Promotion Of Evidence-based Medicine Research Articles

Awareness, attitude, and practice of evidence-based medicine among primary healthcare physicians in Buraidah, Saudi Arabia.

Evidence-based medicine (EBM) is essential for safe and cost-effective care provision to the population. To assess the awareness, attitude and practices and barriers among primary care physicians about EBM in Buraidah, Qassim. Cross-sectional study in Primary Health Care centers (PHCCs) of Buraidah, Qassim. The study was conducted among physicians working in PHCCs of Buraidah. Data were collected online through Google forms. Descriptive analysis was carried out to measure the frequencies and proportions. Chi-square test was used to compare barriers based on gender, academic degree, and experience categories. A total of 96 out of 144 physicians (66.7%) responded to the invitation. About 82.3% of the participants welcomed the promotion of EBM and 92% of the physicians knew about concept of EBM. About 94.8% of the physicians agreed that EBM will improve patient outcomes. The reported barriers were; patient load (87.5%), time availability (70.8%), computer availability (33.3%), internet availability (45.8%), and 56.3% stated updated clinical letters, journals, or guidelines are not available. This study found that there was high self-reported knowledge about the EBM concept; however, the knowledge about tools was poor. A number of barriers were found such as patient load, time, availability of clinical guidelines and journals and other resources such as internet and computers. Primary care physicians should be trained and facilitated for EBM.

S3 guidelines on "full-term vaginal birth" from an anesthesiological perspective : Worthwhile knowledge for anesthesiologists

The publication of the new S3 guidelines on "full-term vaginal birth" and the guidelines on cesarean section, also published in 2020, provide further steps towards the promotion of evidence-based medicine in obstetrics, even if the exact configuration of neonatal monitoring during birth, in particular, is still the subject of current discussions. The multiprofessionality in the medical supervision of a birth is also fundamentally well-represented in the compilation of the S3 guidelines by the participating actors and specialist societies. Important from an anesthesiological perspective is the fact that neuraxial procedures still represent the gold standard in obstetric analgesia. With remifentanil PCA an alternative option is available that enables a reliable analgesia to be accomplished, e.g. when there are contraindications to performing neuraxial methods, if this is appropriate under the prevailing circumstances (1:1 support and appropriate monitoring). During an uncomplicated birth the strict fasting rules are relaxed. Overall, the guidelines underline the importance of self-determination and self-control for the expectant mother and give the highest priority to the safety and well-being of mother and child; however, this presupposes that the expectant mother is sufficiently informed about the value of neuraxial analgesia. For this it appears to be of importance to initiate information proposals, which go beyond the usual information sessions for parents that are often organized exclusively by midwives.

Cochrane, evidence-based medicine and associated factors: A cross-sectional study of the experiences and knowledge of Ethiopian specialists in training.

IntroductionEvidence-based healthcare is a core competency for practicing healthcare practitioners and those in speciality training. In sub-Saharan Africa, little is known about the teaching of evidence-based medicine (EBM) in residency program. This survey evaluated the experiences and knowledge of Cochrane, EBM and associated factors among Ethiopian specialists in training.MethodsA convenient sample of trainee specialists completed a pretested self-administered survey. The majority (93%) were ≤30 years old, males (63%) and 41% in paediatrics speciality. The associations of categorical variables with EBM knowledge was assessed by Fisher’s exact or Chi-Square tests. Covariates contributing to EBM knowledge were identified using multivariate logistic regression analysis.ResultsEighty-three trainees participated in the survey (response rate 88.2%). About 75% have heard about Cochrane but no one recognized Cochrane South Africa. Only 25% of the trainees knew the Cochrane Library but none used it in clinical practice. Most (78%) have heard of EBM, 15% had attended EBM course, 96% wanted to attend EBM course and 81% had positive attitudes to EBM. Trainees EBM knowledge was associated with awareness of Cochrane [Adjusted odds ratio (AOR) = 8.5, 95% Confidence interval (CI) 1.3–54.6, P = 0.02], EBM (AOR = 51.2, 95% CI 2.7–960.8, P = 0.009), and being in third year training (AOR = 28.4, 95% CI 1.9–427.2, P = 0.02). The promotion of EBM in residency hospital (AOR = 22.2, 95% CI 2.2–223.8, P = 0.008) and being aware of Cochrane (AOR = 4.8, 95% CI 1.1–21.7, P = 0.04) were predictors of positive attitude. Familiarity with Cochrane Library was influenced by EBM knowledge (AOR = 6.6, 95% CI 1.4–31.5, P = 0.02) and perceived organization barrier to accessing the resource (AOR = 3.2, 95% CI 1.03–10.1, P = 0.04).ConclusionEthiopian trainee specialists lacked formal EBM training, awareness and use of the Cochrane Library. To improve the healthcare quality and patient outcomes, EBM education should be integrated into residency curricula.

Using social media for knowledge translation, promotion of evidence-based medicine and high-quality information on health.

Knowledge translation activities may be targeted towards all participants in healthcare practices, including patients, consumers, and policy makers. Hereby, use of social media, namely social network Facebook, as a tool for knowledge translation, promotion of evidence-based medicine and high-quality information on health is described. In March 2013, a Facebook page of the Croatian Cochrane Branch was created and its main content are translated plain language summaries (PLS) of the systematic reviews produced by The Cochrane Collaboration. Since the page was created it has gained 1441 followers, mostly from Croatia and neighboring countries with similar language. Most of the page followers are women aged 25 to 44 and the most popular content is related to pregnancy, childbirth and breastfeeding. Page followers are lay persons, health professionals and journalists, who further disseminate the page content. In summary, social media enables multiple possibilities to engage with target audience and to disseminate the evidence-based medicine content. This article is protected by copyright. All rights reserved.

Knowledge and attitudes of students of College of Medicine towards evidence-based medicine and barriers to its use in clinical practice in Erbil city, Iraq

Background and objective: Evidence-based medicine, by guiding medical care towards meaningful outcomes to patients, has a significant worldwide impact on medical care and education. It is important that medical students, whom are the future physicians, keep themselves updated with recent advancement in medical knowledge and health care. The aim of this cross-sectional study was to determine the attitude, knowledge and barriers among students towards evidence-based medicine and making them familiar with the concept and advantage of evidence based medicine. Methods: A cross-sectional study was conducted on 163 sixth year students of the College of Medicine at Hawler Medical University during the period from October 2012 to May 2013. The response rate was 86.5%. Knowledge towards evidence-based medicine, accessing and interpreting evidence and perceived barriers to practice evidence-based medicine among participants were the main outcome measures. Results: Of 141 of participants that filled the questionnaire, only 69.5% had heard about evidence-based medicine. Around 82% stated that they had known evidence-based medicine and only 23.5% had known steps of evidence-based medicine. Around 65% of respondents welcomed the promotion of evidence-based medicine and 74.4% agreed with that finding from the current study in which it would be helpful in daily management of patients. Furthermore, 31.6% of students reported that standard textbook as a frequent source used for medical knowledge. Around 91% of students did not know the strongest evidence in the hierarchy of evidence and only small proportion of students reported that they understand the common epidemiological concepts that are used in evidence-based medicine. Conclusion: Evidence-based medicine is relatively a new concept among students at the College of Medicine in Erbil. Although the students appeared interested in learning and implementing evidence-based medicine in clinical practice, they need more guidance and training to ensure the correct use of evidence-based medicine ideals.

Evidence-based clinical guidelines in Kyrgyz Republic.

Evidence-based clinical guidelines in Kyrgyz Republic.

CHAracteristics of research studies that iNfluence practice: a GEneral survey of Canadian orthopaedic Surgeons (CHANGES): a pilot survey.

BackgroundEvidence Based Medicine (EBM) is increasingly being applied to inform clinical decision-making in orthopaedic surgery. Despite the promotion of EBM in Orthopaedic Surgery, the adoption of results from high quality clinical research seems highly unpredictable and does not appear to be driven strictly by randomized trial data. The objective of this study was to pilot a survey to determine if we could identify surgeon opinions on the characteristics of research studies that are perceived as being most likely to influence clinical decision-making among orthopaedic surgeons in Canada.MethodsA 28-question electronic survey was distributed to active members of the Canadian Orthopaedic Association (COA) over a period of 11 weeks. The questionnaire sought to analyze the influence of both extrinsic and intrinsic characteristics of research studies and their potential to influence practice patterns. Extrinsic factors included the perceived journal quality and investigator profiles, economic impact, peer/patient/industry influence and individual surgeon residency/fellowship training experiences. Intrinsic factors included study design, sample size, and outcomes reported. Descriptive statistics are provided.ResultsOf the 109 members of the COA who opened the survey, 95 (87%) completed the survey in its entirety. The overall response rate was 11% (95/841). Surgeons achieved consensus on the influence of three key designs on their practices: 1) randomized controlled trials 94 (99%), 2) meta-analysis 83 (87%), and 3) systematic reviews 81 (85%). Sixty-seven percent of surgeons agreed that studies with sample sizes of 101–500 or more were more likely to influence clinical practice than smaller studies (n = <100). Factors other than design influencing adoption included 1) reputation of the investigators (99%) and 2) perceived quality of the journal (75%).ConclusionAlthough study design and sample size (i.e. minimum of 100 patients) have some influence on clinical decision making, surgeon respondents are equally influenced by investigator reputation and perceived journal quality. At present, continued emphasis on the generation of large, methodologically sound clinical trials remains paramount to translating research findings to clinical practice changes. Specific to this pilot survey, strategies to solicit more widespread responses will be pursued.

Taking Evidence-Based Plastic Surgery to the Next Level

Applying the principles of evidence-based medicine has the potential to drastically improve quality of care and patient outcomes. For this reason, evidence-based medicine has been held as one of the 15 most important developments in medicine within the past 100 years. In August of 2010, a broad coalition of leaders from numerous organizations representing societies, boards, journals, foundations, and academic institutions met in Colorado Springs, Colorado, for the first Evidence-Based Plastic Surgery Summit. The summit signaled a sea change in the approach of organized plastic surgery to the promotion of evidence-based medicine within the specialty. It was determined that a strategic, coordinated, and sustained effort to drive an evidence-based medicine culture would accelerate adoption and advance quality of care and patient safety. Over the past 2 years, many of the goals of the initial summit have been met. In order to take our evidence-based medicine efforts to the next level, a second summit was recently held to redefine goals, focus efforts, address barriers, and launch new initiatives with broad consensus. This article documents the outcomes of the second Evidence-Based Plastic Surgery Summit.

La médecine factuelle, ou médecine fondée sur les preuves, appliquée aux nutraceutiques vétérinaires

En médecine vétérinaire comme en médecine humaine, le praticien est amené à prendre des décisions diagnostiques, thérapeutiques ou préventives complexes. Le concept de la médecine fondée sur les preuves (evidence-based medicine ou EBM) est apparu pour la première fois au début des années 1990 en médecine humaine pour améliorer le processus de prise de décision, et consiste à intégrer de manière consciencieuse, explicite et judicieuse les meilleures preuves scientifiques (evidence) du moment dans la prise en charge du patient. Le concept fut introduit en médecine vétérinaire dans les pays anglo-saxons en 2003, et il a depuis été développé dans les pays francophones. Bien que des études récentes montrent que l’EBM ne peut être appliquée en médecine vétérinaire dans les mêmes termes qu’en médecine humaine, les praticiens vétérinaires sont tenus sur le plan éthique de prendre des décisions scientifiquement valides. La promotion de l’EBM en médecine vétérinaire requiert le développement d’outils adaptés, tels que des revues systématiques, ainsi que des améliorations spécifiques des études vétérinaires, avec en particulier l’enseignement d’une démarche de réflexion aux futurs praticiens. Le manque de preuves scientifiques de l’efficacité des nutraceutiques illustre à la fois les obstacles rencontrés pour la prise de décisions parfaitement informées et les faiblesses méthodologiques de la recherche en médecine vétérinaire.

Awareness, attitude and practice of evidence‐based medicine among primary health care doctors in Jordan

To assess the awareness, attitude and knowledge towards evidence-based medicine (EBM) among primary health care doctors in Jordan and to identify the perceived barriers for practising EBM. A simple random sample of 34 comprehensive primary health care centres was selected from a list of 64 centres in Jordan using random number table. A family doctor visited all selected centres and invited the available doctors to participate in the study. Participants were asked to fill the self-administrated questionnaire that was designed to assess beliefs and attitude of doctors towards EBM. Of the total 220 clinicians approached, 202 (91.8%) completed the questionnaire. About 80.7% welcomed promotion of EBM and 91.1% agreed on that research findings are helpful in daily management of patients. About 85.1% stated that practising EBM improves patient care, 68.3% stated that EBM reduces health care costs, 74.8% stated that EBM improves quick knowledge update, 93.6% reported that the doctor-patient relationship is affected positively by practising EBM. About 60.9% reported that they know the concept of EBM and 56.1% reported that they ever used the EBM. Patient overload, limited resources and facilities, and the absence of an effective computer system were the most commonly reported barriers to the implementation of EBM. In spite of the positive attitude towards EBM, this study demonstrated numerous personal, interpersonal and institutional barriers towards implementing EBM which necessitate prompt action to formulate a national plan to overcome such barriers.

Work-related carpal tunnel syndrome: the facts and the myths.

Carpal tunnel syndrome is a medical disease, not an injury, although symptoms may occur in association with certain physical activities of the upper extremity. The concept of work-related carpal tunnel syndrome has grown to such proportion as to be problematic for society, having spawned health care industries to support a cultural concept and a largely mythical medical paradigm. Because of these social and economic forces, cultural perceptions and expectations have adjusted to this flawed medical model. Success in improving patient management and making the best use of sound medical evidence depends on the concurrent use of educational strategies addressing social influences and attitudinal changes of practicing physicians, patients, and third-party administrators. The promotion of evidence-based medicine is key. This article discusses these controversies and suggests ways of managing carpal tunnel syndrome.

Evidence-based medicine in primary care: qualitative study of family physicians.

BackgroundThe objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family practice.MethodQualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians.ResultsParticipants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician.DiscussionPrimary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour.

Medicina Baseada em Evidências: a arte de aplicar o conhecimento científico na prática clínica

This article was written with the objective of describing the concept of Evidence Based Medicine (EBM) and the competences required for its practice. EBM should be viewed as an integration of clinical experience with the ability to analyze and rationally apply the scientific information while taking care of patients. The application of methods and strategies to enhance the scientific background of the physician while taking into account the humanitarian values of the medical profession should contribute to improve the quality of the medical care that is offered in Brazil. The Medical Schools and Associations may play important roles in the promotion of EBM.