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1.
Lancet Oncol ; 23(1): e21-e31, 2022 01.
Article in English | MEDLINE | ID: mdl-34973228

ABSTRACT

High-quality randomised clinical trials testing moderately fractionated breast radiotherapy have clearly shown that local control and survival is at least as effective as with 2 Gy daily fractions with similar or reduced normal tissue toxicity. Fewer treatment visits are welcomed by patients and their families, and reduced fractions produce substantial savings for health-care systems. Implementation of hypofractionation, however, has moved at a slow pace. The oncology community have now reached an inflection point created by new evidence from the FAST-Forward five-fraction randomised trial and catalysed by the need for the global radiation oncology community to unite during the COVID-19 pandemic and rapidly rethink hypofractionation implementation. The aim of this paper is to support equity of access for all patients to receive evidence-based breast external beam radiotherapy and to facilitate the translation of new evidence into routine daily practice. The results from this European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus state that moderately hypofractionated radiotherapy can be offered to any patient for whole breast, chest wall (with or without reconstruction), and nodal volumes. Ultrafractionation (five fractions) can also be offered for non-nodal breast or chest wall (without reconstruction) radiotherapy either as standard of care or within a randomised trial or prospective cohort. The consensus is timely; not only is it a pragmatic framework for radiation oncologists, but it provides a measured proposal for the path forward to influence policy makers and empower patients to ensure equity of access to evidence-based radiotherapy.


Subject(s)
Advisory Committees/standards , Breast Neoplasms/radiotherapy , Dose Fractionation, Radiation , Patient Selection , Radiation Oncology/standards , Breast Neoplasms/pathology , COVID-19/epidemiology , Consensus , Europe , Evidence-Based Medicine , Female , Humans , Radiation Dose Hypofractionation
2.
N C Med J ; 83(1): 37-39, 2022.
Article in English | MEDLINE | ID: mdl-34980652

ABSTRACT

Childhood trauma can have lasting impact throughout the life course, affecting both physical and mental health. But it doesn't have to be this way. To better understand the role of adverse childhood experiences (ACEs) as indicators of health, the North Carolina Medical Journal sat down with George (Tripp) Ake, PhD, and Lisa Amaya-Jackson, MD, MPH, two state experts in child traumatic stress.


Subject(s)
Adverse Childhood Experiences , Child , Evidence-Based Medicine , Humans , Life Change Events , Mental Health , North Carolina
3.
Med Clin North Am ; 106(1): 153-168, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34823728

ABSTRACT

Methods to prevent substance use disorders (SUDs) act on the individual risk factors for addiction. Most adults with SUD initiated substance use during their teenage years, so preventive interventions during adolescence are critical. Antisubstance use messaging, routine screening, and pathways for referral to treatment can be extended into all settings whereby trusted adults interact with adolescents such as sports, mentoring programs, child protective services, and juvenile justice settings. Pediatric primary care is an ideal place to incorporate preventive counseling and screening for substance use. Evidence-based technologic interventions for primary, secondary, and tertiary prevention are needed.


Subject(s)
Behavior, Addictive/psychology , Mentoring/methods , Sports/psychology , Substance Abuse Detection/standards , Substance-Related Disorders/prevention & control , Adolescent , Behavior, Addictive/therapy , Child , Child Protective Services/methods , Counseling/methods , Evidence-Based Medicine/methods , Female , Humans , Male , Primary Health Care/methods , Referral and Consultation , Risk Factors , Substance-Related Disorders/ethnology , Substance-Related Disorders/therapy , United States/epidemiology , Young Adult
4.
Med Educ Online ; 27(1): 2010298, 2022 Dec.
Article in English | MEDLINE | ID: mdl-34919030

ABSTRACT

BACKGROUND: Evidence-based medicine (EBM) is defined as the integration of the best available evidence from scientific studies with clinical experience (and context) and with patients' values and preferences. The objective of the present study was to describe self-perceived EBM competencies in physicians and medical students enrolled in a massive virtual EBM course. METHODS: Analytical cross-sectional study. People interested in a free virtual EBM course fulfilled their data in a virtual form for their registration in September 2020. In this form, 22 competencies related to four dimensions of EBM were evaluated: asking a clinical question, search, analysis, and application; using a 5-option Likert scale. The resulting database was analyzed, selecting people who claimed to be physicians or medical students of 18 years or more. RESULTS: 1793 participants were included: 1130 medical students and 663 physicians; more than 80% lived in Peru. The frequency of participants who agreed or strongly agreed with feeling qualified in each competence ranged: from 39.2% to 57.8% for the competencies of the 'Asking a clinical question' dimension, from 39.2% to 56.1% for 'Search,' from 19.9% to 32.0% for 'Analysis,' and from 19.6% to 29.9% for 'Application.' Both in physicians and students, the lowest frequencies were for the competencies of interpretation of impact measures, graphs, and results of systematic reviews; as well as shared decision making and calculation of expected benefit. Physicians who graduated more recently scored better on competencies from search and analysis dimensions. CONCLUSION: Among physicians and medical students enrolled in the course, self-perception of competencies was lower in the dimensions of analysis and application. More recently graduated physicians seem to have a greater self-perception of their research and analysis skills, probably due to curricular updates.List of abbreviations: EBM: Evidence-based medicine; CIMBE, for its acronym in Spanish: International Course on Evidence-Based Medicine; SOCIMEP, for its acronym in Spanish: Peruvian Medical Student Scientific Society.


Subject(s)
Physicians , Students, Medical , Cross-Sectional Studies , Evidence-Based Medicine , Humans , Systematic Reviews as Topic
6.
Multimedia | Multimedia Resources | ID: multimedia-9530

ABSTRACT

Webinar organizado por la Red Centroamericana de Informática en Salud con la participación de Daniela Naranjo Caicedo, Product Sales Manager para Latinoamérica de Elsevier, y realizado el 14 de abril de 2020.


Subject(s)
Evidence-Based Medicine , COVID-19/prevention & control , Health Information Systems , Communication , Databases, Bibliographic , Health Information Exchange , Information Dissemination , Health Personnel/education ,
7.
Article in Spanish | PAHO-IRIS | ID: phr-55391

ABSTRACT

[RESUMEN]. Introducción. La Organización Mundial de la Salud recomienda focalizar la atención en el período neonatal, eliminar la mortalidad de causa prevenible y brindar cuidados de calidad. Es esencial conocer cuáles son las condiciones con alta probabilidad de ocurrencia en esa población para monitorearlos de forma sistemática, de modo que se logre su detección temprana; y el abordaje terapéutico y rehabilitación oportunos. Objetivos. Sintetizar las recomendaciones incluidas en las Directrices de práctica clínica basadas en la evidencia para el seguimiento de recién nacidos en riesgo, publicada por la Centro Latinoamericano de Perinatología/Salud de la Mujer y Reproductiva de la Organización Panamericana de la Salud en el 2020, con el fin de presentar las estrategias para el seguimiento de los niños recién nacidos con condiciones de riesgo desde su nacimiento hasta los 2 años. Métodos. Se llevó a cabo una síntesis de la guía y sus recomendaciones. Además, se realizó una búsqueda sistemática en Pubmed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en la Región de las Américas, con el fin de identificar barreras, facilitadores y estrategias de implementación. Resultados. Se formularon 21 recomendaciones y 14 puntos de buena práctica que aplican a los recién nacidos con condiciones de riesgo hasta los dos años (prematuros y aquellos con alteraciones adquiridas o congénitas). Se identificaron barreras como la disponibilidad de pruebas de tamización, deficiencias en el sistema de referencia y conocimiento de las recomendaciones para su implementación. Conclusiones. La guía brinda recomendaciones sobre los criterios de egreso, incluidas pruebas de tamizaje; información y apoyo para padres y cuidadores; tamizaje y frecuencia de seguimiento de los niños en riesgo hasta los dos años en la Región de las Américas.


[ABSTRACT]. Introduction. The World Health Organization recommends focusing attention on the neonatal period, eliminating mortality from preventable causes, and providing quality care. It is essential to know which conditions have a high probability of occurring in that population in order to monitor them systematically, detect them early, and provide timely treatment and rehabilitation. Objectives. Synthesize the recommendations contained in Directrices de práctica clínica basadas en la evidencia para el seguimiento de recién nacidos en riesgo [Evidence-based Clinical Practice Guidelines for Monitoring At-risk Newborns], published in Spanish in 2020 by the Pan American Health Organization’s Latin American Center for Perinatology, Women's Health, and Reproductive Health, with a view to producing strategies for monitoring at-risk newborns from birth up to the age of 2 years. Methods. The guidelines and recommendations were synthesized and a systematic search was conducted in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature for studies carried out in the Region of the Americas with a view to identifying barriers, facilitators, and implementation strategies. Results. A total of 21 recommendations and 14 good practices were formulated for application to newborns with at-risk conditions (prematurity and congenital or acquired conditions) up to 2 years of age. The barriers identified as standing in the way of their implementation were insufficient availability of screening tests, deficiencies in the referral system, and lack of awareness of the recommendations. Conclusions. The guidelines include recommendations for discharge criteria, screening, and frequency of monitoring for at-risk newborns up to 2 years of age in the Region of the Americas, as well as information and support for parents and caregivers.


[RESUMO]. Introdução. A Organização Mundial da Saúde recomenda focar a atenção no período neonatal, eliminar a mortalidade decorrente de causas preveníveis e oferecer cuidados de qualidade. É essencial conhecer quais são as condições com alta probabilidade de ocorrência nessa população para monitorá-la de forma sistemática, de maneira que ocorra uma detecção precoce, assim como conhecer a abordagem terapêutica e a reabilitação adequadas. Objetivos. Sintetizar as recomendações incluídas nas Diretrizes de prática clínica baseada em evidência para o acompanhamento de recém-nascidos em risco, publicadas em 2020 pelo Centro Latino-Americano de Perinatologia, Saúde da Mulher e Reprodutiva da Organização Pan-Americana da Saúde, com o propósito de apresentar estratégias para o acompanhamento de recém-nascidos em situação de risco, do nascimento até os 2 anos de idade. Métodos. Foi realizada uma síntese do guia e de suas recomendações. Além disso, foi realizada uma busca sistemática nas bases Pubmed, Lilacs, Health Systems Evidence e Epistemonikos e na literatura cinzenta de estudos conduzidos na Região das Américas para identificar barreiras, facilitadores e estratégias de implementação. Resultados. Foram formuladas 21 recomendações e 14 pontos de boas práticas que se aplicam aos recém-nascidos em situação de risco até os dois anos de idade (prematuros e aqueles com alterações adquiridas ou congênitas). Foram identificadas barreiras como a disponibilidade de testes de triagem, deficiências no sistema de encaminhamento e conhecimento das recomendações para sua implementação. Conclusões. O guia oferece recomendações sobre os critérios de alta hospitalar, incluindo testes de triagem; informação e apoio para pais e cuidadores; e triagem e frequência de acompanhamento das crianças em risco até os dois anos de idade na Região das Américas.


Subject(s)
Neonatology , Infant, Premature , Evidence-Based Medicine , Americas , Neonatology , Infant, Premature , Evidence-Based Medicine , Americas , Neonatology , Infant, Premature , Evidence-Based Medicine , Americas
8.
Article in Spanish | PAHO-IRIS | ID: phr-55390

ABSTRACT

[RESUMEN]. Introducción. La retinopatía del prematuro (ROP) es una enfermedad prevenible potencialmente grave que se puede presentar en hasta el 34% de los recién nacidos de pretérmino. La Organización Mundial de la Salud incluye el manejo de esta entidad dentro de sus políticas prioritarias para reducir la prevalencia de ceguera prevenible. Objetivos. Sintetizar las recomendaciones incluidas en la Guía de práctica clínica para el manejo de la retinopatía de la prematuridad, publicada por la Organización Panamericana de la Salud, con el fin de presentar recomendaciones para la prevención, diagnóstico, tratamiento y seguimiento de recién nacidos con retinopatía del prematuro. Métodos. Se llevó a cabo una síntesis de la guía y sus recomendaciones. Además, se realizó una búsqueda sistemática en Pubmed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en la Región de las Américas con el fin de identificar barreras, facilitadores y estrategias de implementación. Resultados. Se formularon 30 recomendaciones y 14 puntos de buena práctica que aplican a los recién nacidos prematuros menores de 32 semanas de edad gestacional y/o menos de 1500 g de peso al nacer que hayan requerido oxígeno o presenten otros factores de riesgo para presentar ROP. Se identificaron barreras de acceso relacionadas con la disponibilidad de recurso humano, insumos y conocimiento de la guía para la implementación de las recomendaciones. Conclusiones. Las recomendaciones formuladas buscan proveer estrategias para la prevención, el diagnóstico y el tratamiento de ROP para los recién nacidos prematuros en América Latina y el Caribe, así como consideraciones para su implementación.


[ABSTRACT]. Introduction. Retinopathy of prematurity (ROP) is a potentially serious preventable disease that can present in up to 34% of preterm newborns. The World Health Organization includes the management of this entity among its priority policies for reducing the prevalence of preventable blindness. Objectives. Synthesize the recommendations contained in Clinical Practice Guidelines for the Management of Retinopathy of Prematurity, a publication of the Pan American Health Organization, with a view to producing recommendations for the prevention, diagnosis, treatment, and monitoring of newborns with retinopathy of prematurity. Methods. The guidelines and recommendations were synthesized and a systematic search was conducted in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature for studies carried out in the Region of the Americas with a view to identifying barriers, facilitators, and implementation strategies. Results. A total of 30 recommendations and 14 good practices were formulated for application to premature newborns under 32 weeks of gestational age and/or with a birthweight of less than 1500 g who have required oxygen or present other risk factors for ROP. Barriers to implementation were lack of available human resources, supplies and equipment, and knowledge about guidelines for implementation of the recommendations. Conclusions. The formulated recommendations aim to provide strategies for the prevention, diagnosis, and treatment of ROP in premature newborns and include suggestions for their implementation in Latin America and the Caribbean.


[RESUMO]. Introdução. A retinopatia da prematuridade (ROP) é uma doença prevenível potencialmente grave que pode se apresentar em até 34% dos recém-nascidos prematuros. A Organização Mundial da Saúde inclui o manejo dessa condição em suas políticas prioritárias para reduzir a prevalência da cegueira prevenível. Objetivos. Sintetizar as recomendações incluídas no Guia de prática clínica para o manejo da retinopatia da prematuridade, publicado pela Organização Pan-Americana da Saúde, com o fim de apresentar recomendações para a prevenção, diagnóstico, tratamento e seguimento de recém-nascidos com retinopatia da prematuridade. Métodos. Foi realizada uma síntese do guia e de suas recomendações. Além disso, foi feita uma busca sistemática nas bases Pubmed, Lilacs, Health Systems Evidence e Epistemonikos, e na literatura cinzenta de estudos conduzidos na Região das Américas para identificar barreiras, facilitadores e estratégias de implementação. Resultados. Foram formuladas 30 recomendações e 14 pontos de boas práticas que se aplicam aos recém-nascidos prematuros com menos de 32 semanas de idade gestacional e/ou menos de 1.500g de peso ao nascer, que precisaram de oxigênio ou apresentaram outros fatores de risco para a ROP. Foram identificadas barreiras de acesso relacionadas com a disponibilidade de recurso humano, insumos e conhecimento do guia para a implementação das recomendações. Conclusões. As recomendações formuladas buscam fornecer estratégias para a prevenção, o diagnóstico e o tratamento da ROP em recém-nascidos prematuros na América Latina e no Caribe, bem como considerações para sua implementação.


Subject(s)
Neonatology , Infant, Premature , Retinopathy of Prematurity , Evidence-Based Medicine , Therapeutics , Disease Prevention , Americas , Neonatology , Infant, Premature , Disease Prevention , Retinopathy of Prematurity , Evidence-Based Medicine , Therapeutics , Americas , Neonatology , Infant, Premature , Disease Prevention , Retinopathy of Prematurity , Evidence-Based Medicine , Americas
9.
Health Res Policy Syst ; 19(1): 151, 2021 Dec 23.
Article in English | MEDLINE | ID: mdl-34949195

ABSTRACT

BACKGROUND: Previous research suggests that the quality of clinical guidelines (CGs) in China is suboptimal. However, little is known about the methodology that CGs follow. We conducted a national survey of methods used by Chinese CG developers for CG development, adaptation, and updating. METHODS: We used a previously piloted questionnaire based on methodologies of CG development, adaptation, and updating, which was distributed during September-November 2020 to 114 organizations identified from published Chinese CGs (searched 2017-2020), recommended by Chinese CG developers, and recommended by clinical discipline experts. RESULTS: We collected 48 completed questionnaires (42.1% response). Most organizations developed CGs based on scientific evidence (89.6%), existing CGs (75%), or expert experience and opinion (64.6%). Only a few organizations had a specific CG development division (6.3%), a CG monitoring plan (on clinicians 33.3%; on patients 18.8%), funding (33.3%), or a conflict-of-interest (COI) management policy (23.4%). Thirty (62.5%) organizations reported using a CG development methodology handbook, from international organizations (14/30, 46.7%), methodology or evaluation resources (3/30, 10.0%), expert experience and opinion (3/30, 10.0%), or in-house handbooks (3/30, 10.0%). One organization followed a published adaptation methodology. Thirty-eight organizations (88.4%) reported de novo CG development: 21 (55.3%) formed a CG working group, and 29 (76.3%) evaluated the quality of evidence (21 [72.4%] using a methodological tool). Nineteen organizations (52.8%) reported CG adaptation: three (31.6%) had an adaptation working group, and 12 (63.2%) evaluated the quality of source CGs (2 (16.7%) using the AGREE II instrument). Thirty-three organizations (68.8%) updated their CGs, seven (17.5%) using a formal updating process. CONCLUSIONS: Our study describes how CGs are developed in a middle-income country like China. To ensure better healthcare, there is still an important need for improvement in the development, adaptation, and updating of CG in China.


Subject(s)
Delivery of Health Care , Evidence-Based Medicine , China , Humans , Surveys and Questionnaires
10.
J Healthc Eng ; 2021: 4425449, 2021.
Article in English | MEDLINE | ID: mdl-34900187

ABSTRACT

This study focuses on clinical pathways guided by evidence-based medicine (EBM). With the clinical pathway as the center, the subjective and objective medical knowledge of medical staff are collected, and a clinical pathway management system guided by EBM is established through a unified process; user demand analysis; main considerations; implementation, evaluation, and monitoring of the clinical path; and dictionary maintenance, to help hospitals fully regulate medical behaviors. Next, the study displays the path access prompt box, area 1 management page, table management page, exit prompt box, mutation record page, doctor order interface, revocation of execution, and monitoring interface, and the system designed is compared with the Beijing Shankang Technology (ASK) clinical data management system in terms of user experience. The results showed that the reporting rate of medical adverse events in the system in this study was 0.21%, and the work efficiency was increased by 14%. In terms of users' satisfaction, the hospital managers' satisfaction was 84 ± 5.36%, and it was 95 ± 4.72% for medical staff and 88 ± 4.91% for system administrators, superior to the ASK system; the differences were statistically significant (P < 0.05). In conclusion, the clinical pathway information management system is in line with the working environment of medical staff, and the synchronous monitoring and management of medical quality are achieved through digital means, which can reduce the occurrence of medical adverse events and improve the work efficiency of medical staff.


Subject(s)
Critical Pathways , Evidence-Based Medicine , Humans , Information Management
11.
Int J Technol Assess Health Care ; 38(1): e11, 2021 Dec 22.
Article in English | MEDLINE | ID: mdl-34933699

ABSTRACT

OBJECTIVE: In England, the time gap between marketing authorization (MA) and guidance publication by National Institute for Health and Care Excellence (NICE) can limit patients' access to new medicines. In this study, our aim was to identify medicine characteristics associated with the long time gap between MA and guidance publication and explore the influencing factors. METHODS: We identified 116 single technology appraisals from 2016 to 2020 using publicly available data, and extracted information on the year of appraisal completion, application type, experiences of similar appraisals, orphan medicinal products (OMPs), cancer medicines, and accelerated assessment. Multiple regression analyses were performed to analyze the associations between the medicine characteristics and key time periods related to health technology assessment and MA processes. RESULTS: OMPs were associated with a long period between MA and guidance publication. Specifically, OMPs and cancer medicines were associated with slow guidance publication after the final scope (FS) development. However, there was no association between OMPs and the period between validation of MA application and FS development. Non-double-blinded randomized clinical trials and the use of comparators not specified in the FS were associated with slow guidance publication after the FS development. CONCLUSIONS: Our results demonstrate that OMPs are associated with a longer period between MA and guidance publication by the NICE than non-OMPs; this may be attributed to the slow guidance publication after the FS development. These findings indicate the necessity to shorten the appraisal process for OMPs.


Subject(s)
Orphan Drug Production , Technology Assessment, Biomedical , Cost-Benefit Analysis , England , Evidence-Based Medicine , Humans , Technology
13.
S Afr Med J ; 111(10): 934-937, 2021 08 17.
Article in English | MEDLINE | ID: mdl-34949284

ABSTRACT

Some clinicians prescribe ivermectin for COVID-19 despite a lack of support from any credible South African professional body. They argue that when faced by clinical urgency, weak signals of efficacy should trigger action if harm is unlikely. Several recent reviews found an apparent mortality benefit by including studies at high risk of bias and with active rather than placebo controls. If these studies are discounted, the pooled mortality effect is no longer statistically significant, and evidence of benefit is very weak. Relying on this evidence could cause clinical harm if used to justify vaccine hesitancy. Clinicians remain responsible for ensuring that guidance they follow is both legitimate and reliable. In the ivermectin debate, evidence-based medicine (EBM) principles have largely been ignored under the guise thatin a pandemic the 'rules are different', probably to the detriment of vulnerable patients and certainly to the detriment of the profession's image. Medical schools and professional interest groups are responsible for transforming EBM from a taught but seldom-used tool into a process of lifelong learning, promoting a consistent call for evidence-based and unconflicted debate integral to clinical practice.


Subject(s)
COVID-19/drug therapy , Ivermectin/administration & dosage , Practice Patterns, Physicians'/standards , /psychology , COVID-19 Vaccines/administration & dosage , Evidence-Based Medicine/standards , Humans , Ivermectin/adverse effects , Research Design , South Africa
16.
BMC Health Serv Res ; 21(1): 1198, 2021 Nov 05.
Article in English | MEDLINE | ID: mdl-34740338

ABSTRACT

BACKGROUND: Implementation and uptake of novel and cost-effective medicines can improve patient health outcomes and healthcare efficiency. However, the uptake of new medicines into practice faces a wide range of obstacles. Earlier reviews provided insights into determinants for new medicine uptake (such as medicine, prescriber, patient, organization, and external environment factors). However, the methodological approaches used had limitations (e.g., single author, narrative review, narrow search, no quality assessment of reviewed evidence). This systematic review aims to identify barriers and facilitators affecting the uptake of new medicines into clinical practice and identify areas for future research. METHOD: A systematic search of literature was undertaken within seven databases: Medline, EMBASE, Web of Science, CINAHL, Cochrane Library, SCOPUS, and PsychINFO. Included in the review were qualitative, quantitative, and mixed-methods studies focused on adult participants (18 years and older) requiring or taking new medicine(s) for any condition, in the context of healthcare organizations and which identified factors affecting the uptake of new medicines. The methodological quality was assessed using QATSDD tool. A narrative synthesis of reported factors was conducted using framework analysis and a conceptual framework was utilised to group them. RESULTS: A total of 66 studies were included. Most studies (n = 62) were quantitative and used secondary data (n = 46) from various databases, e.g., insurance databases. The identified factors had a varied impact on the uptake of the different studied new medicines. Differently from earlier reviews, patient factors (patient education, engagement with treatment, therapy preferences), cost of new medicine, reimbursement and formulary conditions, and guidelines were suggested to influence the uptake. Also, the review highlighted that health economics, wider organizational factors, and underlying behaviours of adopters were not or under explored. CONCLUSION: This systematic review has identified a broad range of factors affecting the uptake of new medicines within healthcare organizations, which were grouped into patient, prescriber, medicine, organizational, and external environment factors. This systematic review also identifies additional factors affecting new medicine use not reported in earlier reviews, which included patient influence and education level, cost of new medicines, formulary and reimbursement restrictions, and guidelines. REGISTRATION: PROSPERO database (CRD42018108536).


Subject(s)
Drug Prescriptions , Adult , Evidence-Based Medicine , Humans
18.
Pol Merkur Lekarski ; 49(293): 321-324, 2021 Oct 22.
Article in Polish | MEDLINE | ID: mdl-34800015

ABSTRACT

Evidence Based Medicine (EBM) is a core competence for clinicians and should be taught in all medical faculties. AIM: The aim of the study was to survey how EBM is taught in medical faculties in Poland. MATERIALS AND METHODS: We conducted a questionnaire study, asking the deans of medical faculties to fill it. RESULTS: We got a response from all medical faculties. Teaching of EBM is carried out in all medical faculties in Poland, apart from Kopernicus University in Torun. EBM is a separate subject in 7 faculties (from 5 to 36 hours). The most often EBM is taught on the IIIrd to the Vth course of the study with exception of Kielce, where it is held on the IInd course. In the most faculties teaching EBM is obligatory. In Lodz and Krakow, apart of being obligatory, EBM may be continued facultatively. Teachers are competent in EBM and continuosly trained. EBM study ends with a credit in 3 faculties. Some faculties intend to introduce EBM as a separate subject or extend number of hours. CONCLUSIONS: Our study showed that EBM is generally taught in medical faculties in Poland although in various length (5-36 hours). It should be extended to 30 hours and unified within a separate subject which ends with a credit.


Subject(s)
Evidence-Based Medicine , Faculty, Medical , Humans , Poland , Surveys and Questionnaires
19.
Article in English | MEDLINE | ID: mdl-34769813

ABSTRACT

This study aimed to determine the prevalence of high levels of knowledge, positive attitude, and good practice on evidence-based medicine (EBM) and identify the associated factors for practice score on EBM among emergency medicine doctors in Kelantan, Malaysia. This cross-sectional study was conducted in government hospitals in Kelantan. The data were collected from 200 emergency physicians and medical officers in the emergency department using the Noor Evidence-Based Medicine Questionnaire. Simple and general linear regressions analyses using SPSS were performed. A total of 183 responded, making a response rate of 91.5%. Of them, 49.7% had a high level of knowledge, 39.9% had a positive attitude and 2.1% had good practice. Sex, race, the average number of patients seen per day, internet access in workplace, having online quick reference application, and attitude towards EBM were significantly associated with EBM practice scores. It is recommended that appropriate authorities provide emergency doctors with broader access to evidence resources. EBM skill training should be enhanced in the current medical school curriculums.


Subject(s)
Health Knowledge, Attitudes, Practice , Physicians , Attitude of Health Personnel , Cross-Sectional Studies , Emergency Service, Hospital , Evidence-Based Medicine , Humans , Malaysia
20.
Urologiia ; (5): 94-98, 2021 Nov.
Article in Russian | MEDLINE | ID: mdl-34743440

ABSTRACT

Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are common disorder in older men. The mainstay of conservative treatment for BPH is 1-adrenoblockers. A review of the literature on silodosin, a selective -adrenergic blocker, is discussed in the article. In clinical studies, there was a significant improvement in IPSS scores and maximum urinary flow rate in patients who received silodosin at a daily dose of 8 mg compared to those receiving placebo. It should be noted that silodosin has demonstrated long-term safety and early onset of efficacy. Compelling literature data to support the clinical benefit of silodosin for the treatment of LUTS associated with BPH is presented.


Subject(s)
Lower Urinary Tract Symptoms , Prostatic Hyperplasia , Adrenergic alpha-1 Receptor Antagonists/therapeutic use , Aged , Evidence-Based Medicine , Humans , Indoles , Lower Urinary Tract Symptoms/drug therapy , Lower Urinary Tract Symptoms/etiology , Male , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/drug therapy , Treatment Outcome
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