Chiropractic is a form of alternative medicine concerned with the diagnosis,treatment and prevention of mechanical disorders of the musculoskeletal system,especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.
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.
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.
The American College of Physicians (ACP) is a Philadelphia-based national organization of internal medicine physicians,who specialize in the diagnosis,treatment,and care of adults. With 161,000 members,ACP is the largest medical-specialty organization and second-largest physician group in the United States. Its flagship journal,the Annals of Internal Medicine,is among the most widely cited peer-reviewed medical journals in the world.
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.
eMedicine is an online clinical medical knowledge base founded in 1996 by doctors Scott Plantz and Jonathan Adler,and computer engineer Jeffrey Berezin. The eMedicine website consists of approximately 6,800 medical topic review articles,each of which is associated with a clinical subspecialty "textbook". The knowledge base includes over 25,000 clinically multimedia files.
Gordon Henry Guyatt is a Canadian physician who is Distinguished University Professor in the Departments of Health Research Methods,Evidence and Impact and Medicine at McMaster University in Hamilton,Ontario. He is known for his leadership in evidence-based medicine,a term that first appeared in a single-author paper he published in 1991. Subsequently,a 1992 JAMA article that Guyatt led proved instrumental in bringing the concept of evidence-based medicine to the world's attention.[2] In 2007,The BMJlaunched an international election for the most important contributions to healthcare. Evidence-based medicine came 7th,ahead of the computer and medical imaging. [3][4] Guyatt's concerns with the role of the medical system,social justice,and medical reform remain central issues that he promoted in tandem with his medical work. On October 9,2015,he was named to the Canadian Medical Hall of Fame.
In medicine,patient compliance describes the degree to which a patient correctly follows medical advice. Most commonly,it refers to medication or drug compliance,but it can also apply to other situations such as medical device use,self care,self-directed exercises,or therapy sessions. Both patient and health-care provider affect compliance,and a positive physician-patient relationship is the most important factor in improving compliance. Access to care plays a role in patient adherence,whereby greater wait times to access care contributing to greater absenteeism. The cost of prescription medication also plays a major role.
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).
Sir Iain Geoffrey Chalmers is a British health services researcher,one of the founders of the Cochrane Collaboration,and coordinator of the James Lind Initiative,which includes the James Lind Library and James Lind Alliance.
David Lawrence Sackett was an American-Canadian physician and a pioneer in evidence-based medicine. He is known as one of the fathers of Evidence-Based Medicine. He founded the first department of clinical epidemiology in Canada at McMaster University,and the Oxford Centre for Evidence-Based Medicine. He is well known for his textbooks Clinical Epidemiology and Evidence-Based Medicine.
The Users’Guides to the Medical Literature is a series of articles originally published in the Journal of the American Medical Association,later rewritten and compiled in a textbook,now in its third edition. The guides provide practical,clinician-friendly advice on all aspects of evidence-based medicine.
The Jadad scale,sometimes known as Jadad scoring or the Oxford quality scoring system,is a procedure to assess the methodological quality of a clinical trial by objective criteria. It is named after Canadian-Colombian physician Alex Jadad who in 1996 described a system for allocating such trials a score of between zero and five (rigorous). It is the most widely used such assessment in the world,and as of May 2024,its seminal paper has been cited in over 24,500 scientific works.
Evidence-based dentistry (EBD) is the dental part of the more general movement toward evidence-based medicine and other evidence-based practices. The pervasive access to information on the internet includes different aspects of dentistry for both the dentists and patients. This has created a need to ensure that evidence referenced to are valid,reliable and of good quality.
Alessandro Liberati was an Italian healthcare researcher and clinical epidemiologist,and founder of the Italian Cochrane Centre.
The discipline of evidence-based toxicology (EBT) strives to transparently,consistently,and objectively assess available scientific evidence in order to answer questions in toxicology,the study of the adverse effects of chemical,physical,or biological agents on living organisms and the environment,including the prevention and amelioration of such effects. EBT has the potential to address concerns in the toxicological community about the limitations of current approaches to assessing the state of the science. These include concerns related to transparency in decision making,synthesis of different types of evidence,and the assessment of bias and credibility. Evidence-based toxicology has its roots in the larger movement towards evidence-based practices.
The United States Cochrane Center (USCC) was one of the 14 centers on the world that facilitated the work of the Cochrane Collaboration. The USCC was the reference center for all 50 US states and US territories,protectorates,and districts:the District of Columbia,American Samoa,Guam,the Northern Mariana Islands,Puerto Rico,and the US Virgin Islands. The USCC was also the reference Center for the following countries:Antigua and Barbuda,Bahamas,Barbados,Belize,Dominica,Grenada,Guam,Guyana,Jamaica,Japan,Saint Kitts and Nevis,Saint Lucia,Saint Vincent and the Grenadines,and Trinidad and Tobago. The USCC discontinued on February 7,2018.
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.
Peter Tugwell is a Canadian physician and Professor in the Department of Medicine and School of Epidemiology and Public Health at the University of Ottawa. He is known for promoting clinical epidemiology and championing for health equity worldwide. In 2013 he was named Officer of the Order of Canada for his efforts as "tireless contributor to global health".
Benjamin Djulbegovic is an American physician-scientist whose academic and research focus revolves around optimizing clinical research and the practice of medicine by comprehending the nature of medical evidence and decision-making. In his work,he has integrated concepts from evidence-based medicine (EBM),predictive analytics,health outcomes research,and the decision sciences.
