Related Research Articles
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.
A randomized controlled trial 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.
Cochrane is a British international charitable organisation formed to synthesize 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.
A medical error is a preventable adverse effect of care ("iatrogenesis"),whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease,injury,syndrome,behavior,infection,or other ailment.
A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis,management,and treatment in specific areas of healthcare. Such documents have been in use for thousands of years during the entire history of medicine. However,in contrast to previous approaches,which were often based on tradition or authority,modern medical guidelines are based on an examination of current evidence within the paradigm of evidence-based medicine. They usually include summarized consensus statements on best practice in healthcare. A healthcare provider is obliged to know the medical guidelines of their profession,and has to decide whether to follow the recommendations of a guideline for an individual treatment.
A systematic review is a 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,critically appraises and summarizes interpretations into a refined evidence-based conclusion. For example,a systematic review of randomized controlled trials is a way of summarizing and implementing evidence-based medicine.
A hierarchy of evidence,comprising levels of evidence (LOEs),that is,evidence levels (ELs),is a heuristic used to rank the relative strength of results obtained from experimental research,especially medical research. There is broad agreement on the relative strength of large-scale,epidemiological studies. More than 80 different hierarchies have been proposed for assessing medical evidence. The design of the study and the endpoints measured affect the strength of the evidence. In clinical research,the best evidence for treatment efficacy is mainly from meta-analyses of randomized controlled trials (RCTs). Systematic reviews of completed,high-quality randomized controlled trials –such as those published by the Cochrane Collaboration –rank the same as systematic review of completed high-quality observational studies in regard to the study of side effects. Evidence hierarchies are often applied in evidence-based practices and are integral to evidence-based medicine (EBM).
Patient safety is a discipline that emphasizes safety in health care through the prevention,reduction,reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events,often known as patient safety incidents,experienced by patients was not well known until the 1990s,when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world,the World Health Organization (WHO) calls patient safety an endemic concern. Indeed,patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.
BMJ Quality &Safety is a peer-reviewed healthcare journal dealing with improving patient safety and quality of care. The journal was established in 1992 as Quality in Health Care,subsequently became Quality &Safety in Health Care and obtained its current name in 2011. It co-owned with the Health Foundation and is published by BMJ Publishing Group. The editor-in-chief role is shared by Bryony Dean Franklin and Eric J Thomas. Before them the co-editors in chief were Kaveh Shojania and Mary Dixon-Woods.
Health information technology (HIT) is health technology,particularly information technology,applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers,providers,payers,and quality monitors. Based on a 2008 report on a small series of studies conducted at four sites that provide ambulatory care –three U.S. medical centers and one in the Netherlands,the use of electronic health records (EHRs) was viewed as the most promising tool for improving the overall quality,safety and efficiency of the health delivery system.
Peter Christian Gøtzsche is a Danish physician,medical researcher,and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen,Denmark. He is a co-founder of the Cochrane Collaboration and has written numerous reviews for the organization. His membership in Cochrane was terminated by its Governing Board of Trustees on 25 September 2018.
Patient participation is a trend that arose in answer to medical paternalism. Informed consent is a process where patients make decisions informed by the advice of medical professionals.
Alessandro Liberati was an Italian healthcare researcher and clinical epidemiologist,and founder of the Italian Cochrane Centre.
Health care quality is a level of value provided by any health care resource,as determined by some measurement. As with quality in other fields,it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them;that is,to ensure good quality of life,cure illnesses when possible,to extend life expectancy,and so on. Researchers use a variety of quality measures to attempt to determine health care quality,including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis,a decrease in the number of risk factors which people have following preventive care,or a survey of health indicators in a population who are accessing certain kinds of care.
A rapid response system (RRS) is a system implemented in many hospitals designed to identify and respond to patients with early signs of clinical deterioration on non-intensive care units with the goal of preventing respiratory or cardiac arrest. A rapid response system consists of two clinical components,an afferent component,an efferent component,and two organizational components –process improvement and administrative.
The Centre for Evidence-Based Medicine (CEBM),based in the Nuffield Department of Primary Care Health Sciences at the University of Oxford,is an academic-led centre dedicated to the practice,teaching,and dissemination of high quality evidence-based medicine to improve healthcare in everyday clinical practice. CEBM was founded by David Sackett in 1995. It was subsequently directed by Brian Haynes and Paul Glasziou. Since 2010 it has been led by Professor Carl Heneghan,a clinical epidemiologist and general practitioner.
Allegiance bias in behavioral sciences is a bias resulted from the investigator's or researcher's allegiance to a specific school of thought. Researchers/investigators have been exposed to many types of branches of psychology or schools of thought. Naturally they adopt a school or branch that fits with their paradigm of thinking. More specifically,allegiance bias is when this leads therapists,researchers,etc. believing that their school of thought or treatment is superior to others. Their superior belief to these certain schools of thought can bias their research in effective treatments trials or investigative situations leading to allegiance bias. Reason being is that they may have devoted their thinking to certain treatments they have seen work in their past experiences. This can lead to errors in interpreting the results of their research. Their “pledge”to stay within their own paradigm of thinking may affect their ability to find more effective treatments to help the patient or situation they are investigating.
Physician burnout has been classified as a psychological syndrome that can be expressed as a prolonged response to due chronic occupational stressors. In the practice of medicine,it has been known to affect a wide variety of individuals from medical students to practicing physicians;although,its impact reaches far beyond that. Because of the toll taken on the healthcare industry,various treatment and prevention strategies have been developed at individual,team,and organizational levels in hopes to seek the best method of addressing this epidemic.
A non-pharmaceutical intervention or non-pharmacological intervention (NPI) is any type of health intervention which is not primarily based on medication. Some examples include exercise,sleep improvement,or dietary habits.
Kathryn McDonald is an American scientist who is Bloomberg Distinguished Professor at the Johns Hopkins University. She serves as co-director of the Johns Hopkins Center for Diagnostic Excellence. McDonald previously led the Centre for Health Policy at Freeman Spogli Institute for International Studies. Her research considers what makes for high-quality and safe healthcare delivery systems.
References
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- ↑ "Kaveh Shojania". scholar.google.com.
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- 1 2 "Past Recipients - National Quality Forum".
- ↑ "The Decade-Long Journey To NEJM Case 34-2010". 21 November 2010.
- ↑ "Editorial Board". BMJ Quality & Safety.
- ↑ Lerner, Barron H. (February 10, 2004). "BOOKS ON HEALTH; Healing an Error-Prone Medical System". The New York Times– via NYTimes.com.
- ↑ To Err Is Human: Building a Safer Health System. National Academies Press. March 1, 2000. doi:10.17226/9728. ISBN 978-0-309-26174-6.
- ↑ Institute of Medicine (US) Committee on Quality of Health Care in America (July 19, 2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press. doi:10.17226/10027. ISBN 978-0-309-07280-9. PMID 25057539.
- ↑ Leape, Lucian L.; Berwick, Donald M.; Bates, David W. (2002-07-24). "What Practices Will Most Improve Safety?". JAMA. American Medical Association (AMA). 288 (4): 501–507. doi:10.1001/jama.288.4.501. ISSN 0098-7484. PMID 12132984. S2CID 15759464.
- ↑ Shojania, Kaveh G.; Duncan, Bradford W.; McDonald, Kathryn M.; Wachter, Robert M. (July 24, 2002). "Safe but SoundPatient Safety Meets Evidence-Based Medicine". JAMA. 288 (4): 508–513. doi:10.1001/jama.288.4.508. PMID 12132985 – via Silverchair.
- ↑ Auerbach, Andrew D.; Landefeld, C. Seth; Shojania, Kaveh G. (August 9, 2007). "The tension between needing to improve care and knowing how to do it". The New England Journal of Medicine. 357 (6): 608–613. doi:10.1056/NEJMsb070738. PMID 17687138.
- ↑ Shojania, Kaveh G.; Ranji, Sumant R.; McDonald, Kathryn M.; Grimshaw, Jeremy M.; Sundaram, Vandana; Rushakoff, Robert J.; Owens, Douglas K. (July 26, 2006). "Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis". JAMA. 296 (4): 427–440. doi:10.1001/jama.296.4.427. PMID 16868301.
- ↑ Tricco, Andrea C.; Ivers, Noah M.; Grimshaw, Jeremy M.; Moher, David; Turner, Lucy; Galipeau, James; Halperin, Ilana; Vachon, Brigitte; Ramsay, Tim; Manns, Braden; Tonelli, Marcello; Shojania, Kaveh (June 16, 2012). "Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis". Lancet. 379 (9833): 2252–2261. doi:10.1016/S0140-6736(12)60480-2. PMID 22683130. S2CID 34529110.
- ↑ Kaushal, Rainu; Shojania, Kaveh G.; Bates, David W. (June 23, 2003). "Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review". Archives of Internal Medicine. 163 (12): 1409–1416. doi:10.1001/archinte.163.12.1409. PMID 12824090. S2CID 5092255.
- ↑ Jl, Kwan; L, Lo; J, Ferguson; H, Goldberg; Jp, Diaz-Martinez; G, Tomlinson; Jm, Grimshaw; Kg, Shojania (September 17, 2020). "Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials". BMJ (Clinical Research Ed.). 370: m3216. doi:10.1136/bmj.m3216. PMC 7495041 . PMID 32943437.
- ↑ Kg, Shojania; Ec, Burton; Km, McDonald; L, Goldman (June 4, 2003). "Changes in rates of autopsy-detected diagnostic errors over time: a systematic review". JAMA. 289 (21): 2849–2856. doi:10.1001/jama.289.21.2849. PMID 12783916.
- ↑ Shojania, Kaveh G; Duncan, Bradford W; McDonald, Kathryn M; Wachter, Robert M; Markowitz, Amy J (1999-12-06). "Making Health Care Safer". Evidence Report/Technology Assessment (Summary). Agency for Healthcare Research and Quality (US) (43): i–x, 1–668. PMC 4781305 . PMID 11510252.
- ↑ Kg, Shojania; M, Sampson; Mt, Ansari; J, Ji; S, Doucette; D, Moher (August 21, 2007). "How quickly do systematic reviews go out of date? A survival analysis". Annals of Internal Medicine. 147 (4): 224–233. doi:10.7326/0003-4819-147-4-200708210-00179. PMID 17638714. S2CID 3988259.
- ↑ "UCSF Hellman Fellows Past Awardees | Executive Vice Chancellor & Provost". evcprovost.ucsf.edu.
- 1 2 "Awards & Recognition - Sunnybrook Hospital". sunnybrook.ca.
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