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Level B Recommendation
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of the patient, and the best available scientific information to guide decision-making about clinical management. The term was originally used to describe an approach to teaching the practice of medicine and improving decisions by individual physicians about individual patients. Background, history and definition Medicine has a long history of scientific inquiry about the prevention, diagnosis, and treatment of human disease. The concept of a controlled clinical trial was first described in 1662 by Jan Baptist van Helmont in reference to the practice of bloodletting. Wrote Van Helmont: The first published report describing the conduct and results of a controlled clinical trial was by James Lind, a Scottish naval surgeon who conducted rese ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Jan Baptist Van Helmont
Jan Baptist van Helmont (; ; 12 January 1580 – 30 December 1644) was a chemist, physiologist, and physician from Brussels. He worked during the years just after Paracelsus and the rise of iatrochemistry, and is sometimes considered to be "the founder of pneumatic chemistry". Van Helmont is remembered today largely for his ideas on spontaneous generation, his 5-year willow tree experiment, and his introduction of the word "gas" (from the Greek word ''chaos'') into the vocabulary of science. His name is also found rendered as Jan-Baptiste van Helmont, Johannes Baptista van Helmont, Johann Baptista von Helmont, Joan Baptista van Helmont, and other minor variants switching between ''von'' and ''van''. Early life and education Jan Baptist van Helmont was the youngest of five children of Maria (van) Stassaert and Christiaen van Helmont, a public prosecutor and Brussels council member, who had married in the Sint-Goedele church in 1567.Van den Bulck, E. (1999Johannes Bapti ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Kaiser Permanente
Kaiser Permanente (; KP), commonly known simply as Kaiser, is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups. As of 2017, Kaiser Permanente operates in eight states (Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia) and the District of Columbia, and is the largest managed care organization in the United States. Kaiser Permanente is one of the largest nonprofit healthcare plans in the United States, with over 12 million members. It operates 39 hospitals and more than 700 medical offices, with over 300,000 personnel, including more than 87,000 physicians and nurses. Each Permanente ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Randomized Controlled Trial
A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical techniques, medical devices, diagnostic procedures or other medical treatments. Participants who enroll in RCTs differ from one another in known and unknown ways that can influence study outcomes, and yet cannot be directly controlled. By Random assignment, randomly allocating participants among compared treatments, an RCT enables ''statistical control'' over these influences. Provided it is designed well, conducted properly, and enrolls enough participants, an RCT may achieve sufficient control over these confounding factors to deliver a useful comparison of the treatments studied. Definition and examples An RCT in clinical research typically compares a proposed new treatment against an existing Standard of care#Medical standard of care, ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Empirical Evidence
Empirical evidence for a proposition is evidence, i.e. what supports or counters this proposition, that is constituted by or accessible to sense experience or experimental procedure. Empirical evidence is of central importance to the sciences and plays a role in various other fields, like epistemology and law. There is no general agreement on how the terms ''evidence'' and ''empirical'' are to be defined. Often different fields work with quite different conceptions. In epistemology, evidence is what justifies beliefs or what determines whether holding a certain belief is rational. This is only possible if the evidence is possessed by the person, which has prompted various epistemologists to conceive evidence as private mental states like experiences or other beliefs. In philosophy of science, on the other hand, evidence is understood as that which '' confirms'' or ''disconfirms'' scientific hypotheses and arbitrates between competing theories. For this role, it is important that ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Case Report
In medicine, a case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports may contain a demographic profile of the patient, but usually describe an unusual or novel occurrence. Some case reports also contain a literature review of other reported cases. Case reports are professional narratives that provide feedback on clinical practice guidelines and offer a framework for early signals of effectiveness, adverse events, and cost. They can be shared for medical, scientific, or educational purposes. Types Most case reports are on one of six topics: * An unexpected association between diseases or symptoms. * An unexpected event in the course of observing or treating a patient. * Findings that shed new light on the possible pathogenesis of a disease or an adverse effect. * Unique or rare features of a disease. * Unique therapeutic approaches. * A positional or quantitative variation of the anatomical structures. ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Placebo-controlled Trials
Placebo-controlled studies are a way of testing a medical therapy in which, in addition to a group of subjects that receives the treatment to be evaluated, a separate control group receives a sham "placebo" treatment which is specifically designed to have no real effect. Placebos are most commonly used in blinded trials, where subjects do not know whether they are receiving real or placebo treatment. Often, there is also a further "natural history" group that does not receive any treatment at all. The purpose of the placebo group is to account for the placebo effect, that is, effects from treatment that do not depend on the treatment itself. Such factors include knowing one is receiving a treatment, attention from health care professionals, and the expectations of a treatment's effectiveness by those running the research study. Without a placebo group to compare against, it is not possible to know whether the treatment itself had any effect. Patients frequently show improvement e ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Randomized
In common usage, randomness is the apparent or actual lack of pattern or predictability in events. A random sequence of events, symbols or steps often has no order and does not follow an intelligible pattern or combination. Individual random events are, by definition, unpredictable, but if the probability distribution is known, the frequency of different outcomes over repeated events (or "trials") is predictable.Strictly speaking, the frequency of an outcome will converge almost surely to a predictable value as the number of trials becomes arbitrarily large. Non-convergence or convergence to a different value is possible, but has probability zero. For example, when throwing two dice, the outcome of any particular roll is unpredictable, but a sum of 7 will tend to occur twice as often as 4. In this view, randomness is not haphazardness; it is a measure of uncertainty of an outcome. Randomness applies to concepts of chance, probability, and information entropy. The fields of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Cochrane Collaboration
Cochrane (previously known as the Cochrane Collaboration) is a British international charitable organisation formed to organise medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers. It includes 53 review groups that are based at research institutions worldwide. Cochrane has approximately 30,000 volunteer experts from around the world. The group conducts systematic reviews of health-care interventions and diagnostic tests and publishes them in the Cochrane Library. According to the Library, articles are available via one-click access, but some require paid subscription or registration before reading. A few reviews, in occupational health for example, incorporate results from non-randomised observational studies as well as controlled before–after (CBA) studies and interrupted time-series studies. History Cochrane, previously known as the Cochrane Collaboration, was founded in ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Systematic Review
A systematic review is a Literature review, scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on the topic, then analyzes, describes, and summarizes interpretations into a refined conclusion. For example, a systematic review of randomized controlled trials is a way of summarizing and implementing evidence-based medicine. While a systematic review may be applied in the Biomedical research, biomedical or health care context, it may also be used where an assessment of a precisely defined subject can advance understanding in a field of research. A systematic review may examine clinical tests, public health interventions, environmental interventions, social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations. An understanding of systematic review ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Internal Validity
Internal validity is the extent to which a piece of evidence supports a claim about cause and effect, within the context of a particular study. It is one of the most important properties of scientific studies and is an important concept in reasoning about evidence more generally. Internal validity is determined by how well a study can rule out alternative explanations for its findings (usually, sources of systematic error or 'bias'). It contrasts with external validity, the extent to which results can justify conclusions about other contexts (that is, the extent to which results can be generalized). Details Inferences are said to possess internal validity if a causal relationship between two variables is properly demonstrated.Shadish, W., Cook, T., and Campbell, D. (2002). Experimental and Quasi-Experimental Designs for Generilized Causal Inference Boston:Houghton Mifflin. A valid causal inference may be made when three criteria are satisfied: # the "cause" precedes the "eff ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting measurements that are expected to have some degree of error. The aim then is to use approaches from statistics to derive a pooled estimate closest to the unknown common truth based on how this error is perceived. Meta-analytic results are considered the most trustworthy source of evidence by the evidence-based medicine literature.Herrera Ortiz AF., Cadavid Camacho E, Cubillos Rojas J, Cadavid Camacho T, Zoe Guevara S, Tatiana Rincón Cuenca N, Vásquez Perdomo A, Del Castillo Herazo V, & Giraldo Malo R. A Practical Guide to Perform a Systematic Literature Review and Meta-analysis. Principles and Practice of Clinical Research. 2022;7(4):47–57. https://doi.org/10.21801/ppcrj.2021.74.6 Not only can meta-analyses provide an estimate of the un ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Governmentality
Governmentality is a concept first developed by the French philosopher Michel Foucault in the later years of his life, roughly between 1977 and his death in 1984, particularly in his lectures at the Collège de France during this time. Governmentality can be understood as: * the organized practices (mentalities, rationalities, and techniques) through which subjects are governed Governmentality may also be understood as: * the "art of government" * the "how" of governing (that is, the calculated means of directing how we behave and act)Jeffreys and Sigley (2009) 'Governmentality, Governance and China' in China's Governmentalities, (ed.) Elaine Jeffreys, * "governmental rationality" * "a 'guideline' for the analysis that Michel Foucault offers by way of historical reconstructions embracing a period starting from Ancient Greece right through to modernity and neo-liberalism" * "the techniques and strategies by which a society is rendered governable" * The 'reasoned way of governing ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
