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Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. ... [It] means integrating individual clinical expertise with the best available external clinical evidence from systematic research." 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.
Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. It is a form of hyperlipidemia, hyperlipoproteinemia, and dyslipidemia.
In a physical examination, medical examination, clinical examination, or medical checkup, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patient's medical history followed by an examination based on the reported symptoms. Together, the medical history and the physical examination help to determine a diagnosis and devise the treatment plan. These data then become part of the medical record.
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 medical algorithm is any computation, formula, statistical survey, nomogram, or look-up table, useful in healthcare. Medical algorithms include decision tree approaches to healthcare treatment and also less clear-cut tools aimed at reducing or defining uncertainty. A medical prescription is also a type of medical algorithm.
Evidence-based practice is the idea that occupational practices ought to be based on scientific evidence. The movement towards evidence-based practices attempts to encourage and, in some instances, require professionals and other decision-makers to pay more attention to evidence to inform their decision-making. The goal of evidence-based practice is to eliminate unsound or outdated practices in favor of more-effective ones by shifting the basis for decision making from tradition, intuition, and unsystematic experience to firmly grounded scientific research. The proposal has been controversial, with some arguing that results may not specialize to individuals as well as traditional practices.
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).
Occupational and Environmental Medicine (OEM), previously called industrial medicine, is a board certified medical specialty under the American Board of Preventative Medicine that specializes in the prevention and treatment of work-related illnesses and injuries.
The United States Preventive Services Task Force (USPSTF) is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services". The task force, a volunteer panel of primary care clinicians with methodology experience including epidemiology, biostatistics, health services research, decision sciences, and health economics, is funded, staffed, and appointed by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.
James Michael McGinnis is an American physician, epidemiologist, and long-time contributor to national and international health programs and policy, including continuous policy responsibilities for leadership in disease prevention and health promotion through four US Government Administrations. An elected member of the Institute of Medicine of the National Academies, he currently also serves as IOM Senior Scholar, as well as executive director of its Roundtable on Value & Science-Driven Health Care.
Albert Siu is a Cuban American internist and geriatrician and the Ellen and Howard C. Katz Chairman and Professor of the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Hospital in New York City. He is also the director of the Geriatric Research, Education, and Clinical Center at the James J. Peters VA Medical Center in The Bronx, a senior associate editor of Health Services Research, a senior fellow of the Brookdale Foundation and a former trustee of the Nathan Cummings Foundation.
David M. Eddy is an American physician, mathematician, and healthcare analyst who has done seminal work in mathematical modeling of diseases, clinical practice guidelines, and evidence-based medicine. Four highlights of his career have been summarized by the Institute of Medicine of the National Academy of Sciences: "more than 25 years ago, Eddy wrote the seminal paper on the role of guidelines in medical decision-making, the first Markov model applied to clinical problems, and the original criteria for coverage decisions; he was the first to use and publish the term 'evidence-based'."
The 10 Essential Public Health Services(EPHS) serve as a framework to guide the field of public health, describing the activities that public health systems should undertake in all communities in the United States.
Diane Medved Harper is a United States professor in the Department of Family Medicine at the University of Michigan. Her area of expertise is human papillomavirus (HPV) and the diseases associated with it, as well as colposcopy, and she was one of the investigators in the clinical trials of Gardasil and Cervarix, vaccines against HPV.
Cynthia Mulrow is an American physician and scholar from Edinburg, Texas. She has regularly contributed academic research on many topics to the medical community. Her academic work mainly focuses on systematic reviews and evidence reports, research methodology, and chronic medical conditions.
Karina W. Davidson is senior vice president of research at Northwell Health and director of the Institute of Health System Science at the Feinstein Institutes of Medical Research. She was previously vice-dean of organizational effectiveness and executive director of the Center for Behavioral Cardiovascular Health at Columbia University Medical Center. She was also Chief Academic Officer at NewYork-Presbyterian Hospital in New York City.
Kirsten Bibbins-Domingo is an American epidemiologist and physician. She is the 17th Editor in Chief of the Journal of the American Medical Association (JAMA) and the JAMA Network. She is Professor of Epidemiology and Biostatistics and the Lee Goldman, MD Endowed Professor of Medicine at University of California, San Francisco. She is a general internist and attending physician at San Francisco General Hospital.
Alternative medicine describes any practice which aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested or untestable. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon.
A fact box is a simplified display format that presents evidence based data about the benefits and harms of medical treatments, screenings or interventions.
Melissa Andrea Simon is an American clinical obstetrician/gynecologist and scientist who focuses on health equity across the lifespan. Simon is founder and director of the Center for Health Equity Transformation (CHET) in the Feinberg School of Medicine at Northwestern University in Chicago, Illinois, and founder of the Chicago Cancer Health Equity Collaborative, a National Cancer Institute comprehensive cancer partnership led by the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Northeastern Illinois University, and the University of Illinois at Chicago. She is the George H. Gardner, MD Professor of Clinical Gynecology, the Vice-Chair of Clinical Research in the Department of Obstetrics and Gynecology, tenured professor of Obstetrics and Gynecology, Preventive Medicine and Medical Social Sciences at Northwestern University Feinberg School of Medicine, and Associate Director of Community Outreach and Engagement at the Robert H. Lurie Comprehensive Cancer Center.
References
- ↑ Council of Europe, Developing a methodology for drawing up guidelines on best medical practice Archived 2019-12-02 at the Wayback Machine (Recommendation Rec(2001)13 and explanatory memorandum), Strasbourg: Council of Europe Publishing, 2002.
- ↑ "Guidelines for Ensuring the Quality of Information Disseminated to the Public". United States Department of Health and Human Services. 13 December 2006. Retrieved 18 August 2013.