Posts Tagged ‘evidence’
Poor Evidence For Effectiveness Of Influenza Vaccines In Elderly
Evidence for the safety and efficacy of influenza vaccines in the over 65s is poor, despite the fact that vaccination has been recommended for the prevention of influenza in older people for the past 40 years. These are the conclusions of a new Cochrane Systematic Review. Adults aged 65 and over are some of the most vulnerable during influenza season and a priority for vaccination programmes…
Training of patient and consumer representatives in the basic competencies of evidence-based medicine: a feasibility study
Background:Evidence based medicine (EBM) has become standard approach in medicine. Patients and health authorities increasingly claim active patient roles in decision making. Education to cope with these roles might be useful. We investigated the feasibility, acceptability and possible impact of EBM training courses for patient and consumer representatives.Methods:We designed a generic one week EBM course based on previous experience with EBM courses for non medical health professionals. A course specific competence test has been developed and validated to measure EBM skills. Formative and summative evaluation of the course comprised: 1) EBM skills; 2) individual learning goals; 3) self reported implementation after six months using semi-structured interviews; 4) group based feedback by content analysis. EBM skills’ achievement was compared to results gathered by a group of undergraduate University students of Health Sciences and Education who had attended a comparable EBM seminar.Results:Fourteen EBM courses were conducted including 161 participants without previous EBM training (n=54 self-help group representatives, n=64 professional counsellors, n=36 patient advocates, n=7 others); 71% had a higher education degree; all but five finished the course. Most participants stated personal learning goals explicitly related to practicing EBM such as acquisition of critical appraisal skills (n=130) or research competencies (n=67). They rated the respective relevance of the course on average with 80% (SD 4) on a visual analogue scale ranging from 0 to 100%.Participants passed the competence test with a mean score of 14.7 (SD 3.0, n=123) out of 19.5 points. The comparison group of students achieved a mean score of 14.4 (SD 3.3, n=43). Group based feedback revealed increases of self confidence, empowerment through EBM methodology and statistical literacy, and acquisition of new concepts of patient information and counselling. Implementation of EBM skills was reported by 84 of the 129 (65%) participants available for follow-up interviews. Barriers included lack of further support, limited possibilities to exchange experiences, and feeling discouraged by negative reactions of health professionals.Conclusions:Training in basic EBM competencies for selected patient and consumer representatives is feasible and accepted and may affect counselling and advocacy activities. Implementation of EBM skills needs support beyond the training course.
Early fatherhood: a mapping of the evidence base relating to pregnancy prevention and parenting support
Teenage pregnancy prevention programmes targeted at young women have received considerable attention from researchers and programme developers. However, to date, relatively limited information is available on preventing teenage fatherhood or improving outcomes for young fathers. A notable gap is concerned with understanding the forms of sexual health programmes that are most effective from the perspective of young men. We conducted a systematic mapping to identify studies involving young men aimed at preventing teenage pregnancy, improving outcomes for teenage fathers or exploring the perspectives of young men around pregnancy and fatherhood. We searched a wide range of electronic databases from January 1996 to August 2008. Three quantitative and 15 qualitative studies were identified, of which nine were UK based. Key themes related to the inappropriateness of current sexual health promotion to respond to the needs of young men. While young men often possessed very similar ideals to young women, existing programmes were problematic when they negatively stereotyped young men and ineffectively addressed models of masculinity or the difficulties young men may have forming meaningful relationships. Further investigations are required on programme development for young men, particularly on sexual health promotion interventions for ‘looked-after’ young men and those from unstable childhoods.
Lack Of Evidence A Problem For Policymakers, Doctors And Patients
One category of medical mysteries that stumps expert doctors and policymakers alike falls under the heading: What works? News reports on two new studies – and one that was never completed – offer insight into that issue. It turns out that “one of the first things you do at a doctor’s visit” may not do much to improve your health, the Chicago Tribune reports.
TENS For Osteoarthritis: Not Enough Evidence To Recommend
Despite twenty years of research on the use of electrostimulation techniques (TENS) for treatment of osteoarthritis in the knee, researchers still cannot say whether it reduces pain or physical disability. This is the conclusion of a new review of electrostimulation trials in osteoarthritis.
Insufficient Evidence To Recommend TENS For Osteoarthritis
Despite twenty years of research on the use of electrostimulation techniques (TENS) for treatment of osteoarthritis in the knee, researchers still cannot say whether it reduces pain or physical disability. This is the conclusion of a Cochrane Systematic Review of electrostimulation trials in osteoarthritis. Osteoarthritis is the most common cause of pain and physical disability in older people.
A randomised-controlled trial of two educational modes for undergraduate evidence-based medicine learning in Asia
Background:As the overall evidence for the effectiveness of teaching of evidence based medicine (EBM) is not strong, and the impact of cultural and societal influences on teaching method is poorly understood, we undertook a randomised-controlled trial to test the effectiveness and learning satisfaction with two different EBM teaching methods (usual teaching vs. problem based learning (PBL)) for undergraduate medical students.Methods:A mixed methods study that included a randomised-controlled crossover trial with two intervention arms (usual teaching and PBL) and a nested qualitative study with focus groups to explore student perceptions of learning and to assess the effectiveness and utility of the two teaching methods.All 129 second-year medical students at the University of Hong Kong in 2007.The main outcomes measures were attitudes towards EBM; personal application and current use of EBM; EBM knowledge; future use of EBM.Results:PBL was less effective at imparting knowledge than usual teaching consisting of a lecture followed by a group tutorial. After usual teaching students showed improvement in scores for ‘attitudes towards EBM’, ‘personal application and current use of EBM’ and ‘EBM knowledge, which were not evident after PBL. In contrast to the usual teaching, students found PBL difficult as they lacked the statistical knowledge necessary to support discussion, failed to understand core concepts, and lost direction.Conclusions:The evidence presented here would suggest that the teaching of EBM within an Asian environment should adopt a format that facilitates both the acquisition of knowledge and encourages enquiry.
Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice: the EU-EBM project.
Background:Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional development (CPD) courses that train clinical trainers to teach EBM through on-the-job training by demonstration of applied EBM real time in clinical practice. We developed such a course to encourage clinically relevant teaching of EBM in post-graduate education in various clinical environments.Methods:We devised an e-learning course targeting trainers with EBM knowledge to impart educational methods needed to teach application of EBM teaching in commonly used clinical settings. The curriculum development group comprised experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions in seven European countries. The e-learning sessions were designed to allow participants (teachers) to undertake the course in the workplace during short breaks within clinical activities. An independent European steering committee provided input into the process.Results:The curriculum defined specific learning objectives for teaching EBM by exploiting educational opportunities in six different clinical settings. The e-modules incorporated video clips that demonstrate practical and effective methods of EBM teaching in everyday clinical practice. The course encouraged focussed teaching activities embedded within a trainer’s personal learning plan and documentation in a CPD portfolio for reflection.Conclusion:This curriculum will help senior clinicians to identify and make the best use of available opportunities in everyday practice in clinical situations to teach various steps of EBM and demonstrate their applicability to clinical practice. Once fully implemented, the ultimate outcome of this pilot project will be a European qualification in teaching EBM, which will be used by doctors, hospitals, professional bodies responsible for postgraduate qualifications and continuing medical education.
Officials And The Public Should Use The Latest Evidence As A Guide In H1N1 Prevention And Protection Procedures: Scientific Community Recommendation
As flu season draws nearer along with the potential for resurgence in H1N1, leading infectious diseases doctors, hospital epidemiologists, and infection preventionists urge officials to base recommendations for the public and healthcare workers on scientific knowledge and frontline experience gained from the outbreak this summer.
Assessing competency in Evidence Based Practice: strengths and limitations of current tools in practice.
Background:Evidence Based Practice (EBP) involves making clinical decisions informed by the most relevant and valid evidence available. Competence can broadly be defined as a concept that incorporates a variety of domains including knowledge, skills and attitudes. Adopting an evidence-based approach to practice requires differing competencies across various domains including literature searching, critical appraisal and communication. This paper examines the current tools available to assess EBP competence and compares their applicability to existing assessment techniques used in medicine, nursing and health sciences.DiscussionOnly two validated assessment tools have been developed to specifically assess all aspects of EBP competence. Of the two tools (Berlin and Fresno tools), only the Fresno tool comprehensively assesses EBP competency across all relevant domains. However, both tools focus on assessing EBP competency in medical students; therefore neither can be used for assessing EBP competency across different health disciplines. The Objective Structured Clinical Exam (OSCE) has been demonstrated as a reliable and versatile tool to assess clinical competencies, practical and communication skills. The OSCE has scope as an alternate method for assessing EBP competency, since it combines assessment of cognitive skills including knowledge, reasoning and communication. However, further research is needed to develop the OSCE as a viable method for assessing EBP competency.SummaryDemonstrating EBP competence is a complex task – therefore no single assessment method can adequately provide all of the necessary data to assess complete EBP competence. There is a need for further research to explore how EBP competence is best assessed; be it in written formats, such as the Fresno tool, or another format, such as the OSCE. Future tools must also incorporate measures of assessing how EBP competence affects clinician behaviour and attitudes as well as clinical outcomes in real-time situations. This research should also be conducted across a variety of health disciplines to best inform practice.
Rx Drug Compare
Translator
By N2H