جستجوی مقالات مرتبط با کلیدواژه « based medicine » در نشریات گروه « پزشکی »

Evidence-based medicine is the systematic process of assessing the most reliable evidence from clinical research for decision making in clinical care. The variety of assessment criteria and confusion in selecting the reliable scientific resources has challenged users. Therefore, the current study was conducted with the aim to rank evidence-based medical databases using Ovid's assessment criteria through hierarchical analysis method.
The current study is an applied descriptive-survey research conducted using field and cross-sectional studies in the first six months of 2017 in libraries of Tehran city medical universities (Tehran, Shahid Beheshti, Iran, and Baqiyatallah). Data were provided through systematic review based on Ovid assessment criterion, and collected in the form of paired comparison questionnaire by 20 expert's opinions. After that, data were analyzed using hierarchical analysis technique and Expert Choice 11 software. This criterion includes 6 main measures and 48 sub-measures.
According to the obtained results of the study, a search criterion with the weight of 0.247, guides criterion with the weight of 0.172, services criterion with the weight of 0.166, display criterion with the weight of 0.156, link criterion with the weight of 0.151, and performance criterion with the weight of 0.109 were put in the first, second, third, fourth, fifth, and the last or sixth priority with inconsistency rate of 0.10, respectively. The Cochrane database with the coefficient of 0.491 and Up to Date database with the coefficient of 0.224, assigned the highest and the lowest priority to themselves amongst the databases.
In order to develop and improve the activities of medical evidence-based databases, authorities should pay attention to the user's desired criteria and apply their recommendations. Moreover, the users must be taught how to use databases

Evidence-based medicine (EBM) as a dominant medical paradigm has been integrated in several components of medical education today. The aim of this study was to investigate the main necessities and challenges of teaching EBM to undergraduate medical students in Iran.
In this overview, several databases such as PubMed, Magiran and SID and search engine Google Scholar have been searched using relevant key words from inception to now. Researches conducted about necessities and challenges of teaching EBM to undergraduate medical students in Iran have been investigated in four categories namely knowledge and attitude about concepts of EBM, barriers to implementing EBM, teaching methods of EBM and evidence-based clinical training. To have an effective teaching of EBM principles to medical students it is necessary to change the teacher’s knowledge and attitude in first step and then integrate EBM education in undergraduate medical curriculum. Also teaching principles of critical thinking and clinical reasoning during the first years is the main prerequisite of effective teaching of EBM

I commonly meet colleagues, resident dermatologists, and medical students who have a misunderstanding about an important point of evidence-based medicine (EBM). Their problem is rooted in their misinterpretation of the "highest level of evidence" and "current best evidence". They usually do not differentiate the crucial difference between the two. Indeed, if they cannot find the "highest level of evidence" for a certain disease, they interpret it as "not having the current best evidence".
It is important to remember that when the "highest level of evidence" cannot be found, the next level of evidence will be considered as the "best current evidence". For example, if there is no systematic review of homogenous, high quality randomized controlled trials for the treatment of a certain disease, the next level, i.e. high quality randomized controlled trial(s), will be "the current best level of evidence". So, there is a need for looking for lower levels of evidence when we could not find the higher ones. Rare diseases are common in dermatology, in many cases the "current best evidence" may be limited to a case report or a colleague's experience.

About 25 years have been passed since the evidence-based medicine (EBM) group declared it as a new approach to teaching and practicing clinical medicine. EBM was based on the combination of three principles: use of current best evidence from research, clinical expertise, and patient's values and preferences. Practically, EBM substitutes pathophysiological reasoning based on basic science research with use of clinical evidence from high quality randomized controlled clinical trials. Like all other approaches to clinical medicine, EBM has been criticized since it was introduced. Herein, we review common problems of EBM according to its critics, introduce what is known as real EBM, and briefly discuss how we could move towards real EBM.

Three decades have passed since the first time evidence-based medicine (EBM)، in its current form، was introduced. Arguably، over the past two decades it has been the most significant movement in medicine. There is no need to emphasize any approach to clinical medicine practice، including EBM، has its proponents and opponents. Certainly، EBM has been subjected to many challenges and criticisms. Some of those challenges are basically related to misunderstanding and misinterpretations of EBM. However، there are some challenges that are real and are acknowledged by the most loyal EBM supporters. After hearing some criticisms posed by few knowledgeable and competent dermatologists during the recently held 7th Evidence-Based Dermatology (EBD) seminar in Tehran، the authors of this letter، two of the pioneers of EBD in Iran، decide to open a gate for sharing and discussing different viewpoints on EBM and EBD.

Nowadays, development and influence of technology in medical information and emergence of the extensive information have provided opportunity for the development of applying evidence-based medicine as a reasonable framework for decision making in medicine and it has attracted attention due to its importance. Aim of this study was to determine awareness, attitude, ability and facilities of evidence-based medicine in medical residents. In this study, 40 residents of hospitals of selected Medical Sciences Universities of Tehran were included in the study with proportional stratified random sampling in 2013. Data collection instrument was a researcher-made questionnaire including 5 parts, such as demographic specifications and four criteria of awareness, attitude, evidence-based performance and its executive facilities. Validity of questionnaire was determined through content validity and internal consistency of the questions through Cronbach's alpha of 0.71. Data were analyzed by SPSS software. Awareness of residents about evidence-based medicine was medium. Physicians had negative attitude toward evidence-based medicine. Ability of evidence-based medicine was undesirable and physicians sometimes had access to facilities of evidence-based medicine. Results showed that residents had low awareness with evidence-based medicine. Therefore, there is need for systematic education for awareness and execution of evidence-based medicine among residents.

although evidence-based medicine is an important part of recent research attempts to reform the healthcare system، it requires to be evaluated in real situations of the society and patients. The current study was conducted to explain the concept of evidence-based medicine according to the academic and medical experiences of the clinical faculty members of Kermanshah University of Medical Sciences. this study was designed as a qualitative phenomenology. The statistical society comprised of the clinical faculty members of Kermanshah University of Medical Sciences. The participants were selected through purposeful sampling. The study sample was determined by the sufficiency principle. Data were collected through semi-structured interviews. The obtained data were analyzed by Collaizzi’s model at the time of data collection. three major themes were extracted from the analysis of data، including unawareness and lack of use (unaware of the concepts، lack of use، referring to the colleagues، test prescription)، conscious or unconscious use (use of journals، academic sites، aware of the processes) and beliefs (believing in the necessity and not believing the necessity). a regular educational planning aiming to change the behavior is required to change the behavior of the clinical faculty members from an inactive state to an active use of evidence-based medicine and to change negative beliefs to the positive ones. Moreover، providing appropriate facilities and infrastructure and removing the obstacles of evidence-based medicine can be effective in this regard.

Review of the literature shows that clinical decision-making is not often based on scientific evidence and in many cases it results from personal experience، subjectivity، and previous models or methods used in clinical wards. In other words، we cannot say with confidence whether the diagnostic decisions are the best possible decisions in clinical settings and most beneficial for the patient? Is it possible to make all decisions based on strong scientific evidence? As the element of «decision» constitutes the core of medical education، this paper aims to review the status of evidence-based medicine in terms of nature of science and circumstances of decision making in order to extend the concept of evidence-based medicine. This research was qualitative، using an analytical-theoretical method through the integration of the decision making theories and nature of science based on these criteria: certainty of situation، predictability، certainty of theories، objectivity، thinking، and openness. Based on the existing theoretical methods of decision making in the range of certainty to uncertainty، decision-making was classified into three categories. Also based on the mentioned indicators، science was classified into basic sciences (non-living systems)، experimental sciences (living systems) and humanities (social sciences). Finally، based on the analytical approach، the conceptual framework was drawn. As the nature of medical sciences is experimental، the development of evidence-based medicine approach can foster the critical evaluation of scientific evidence، reduce subjective judgment، and lead to the gradual formation of new ideas.

David Lawrence Sackett, OC, MD, FRSC, FRCP was an American-Canadian physician, trialist, and teacher. He is best known as one of the pioneers of evidence-based medicine (EBM), which is arguably the most important movement in medicine over the past three decades. He founded the first clinical epidemiology department in McMaster University in Hamilton, Canada in 1967. In addition, he was the head of the Center for the Evidence-Based Medicine in Oxford, UK. He also was the first chair of Cochrane Collaboration and the first founding coeditor of the journal of Evidence-Based Medicine and had many other honors. He published 12 books, 60 chapters in other books, and about 300 articles in scientific and medical journals. He died on May 13, 2015 at age 80 because of cholangiocarcinoma. While Dr. Sackett will be missed by his friends, colleagues, mentees as well as EBM proponents and followers all over the world, his contributions to EBM in particular, and to medicine in general will never be forgotten.

Utilization of resources of evidence based medicine depends on quick and easy access to reliable databases, which meet different functionalities of a user interface, usability and technical issues. Given the importance of evidence based medicine resources in accelerating response to clinical questions, the present study is an attempt to evaluate compliance of evidence based medicine resources based on Ovid Criteria. This study is an applied work, which was carried through surveys and webometric methods between 2012 and 2013. The population was consisted of six evidence based medicine resources. Evaluations were done using Ovid criteria. The collected data was analyzed in SPSS (20) using descriptive statistics (frequency and frequency percentage). Findings indicated that resources of evidence based medicine obtained less than half of the total rating Ovid Criterion. In general, they were placed at 36.92% level and obtained 319 points out of 864. Therefore; compliance of all resources of evidence based medicine based on Ovid criteria was at the low level. Despite the fact that resources of evidence based medicine are aimed to provide rapid access to medicine evidence; the problems regarding satisfactory ease of use, effective user interface and observance of the technical issues were undeniable. Dealing with these problems successfully, leads to quick and easy access to the evidences by users. It is suggested, based on the findings, those experts of database design and public information need to pay more attention to the components such as search, service, display, links, guides or documentation.

Introduction and Evidence based medicine aids the delivery of effective service to patients, diagnosing and treating. According to Clinical guidelines of evidence-based medicine, it’s possible to change clinical decision, improve treatment and promote the patients´ health. The purpose of this study is to survey knowledge, attitudes and performance about evidence-based medicine among physicians. All of the physicians in educational hospitals of medical faculty of Neyshabur, were entered in this cross-descriptive study by convenience sampling method. The questionnaire included demographic information and also information about knowledge, attitudes and obstacles of evidence-based medicine. Data were analyzed by SPSS v.16 software and descriptive statistics. Results showed that 88 % of physicians had little familiarity with evidence-based medicine and its resources. 47.8 % of them employed evidence-based medicine in their treatment decisions and 60.4 % knew the significance of evidence-based medicine for medical teams. Overloud of information were reported by 55.1 % of participants as preventive factor in use of evidence-based medicine. According to low level of knowledge and performance in evidence-based medicine among physicians, promoting awareness and practice is needed.

Nearly two decades have passed since the establishment of evidence-based medicine (EBM). EBM is of great importance due to its ability to fill the information gap between medical research and clinical practice. The aim of the present study was to evaluate the existing evidence of the application of EBM in published Iranian educational papers.

This is a systematic review of Iranian papers published in both Iranian and international journals. The results were reviewed by two researchers separately to assess the inclusion and exclusion criteria and evaluate the level of evidence. We used the Best Evidence Medical Education (BEME) guideline for conducting the systematic review and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart to present the selection process. In addition, the Medical Education Research Quality Index (MERSQI) was used for the evaluation of the quality of the studies.

EBM was used in 11 fields which can be categorized as the 4 clinical, educational, research, and policy-making groups. The educational group consisted of 3 domains of holding a journal club, case discussions, and teaching and learning. Only 6 studies were found to report the effect of education on the application of evidence-based medicine. The evaluation of their quality showed average quality.

Although there are a limited number of studies on the effect of education on EBM application, they present satisfactory and average quality evidence. Despite the existence of various educational courses on EBM in Iran, no high level and high quality evidence exists to show the effectiveness of education on knowledge, attitude, practice, and behavior of healthcare professionals especially in the long-term. Thus, the designing and performing of high quality research is required in this field.