based medicine shall be followed to obtain high-quality evidence; besides, we shall also fully realize that clinical scientific study is carried out with the epidemic treatment as the primary task. The scientific hypothesis comes from the clinical problems unsolved. The scientific study conclusions aim to give feedbacks to clinical diagnosis and treatment regimens. The core elements of clinical trials are population(P), intervention(I), control(C), outcome(O), which are abbreviated as "PICO". The evaluation of intervention measures for new public health emergencies with traditional Chinese medicine shall have clear study objectives and a high quality, with a correct analysis method as the guarantee of real and reliable results. Then, the selection of patients, the de-finition of intervention measures and control measures, the development of end-point indicators, the clinical quality control under special epidemics, the data verification, and the data analysis methods to be adopted are all characteristics and key points that need special consideration. It is suggested that scientific experimental design, rigorous collection and scientific data analysis shall be conducted to reflect the therapeutic value of traditional Chinese medicine, so that the study results could be adopted and shared, and become the scientific evidence for China and even the global to republish the diagnosis and treatment regimens.

Clinical practice and teaching of pharmaceutical care procedures for obstetric diseases

ObjectivesOur goal was to explore the pharmaceutical service and teaching methods of obstetric clinical pharmacists to establish standardised pharmaceutical care procedures for obstetric diseases.MethodsAccording to the evidence-based medicine method, the...

Expert consensus guidelines on clinical use of Xiyanping injection for acute infectious diseases

Xiyanping injection, a traditional Chinese medicine injection made of andrographolide sulfonate, consisting of well-defined ingredients with antiviral, antibacterial, anti-inflammatory and antipyretic efficacy, has been widely used for treating infectious diseases of respiratory and digestive systems. However, its wide applications may easily lead to unreasonable clinical medication. In order to guide the precise clinical application and rational use of Xiyanping injection, experts in related fields conducted systematically literature review, evaluated and deliberated the application of Xiyanping injection in treating acute infectious diseases using evidence-based medicine method, and jointly drafted the consensus to summarize types of acute infectious diseases in children and adults that can be treated with Xiyanping injection, and recommend the intervention time, usage and dosage, course of treatment and combined medication of the injection. Besides, the consensus elucidates the safety, precautions and contraindications of the injection, so as to provide guidance for clinical use.

Technology of Supporting Medical Decision-Making Using Evidence-Based Medicine and Artificial Intelligence.

Currently, Medical errors are a serious problem when examining patients. Creating information systems that use the capabilities of evidence-based medicine and artificial intelligence methods will allow the doctor to make an informed and proven decision. In this article, the authors offer a description of an information system that solves the problem of supporting medical decision making based on evidence-based medicine. This is achieved by using artificial intelligence methods. This work was supported by a grant from the Ministry of Education and Science of the Russian Federation, a unique project identifier RFMEFI60819X0278.

Exploration for clinical teaching mode of evidence-based laboratory medicine in clinical laboratory students

In order to improve the core competitiveness and the comprehensive ability of laboratory medicine students, we implemented the clinical teaching mode of evidence-based laboratory medicine in the department of Clinical Laboratory Center of Beijing Children's Hospital, Capital Medical University. This study relied on the platform of National Center for Children's Health, which had abundant case resources and excellent expert team. This study started with the clinical problem, summarized the scientific problem, and carried out teaching activities around the scientific problem. By guidance of the teachers, students used evidence-based medicine methods (clinical case information collection, literature reading, interviews with clinical experts and experimental data collection) to solve the clinical problem. Through research cases,evidence-based medicine methods, clinical thinking and scientific thinking were imparted to students, which can help them integrate theoretical knowledge with clinical practice, and improve learning efficiency, training in clinical thinking and scientific research innovation ability, so as to enhance core competitiveness. Key words: Laboratory medicine; Evidence-based medicine; Teaching mode

The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

BackgroundThe Appraisal of Guidelines for Research & Evaluation (AGREE) II has been widely used to evaluate the quality of clinical practice guidelines (CPGs). While the relationship between the overall assessment of CPGs and scores of six domains were reported in previous studies, the relationship between items constituting these domains and the overall assessment has not been analyzed. This study aims to investigate the relationship between the score of each item and the overall assessment and identify items that could influence the overall assessment.MethodsAll Japanese CPGs developed using the evidence-based medicine method and published from 2011 to 2015 were used. They were independently evaluated by three appraisers using AGREE II. The evaluation results were analyzed using regression analysis to evaluate the influence of 6 domains and 23 items on the overall assessment.ResultsA total of 206 CPGs were obtained. All domains and all items except one were significantly correlated to the overall assessment. Regression analysis revealed that Domain 3 (Rigour of Development), Domain 4 (Clarity of Presentation), Domain 5 (Applicability), and Domain 6 (Editorial Independence) had influence on the overall assessment. Additionally, four items of AGREE II, clear selection of evidence (Item 8), specific/unambiguous recommendations (Item 15), advice/tools for implementing recommendations (Item 19), and conflicts of interest (Item 22), significantly influenced the overall assessment and explained 72.1% of the variance.ConclusionsThese four items may highlight the areas for improvement in developing CPGs.

Treadmill training in patients affected by Charcot-Marie-Tooth neuropathy: results of a multicenter, prospective, randomized, single-blind, controlled study.

Background and purposeMuscle‐strengthening, stretching or proprioceptive treatments may slow symptom progression in Charcot—Marie–Tooth (CMT) neuropathy. The aim of the study was to evaluate safety and efficacy of treadmill training in CMT1A.MethodsWe planned a multicenter, prospective, randomized, single‐blind, controlled study. We recruited 53 outpatients affected by CMT1A and randomized them into two treatment groups: one underwent stretching and proprioceptive exercise, whereas the other was additionally treated with treadmill training (TreSPE). Primary outcome measures (OMs) were the walking evaluations and secondary OM was the balance assessment. All participants were assessed at baseline and after 3 and 6 months of treatment.ResultsMost patients showed an improvement in at least one OM after 3 months [42/47 (89.4%)] and 6 months [38/40 (95%)] of treatment. No adverse events were reported in either group.ConclusionsThe most important finding was that both stretching and proprioceptive exercise and treadmill training had an objective benefit on patients affected by CMT disease, without causing overwork weakness. We had a low rate of drop out and did not find deterioration in motor performance. Our results also confirm that applying evidence‐based medicine methods to rehabilitative research is the correct way to test the efficacy of a treatment.

Highlighting the need for de-implementation\xa0\u2013 Choosing Wisely recommendations based on clinical practice guidelines

BackgroundThe Choosing Wisely campaign has spread to many countries. Methods for developing recommendations are inconsistent. We describe our process of developing such recommendations from a comprehensive national set of clinical practice guidelines (Current Care, CC) and the results of a one-year Choosing Wisely Finland project.MethodsTwo of the authors drafted the quality and process criteria for all the Choosing Wisely Finland recommendations. The quality criteria were relevance, feasibility, evidence-based and strength. These were discussed in editors’ meetings and subsequently revised. Two different processes for developing recommendations within national clinical practice guidelines were designed and piloted (processes A and B). Process A was based on a published guideline. The recommendations are drafted by an editor and revised and approved by the guideline development group. In process B the development of the recommendations is integrated with guideline production or update. Choosing Wisely recommendations were then drafted for half of the published CC Guidelines. An additional process (process C) was designed for producing independent recommendations outside a guideline.ResultsAt least one Choosing Wisely recommendation could be identified from 39 out of 52 reviewed guidelines. Of the 106 recommendations drafted, 62 (58%) were accepted for publication. The main reasons for rejection were inability to give a strong recommendation (n = 18, 41%) and insufficient relevance (n = 14, 32%). Two thirds (n = 41, 66%) of the published recommendations were based on high to moderate level of evidence, and 18% (n = 11) on low or very low level of evidence, whereas for the rest, the quality of evidence was not critically appraised.ConclusionsChoosing Wisely recommendations can be produced systematically from existing clinical practice guidelines. The rigorous methods of evidence-based medicine ensure high-quality recommendations. We welcome the use of our processes and methods describes in this article by other guideline-producing organizations.

Multi-disciplinary anonymous survey on a university hospital's medical doctors' knowledge of established terms and parameters inevidence-based medicine

Patient care according to the principles of evidence-based medicine (EbM) is defined by the Social Code (SGB, inter alia § 137f SGB V). As part of quality assurance in medicine, a mandatory further education for doctors is demanded. The aim of this investigation was to evaluate how familiar medical practitioners are with common terms and parameters of EbM. Another question was, at which point of the medical training a possible postgraduate training on EbM methods should take place. In February 2017, an anonymous survey (paper questionnaire) was conducted at four clinics of the Witten/Herdecke University. The questionnaire offered 12 application scenarios for EbM methods; all items could be clearly answered with "right" or "wrong"; the refusal of an answer to single items was allowed. The investigation's primary endpoint was the individual proportion [%] of correctly among all available answers for each survey participant. The primary analysis sought to estimate this proportion of correct answers by means of a two-sided 95 % confidence interval.Results A total of 70 evaluable questionnaires could be evaluated (15-19 per clinic). The median individual proportion of correct answers was 47 % (95 % CI 40 %; 50 %). The four clinics did not differ significantly with respect to this proportion of correct answers (Kruskal/Wallis p = 0.388) and showed median proportions between 40 % and 50 %. Medical practitioners at university hospitals can be expected to have certain knowledge on common methods of clinical research. However, less than 50 % of the answer were correct and a need for further training in EbM-specific methods appears to be indicated. The survey did not provide information on the optimal timing of such offers during medical training.

Werkstattbericht: Geschichten auf die Ohren: Podcast und Storytelling für die Wissenschafts- und Evidenz-Kommunikation

The podcast project Evidenz-Geschichte(n) uses storytelling as a method to communicate principles and methods of evidence-based medicine in an attractive way. Both podcasts and storytelling have become quite popular for science communication in general. However, they bring both chances and risks that need to be considered thoroughly. Ideally, communication concepts using storytelling and/or podcasts should be evaluated in their specific contexts.

Czech national project 'Clinical Practice Guidelines' methodology and current results.

Currently in the Czech Republic, there does not exist such an institution as a 'National Centre for Clinical Practice Guidelines'. In 2017, there were about 123 professional medical organizations which developed about 1909 'guidelines' until 2017. However, the majority of these guidelines are 'expert opinion' or 'consensual' based 'guidance' or rather recommendations in the most cases missing a systematic approach that reflects evidence-based medicine principles and methods. The project is led by the Czech Health Research Council, the first partner is the Ministry of Health of the Czech Republic and the second partner is the Institute of Health Information and Statistics of the Czech Republic with support from policy makers, academics, clinicians and members of the Czech National Centre for Evidence-Based Healthcare and Knowledge Translations. This centre is an umbrella for three very important international collaborations which play a key role in Evidence-Based Healthcare, Evidence Synthesis, Evidence Implementation and trustworthy guidelines development. These are Cochrane Czech Republic, Masaryk University Grade Centre and the Czech Republic Centre for Evidence-Based Healthcare: The Joanna Briggs Institute Centre of Excellence.The main aim of this article is to present the Czech National Methodology of the Trustworthy Clinical Practice Guideline (CPG) development and the first results of the project 'Clinical Practice Guidelines'.A pilot phase of the project was realized during the first year of the project from January to December 2018. As the first step, there were established managing authorities including a Guarantee Committee and an Appraisal (Methodological) Committee. The Members of the Appraisal Committee developed a pilot version of the National Methodology of CPG development based on the best available approaches to Trustworthy CPGs development followed by testing on the first five pilot CPGs.

Aspects unique to medical device studies in review and consultation by ethics committees

The evaluation of the safety and performance of medical devices like implants, measuring devices or software may require clinical investigations sponsored by the manufacturer. Such clinical investigations need to be approved by the national competent authority and need the favourable opinion of the ethics committee.In the ethics committee's view, clinical investigations of medical products are special in several respects: (1)Medical devices may be marketed without authorization; (2)the effect of adevice may depend on the user; (3)study designs differ strongly because there are so many different devices; (4)authorities monitor medical devices with different intensity based on risk classes; (5)device regulations are less known to physicians and ethics committees, as device regulations are younger than those for drugs; (6)many small manufacturers are not prepared for clinical investigation; (7)medical devices tend to have short lifecycles and are developed incrementally, while investigations should be product specific; and (8)manufacturers use standards.Because of these peculiarities, ethics committee consultations need to consider some distinct points: the intended use and purpose of the medical device, general requirements, existing and achievable evidence, patient's benefit, ambition of trial objectives, choice of comparator, changes to the clinical investigation plan, measures against bias, instruction of users and their learning curve, traceability of devices and of data, quality and risk management, custom-made devices, validated measuring instruments, standards and state of the art as well as funding. In short, ethics committees often have to refer to the rules and methods of evidence-based medicine.

A meta-analysis of clinical outcomes of limited wrist invasion versus limited palmar invasion for the treatment of carpal tunnel syndrome

Objective To evaluate the efficacy of carpal tunnel release with small incision in wrist and palm for the treatment of carpal tunnel syndrome using evidence-based medicine method. Methods PubMed, Cochrane Library, EMBASE, CBM, CNKI and Wanfang databases were searched by computer for relevant studies from their establishment to March 2018. References of relevant articles were checked for additional articles. All relevant randomized controlled trials were collected and the methodological quality of the included studies was evaluated. Revman 5.3 software was used for meta-analysis to obtain the evidence of differences in the efficacy of carpal tunnel release through wrist and palm incisions in the treatment of carpal tunnel syndrome. Results Five randomized controlled trials were included for evaluation. Meta-analysis showed that there was no significant difference in BCTQ postoperative symptom score and operation time between wrist incision group and palm incision group (P>0.05). The BCTQ postoperative functional score and incidence of scar discomfort in wrist incision group were better than those in palm incision group (P<0.05). Conclusion Compared with the palm incision group, the wrist incision group has some advantages in promoting functional recovery and reducing the incidence of scar discomfort, but it still needs a large sample of high-quality randomized controlled trials to verify the results of this analysis. Key words: Carpal tunnel syndrome; Meta-analysis; Limited invasion; Randomized controlled trials

A Longitudinal Evidence-Based Medicine Curriculum and Its Impact on the Attitudes and Perceptions of Student Pharmacists

Objective. To describe a longitudinal evidence-based medicine (EBM) curriculum and to evaluate its impact on the attitudes and perceptions of student pharmacists toward EBM. Methods. Western University of Health Sciences has had a structured, longitudinal, EBM curriculum for more than 10 years, spanning the first to third years, including the introductory experiential experiences. A survey was administered prior to the main EBM course and at the completion of the course at three time periods to assess student pharmacists' attitudes and perceptions of EBM and interactive pedagogical methods. Student pharmacists at Western University of Health Sciences voluntarily participated in the self-administered survey. The three time periods examined included: directly after completion of the EBM course, after completion of the didactic curriculum, and after completion of the advanced pharmacy practice experiences (APPE). Results. The response rates were: pre-survey 94% and post-survey 53%. The three classes surveyed had similar baseline characteristics. Students' perceptions of EBM skills and attitudes improved at all time periods post-course. Students felt strongly both before and after exposure to the EBM course and the longitudinal EBM curriculum about learning new EBM skills and that all pharmacists should have these skills. Significantly more students appreciated all the interactive pedagogical methods after APPE completion (>85% of students), as compared with over 74% of students directly after the EBM course, and over 79% of students after didactic completion. Conclusion. The attitudes and perceptions of student pharmacists toward EBM improved after exposure to a longitudinal EBM curriculum.