MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'evidence,'. Tue, 04 May 2010 18:20:31 +0100 http://www.medworm.com/index.php?rid=3511801&cid=t_304170_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F04%2Ferpr-testing-guidelines-joint-capasco-recommendations.html The College of American Pathologists (CAP) and the American Society of Clinical Oncology (ASCO) issue a joint guideline on April 19, 2010 in an effort to improve the accuracy of immunohistochemistry testing for estrogen (ER) and progesterone receptors (PgR) expression in breast cancer. This is similar to the joint effort the groups made with HER2 testing guideline in 2007.  The guideline is being published in the April 19 issues of ASCO’s Journal of Clinical Oncology (JCO) and the CAP’s Archives of Pathology & Laboratory Medicine in June 2010 but is available in electronic form here.  The ASCO Web page on the guidelines (http://www.asco.org/guidelines/erpr) has links to the unabridged version (yikes!) as well as downloadable slides.The major recommendation are sum... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3511801 Wed, 28 Apr 2010 04:55:02 +0100 3511801 http://www.medworm.com/index.php?rid=3483060&cid=t_304170_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2010%2F04%2Fscience-camp-and-social-stories.html I'm told it's a fifth grade rite of passage, but I can think of many other descriptions. Last year I remember "reading" about it and thinking, never in a month of Sundays.. and now it's nearly here.Now it's nearly here, although we've been preparing for over a month, the levels of anxiety are palpable.To list the deficits would be demeaning and fail to encompass the magnitude of the challenge.There are lots of parents with young autistic children who are struggling to learn basic skills: dressing, toileting, feeding, talking. They're not thinking about Science Camp - why would they? I certainly never did. I was a miserable skeptic before they arrived - it's genetic. Such things as science camp seemed completely unobtainable, barely struggling through the average 24 hour day. We had more so... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=3483060 Mon, 19 Apr 2010 06:37:00 +0100 3483060 http://www.medworm.com/index.php?rid=3482993&cid=t_304170_125_f&fid=36046&url=http%3A%2F%2Fdentistrylibrary.blogspot.com%2F2010%2F04%2Fwhat-is-systematic-review.html Systematic reviews have increasingly replaced traditional narrative reviews and expert commentaries as a way of summarising research evidence. Read more about systematic reviews in this article published in Bandolier, an independent journal about evidence-based healthcare from Oxford. (Accessed on 19/4/2010) Subscribe in a reader (Source: DentistryLibrary@Sydney) DentistryLibrary@Sydney blogs http://www.medworm.com/rss/comments.php?id=3482993 Sun, 18 Apr 2010 22:43:00 +0100 3482993 http://www.medworm.com/index.php?rid=3448891&cid=t_304170_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F2rTmHoXFGM4%2Fevidence-or-lack-thereof-behind.html This article (first reference below) in the February issue of the Aesthetic Surgery Journal is a review of the evidence behind retinoids in cosmeceutical products.  It turns out there isn’t much. First, let’s begin with some definitions: Retinoids include Vitamin A and its derivatives which may be either natural or synthetic. Cosmeceutical products are formulations which are not classified as prescription medications.  Retinoids which are prescription medications include tretinoin, isotretinoin, alitretinoin, tazarotene, and adapalene.  Because they are classified as prescription medications, these do not qualify as cosmeceuticals. This is an important distinction as there is a large body of evidence to support tretinoin in the treatment of photoaging.  This articl... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3448891 Thu, 08 Apr 2010 11:01:00 +0100 3448891 http://www.medworm.com/index.php?rid=3416388&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F03%2Frole-of-occupational-therapy-for.html Behavioral problems in children are sometimes difficult to solve. Caregivers and even professionals often search for what I call an 'easy button' to solve complex problems. I have always believed that using a general systems methodology prevents the inappropriate reduction of complex system problems to single-point causes.Human beings are meaning-making creatures, however, and that causes us to sometimes reduce complex data into single-points even though it doesn't make sense to do so. As an obtuse example - if you ask the average person what caused the shuttle Challenger to explode they will tell you that it was Morton Thiokol and faulty O-rings. Although that is true, it is more true that there were other factors including cold temperatures, design errors, lack of redundancy, and flawed ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3416388 Mon, 29 Mar 2010 15:22:00 +0100 3416388 http://www.medworm.com/index.php?rid=3404023&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2010%2F03%2F25%2Fread-summaries-of-systematic-reviews%2F Wouldn’t it be nice if you could find all the systematic reviews pertaining to dentistry in one place?  You can! The American Dental Association (ADA)  Evidence Based Dentistry website includes a database of systematic reviews in oral health. The reviews may be found by searching the site or using the ADA’s drill down topic menu. Even [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=3404023 Thu, 25 Mar 2010 17:08:39 +0100 3404023 http://www.medworm.com/index.php?rid=3386864&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F03%2F21%2Finformation-is-beautiful-visualizing-the-evidence-for-health-supplements%2F In a world driven by data, we need a simple means of digesting it all. Visualization of data may help to coop with the information overload. Good visualizations enable people to look at vast quantities of data quickly. Bram Hengeveld at Geriatric Care (geriatricare.wordpress.com) told me of Snake Oil, a fantastic visualization of scientific evidence for [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3386864 Sun, 21 Mar 2010 17:17:54 +0100 3386864 http://www.medworm.com/index.php?rid=3385311&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F03%2F20%2Fan-evidence-pyramid-that-facilitates-the-finding-of-evidence%2F Earlier I described that there are so many search- and EBM-pyramids that it is confusing. I described  3 categories of pyramids: Search Pyramids Pyramids of EBM-sources Pyramids of EBM-levels (levels of evidence) In my courses where I train doctors and medical students how to find evidence quickly, I use a pyramid that is a mixture of 1. and 2. [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3385311 Sat, 20 Mar 2010 15:27:17 +0100 3385311 http://www.medworm.com/index.php?rid=3378508&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2010%2F03%2Fstatins-heart-disease-and-risk.html What gives? How can someone with high blood cholesterol levels for 30+ years end up with clean arteries, if indeed there is any causation between blood cholesterol levels and plaque accumulation. ... Perhaps actual blood cholesterol levels have no cause of heart disease on their own a-priori. And, if any of these crazy hypotheses are true, then how can a health system prescribe drugs like statins so casually and routinely to anyone with cholesterol over 230? This is particularly true, when the long term side effects of such drugs must still be unknown.Lots of questions -- some scientific, some health-plan political... But mainly I am looking for just straight talk on this whole cholesterol/heart disease issue.You ask a lot of good questions. Let me paraphrase them for ease of presentation.... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=3378508 Wed, 17 Mar 2010 19:34:00 +0100 3378508 http://www.medworm.com/index.php?rid=3370433&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2010%2F03%2Fwhen-is-physical-exam-useful.html The hope that the physical exam might bridge the gap between provider and patient is natural and even salutary, but we should clarify why we think the physical exam is useful.More at KevinMD. (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=3370433 Mon, 15 Mar 2010 20:06:00 +0100 3370433 http://www.medworm.com/index.php?rid=3350258&cid=t_304170_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FUbaWkbQpyek%2F By Andrew J. CoulsonDiane Ravitch is a leading education historian. Her work in that field is characteristically thorough and well-researched, and her books The Troubled Crusade and The Great School Wars, in particular, made significant contributions to our understanding of U.S. education history. On the presumption that Ravitch is as much an expert on policy as she is on history, her latest book, recounting her change of heart on certain policy questions, has garnered enormous media attention. I suggest, with all due respect, that this presumption is a mistake. Unlike her thorough and rigorous historical writing, Ravitch’s policy opinions were never grounded in a systematic and comprehensive review of the relevant evidence. They should never have been given credence in the first place. ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3350258 Tue, 09 Mar 2010 23:41:51 +0100 3350258 http://www.medworm.com/index.php?rid=3346414&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F03%2F09%2Fthe-placebo-homeopathy-effects%2F Ben Goldacre is the man behind the book “Bad Science“, the blog “Bad Science” (http://www.badscience.net/) and the weekly Bad Science column in the Guardian. He is a medical doctor who specializes in “unpicking dodgy scientific claims made by scaremongering journalists, dodgy government reports, evil pharmaceutical corporations, PR companies and quacks.“ One of Ben’s favorite subjects [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3346414 Tue, 09 Mar 2010 15:15:08 +0100 3346414 http://www.medworm.com/index.php?rid=3338336&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2010%2F03%2F05%2Fupdated-list-of-iphone-apps-for-dentistry%2F The following is a list of iPhone applications pertaining to dentistry: (updated March 5, 2010) 3D Teeth ($1.99): General information about teeth and mouth, shown in 3D. Information on dental caries, dental disease, implants and dental care. 3D Head and Neck Skeleton System: Concentrates on the bones of the head and neck. Allows user to zoom in and [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=3338336 Fri, 05 Mar 2010 19:19:26 +0100 3338336 http://www.medworm.com/index.php?rid=3335314&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2010%2F03%2Fhow-can-patients-and-doctors-talk-about.html Check out this presentation (based on other people's research) that I'm giving tomorrow at the meeting of the Mid-Atlantic branch of the Society of General Internal Medicine. The Power Point version, prettier in its Microsoft way, is here. (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=3335314 Thu, 04 Mar 2010 19:34:00 +0100 3335314 http://www.medworm.com/index.php?rid=3331245&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F03%2F04%2Fsearching-skills-toolkit-finding-the-evidence-book-review%2F Most books on Evidence Based Medicine give little attention to the first two steps of EBM: asking focused answerable questions and searching the evidence. Being able to appraise an article, but not being able to find the best evidence may be challenging and frustrating to the busy clinicians. “Searching Skills Toolkit: Finding The Evidence” is a [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3331245 Thu, 04 Mar 2010 00:18:19 +0100 3331245 http://www.medworm.com/index.php?rid=3327235&cid=t_304170_134_f&fid=34841&url=http%3A%2F%2Fwww.diabetesmine.com%2F2010%2F03%2Fthe-%25e2%2580%259cpatient-centered-medical-home-too-good-to-be-true.html Those of you who follow me on twitter may know that I traveled to Washington DC late last week to take part in a “roundtable event” discussing paths to better diabetes care. Now, I’m no policy-maker, and certainly no expert on the crazy mixed-up reimbursement system in this country.  I was there, again, to talk [...] (Source: Diabetes Mine) Diabetes Mine blogs http://www.medworm.com/rss/comments.php?id=3327235 Wed, 03 Mar 2010 13:00:38 +0100 3327235 http://www.medworm.com/index.php?rid=3298524&cid=t_304170_134_f&fid=34841&url=http%3A%2F%2Fwww.diabetesmine.com%2F2010%2F02%2Fgrowing-your-own-decision-tree.html To what degree is the state of our health really in our own hands? According to author Thomas Goetz, it very largely is. In his new book The Decision Tree, published last week, Thomas argues that since we live in a world where data on anything, including personal health, is abundant, [...] (Source: Diabetes Mine) Diabetes Mine blogs http://www.medworm.com/rss/comments.php?id=3298524 Tue, 23 Feb 2010 13:00:04 +0100 3298524 http://www.medworm.com/index.php?rid=3280215&cid=t_304170_167_f&fid=38576&url=http%3A%2F%2Fwww.drbriffa.com%2Fblog%2F2010%2F02%2F17%2Fno-good-evidence-flu-vaccination-helps-the-elderly%2F Here in the UK it’s cold, and the cold weather tends to bring with it an upsurge in the rates of viral infections such as the common cold and flu. It has been suggested that one reason such infections surge in the winter is because we’re more likely to be cooped up with other people, [...] (Source: Dr John Biffa's Blog) Dr John Biffa's Blog blogs http://www.medworm.com/rss/comments.php?id=3280215 Wed, 17 Feb 2010 17:32:55 +0100 3280215 http://www.medworm.com/index.php?rid=3267225&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F02%2Fare-we-focusing-on-best-things-so-we.html The value of anecdote is not in capturing a comprehensive analysis of a system's problems - but rather in making an example of a small issue that reflects a broader pattern. I understand that use of anecdote as a tool can also be fundamentally incorrect or even dangerous but I hope that I have documented enough other information about the early intervention program (in places like here and here) so that this presentation will be honest and fair.I also understand that any 'for the children' rhetoric causes large swaths of people to immediately tune out of a conversation but it is difficult to frame this discussion about early intervention services outside the context of how it actually impacts children and families. The truth is that the future is a little uncertain about early intervention... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3267225 Thu, 11 Feb 2010 16:49:00 +0100 3267225 http://www.medworm.com/index.php?rid=3231423&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F02%2F02%2Feducation-for-primary-care-2009-vol-20-no-6%2F Contents Page Fade Fave: Online learning in primary care: the importance of e-professionalism Fade Skinny: Electronic learning for medical professionals has transformed medical education. Medical professionals are increasingly engaging with colleagues and clinicians via instant messaging, social networking sites and podcasts to seek answers to clinical questions or for opinions or discussions on aspects of healthcare as the need arises.  The biggest concern for networking sites and for blogging is confidentiality. The concept of e-professionalism is discussed which includes confidentiality, awareness of online personas, admissions during the postings and student safety decisions. Contact the library for a copy of this article Filed under: Current Awareness, Journals, Primary Care Tagged:... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3231423 Tue, 02 Feb 2010 08:06:15 +0100 3231423 http://www.medworm.com/index.php?rid=3227831&cid=t_304170_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F02%2F01%2Fare-antidepressants-really-that-ineffective%2F The more researchers delve into the research behind antidepressants — the class of drugs commonly prescribed to treat depression — the more they find that perhaps the majority of antidepressants’ treatment effect is based upon the simple belief that the drug will help. Newsweek’s Sharon Begley has a lengthy article discussing the growing body of evidence that calls into question decades’ worth of prescriptions. It’s a story that we’ve covered previously, that TIME covered nearly a year ago, and that Therese Borchard had a response to. It seems to be journalists’ favorite “go to” story now in mental health, because there’s a black-and-white controversy — do antidepressants work or don’t they? People mistakenly be... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3227831 Mon, 01 Feb 2010 17:10:49 +0100 3227831 http://www.medworm.com/index.php?rid=3269661&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F02%2F01%2Fnotsofunny-ridiculing-rcts-and-ebm%2F I remember it well. As a young researcher I presented my findings in one of my first talks, at the end of which the chair killed my work with a remark, that made the whole room of scientists laugh, but was really beside the point. My supervisor, a truly original and very wise scientist, suppressed [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3269661 Mon, 01 Feb 2010 02:28:37 +0100 3269661 http://www.medworm.com/index.php?rid=3227701&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F02%2F01%2Fnotsofunny-ridiculing-rcts-and-ebm%2F I remember it well. As a young researcher I presented my findings in one of my first talks, at the end of which the chair killed my work with a remark, that made the whole room of scientists laugh, but was really beside the point. My supervisor, a truly original and very wise scientist, suppressed [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3227701 Mon, 01 Feb 2010 02:28:37 +0100 3227701 http://www.medworm.com/index.php?rid=3216841&cid=t_304170_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FnVIz0q18SZE%2F You’ve heard of evidence-based medicine. Well, a new paper summarizes a panalopy of practices employed over the past two decades or so - ghostwriting, suppressing or spinning data, disease mongering and managing side effect perceptions among docs - that the authors call marketing-based medicine. And they rely on internal documents from litigation - such as the much-publicized lawsuits over antipsychotics and antidepressants - to illustrate their point. “While much excitement has been generated surrounding evidence-based medicine, internal documents from the pharmaceutical industry suggest that the publicly available evidence base may not accurately represent the underlying data regarding its products,” they write in Bioethical Inquiry (see here). “We propose that wh... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3216841 Thu, 28 Jan 2010 13:07:23 +0100 3216841 http://www.medworm.com/index.php?rid=3208305&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F01%2F26%2Five-got-good-news-and-ive-got-bad-news%2F If someone tells you: “I’ve got Good News and I’ve got Bad News”, you probably ask this person: “Well, tell me the bad news first!” Laika’s MedLibLog has good and bad news for you. The Bad News is, that this blog didn’t make it to the Finals of the sixth annual Medical Weblog Awards, organized by Medgadget. [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3208305 Tue, 26 Jan 2010 13:28:01 +0100 3208305 http://www.medworm.com/index.php?rid=3204816&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2010%2F01%2F24%2Fcochrane-evidence-aid-for-catastrophes-like-haitis-earthquake-helping-by-doing-what-we-do-best%2F How it started [1] 2005. December 26th. Someone* working for the Cochrane Collaboration was on the Internet when he accidentally saw the AOL’s home page mentioning a powerful earthquake in the Indian Ocean, triggering a powerful tsunami that swept the coasts of neighboring countries. The story and the horror unfolded over the next hours [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3204816 Sun, 24 Jan 2010 22:52:12 +0100 3204816 http://www.medworm.com/index.php?rid=3197788&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2010%2F01%2F21%2Fnew-systematic-reviews-in-oral-health%2F The Cochrane Collaboration recently published the following systematic reviews.  Full text access is available for URMC affiliates. Interventions for treating traumatised ankylosed permanent front teeth:  This review found that there is currently insufficient high level evidence for comparing the effectiveness of different treatment methods for ankylosed front teeth. Interventions for treating oral mucositis for patients with cancer [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=3197788 Thu, 21 Jan 2010 20:19:13 +0100 3197788 http://www.medworm.com/index.php?rid=3189434&cid=t_304170_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F01%2Fasco-recommendations-for-genetic-testing.html ASCO Releases Updated Policy Statement on Genetic TestingASCO issued its latest recommendations for genetic testing for cancer susceptibility. The updated statement addresses new developments during the past seven years, including the availability of genetic tests of unproven clinical benefit and direct-to-consumer (DTC) genetic testing. Read the press release, visit Cancer.Net for information for your patients, and read the statement in JCO.The comments relating to DTC genetic testing are worth reading this alone.  Marketing directly to consumers places us pathologists even more out of the loop given how in recent years, sales reps for test manufacturers have bypassed the lab and marketed directly to clinicians (e.g. ThinPrep, SurePath, OncotypeDx,). &#... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3189434 Wed, 20 Jan 2010 02:19:45 +0100 3189434 http://www.medworm.com/index.php?rid=3189437&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F01%2Ffolk-taxonomies-and-sensory-processing.html This article effectively demonstrates how professional training and item wording can strongly impact the way that different diagnosticians interpret common behavioral attributes.When people think that a disorder is present I believe that it is most important to begin with actually determining if there is a functional behavioral problem that is interfering with ability to carry out everyday tasks. That can help us avoid falling into the trap of labeling every nuanced form of trait or characteristic difference that people may express. Humans are natural 'meaning-makers' and we don't advance the cause of understanding our patient's concerns unless we improve our ability to become armchair anthropologists about our own professional culture.It might be interesting to write a blog post and call ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3189437 Tue, 19 Jan 2010 16:50:00 +0100 3189437 http://www.medworm.com/index.php?rid=3185279&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F19%2Fjournal-of-evaluation-in-clinical-practice-2009-vol-15-no-6%2F contents page Fade Fave: ‘We hold these truths to be self-evident’: deconstructing ‘evidence-based’ medical practice Fade Skinny: Evidence-based medicine (EBM) claims to be based on ‘evidence’, rather than ‘intuition’. Argues that EBM’s strict distinction between admissible evidence (based on RCTs) and other supposedly inadmissible evidence is not itself based on evidence, but rather, on intuition. (NHS Athens is required to access this article online) Posted in Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Current Awareness, E-Journals, Evidence Based Practice (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3185279 Tue, 19 Jan 2010 11:47:19 +0100 3185279 http://www.medworm.com/index.php?rid=3182150&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F01%2F17%2Fnursing-times-2010-vol-108-no-1%2F This article reports on an alliance between NHS Quality Improvement Scotland and The Joanna Briggs Institute in Australia set up to promote and facilitate the use of online tools and resources to support the development of  practice and ultimately, to enhance care. This article summarises the tools available and discusses the implementation and evaluation of this project. Contact the library for a copy of this article Posted in Current Awareness, Journals Tagged: Clinical Practice, Electronic Resources, Evidence Based Practice, Nursing, Online Learning (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3182150 Sun, 17 Jan 2010 18:55:30 +0100 3182150 http://www.medworm.com/index.php?rid=3167274&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2010%2F01%2F13%2Fread-our-latest-newsletter%2F The January 2010 issue of the Bibby Library Gazette is packed with information on our resources and services.  Check it out! Posted in Bibby Library, Dental Journals, Dental Libraries, Dental Resources, Eastman Dental Center, Eastman Institute for Oral Health, Evidence Based Dentistry (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=3167274 Wed, 13 Jan 2010 15:25:44 +0100 3167274 http://www.medworm.com/index.php?rid=3153377&cid=t_304170_90_f&fid=0&url=http%3A%2F%2Fannietv600.wordpress.com%2F2010%2F01%2F07%2Fcmaj_kt%2F This series began in 2009, when CMAJ was still an Open Access journal.  Link to free full text for Parts 1-5 below at http://tiny.cc/CMAJ_KT. Part 1: Straus SE, Tetroe J, Graham I. Defining knowledge translation. CMAJ 2009;181(3-4):165-8. Part 2: Brouwers M, Stacey D, O’Connor A. Knowledge creation: synthesis, tools and products. CMAJ 2009 Nov 2. [Epub ahead of print] Part 3: Kitson A, Straus SE. The knowledge-to-action cycle: Identifying the gaps.  CMAJ 2009 Nov 30. [Epub ahead of print] Part 4: Harrison MB, Légaré F, Graham ID, Fervers B. Adapting clinical practice guidelines to local context and assessing barriers to their use.  CMAJ 2009 Dec 7. [Epub ahead of print] Part 5: Wensing M, Bosch M, Grol R. Developing and selecting interventions for translating knowledge to acti... ANNE T-V's BLOG blogs http://www.medworm.com/rss/comments.php?id=3153377 Thu, 07 Jan 2010 22:03:34 +0100 3153377 http://www.medworm.com/index.php?rid=3135493&cid=t_304170_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F12%2Fwhat-november-2009-breast-cancer.html In November, 2009, a rancorous argument about screening mammography for women aged 40-49 was touched off by the publication of updated guidelines(1), supported by a systematic literature review(2) by the US Preventive Services Task Force (USPSTF).  The guidelines suggested that yearly mammographic screening for women in that age group should not be automatic, but a decision made for individual patients after discussion between the patients and their doctors.  This was based on a critical review of the best available data which suggested that the benefits of screening acrue to only a few patients.  1904 women would have to start screening and continue for multiple rounds to prevent one cancer death over 11-20 years of follow-up.  These benefits had to be b... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3135493 Thu, 31 Dec 2009 17:43:00 +0100 3135493 http://www.medworm.com/index.php?rid=3133554&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F31%2Fimpact-of-alcohol-consumption-on-young-people-a-systematic-review-of-published-reviews%2F Title: Impact of Alcohol Consumption on Young People: A Systematic Review of Published Reviews Skinny: Systematic review identifying theadverse consequences of drinking alcohol during childhood and adolescence which would seem to outweigh the modest number of positive impacts. Overall, it seems that delaying the age of alcohol initiation and limiting the amount drunk by young people is likely to enhance their health and well-being. Publisher: DCSF Size of Publication: 69p. Published: 30/12/2009 Posted in Alcohol, Children, Evidence Based Practice, Grey Literature, Young People Tagged: Alcohol, Children, Evidence Based Practice, Grey Literature, Young People (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3133554 Thu, 31 Dec 2009 11:22:24 +0100 3133554 http://www.medworm.com/index.php?rid=3092651&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F12%2F16%2Fnot-one-rct-on-swine-flu-or-h1n1-outrageous%2F Last week doctorblogs (Annabel Bentley) tweeted: “Outrageous- there isn’t ONE randomised trial on swine flu or #H1N1“ Annabel referred to an article at Trust the Evidence, the excellent blog of the Centre for Evidence-Based Medicine (CEBM) in Oxford, UK. In the article “Is swine flu the most over-published and over-hyped disease ever?” Carl Heneghan first showed [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3092651 Wed, 16 Dec 2009 10:46:49 +0100 3092651 http://www.medworm.com/index.php?rid=3084714&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F14%2Fbirth-and-beyond-a-review-of-the-evidence-about-antenatal-education%2F Title: Birth and beyond: a review of the evidence about antenatal education Skinny: Synthesises published evidence concerning the cost and effectiveness of antenatal education, alongside evidence about stakeholder perspectives. Publisher: DH Size of Publication:65p. Published: 08/12/2009 Posted in Antenatal Care, Grey Literature, Midwifery, Obstetrics Tagged: Antenatal Education, Cost Effectiveness, Evidence Based Practice, Grey Literature, Midwifery, Obstetrics, Stakeholder Engagement (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3084714 Mon, 14 Dec 2009 16:00:32 +0100 3084714 http://www.medworm.com/index.php?rid=3067327&cid=t_304170_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2009%2F12%2Fmore-recommendations-for-lymph-node-adequacy-in-crc.html The Dutch National Working Group on Gastrointestinal Cancers has recently released colorectal cancer guidelines which includes a recommendation of a minimum of 10 lymph nodes to establish a negative lymph node status.  At the same time, the group states that "determining the lymph node status of a patient requires evaluation as many lymph nodes as possible using conventional techniques." (emphasis mineThe discussion of this recommendation states that "no definitive criteria were found in the literature regarding the minimum number of examined lymph nodes.  There is no evidence to support 12 lymph nodes, as recommended by TNM." (emphasis mine)Furthermore, they specifically do not recommend using immunohistochemistry to detect metastases or pre-treatment of me... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3067327 Mon, 07 Dec 2009 19:56:40 +0100 3067327 http://www.medworm.com/index.php?rid=3067331&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F12%2Fquestions-about-aotas-response-to.html The National Autism Center published a comprehensive National Standards report regarding evidence-based practice guidelines for children and young adults who have autism. The report is an excellent summary of research about intervention methods and effectiveness. It was particularly interesting to me that this report referenced and hoped to expand on the New York State Early Intervention Clinical Practice Guidelines for autism spectrum disorders which of course is a document that is familiar to many of the families in my geographic area. The NYS guidelines were published ten years ago so an update to include new research was needed.The new report focuses on quantitative studies and in this sense some important occupational therapy literature may not have met the inclusion criteria. There h... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3067331 Mon, 07 Dec 2009 19:37:00 +0100 3067331 http://www.medworm.com/index.php?rid=3052156&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F12%2Fwhat-bridges-gap-between-evidence-based.html Under the withering barrage of recent guideline changes, doctors and patients alike have raised their hands in surrender. It seems like guideline group after group have changed their recommendations to say (more or less) the same thing: "[name of screening test here] should be discussed with the patient according to their risk profile."We used to think that population studies ("big-E epidemiology") would provide us with the tools to fix health care. The drill of empirical science would become the Swiss Army knife of evidence-based medicine.But something got in the way: inconveniently enough, that something is the patient.A patient is not a population, but a unique individual with a one-of-a-kind combination of characteristics. So how to apply the population findings (or even the evidence-b... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=3052156 Thu, 03 Dec 2009 04:55:00 +0100 3052156 http://www.medworm.com/index.php?rid=3039736&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F30%2Fconsultation-on-proposals-for-the-innovation-pass-pilot%2F Title: Consultation on proposals for the Innovation Pass pilot Skinny: Seeks views from the NHS, industry and other stakeholders on the Government’s proposals for an Innovation Pass pilot.  These proposals will be revised in light of comments received as part of this consultation and will be used to inform the first set of decisions for the pilot in 2010/1.  The Innovation Pass will make selected innovative medicines available on the NHS for a time-limited period, prior to a NICE appraisal.  Funding will be drawn from a new ring-fenced £25m budget, set aside exclusively for the Innovation Pass. The Pass gives earlier access to innovative drugs for patients with the greatest need, and at the same time it will facilitate the collection of further information to support a subsequent NIC... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3039736 Mon, 30 Nov 2009 14:46:16 +0100 3039736 http://www.medworm.com/index.php?rid=3039740&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F11%2F30%2Fcomplementary-medicine-pharmacists%2F I don’t know if the situation is the same in other countries, but in the Netherlands we can only get prescribed medications in pharmacies. Drugstores are only allowed to sell over-the counter (OTC) medicines. Most Pharmacies have a small shop of 5 square meters (besides a large storage room). What surprises me is that the counter [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3039740 Mon, 30 Nov 2009 03:05:54 +0100 3039740 http://www.medworm.com/index.php?rid=3035869&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F11%2F27%2Ffollowfriday-ff-the-ebm-skeptics-cochranecollab-evidencematters-oracknows-acpinternists%2F FollowFriday is a twitter tradition in which twitter users recommend other users to follow (on Friday) by twittering their name(s), the hashtags #FF or #FollowFriday, and the reason for their recommendation(s). Since the roll out of Twitter lists I add the #FollowFriday Recommendations to a (semi-)permanent #FollowFriday Twitter list: @laikas/followfridays-ff This week I have added 4 people to [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3035869 Fri, 27 Nov 2009 22:54:01 +0100 3035869 http://www.medworm.com/index.php?rid=3033571&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F11%2F26%2Fadding-methodological-filters-to-myncbi%2F Idea: Arnold Leenders Text: “Laika” Methodological Search Filters can help to narrow down a search by enriching for studies with a certain study design or methodology. PubMed has build-in methodological filters, the so called Clinical Queries for domains (like therapy and diagnosis) and for evidence based papers (like the“Systematic Review subset” in Pubmed). These searches are [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3033571 Thu, 26 Nov 2009 17:54:45 +0100 3033571 http://www.medworm.com/index.php?rid=3029822&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F11%2Frelaxed-guidelines-and-breast-cancer.html I'm glad Hadassah is encouraging women to start annual breast exams at 40 and not follow the new "relaxed" guidelines. "Relaxed" is what I would call "evidence-based," but never mind.The reason, shared with us by Allison Hoffman in Tablet's The Scroll, is that "Ashkenazi Jewish women are about five times likelier than everyone else to have the genetic abnormality that can lead to breast cancer." Perhaps Hadassah and the Susan G. Kornen Breast Cancer Foundation ("who has given Hadassah about $335,000 in grants for breast-cancer awareness") would care to explain to those Ashkenazi Jewish women why they are recommending annual breast exams that lead to unneeded biopsies and unjustified cancer diagnoses. Or maybe Ashkenazi Jewish women just don't care about those things? One wonders if we need... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=3029822 Wed, 25 Nov 2009 18:31:00 +0100 3029822 http://www.medworm.com/index.php?rid=3015325&cid=t_304170_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F11%2F20%2F2009-rosalynn-carter-symposium-on-mental-health-policy-recommendations%2F Earlier this month, I was honored to attend the 25th Annual Rosalynn Carter Symposium on Mental Health Policy in Atlanta, Georgia. The focus of this symposium every year is to tackle a particular issue in mental health policy, population or care. This year focused, fittingly enough, on health care reform and how mental health and substance abuse programs need to be an integrated part of that effort: Currently health care in this country is focused on illness rather than health, on procedures and face-to-face interventions rather than on coordination and prevention, and on fragmented, specialty-driven care rather than on a primary care-driven delivery system. There is a solid evidence base that shows that a health system centered on primary care costs less and has better outcomes on a popu... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3015325 Fri, 20 Nov 2009 19:05:44 +0100 3015325 http://www.medworm.com/index.php?rid=2999484&cid=t_304170_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F11%2Feditorial-that-wasnt-evidence-for.html Woe to those of us who have been advocates for evidence-based medicine.  A short description of the evidence-based medicine is medicine whose practice is informed by critical, rigorous review of the best available evidence from clinical research as revealed by systematic search of the published research literature, as well as by the clinician's understanding of biology and the medical and biopsychosocial context, and by the patient's own values. Evidence-based medicine is based on some key assumptions.  One is that a systematic review will reveal all the results of research studies that are relevant to the issue at hand.  A second is that while the research studies may be flawed and imperfect, they are reported honestly.Unfortunately, as we have repeatedly discusse... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2999484 Mon, 16 Nov 2009 21:55:00 +0100 2999484 http://www.medworm.com/index.php?rid=2995773&cid=t_304170_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F11%2F16%2Fare-we-racially-color-blind-yet%2F This study shows that these transference errors may be more likely in cross-race identifications. Ouch. That means that when it comes to eye-witness identification, whites are twice as likely to mis-identify a black person than a white person. Obviously, this sort of high error rate has significant ramifications for trials and the use of eye-witness accounts. With lower accuracy comes a higher likelihood of error and identifying someone as the perpetrator of a crime when, in fact, they were not. As the researchers noted, context is especially important. “When making an identification, witnesses must not only remember whether they have ever seen a specific individual, but also in what circumstance they encountered that individual.” Just because you recognize a face doesn’... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2995773 Mon, 16 Nov 2009 09:50:01 +0100 2995773 http://www.medworm.com/index.php?rid=2995705&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F11%2F16%2Fpresentation-at-the-nvb09-help-the-doctor-is-drowning%2F Last week I was invited to speak at the NVB-congress, the Dutch society for librarians and information specialists. I replaced Josje Calff in the session “the professional”, chaired by Bram Donkers of the magazine InformatieProfessional. Other sessions were: “the client”, “the technique” and “the connection”. (see program) It was a very successful meeting, with Andrew Keen [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2995705 Mon, 16 Nov 2009 00:45:55 +0100 2995705 http://www.medworm.com/index.php?rid=2993725&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F15%2Fbristol-myers-squibb-pharmaceuticals-ltd-r-on-the-application-of-v-national-institute-for-health-and-clinical-excellence-2009%2F Title: Bristol-Myers Squibb Pharmaceuticals Ltd, R (on the application of) v National Institute for Health and Clinical Excellence [2009] The Skinny: Challenges of the decision of the defendant, the National Institute for Health and Clinical Excellence (NICE) refusing to recommend the use of abatacept (ABA) for treatment in connection with rheumatoid arthritis in the National Health Service in the United Kingdom. Publisher: Bailii Size of Document: Webpage Case No.:EWHC 2780 (Admin) (06 November 2009) Posted in Jurisprudence Tagged: Arthiritis, Cost Effectiveness, Drug Therapy, Evidence Based Practice, Jurisprudence (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2993725 Sun, 15 Nov 2009 12:11:20 +0100 2993725 http://www.medworm.com/index.php?rid=2993732&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F15%2Fneonatal-services-toolkit%2F Title: Neonatal services toolkit – updated 12 November 2009 Skinny: New guidance to help the NHS improve the care provided for premature and sick babies and their families.  NHS staff from across England and members of Bliss (the baby charity) have helped to develop the toolkit, which provides evidence based guidance for all neonatal services.  Neonatal care should be more family-centred ensuring that the psychological as well as physical needs of babies and families are considered.  The toolkit created by and for the NHS provides guidance on how to improve services in the areas that really matter to parents including: Communication and inclusion in decision making Access to psychological and social support Improved access to and availability of specialised transfer services Safe... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2993732 Sun, 15 Nov 2009 07:42:06 +0100 2993732 http://www.medworm.com/index.php?rid=2989424&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F11%2Ffeedback-on-alternatives-to-therapy-cap.html Occupational therapy payment restrictions, typically referred to as 'therapy caps' on Medicare Part B, are daily concerns for all occupational therapists working in private practice, outpatient clinics, and nursing facilities. AOTA is participating in a long-term project aimed at finding an alternative to the current cap system. RTI International, the entity that was awarded the government contract to conduct this research, states that "CMS envisions a new method of paying for outpatient therapy services that is based on classifying individual beneficiary’s needs and the effectiveness of therapy services, e.g., diagnostic category, functional status, health status. Currently, CMS cannot evaluate or implement this type of approach because CMS does not currently collect the appropriate dat... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2989424 Thu, 12 Nov 2009 18:34:00 +0100 2989424 http://www.medworm.com/index.php?rid=2981100&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F11%2Fwhen-evidence-based-medicine-rules-land.html ...and every provider everywhere knows exactly how to apply population-level data to the patient in front of them, and what recommendations to make, there will be times (to the chagrin of me and every evidence acolyte) when the patient says no.Even worse, that patient might be right. (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2981100 Tue, 10 Nov 2009 04:19:00 +0100 2981100 http://www.medworm.com/index.php?rid=2971985&cid=t_304170_123_f&fid=39035&url=http%3A%2F%2Fwww.liddlekidzblog.com%2F2009%2F11%2Fus-health-care-best-in-world.html For many Americans there is an unfortunate notion that our health care is the best in the world, so, when I recently read an article entitled "The Epidemic of Medical Child Abuse, and what can be done", I had to share some statements and comment. Just read the first statement from author, Dana Ullman: The primary purpose of this article is to encourage a stronger commitment from doctors and parents to consider using safer medical care for infants and children FIRST before resorting to more dangerous treatments. I absolutely agree with this statement. It's not to say that there are not medical treatments which are necessary and lifesaving, but are there options. What are those options? Take constipation for example. I have seen numerous children hospitalized due to constipation. When if... Liddle Kidz Infant and Pediatric Massage Blog blogs http://www.medworm.com/rss/comments.php?id=2971985 Sat, 07 Nov 2009 17:30:00 +0100 2971985 http://www.medworm.com/index.php?rid=2971886&cid=t_304170_88_f&fid=35612&url=http%3A%2F%2Ftheknifeman.blogspot.com%2F2009%2F11%2Fneeds-of-few-vs-cost-to-many.html One of the problems with trying to adopt an evidence based approach, to anything, but in particular, to medical testing and treatment, is that population studies do not tell individual stories.The problem with using individual stories is that the plural of anecdote is not data, and association does not prove causation.However....A young middle-aged woman with chest pains present to the ED. They had woken her from sleep, but been transient, and she had gone back to sleep. In the morning she had something of a dull ache behind her breastbone, and felt a little short of breath. Simple remedies had not helped. Her pain had settled at time of exam, and she examined normally. An ECG was normal.Past history, family history, all negative.How to proceed?She was admitted for observation and serial c... The KnifeMan blogs http://www.medworm.com/rss/comments.php?id=2971886 Fri, 06 Nov 2009 13:18:00 +0100 2971886 http://www.medworm.com/index.php?rid=2958854&cid=t_304170_90_f&fid=0&url=http%3A%2F%2Fannietv600.wordpress.com%2F2009%2F11%2F03%2Fdavid-sackett%2F Here is an interesting interview from the October 30 issue of The Globe and Mail: Picard A. ‘When we began, we were almost pariahs’ : A research pioneer [Dr. Dave Sackett] tells André Picard about the battle for evidence-based medicine Excerpts:  Dave Sackett, a professor emeritus at McMaster University in Hamilton, has been awarded the prestigious Gairdner Wightman Award, which is given to a Canadian who has demonstrated outstanding leadership in medicine   …  Dr. Sackett is a pioneer in the field of clinical epidemiology and evidence-based medicine, which aim to teach health professionals how to separate good research from bad and apply it to the individual needs of their patients. He is also a world expert on the design and implementation of clinical trials  &#82... ANNE T-V's BLOG blogs http://www.medworm.com/rss/comments.php?id=2958854 Tue, 03 Nov 2009 17:32:33 +0100 2958854 http://www.medworm.com/index.php?rid=2950698&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F02%2Fnursing-times-2009-vol-105-no-42%2F This article outlines the goals of the teenage pregnancy strategy, it’s progress in reducing conceptions over the last 10 years and the evidence in the effectiveness of these policies. Contact the Library for a copy of this article Posted in Current Awareness, Journals Tagged: Evidence, Interventions, Teenage Pregnancy (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2950698 Mon, 02 Nov 2009 08:28:40 +0100 2950698 http://www.medworm.com/index.php?rid=2939250&cid=t_304170_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F10%2Ffailing-to-report-adverse-effects-of.html We have frequently advocated the evidence-based medicine (EBM) approach to improve the care of individual patients, and to improve health care quality at a reasonable cost for populations. Evidence-based medicine is not just medicine based on some sort of evidence. As Dr David Sackett, and colleagues wrote [Sackett DL, Rosenberg WM, Muir Gray JA, Haynes RB, Richardson WS. Evidence-based medicine; what it is and what it isn't. BMJ 1996; 312: 71-72. Link here. ]Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. One can find ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2939250 Wed, 28 Oct 2009 20:55:00 +0100 2939250 http://www.medworm.com/index.php?rid=2927243&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F25%2Fnursing-times-2009-vol-105-no-41%2F This article gives an overview of the evidence from evaluated diabetes programmes, reviews different strategies for identifying high risk groups and highlights key strategies for communicating risk and promoting lifestyle change. Contact the library for a copy of this article Posted in Current Awareness, Journals Tagged: Diabetes, Evidence, Prevention, Type 2 Diabetes (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2927243 Sun, 25 Oct 2009 20:52:58 +0100 2927243 http://www.medworm.com/index.php?rid=2923309&cid=t_304170_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F10%2F23%2Fgetting-help-for-depression-online%2F As promised, this is one in a series of posts I’ll write about online interventions that help treat specific mental health concerns. In this post, I’ll talk about some of the depression programs available online. The Australian National University’s Centre for Mental Health Research is one of the unsung heroes in the development and research of programs to treat depression online, for both adults and teens. What they have done over the past decade is not exactly rocket science, and yet, surprisingly, most people have never heard of one of their free online programs. They’ve taken cognitive behavioral theories and techniques and translated them into online tutorials and programs. Then they did something a lot of organizations (and virtually all companies) fail to do ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2923309 Fri, 23 Oct 2009 16:56:20 +0100 2923309 http://www.medworm.com/index.php?rid=2908545&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F10%2F19%2Fcochrane-colloquium-2009-better-working-relationship-between-cochrane-and-guideline-developers%2F Last week I attended the annual Cochrane Colloquium in Singapore. I will summarize some of the meetings. Here is a summary of an interesting (parallel) special session: Creating a closer working relationship between Cochrane and Guideline Developers. This session was brought together as a partnership between the Guidelines International Network (G-I-N) and The Cochrane Collaboration to [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2908545 Mon, 19 Oct 2009 22:02:35 +0100 2908545 http://www.medworm.com/index.php?rid=2886775&cid=t_304170_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2009%2F10%2Fnih-stateofthescience-statement-on-breast-dcis.html The conference statement from the recent NIH "State-of-the-Science" conference on ductal carcinoma-in situ (held September 22-24, 2009) is available online.  You can download a pdf for free.Some interesting findings: While the incidence of "noncomedo" DCIS continues to increase, the incidence of the (to me, more biologically worrisome) comedo type peaked in 1995 and has been declining (through 2006). MRI in DCIS?  Most studies show that MRI is more sensitive in detecting multicentric disease but is not specific.  MRI also reportedly over- and under-estimates the extent of DCIS compared to pathological exam. Although the absolute numbers are small (due to the overall high survival rates in DCIS), there are higher breast cancer recurrence and mortality r... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=2886775 Mon, 12 Oct 2009 18:54:18 +0100 2886775 http://www.medworm.com/index.php?rid=2807898&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F09%2Fcut-to-chase-simple-question-that.html At the beginning of each school year I marvel at how big of a challenge it is to get everything organized. Education is not new, drawing school district lines is not new, establishing bus schedules is not new, and determining outcome measures for education is not new - but each year it is as if no one has ever done it before, and people are left floundering around trying to figure out what needs to be done and how it needs to be done!In my own little OT corner of the universe we came upon the issue of 'what are the best scissors for preschoolers to learn how to cut with?' Well there are no shortage of opinions but there is very little evidence I could find. That was a little surprising given the length of time we have been teaching preschoolers how to use scissors.Having practiced OT for o... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2807898 Thu, 17 Sep 2009 19:39:00 +0100 2807898 http://www.medworm.com/index.php?rid=2793107&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F14%2Fannals-of-rheumatic-diseases-2009-vol-68-no-10%2F contents page Fade Fave: Management of Behçet disease: a systematic literature review for the European League Against Rheumatism evidence-based recommendations for the management of Behçet disease Fade Skinny: Finds good evidence supporting the use of azathioprine and ciclosporin A in eye involvement and interferon (IFN) in mucocutaneous involvement. There were no RCTs with IFN or tumour necrosis factor (TNF) antagonists in eye involvement. Similarly controlled data for the management of vascular, gastrointestinal and neurological involvement is lacking. (NHS Athens is required to access this article online) Posted in Access from Home, Access from Work, Access in the Library, Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Behçet Disease, Current Awareness, E-Jo... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2793107 Mon, 14 Sep 2009 15:54:29 +0100 2793107 http://www.medworm.com/index.php?rid=2772495&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F09%2F06%2Fgrey-literature-time-to-make-it-systematic%2F Guest author: Shamsha Damani (@shamsha) Grey literature is a term I first encountered in library school; I remember dubbing it “the-wild-goose-chase search” because it is time consuming, totally un-systematic, and a huge pain altogether. Things haven’t changed much in the grey literature arena, as I found out last week, when my boss asked me to help [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2772495 Sun, 06 Sep 2009 19:20:13 +0100 2772495 http://www.medworm.com/index.php?rid=2765960&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F04%2Fthe-lancet-2009-volume-374-issue-9692%2F Contents Page Fade Fave: Avoidable waste in the production and reporting of evidence Fade Skinny: Asks the crucial question how much research is wasted because those who might benefit from it cannot afford to see its results? (Print Subscription Held by the Fade Library) Posted in Current Awareness, Journals Tagged: Current Awareness, Evidence Based Practice, Journals, Research (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2765960 Fri, 04 Sep 2009 09:30:47 +0100 2765960 http://www.medworm.com/index.php?rid=2757693&cid=t_304170_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F09%2Fnew-perspective-on-evaluating-effects.html Conclusions and Future DirectionsGreenland concluded that investigator bias is very important.Investigator bias has the potential to overwhelm all other biases. It can become the dominant force in contexts (such as expert reports and testimony for litigation) in which the restraints imposed by editors and peer review are absent. Thus, because of its importance, investigator bias should not be dismissed as unapproachable, any more than we should give up research on what seem to be hopelessly mysterious diseases.He reminded us that not all investigator bias is due to financial COIs, although that should not be used to deny the importance of bias due to financial COIs,Although I have focused on distortion from financial input, I have no doubt that ideological commitment can be just as distort... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2757693 Wed, 02 Sep 2009 15:35:00 +0100 2757693 http://www.medworm.com/index.php?rid=2744319&cid=t_304170_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2009%2F08%2Fcritical-appraisal-of-research-articles.html As clinicians, we must be able to screen and then critically appraise research articles that will help us practice evidence-based medicine and, hopefully, take better care of our patients. More importantly, journal editors have a duty to do be diligent in adequately analyzing the papers submitted to them for review. This burden for editors is even more critical for us given the conflict between the limited time available for reading journals and integrating relevant articles for use in one's daily practice, the exploding volume of articles and journals and other new media (like blogs!), and our insufficient tools and skills for properly evaluating articles.  Young and Solomon, in the February 2009 Nature Clinical Practice Gastroenterology & Hepatology, have published an artic... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=2744319 Fri, 28 Aug 2009 22:18:42 +0100 2744319 http://www.medworm.com/index.php?rid=2709077&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F18%2Fbritish-journal-of-healthcare-management-2009-volume-15-issue-8%2F Contents Page Fade Fave: Implementing Lean in primary care Fade Skinny: Focus’ on the implementation of Lean in a provider service to promote quality service and evidence based outcomes in the delivery of primary care. (Print copy held at the Fade Library) Posted in Current Awareness Tagged: Current Awareness, Evidence Based Practice, Journals, Lean Thinking, Outcomes, Primary Care, Quality (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2709077 Tue, 18 Aug 2009 11:00:01 +0100 2709077 http://www.medworm.com/index.php?rid=2709095&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F17%2Fassessing-complementary-practice-building-consensus-on-appropriate-research-methods-report-of-an-independent-advisory-group%2F This report aims to establish a consensus on the ways in which research might be conducted that both the conventional and complementary health care communities can support. Publisher: King’s Fund Size of Publication: 32p Published: 10/08/2009 Posted in Clinical Governance, Complementary Medicine, Grey Literature, Health Economics, Quality Tagged: Complimentary Therapies, Cost Effectiveness, Evidence Based Practice, Grey Literature, Research (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2709095 Mon, 17 Aug 2009 14:59:37 +0100 2709095 http://www.medworm.com/index.php?rid=2688945&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F08%2Fsubjective-conversation-about-issue-of.html My occupational therapy practice is sometimes as much about parents as it is about children - and in fact the two are so intertwined that making the distinction is irrelevant. We get questions all the time about parenting decisions - and as these are directly related to both parenting and childhood occupations we try to help. Summertime is famous for conversations about retention.I have read all the studies - but won't list them here because they may not apply. Still, the studies state that there is sometimes temporary/immediate benefit to grade retention but that those benefits disappear in subsequent years.The problem with the studies is that they are done on such a large and heterogeneous group that it is difficult to say exactly who these results apply to. Parents and teachers and admi... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2688945 Mon, 10 Aug 2009 14:47:00 +0100 2688945 http://www.medworm.com/index.php?rid=2671124&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F08%2Freforming-funding-for-school-based.html Nearly three years ago I offered to work for NYS for free to help tackle the problems of Medicaid fraud for special education services (see http://abctherapeutics.blogspot.com/2006/06/new-york-states-medicaid-problem-in.html). The system needs reform badly - and although I never expected to be asked to serve I was actually quite sincere in my concern and desire to effect some improvement in the system.As I predicted back then, there would eventually come a day of reckoning to pay for the fraud and abuse - and it seems that we are at that day. In today's Albany Times Union, reporter James M. Odato informs us that the New York State Education Department is withholding Medicaid payments to school districts in accordance with a settlement agreement that has NY State paying out hundreds of mill... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2671124 Tue, 04 Aug 2009 12:52:00 +0100 2671124 http://www.medworm.com/index.php?rid=2645590&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F07%2Ffun-filled-game-of-day-guess-cses.html Why would a CSE chairperson who has worked in the field for over 20 years suddenly want more information on the Beery VMI?? This chairperson has seen this assessment used hundreds of other times... so why more information now??Inquiring therapists want to know.re: Johnny XXXTo Whom it May Concern:At the request of the district CSE Chairperson, here is additional information regarding Johnny's performance on the Beery VMI. Quite honestly this is an unusual request as this test is perhaps the most commonly used assessment in school-based occupational therapy and I do not understand why special explanations are required for this child. I am hopeful that this information will help to get an appropriate plan for this child into place.The Beery Developmental Test of Visual Motor Integration 5th ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2645590 Mon, 27 Jul 2009 19:32:00 +0100 2645590 http://www.medworm.com/index.php?rid=2634413&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F07%2Fgod-doctor-and-patient-uncomfortable.html I would never pray with a patient at the bedside. What doctor has time to talk about God? And who knows whether a patient will find the suggestion of prayer offensive, helpful, or rapport-building? Most of us doctors, when we think about prayer at all, keep it as far from our work as possible. I am an observant Jew, yarmulke wearing and Sabbath observing, and I pray three times a day. But never would I mention to my colleagues a word about my daily spiritual practice. We are practitioners of our own esoteric art, which we like to pretend is uncontaminated by outside influence, and our white coats are not cassocks. Even when an appreciation of religion might be of some use, we make an extra effort to keep it at a distance. When patients are about to die, or when our care is serving only to ... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2634413 Fri, 24 Jul 2009 01:57:00 +0100 2634413 http://www.medworm.com/index.php?rid=2634381&cid=t_304170_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F07%2Fpseudo-evidence-based-medicine.html As I posted yesterday, the increasingly noisy debate about health care reform in the US has not dealt much with the issues we often discuss on Health Care Renewal. These include problems in how health care organizations are lead which threaten physicians' and other health care professionals' core values using tactics including perverse incentives, deception, and intimidation.Last night, however, President Obama held a news conference mostly devoted to health care issues, in which he stressed the importance of changing not just how health insurance works, but how health care decisions are made. As Newsweek's "The Gaggle" blog reported,Can I guarantee that there are going to be no changes in the health care delivery system? No. The whole point of this is to try to encourage changes that work... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2634381 Thu, 23 Jul 2009 14:27:00 +0100 2634381 http://www.medworm.com/index.php?rid=2611058&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2009%2F07%2F16%2Famerican-dental-association-seeks-questions%2F Do you have a clinical question that needs an answer? Have you come across a situation where a scientific analysis of the literature would complement your treatment decisions? The ADA encourages you [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=2611058 Thu, 16 Jul 2009 18:37:51 +0100 2611058 http://www.medworm.com/index.php?rid=2602116&cid=t_304170_125_f&fid=36046&url=http%3A%2F%2Fdentistrylibrary.blogspot.com%2F2009%2F07%2Fnew-ebp-clinical-educational-resource.html The Library has organized a trial of JAMAevidence, a learning tool which provides students, educators and clinicians with the tools required for understanding and applying evidence, and making clinical decisions based on evidence. To access this resource please go to Databases on trial and scroll down to JAMAevidence. Unikey required for off-campus login.Please try it out and let us know what you think using the Database Evaluation Form. Your comments are vital to the overall evaluation process and will have an important influence on whether the Library will subscribe to this resource. The trial is running until the 10th August 2009. Subscribe in a reader (Source: DentistryLibrary@Sydney) DentistryLibrary@Sydney blogs http://www.medworm.com/rss/comments.php?id=2602116 Wed, 15 Jul 2009 04:06:00 +0100 2602116 http://www.medworm.com/index.php?rid=2591408&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F10%2Fevidence-for-transforming-community-services%2F Documents: Overview Review: acute services in the community Review: services for children and families Review: services for long term conditions Review: rehabilitation services Review: wellbeing and health inequalities Review: services for end of life care The Skinny: Independent research by , The Health Services Management Centre (HSMC) at the University of Birmingham to examine the evidence for a range of community services, commissioned by DH to underpin the guidance within the 6 transformational guides: Publisher: DH Size of Document: 10p (25p,  18p, 27p, 21p,  24p and 15p) Posted in Grey Literature, NHS, Primary Care Tagged: Acute Services, Chronic Diseases, Closer to Home, Equity, Evidence Based Practice, Grey Literature, NHS, Organisational Design, Paediatrics, Palliative Care, ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2591408 Fri, 10 Jul 2009 14:41:29 +0100 2591408 http://www.medworm.com/index.php?rid=2572895&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F07%2F05%2Fuptodate-versus-dynamed%2F Guest author: Shamsha Damani (@shamsha) ; Submission for the July Medlib’s Round Doctors and other healthcare providers are busy folks. They often don’t have time to go through all the primary literature, find the best evidence, critique it and apply it to their patients in real-time. This is where point-of-care resources shine and make life a bit [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2572895 Sun, 05 Jul 2009 09:36:57 +0100 2572895 http://www.medworm.com/index.php?rid=2570328&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F07%2F05%2Fuptodate-versus-dynamed%2F Guest author: Shamsha Damani (@shamsha) ; Submission for the July Medlib’s Round Doctors and other healthcare providers are busy folks. They often don’t have time to go through all the primary literature, find the best evidence, critique it and apply it to their patients in real-time. This is where point-of-care resources shine and make life a bit [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2570328 Sun, 05 Jul 2009 09:36:57 +0100 2570328 http://www.medworm.com/index.php?rid=2561183&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F06%2F30%2Fhigh-quality-care-for-all-our-journey-so-far%2F Title: High Quality Care for All: Our journey so far The Skinny: Examines the progress that has been made since High Quality Care for All was published a year ago.  Major improvements highlighted in the report include the opening of 50 new GP led Health Centres, the introduction of personal care plan for 9.3 million patients with long term conditions and the growth in keyhole surgery. The focus on quality has moved up the agenda for staff and organisations, supported by the promotion of innovation through the introduction of tools and funds such as NHS Evidence, the Innovation Fund and the Challenge Prizes.  Also outlines plans to drive up the quality agenda even further and free up clinicians time to do this by: Refining targets based on evidence Clinician budget ownership Peer review ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2561183 Tue, 30 Jun 2009 10:52:22 +0100 2561183 http://www.medworm.com/index.php?rid=2556181&cid=t_304170_111_f&fid=38039&url=http%3A%2F%2Fsomedaynurse.wordpress.com%2F2009%2F06%2F29%2Fevidence-based-guides-for-neuro-care%2F While panning the interwebs for neuro nursing gold, I came across a cool collection published by the American Association of Neuroscience Nurses (AANN). The AANN has created a series of evidence-based guidelines intended to provide an overview on caring for patients with brain disorders. Guidelines outline etiology, treatments, nursing considerations, legal aspects of care, patient and family teaching, and other pearls. Topics include: Care of the Patient With Aneurysmal Subarachnoid Hemorrhage Care of the Patient With Seizures and more. This guides are great for new nurses trying to brush up on their neuro care, as well as seaoned neuro nurses looking to stay on top of the lastest evidence-based care. image credit (Source: How I Spent My Nursing Education) How I Spent My Nursing Education blogs http://www.medworm.com/rss/comments.php?id=2556181 Mon, 29 Jun 2009 20:40:57 +0100 2556181 http://www.medworm.com/index.php?rid=2553000&cid=t_304170_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FJvZlJEPNyj8%2F I’ve been tasked with presenting the genetic and rare disease perspective on comparative effectiveness. I’ll dispense with ‘rare’ right away.  If by rare, we mean single gene disorders, then perhaps it is a useful designation. If by rare, we just mean the equivalent of the US definition of orphan disease, i.e., less than 200,000 people in the US, then we should ask a few questions. In the old model of test and drug development, the ‘block buster, body count’, model, rare was a useful designation.  In a system built for BIG, then rare needed a boost.  In the new age of personalized medicine, all conditions are rare. In fact, they are usually an N of 1 after factoring in the myriad of genes involved, epigenetics, environment and so on.  As we enter new... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2553000 Sun, 28 Jun 2009 19:14:59 +0100 2553000 http://www.medworm.com/index.php?rid=2510202&cid=t_304170_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FLlDHWQOUAhM%2F My organization, the National Hispanic Medical Association, is committed to improving the health of Hispanics and other underserved. We support policies that will reform public health and medical services to decrease health care disparities and improve the health status of vulnerable groups. The National Disparities Report by the Agency for Healthcare Research and Quality found that our community has the worst access and quality care compared to non-Hispanics in the nation. Evidence-based public health and medicine strategies are necessary to decrease variation of service delivery that impacts and rations care to Latinos, especially in our poor neighborhoods. Medical treatment should be based on comparative effectiveness value of treatment strategies that produce the greatest benefit for t... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2510202 Wed, 24 Jun 2009 15:32:09 +0100 2510202 http://www.medworm.com/index.php?rid=2512037&cid=t_304170_123_f&fid=37052&url=http%3A%2F%2Fwww.youtube.com%2Fv%2FioAugKwx4DQ%26amp%3Bhl%3Den%26amp%3Bfs%3D1%26amp%3B The great evidence based tool, Essential Evidence Plus previously known as infoPOEMs is reviewed on the Pocket PC platform in the following video; This is a filtered synopsized graded evidence based clinical knowledge database right on our PDA. The content is derived from more than 100 high profile medical journals that are continuously monitored for the latest that matters. It also include some other tools check out Pda4peds for reviews of the following sections: CME ICD Codes Derm Expert What’s great about it, is that it talks in simple language making all those Cochrane reviews easy to read and easy to understand. POEM in fact stands for Patient Oriented Evidence that Matters; it really is. They present the complicated literature articles in a clinical question format answered ... The Pediatric PDA Blog blogs http://www.medworm.com/rss/comments.php?id=2512037 Thu, 18 Jun 2009 23:36:00 +0100 2512037 http://www.medworm.com/index.php?rid=2523001&cid=t_304170_97_f&fid=36415&url=http%3A%2F%2Fwww.dcscience.net%2F%3Fp%3D1775 Conclusion Chiropractic spinal manipulation is no more effective than placebo in the treatment of infantile colic. This study emphasises the need for placebo controlled and blinded studies when investigating alternative methods to treat unpredictable conditions such as infantile colic. More on this dishonest selectivity can be found at Holfordwatch. No doubt there will soon be more analyses of what passes, in the eyes of the BCA, for evidence, The nine papers they cite for colic are truly pathetic. Not a single one of them amounts to anything that would be recognised as evidence in the real world. And papers that do provide real evidence are not mentioned. Follow-up As always, the blogs provided a very fast response to a document that appeared only late last night.  And, as always,... DC's Improbable Science blogs http://www.medworm.com/rss/comments.php?id=2523001 Thu, 18 Jun 2009 08:58:20 +0100 2523001 http://www.medworm.com/index.php?rid=2523002&cid=t_304170_97_f&fid=36415&url=http%3A%2F%2Fwww.dcscience.net%2F%3Fp%3D1764 A flood of complaints against chiropractors has arrived at the General Chiropractic Council (GCC) in the wake of the British Chiropractic Association (BCA) v Singh affair. It is really rather beautiful that people have put some such enormous effort into writing complaints for no gain to themselves. My own paltry two complaints to the GCC produced an interesting reaction. Yesterday I was told by the GCC “Under the provisions of the General Chiropractic Council (Investigating Committee) Rules 2000 (”the Rules”), the Committee is required to invite you to make a statement of evidence in relation to your complaint by way of statutory declaration or affidavit. If you wish to, you can discuss your complaint with a solicitor who acts on behalf of the Committee who could help y... DC's Improbable Science blogs http://www.medworm.com/rss/comments.php?id=2523002 Wed, 17 Jun 2009 07:20:49 +0100 2523002 http://www.medworm.com/index.php?rid=2473435&cid=t_304170_97_f&fid=36415&url=http%3A%2F%2Fwww.dcscience.net%2F%3Fp%3D1718 Jump to follow-up Peter Dixon is a chiropractor. He is chair of the General Chiropractic Council (GCC). He was also a member of the hotly-disputed NICE low back pain guidance group that endorsed (you guessed it) the use of chiropractic, a decision that has led to enormous criticism of the standards of the National Institute of health and Clinical Excellence (NICE). As a consequence largely of the decision of the British Chiropractic Association (BCA) to sue Simon Singh for defamation, there has been an unprecedented interest taken in the claims made by chiropractors in general. Peter Dixon has a problem because something like 600 individual complaints about unjustified health claims have been sent to the GCC. Even when a web site does not claim to be able to benefit things like asthma and ... DC's Improbable Science blogs http://www.medworm.com/rss/comments.php?id=2473435 Sat, 13 Jun 2009 19:17:33 +0100 2473435 http://www.medworm.com/index.php?rid=2464159&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F06%2Fevidence-based-lobbying.html Leaders of the medical-industrial complex wonder if the Dartmouth research findings might be a touch overblown. I dunno - maybe. But don't we doctors do a lot else based on much less evidence? What fraction of hallowed medical practice is based on no more than class IIb recommendations?Heck, I'm ready for New York to get less medical money. I don't think the kinds of places I'd rather practice are the ones that are overspending. (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2464159 Tue, 09 Jun 2009 04:47:00 +0100 2464159 http://www.medworm.com/index.php?rid=2774804&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F06%2Fif-we-know-we-shouldntwhy-do-we-still.html Ihave posted several articles on the overuse of imaging in musculoskeletal care (find them here, here, here, and here). Now we have another study from the Archives of Internal Medicine making not only that statement but going as far as speculating that this is related to financial gain, improved patient satisfaction, and potential for more harm that good.In a news release from Musculoskeletal Report, the study found:Patients were more likely to undergo imaging tests if their primary care physician worked in large practices and if the doctor was offered patient satisfaction-based financial incentives. Practices with clinical quality-based incentives, however, were less likely to order advanced imaging tests for low back pain patients in the absence of clinical red flags.Additionally, the ar... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774804 Wed, 03 Jun 2009 15:25:00 +0100 2774804 http://www.medworm.com/index.php?rid=2452541&cid=t_304170_97_f&fid=36415&url=http%3A%2F%2Fwww.dcscience.net%2F%3Fp%3D1606 This article, which was some time in gestation, appeared shortly afte the last degree in homeopathy in the UK closed its doors. So perhaps it should have been called The Return of Reason. What’s interesting is that it has become commonplace for the mainstream newspapers to print articles like this and to dump some of their whackier lifestyle articles. The print version had a much better title too, The Retreat from Reason, with a two-page spread.. They published the entire ‘Patients’ Guide to Magic Medicine‘ as a sidebar on page 4. To these has now been added, inspired by Jack of Kent, Libel: A very expensive remedy, to be used only when you have no evidence. Appeals to alternative practitioners because truth is irrelevant One part of the article that I particular... DC's Improbable Science blogs http://www.medworm.com/rss/comments.php?id=2452541 Wed, 03 Jun 2009 08:18:35 +0100 2452541 http://www.medworm.com/index.php?rid=2441279&cid=t_304170_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F05%2Fmore-documents-about-selling-of.html We posted earlier this year about how documents produced on discovery and recently unsealed during litigation suggested how AstraZeneca handled clinical research data in the marketing of its atypical anti-psychotic drug Seroquel (quetiapine). A new crop of documents has just been released, providing yet more insights, as reported by the St Petersburg (Florida) Times:Behind the scenes at the global pharmaceutical company AstraZeneca, the team in charge of the blockbuster antipsychotic Seroquel had one mission: make the multibillion-dollar seller even bigger.To that end, internal company documents released Wednesday show how the British drugmaker hid unfavorable study results, promoted unapproved uses and even considered pitching the drug as less likely to lead to suicidal thinking than comp... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2441279 Fri, 29 May 2009 20:46:00 +0100 2441279 http://www.medworm.com/index.php?rid=2442142&cid=t_304170_123_f&fid=37052&url=http%3A%2F%2Fwww.youtube.com%2Fv%2FQg-QHKBn_Oc%26amp%3Bhl%3Den%26amp%3Bfs%3D1 Certainly, it’s a great idea to have all those evidence based policies and guidelines endorsed by the APP in the palm of hands! The AAP’s compilation of the latest guidelines and policies is available in the form of Mobipocket document. The PDA version of the Pediatric Clinical Practice Guidelines and Policies “9th edition” offers more than just the policies and statements, it includes some other very useful features. Turn your audio on and see the following video for more details. The addition of a bilirubin assessment tool, the vaccines scheduling, patient guidance, and some ICD codes makes this great evidence-based PDA reference a repository of the all tools that a pediatrician may need in practice. However, as mentioned in the video above, the app need to be a... The Pediatric PDA Blog blogs http://www.medworm.com/rss/comments.php?id=2442142 Fri, 29 May 2009 07:59:22 +0100 2442142 http://www.medworm.com/index.php?rid=2442932&cid=t_304170_165_f&fid=36770&url=http%3A%2F%2Fmetaot.com%2Fblog%2Fanother-case-role-blurring There are several examples of role blurring with (or due to interaction with) physiotherapists in the British Association of Occupational Therapists' internet discussion forum[1,2,3,4]. Currently, National Health Service physiotherapists seem to be moving away from 'physiotherapy' in musculoskeletal settings towards biopsychosocial treatment. One even suggested scrapping massage as a physiotherapy modality[5]. I believe that physiotherapists are now addressing problems with treatment approaches that would be better addressed by occupational therapists, or perhaps clinical psychologists. This may be detrimental to all of the concerned professions as well as patients, so I wrote a letter to express my opinion[6]. Unfortunately I feel that the editing took some of the weight out of my argumen... meta-ot blogs blogs http://www.medworm.com/rss/comments.php?id=2442932 Wed, 27 May 2009 12:40:33 +0100 2442932 http://www.medworm.com/index.php?rid=2441348&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F05%2Fde-testimonio%2F I recently discovered the online slideshow (with audio) version of Professor Sir Michael Rawlins’ 2008 Harveian Oration titled “De testimonio: On the evidence for decisions about the use of therapeutic interventions”. Now, I’ve nodded off in more than my share of lectures on medical statistics and clinical trials, so believe me when I claim that this [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2441348 Thu, 21 May 2009 21:00:14 +0100 2441348 http://www.medworm.com/index.php?rid=2441350&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F05%2Fmost-popular%2F The title of the most popular systematic review in the Cochrane database over the past 30 days is: ‘Sexual intercourse for cervical ripening and induction of labour’ Find out what the evidence says here. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2441350 Wed, 20 May 2009 21:00:27 +0100 2441350 http://www.medworm.com/index.php?rid=2774806&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F05%2Fmore-evidence-of-acupunctures-lack-of.html Acupuncture (sticking needles at specific points to a certain depth in the skin) is not an effective treatment for chronic low back pain. This may sound surprising as the media has jumped all over a new study that supposedly shows that acupuncture is more effective than "usual care". Unfortunately - as the media usually does - they've misinterpreted the results of the study. In fact the study showed that there is no difference in the effectiveness between "fake" and "real" acupuncture. Meaning, there is no effect of acupuncture.Steven Novella over at Science-based Medicine does a masterful job of explaining this in detail. Please visit his post on this study to become enlightened by logical and scientifically based thoughts and discussion - as opposed to hype.Jason L. Harris (Source: Evide... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774806 Wed, 20 May 2009 16:13:00 +0100 2774806 http://www.medworm.com/index.php?rid=2414835&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F05%2Fevidence-based-medicine-pragmatic.html In the spring issue of Perspectives in Biology and Medicine, Maya Goldenberg dissects the contradictions of evidence-based medicine (EBM). (I found the article through philpapers.org, which I didn't know about before.) On the one hand, EBM's commitments to pragmatismare readily apparent in EBM’s clear allegiance to experimental methods of inquiry that set aside past habitual thinking in favor of purely empirical investigation. Indeed, EBM’s promise of “the application of the best research evidence to medical decision-making” (EBMWG 1992) could have been achieved by strictly pragmatic scientific methodology. On the other hand, EBM lays claim to the marble statuary of objectivism, which is problematic.[The] objectivist ontology,where the evidence “speaks” and reliable knowledge f... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2414835 Fri, 15 May 2009 12:00:00 +0100 2414835 http://www.medworm.com/index.php?rid=2774808&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F05%2Fback-pain-surgery-drugs-imagaing.html The Insurance Journal released an article discussing how a "surprising" share of work comp case costs come from unanticipated costs or, as they term it, "Adverse Surprise Costs." The study reported on was said to find:Adverse surprise cases were disproportionately chronic conditions with multiple surgeries. They were also disproportionately back pain cases.That's no surprise to me, however, and should really not be a surprise to anyone dealing with chronic pain and low back injuries. While back pain is not the only musculoskeletal condition being over-treated with narcotics, expensive imaging, and surgery, it certainly is the most costly of all. In fact, most of my recent posts have centered around this subject (you can find them here, here, and here).What is surprising is that, despite al... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774808 Tue, 12 May 2009 04:38:00 +0100 2774808 http://www.medworm.com/index.php?rid=2389757&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F05%2Femergency-medicine-web-resources%2F The time-poor ED physician, faced with an ever increasing patient load, is finding it difficult to keep up to date with the expansive proliferation of clinical knowledge and more worryingly the presumption of technological competence. The concept of using a locally derived, living database of clinical and other teaching material connected to a user-friendly web-based interface, raises many [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2389757 Mon, 04 May 2009 16:11:02 +0100 2389757 http://www.medworm.com/index.php?rid=2386905&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F05%2Fwhat-are-we-to-learn-at-bedside-re.html This article makes as powerful a case as any I've read for the re-centering and re-honing of my skills, and it comes at just the right time, when I have the chance to make a transition to be the kind of doctor I want to be. But Verghese is confused in his defense of the physical exam - he doesn't know what rationale he wants to focus on, or how he feels about physical diagnosis as justified (or questioned) by evidence-based medicine. Here he is in one place:If one eschews the skilled and repeated examination of the real patient, then simpl diagnoses and new developments are overlooked, while tests, consultations, and procedures that might not be needed are ordered.This is the argument from efficiency, or maybe from diagnostic rigor - exceeded somewhat by Verghese's clear affection for the... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2386905 Mon, 04 May 2009 03:59:00 +0100 2386905 http://www.medworm.com/index.php?rid=2382319&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F05%2Ftoxicology-conundrum-014%2F You receive a call from a district hospital that is 2 hours away from your tertiary center by road. The call concerns a 50 year-old man (75 kg) with a past history of asthma and depression. He was taken to hospital by ambulance after admitting that he had ingested an overdose of his theophylline tablets. [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2382319 Fri, 01 May 2009 21:00:06 +0100 2382319 http://www.medworm.com/index.php?rid=2380694&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F04%2F30%2Feye-bring-you-searching-nhs-evidence%2F Default Search NHS Evidence searches for instances where each word you type is present in retrieved items.  This is an automatic AND search just like Google does. Our highly public health friendly venn diagram below shows how this works  with a search for FISH AND CHIPS only items where both are present are found: Key Message: AND limits a search Using OR To expand your search to cope with alternative terms you might want to use OR.  In NHS Evidence this is best achieved by surrounding an OR search with brackets.  So with our current example if I just want food a search for (FISH OR CHIPS) in NHS Evidence ensures I get either or both. The real power of this technique comes when I have more than one sets of alternative terms as this search line to locate material about SWINE FLU shows: ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2380694 Thu, 30 Apr 2009 11:10:35 +0100 2380694 http://www.medworm.com/index.php?rid=2380695&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F04%2F30%2Feye-eye-its-nhs-evidence%2F Staring out of the screen at me this morning is NHS Evidence the new google like search to give ready access to best evidence in the NHS.  Got to say I’m impressed with response speed to a quick search for (flu OR influenza OR h1n1) (swine OR porcine) as it’s the topic of the moment and as quick as a flash came back with 58 results. Initial reaction is they look relevant and useful resources.  As ever though the Grey Literature is the bit that intersts me and there is a nice little filter on the left hand side of the results that allows me to filter the grey literature.  Of the four results it brings back, none is on topic, see list below and see if you can find the link! Outbreaks of influenza and influenza-like illness in schools in England and Wales, 2005/06 How can ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2380695 Thu, 30 Apr 2009 09:19:55 +0100 2380695 http://www.medworm.com/index.php?rid=2353964&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2009%2F04%2F21%2Fattention-pediatric-dental-professionals%2F Cochrane Collaboration Publishes Two Sytematic Reviews for Pediatric Dentistry Two new systematic reviews pertaining to pediatric dentistry are available in the Cochrane Library. The first, Dental fillings for the treatment of caries in the primary dentition, compared the outcomes  for restorative materials used to treat caries in the primary dentition in children.  There was insufficient evidence from [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=2353964 Tue, 21 Apr 2009 14:44:21 +0100 2353964 http://www.medworm.com/index.php?rid=2348435&cid=t_304170_109_f&fid=36089&url=http%3A%2F%2Fthesituationist.wordpress.com%2F2009%2F04%2F18%2Fthe-situation-of-situation-in-employment-discrimination-law-abstract%2F This article puts the debate over social framework expert testimony in context, explaining what the testimony is and the role it has played in employment discrimination litigation, with a particular focus on the way the testimony has been offered in class action suits like Dukes v. Wal-Mart. It explains how the normal rules of evidence law should apply to social framework expert testimony, and under the flexible and permissive standards of the Federal Rules of Evidence, framework testimony offered by a qualified expert should be admissible in many employment class actions. The argument that this kind of evidence should always be excluded is driven as much by a particular view of employment discrimination law as by the governing evidentiary rules. Ultimately, the arguments for blanket exclu... The Situationist blogs http://www.medworm.com/rss/comments.php?id=2348435 Sat, 18 Apr 2009 04:01:39 +0100 2348435 http://www.medworm.com/index.php?rid=2342020&cid=t_304170_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F04%2F17%2Fon-the-evidence-for-decisions-about-the-use-of-therapeutic-interventions%2F You might have seen a theme emerging this week in my posts - clinical reasoning, evidence-base for treatments, balance between science and art … I came across this rather weighty document today in which Professor Sir Michael David Rawlins presents THE HARVEIAN ORATION Delivered before the Fellows of The Royal College of Physicians of London on Thursday 16 October 2008. Despite the rather grand titles, this discussion (published in full in pdf) is both a well-articulated explanation of levels of evidence and judgement, and quite an easy read. In his paper, he describes the development and elevation of the RCT to the ‘pinnacle’ of evidence. He also describes the limitations of the RCT - which is particularly appropriate in the area of nonpharmaceutical therapies for pain m... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2342020 Thu, 16 Apr 2009 19:34:42 +0100 2342020 http://www.medworm.com/index.php?rid=2342022&cid=t_304170_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F04%2F14%2Fwhen-and-how-should-new-therapies-become-routine-clinical-practice%2F Following on from my last post about when to adopt new therapies - a wonderful colleague of mine (who shall remain nameless, but You Know I Know Who You Are) sent me a copy of this paper from a physiotherapy journal. Bo and Herbert argue that the current way that new therapies become integrated into our daily clinical work is ‘far from optimal because innovative therapies still become accepted practice on the basis of laboratory research alone.’ I agree. Worse still, old therapies that have little evidence to support them continue to be used - even in the face of clinical studies demonstrating that they have no greater effect than placebo. Bo and Herbert suggest there are several ways that new therapies are adopted within physiotherapy practice. I suggest that there is little d... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2342022 Tue, 14 Apr 2009 05:41:55 +0100 2342022 http://www.medworm.com/index.php?rid=2342023&cid=t_304170_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F04%2F14%2Fwhen-should-we-adopt-a-new-therapy%2F This is a vexed question for me. New therapies should be more effective, less time-consuming, have fewer negative effects or take less effort than old - or at least offer something positive - before they’re adopted. I’ve been critical of the way new therapies have come and then gone in pain management to the point where I’m just a tiny bit hesitant to try a new approach until… well that’s the point of today’s post! There are a few factors I find myself using to review a novel therapy. The first is to establish whether it really is a new therapy - perhaps what is being called ‘new’ is merely rebranding. Often I’ll go to Cochrane Reviews or similar to see whether the treatment has been reviewed before under another name. The ‘gold ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2342023 Mon, 13 Apr 2009 19:01:34 +0100 2342023 http://www.medworm.com/index.php?rid=2347670&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F04%2F08%2Fmedlibs-round-13%2F The 3rd Medlib’s Round, a blog carnival of medical-library related blogposts, is up at First Person Narrative. Anne Welsh did a great job pulling together an interesting collection of posts. From Anne’s introduction This month’s theme was “evidence” - not just in the terms of “Evidence Based Medicine” but in the widest possible sense. Evidence is a [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2347670 Wed, 08 Apr 2009 21:26:00 +0100 2347670 http://www.medworm.com/index.php?rid=2326618&cid=t_304170_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F04%2F07%2Fmedicare-expands-coverage-of-pet-scans-as-cancer-diagnostic-tool%2F “The Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination (NCD) to expand coverage for initial testing with positron emission tomography (PET) for Medicare beneficiaries who are diagnosed with and treated for most solid tumor cancers.  This decision applies to PET scans used to support initial diagnosis and treatment for most [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2326618 Tue, 07 Apr 2009 21:36:08 +0100 2326618 http://www.medworm.com/index.php?rid=2305855&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F04%2F05%2Fhow-evidence-based-is-uptodate-really%2F KevinMD or Kevin Pho is one of the top physician bloggers. He writes many posts per day, often provocatively commenting on breaking medical news or other blogposts. A few weeks ago Kevin wrote a post on comparative effectiveness research [5] (tweet below), which is “(funded) research to evaluate and compare clinical outcomes, effectiveness, risk, and benefits [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2305855 Tue, 07 Apr 2009 08:50:43 +0100 2305855 http://www.medworm.com/index.php?rid=2310003&cid=t_304170_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F04%2Fevidence-based-medicine-meets-times.html A great post by David H. Newman (an ER doc) on their Health blog, Believing in Treatments That Don't Work.A problem, though: occasionally, instead of practice not following evidence, the evidence lags clinical practice (there are clinical problems which haven't been studied yet, or at least not in the population the clinician is seeing), and then it's very difficult for the doctor to know what to do. Then he or she has to integrate different kinds of clinical evidence.Evidence-based medicine is everything, but it's not the only thing... (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2310003 Sun, 05 Apr 2009 23:35:00 +0100 2310003 http://www.medworm.com/index.php?rid=2774810&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F04%2Fback-pain-need-for-real-health-care.html A pair of article from the April 1st issue of Spine remind us of what real reform in health care we need. While President Obama is at least attempting to get the ball rolling with changes in health care, Electronic Medical Records (EMR), expanded coverage, and "investing" in prevention and wellness aren't going to change today's problems at the root of rocketing health care costs.One piece at the root of these rocketing costs is excessive use of imaging, surgery, and drugs. Low back pain treatment often gets the full brunt of these high cost, low efficacy procedures. Now, the new issue of Spine shines some light on the harm this approach can cause.In the first article by Timothy Carey, MD - Practice patterns and evidence in chronic low back pain care - it was found that (surprise) there is... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774810 Sun, 05 Apr 2009 04:05:00 +0100 2774810 http://www.medworm.com/index.php?rid=2305856&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F04%2F04%2Fevidence-based-medicine-the-facebook-of-medicine%2F Guest author: Shamsha Damani (@shamsha) ; Submission for the April Medlib’s Round Let’s face it: Facebook is pretty popular these days. Everyone and their grandmother (literally!) is on Facebook. In fact, if you don’t have a Facebook account, you are considered a social pariah. As I pondered over my next guest blog post on Jacqueline’s blog (thanks [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2305856 Sat, 04 Apr 2009 20:56:56 +0100 2305856 http://www.medworm.com/index.php?rid=2307452&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F04%2Fgoogle-runs-anti-vaccination-ads%2F 6minutes.com.au’s Jared Reed recently highlighted the questionable nature of some the Google-sponsored health ads that have proliferated all over the Internet. In the comments section raged a slightly over-the-top arm wrestle between some anti-vaccinationists and a GP from Nowra… I chimed in with a comment: I generally try to avoid having battles of wits with unarmed opponents [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2307452 Sat, 04 Apr 2009 04:05:07 +0100 2307452 http://www.medworm.com/index.php?rid=2307454&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F04%2Fquackery-without-scruples%2F With disappointment I report the existence of the organisation called “Homeopaths Without Borders” . Yes, really. They really do exist.  I have to agree with PZ Myers who, given the brazen adulteration the good name of MSF (”Doctors Without Borders”), thinks that “Quackery Without Scruples” is more appropriate. The propagation of any practice - especially something [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2307454 Fri, 03 Apr 2009 21:00:26 +0100 2307454 http://www.medworm.com/index.php?rid=2308084&cid=t_304170_90_f&fid=36413&url=http%3A%2F%2Fdcscience.net%2F%3Fp%3D1329 In March 2007 I wrote a piece in Nature on Science degrees without the science.  At that time there were five “BSc” degrees in homeopathy. A couple of weeks ago I checked the UCAS site for start in 2009, and found there was only one full “BSc (hons)” left and that was at Westminster University. Today [...] (Source: DC's goodscience) DC's goodscience blogs http://www.medworm.com/rss/comments.php?id=2308084 Fri, 03 Apr 2009 20:12:35 +0100 2308084 http://www.medworm.com/index.php?rid=2414825&cid=t_304170_97_f&fid=36415&url=http%3A%2F%2Fwww.dcscience.net%2F%3Fp%3D1329 In March 2007 I wrote a piece in Nature on Science degrees without the science.  At that time there were five “BSc” degrees in homeopathy. A couple of weeks ago I checked the UCAS site for start in 2009, and found there was only one full “BSc (hons)” left and that was at Westminster University. Today I checked again and NOW THERE ARE NONE. A phone call to the University of Westminster tonight confirmed that they have suspended entry to their BSc (Hons) homeopathy degree. They say that they have done so because of “poor recruitment”.   It was a purely financial decision.  Nothing to do with embarrasment.  Gratifying though it is that recruits for the course are vanishing, that statement is actually pretty appalling   It ... DC's Improbable Science blogs http://www.medworm.com/rss/comments.php?id=2414825 Mon, 30 Mar 2009 18:10:06 +0100 2414825 http://www.medworm.com/index.php?rid=2299062&cid=t_304170_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F03%2F29%2Fthe-rock-band-ned-their-medical-skills-save-many-their-music-could-save-thousands%2F When spoken by a doctor, the medical term “N.E.D.” – No Evidence of Disease – is music to the ears of an ovarian cancer survivor.   A band of doctors, called “N.E.D.,” wants to be music to the ears of the general public when it comes to raising awareness about women’s cancers. …During the day, this [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2299062 Sat, 28 Mar 2009 18:22:12 +0100 2299062 http://www.medworm.com/index.php?rid=2293092&cid=t_304170_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FGdpba4jkjjY%2F What started as an academic dispute regarding disclosure of conflict of interest is now snowballing into the mainstream media, due to the over-reaction by JAMA editors as reported in this Wall Street Journal blog post, JAMA editor calls Critic a "Nobody and a Nothing" In summary, Dr. Jonathan Leo, the "Critic", dared to draw attention to 2 important points regarding a study comparing the efficacy of therapy vs. medication published in the Journal of the American Academy of Medicine (JAMA) - one of the most prestigious scientific publications: 1) The study results were presented and reported in a biased way, since they favored one specific intervention, a drug, while ignoring another one, therapy-based, that had equally statistically significant effects. 2) Both the lead... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=2293092 Tue, 24 Mar 2009 16:44:41 +0100 2293092 http://www.medworm.com/index.php?rid=2414826&cid=t_304170_97_f&fid=36415&url=http%3A%2F%2Fwww.dcscience.net%2F%3Fp%3D1284 The Health Professions Council (HPC) is yet another regulatory quango. The HPC’s strapline is “Working with health professionals to protect the public” At present the HPC regulates; Arts therapists, biomedical scientists, chiropodists/podiatrists, clinical scientists, dietitians, occupational therapists, operating department practitioners, orthoptists, paramedics, physiotherapists, prosthetists/orthotists, radiographers and speech & language therapists. These are thirteen very respectable jobs. With the possible exception of art therapists, nobody would doubt for a moment that they are scientific jobs, based on evidence. Dietitians, for example, are the real experts on nutrition (in contrast to “nutritional therapists” and the like, who are part of... DC's Improbable Science blogs http://www.medworm.com/rss/comments.php?id=2414826 Tue, 24 Mar 2009 15:18:12 +0100 2414826 http://www.medworm.com/index.php?rid=2308085&cid=t_304170_90_f&fid=36413&url=http%3A%2F%2Fdcscience.net%2F%3Fp%3D1284 The Health Professions Council (HPC) is yet another regulatory quango. The HPC’s strapline is “Working with health professionals to protect the public” At present the HPC regulates; Arts therapists, biomedical scientists, chiropodists/podiatrists, clinical scientists, dietitians, occupational therapists, operating department practitioners, orthoptists, paramedics, physiotherapists, prosthetists/orthotists, radiographers and speech & language therapists. These are thirteen very respectable [...] (Source: DC's goodscience) DC's goodscience blogs http://www.medworm.com/rss/comments.php?id=2308085 Tue, 24 Mar 2009 15:18:12 +0100 2308085 http://www.medworm.com/index.php?rid=2270490&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F03%2Ftoxicology-conundrum-003%2F A 27 year-old woman felt a sting on the back of the right leg while pulling on her tracksuit pants. She investigated further and discovered a small black spider, with a red-stripe on its back, crawling around  in  her tracksuit pants. A burning itch developed soon after (affecting the back of her right leg) and lasted [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2270490 Sun, 15 Mar 2009 07:51:53 +0100 2270490 http://www.medworm.com/index.php?rid=2259655&cid=t_304170_125_f&fid=34820&url=http%3A%2F%2Fwww.dentalblogs.com%2Farchives%2Fadministrator%2Fada-launches-evidence-based-dentistry-website%2F Check out www.ebd.ada.org to find some great information on evidence-based dentistry. From systematic reviews and summaries to clinical recommendations and ideas, the site provides a wealth of information – free! What is evidence-based dentistry? Click here to find out. Press Release (Source: dental blog for dentists about dentistry) dental blog for dentists about dentistry blogs http://www.medworm.com/rss/comments.php?id=2259655 Wed, 11 Mar 2009 14:49:27 +0100 2259655 http://www.medworm.com/index.php?rid=2259632&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2009%2F03%2F10%2Fada-launches-center-for-evidence-based-dentistry-web-site%2F I am excited to announce the all new Evidence-Based Dentistry web site from the American Dental Association, prepared by dentists for dentists and their patients.  This site provides access to the most current and clinically relevant information. Nicely organized by three categories, the site brings together: A Database of systematic reviews—Organized by topic, currently over 1300 reviews, [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=2259632 Tue, 10 Mar 2009 17:45:59 +0100 2259632 http://www.medworm.com/index.php?rid=2243025&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2009%2F03%2F06%2Fstem-cells-for-dentin-bone-and-salivary-regeneration%2F Are you interested in learning more about the use of stem cells for dental therapies? Dentaltown, an ADA recognized continuing education provider, is offering  a self-instructional program titled “Stem Cells: Emerging Medical and Dental Therapies for the Dental Professional“.    There is no fee for the class and continuing education credits are available. Additional resources include: A list [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=2243025 Fri, 06 Mar 2009 17:05:13 +0100 2243025 http://www.medworm.com/index.php?rid=2234622&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F03%2Fsensory-integration-how-occupational.html I am working with a student who is completing a literature review on the concept of fidelity in sensory integration. At the same time I am completing a book chapter on entrepreneurship and today came to an interesting perspective on the state of sensory integration theory and practice models. Reality dictates that people purchase goods and products and will pay for them based on some value formula. Occupational therapists have famously made references to the value of their services - from Mary Reilly's belief that OT could be one of the great ideas of 20th century medicine to the more recent AOTA branding campaign on how OT helps people live life to its fullest. If both of these statements were true people would be flocking to seek out and pay for our services. Is this the case? Certainly ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2234622 Tue, 03 Mar 2009 17:11:00 +0100 2234622 http://www.medworm.com/index.php?rid=2212631&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F02%2Fmedconnect-where-medicine-connect%2F Elsevier Australia has long been associated with publishing textbooks and journals for the Australian and New Zealand markets. Until recently, the Australasian arm of the Elsevier publishing giant had been content with their role as ‘hard copy’ publishers of high quality health related literature, leaving the internet and software based platforms to their US counterparts. However [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2212631 Wed, 25 Feb 2009 10:51:17 +0100 2212631 http://www.medworm.com/index.php?rid=2414828&cid=t_304170_97_f&fid=36415&url=http%3A%2F%2Fwww.dcscience.net%2F%3Fp%3D1191 BSc courses in homeopathy are closing. Is it a victory for campaigners, or just the end of the Blair/Bush era? The Guardian carries a nice article by Anthea Lipsett, The Opposite of Science (or download pdf of print version). Dr Peter Davies, dean of Westminster’s school of integrated health, says “he welcomes the debate but it isn’t as open as he would like.” Well you can say that again. The University of Westminster has refused to send me anything much, and has used flimsy excuses to avoid complying with the Freedom of Information Act. Nevertheless a great deal has leaked out. Not just amethysts emit hig Yin energy, but a whole lot more (watch this space). Given what is already in the public, arena, how can they possibly say things like this? “Those t... DC's Improbable Science blogs http://www.medworm.com/rss/comments.php?id=2414828 Tue, 24 Feb 2009 09:27:51 +0100 2414828 http://www.medworm.com/index.php?rid=2211700&cid=t_304170_90_f&fid=36413&url=http%3A%2F%2Fdcscience.net%2F%3Fp%3D1191 BSc courses in homeopathy are closing. Is it a victory for campaigners, or just the end of the Blair/Bush era? The Guardian carries a nice article by Anthea Lipsett, The Opposite of Science (or download pdf of print version). Dr Peter Davies, dean of Westminster’s school of integrated health, says “he welcomes [...] (Source: DC's goodscience) DC's goodscience blogs http://www.medworm.com/rss/comments.php?id=2211700 Tue, 24 Feb 2009 09:27:51 +0100 2211700 http://www.medworm.com/index.php?rid=2200495&cid=t_304170_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F02%2F19%2Fsocial-networking-harms-health-lol%2F Just when you think journalism from respected news organizations couldn’t sink any lower, the BBC (amongst many other news agencies) is reporting today that “Online networking ‘harms health:’” People’s health could be harmed by social networking sites because they reduce levels of face-to-face contact, an expert claims. The rest of the article (which bears no byline) is a one-sided, biased piece of reporting that doesn’t even raise a single skeptical eyebrow. Had it bothered to do any, well, actual journalism, the reporter may have discovered that Aric Sigman’s (2009) hypothesis relies on a flimsy connection — that Internet relationships are less real and result in greater social isolation and loneliness for people who increasingly t... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2200495 Thu, 19 Feb 2009 18:35:12 +0100 2200495 http://www.medworm.com/index.php?rid=2774811&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F02%2Fphysiopedia-wikipedia-for-physical.html Announced today is the formation of the first wiki-based collaborative online educational resource for the global physiotherapy community. Physiopedia is an ambitious project which aims to eventually offer an evidence-based knowledge resource for physiotherapy professionals throughout the world. Through utilising collaborative wiki technology Physiopedia is a place where all physiotherapists can participate by contributing, sharing and building knowledge to develop a global understanding. For educators Physiopedia offers an opportunity to involve their students in this knowledge creation process as part of an educational program. Individuals and educational institutions around the world are contributing to Physiopedia in various ways. Educational institutions are engaging their students to... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774811 Wed, 18 Feb 2009 14:25:00 +0100 2774811 http://www.medworm.com/index.php?rid=2774812&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F02%2Fstop-madness-low-back-pain-and-routine.html Lancet recently published a systemic review looking at routine imaging for Low Back Pain (LBP) without "red flags" that would suggest serious underlying conditions (eg, myelopathy, cancer, fracture, etc). While the results aren't surprising to the majority of conservative musculoskeletal practitioners, they do need to be publicized to the general public just as much as the silly studies that show "acupuncture" being effective treatment fot LBP. The authors conclude:Lumbar imaging for low back pain without indications of serious underlying conditions does not improve clinical outcomes," they conclude. "Therefore, clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low back pain and without features suggesting a serious underlying conditionHowe... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774812 Mon, 09 Feb 2009 12:00:00 +0100 2774812 http://www.medworm.com/index.php?rid=2207655&cid=t_304170_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F02%2F08%2Fhow-to-make-ebm-easy-to-swallow-bmj-pico%2F Guest author: Shamsha Damani (@shamsha) As a medical librarian, I try to instill the importance of Evidence Based Medicine (EBM) to all my users. They agree that EBM is important, and yet, still resort to shortcuts (like using Google, asking colleagues, etc). And you know what, I don’t blame them. Given the amount of medical literature [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=2207655 Sat, 07 Feb 2009 23:08:55 +0100 2207655 http://www.medworm.com/index.php?rid=2160272&cid=t_304170_90_f&fid=34499&url=http%3A%2F%2Fcalifmedicineman.blogspot.com%2F2009%2F02%2Ftaking-trust-with-grain-of-sodium.html I was rather intrigued when a drug company representative showed up at my institution with some literature on a medication called Vaprisol manufactured by Astellas Pharma. This drug is one of a class of drugs called vasopressin receptor antagonists (VRA's) and is used to treat low blood sodium levels (also called hyponatremia).I may be the worst philistine in academia but to me, Vaprisol is a so-so solution in search of a problem. Hyponatremia is typically treated by first identifying its underlying cause. Once that cause is determined, treating it generally makes the hyponatremia go away or at least improve. And guess what? Even if the problem can't be cured, the chronically low sodium that results rarely causes serious problems by itself.That said, I can imagine rare scenarios whereby dr... California Medicine Man blogs http://www.medworm.com/rss/comments.php?id=2160272 Wed, 04 Feb 2009 08:53:00 +0100 2160272 http://www.medworm.com/index.php?rid=2152791&cid=t_304170_90_f&fid=0&url=http%3A%2F%2Fannietv600.wordpress.com%2F2009%2F02%2F02%2Fknowledge-translation%2F The following articles are available free online from CACHE’s Open Access Library: Cordero C, Delino R, Jeyaseelan L, Lansang MA, Lozano JM, Kumar S, Moreno S, Pietersen M, Quirino J, Thamlikitkul V, Welch VA, Tetroe J, Ter Kuile A, Graham ID, Grimshaw J, Neufeld V, Wells G, Tugwell P.  Funding agencies in low- and middle-income countries: Support for knowledge translation. Bull World Health Organ 2008 Jul;86(7):524-34. Kerner JF.  Knowledge translation versus knowledge integration: A “funder’s” perspective. J Contin Educ Health Prof 2006 Winter;26(1):72-80.  Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N.  Lost in knowledge translation: Time for a map? J Contin Educ Health Prof 2006 Winter;26(1):13-24. Straus SE, Graham ID, Mazmani... ANNE T-V's BLOG blogs http://www.medworm.com/rss/comments.php?id=2152791 Mon, 02 Feb 2009 21:10:24 +0100 2152791 http://www.medworm.com/index.php?rid=2152794&cid=t_304170_90_f&fid=0&url=http%3A%2F%2Fannietv600.wordpress.com%2F2009%2F02%2F02%2Fevidence-based-health-care%2F The following articles are available free online from CACHE’s Open Access Library: De Vito C, Nobile CG, Furnari G, Pavia M, De Giusti M, Angelillo IF, Villari P.  Physicians’ knowledge, attitudes and professional use of RCTs and meta-analyses: A cross-sectional survey. Eur J Public Health 2009 Jan 7. Montori VM, Guyatt GH. Progress in evidence-based medicine. JAMA 2008 Oct 15;300(15):1814-6. Eccles MP, Johnston M, Hrisos S, Francis J, Grimshaw J, Steen N, Kaner EF.  Translating clinicians’ beliefs into implementation interventions (TRACII): A protocol for an intervention modeling experiment to change clinicians’ intentions to implement evidence-based practice. Implement Sci 2007 Aug 16;2:27. Jennings SF.  Personal development plans and self-directed learning fo... ANNE T-V's BLOG blogs http://www.medworm.com/rss/comments.php?id=2152794 Mon, 02 Feb 2009 20:44:00 +0100 2152794 http://www.medworm.com/index.php?rid=2144483&cid=t_304170_109_f&fid=34793&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FOkSoImNotReallyACowboy%2F%7E3%2F526253542%2F Conclusion In his original post, Dr. Rob said: But there are some who would suggest that I am deluded. I am brainwashed by the vaccine manufacturers, drug reps, or narrow-minded training. Yes, I can be trusted to rescue their child from the brink of death, but can I be counted on when I recommend vaccines? I don’t happen to think anything of the sort about Dr. Rob. I do however feel that the knee-jerk reaction to counter the anti-vaccine posturing with hysterics of our own is both counter-productive and disingeuous. We really have very little idea about just how safe or unsafe vaccines are. And anti-vaccination groups are more than cognizant of this fact. Much of what I’ve written about here is likewise trumpeted by many anti-vaccination groups. These criticisms are valid and u... OK so I'm not really a cowboy. blogs http://www.medworm.com/rss/comments.php?id=2144483 Thu, 29 Jan 2009 12:09:55 +0100 2144483 http://www.medworm.com/index.php?rid=2511103&cid=t_304170_109_f&fid=34793&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FOkSoImNotReallyACowboy%2F%7E3%2FOtjLXfiG7yY%2F Conclusion In his original post, Dr. Rob said: But there are some who would suggest that I am deluded. I am brainwashed by the vaccine manufacturers, drug reps, or narrow-minded training. Yes, I can be trusted to rescue their child from the brink of death, but can I be counted on when I recommend vaccines? I don’t happen to think anything of the sort about Dr. Rob. I do however feel that the knee-jerk reaction to counter the anti-vaccine posturing with hysterics of our own is both counter-productive and disingeuous. We really have very little idea about just how safe or unsafe vaccines are. And anti-vaccination groups are more than cognizant of this fact. Much of what I’ve written about here is likewise trumpeted by many anti-vaccination groups. These criticisms are valid and u... OK so I'm not really a cowboy. blogs http://www.medworm.com/rss/comments.php?id=2511103 Thu, 29 Jan 2009 11:55:29 +0100 2511103 http://www.medworm.com/index.php?rid=2138951&cid=t_304170_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2009%2F01%2F27%2Flearn-about-the-link-between-heart-disease-and-oral-health%2F February is American Heart Month.  What does this have to do with dentistry?  Come to find out, alot! Research suggests a significant link between oral and cardiovascular health. In particular, periodontal health seems to play a major role.  Read what the American Academy of Periodontology has to say about periodontal disease and the heart. You may also [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=2138951 Wed, 28 Jan 2009 15:21:20 +0100 2138951 http://www.medworm.com/index.php?rid=2774813&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F01%2Fover-treating-chronic-back-pain-us.html Richard Deyo MD, the keynote speaker at the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) National Conference in October 2008, has again published data indicting the US approach to chronic back pain dramatically increases costs without improved outcomes. Deyo and colleagues reported in the January 2009 issue of the Journal of American Board of Family Practice the following staggering statistics:A 629% increase in Medicare expenditures for epidural steroid injections;A 423% increase in expenditures for opioids for back pain; A 307% increase in the number of lumbar magnetic resonance images among Medicare beneficiaries; A 220% increase in spinal fusion surgery rates. The incidence of chronic and acute Low Back Pain, as documented by office visits, has not changed during... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774813 Wed, 28 Jan 2009 13:00:00 +0100 2774813 http://www.medworm.com/index.php?rid=2138524&cid=t_304170_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F01%2Fpsychosocial-occupational-therapy-in.html I am not certain how many problems can be solved at odd hours of the morning, but it is 4:30am and I can't shake some concerns I have about psychosocial intervention models in schools.According to all data, occupational therapists are less frequently employed in psychosocial practice settings. There are all kinds of complexities behind this includinghistorical lack of parity for reimbursement in mental health systems that drove professionals out of psychosocial practicelost opportunities for OTs to have legislative inclusion as QMHPslack of vision and leadership in articulating the occupational therapy scope of practiceanalysis paralysis and inability to implement plans to reverse negative practice trendslack of mental health fieldwork mandates for occupational therapy studentsThese contri... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2138524 Wed, 28 Jan 2009 09:29:00 +0100 2138524 http://www.medworm.com/index.php?rid=2137521&cid=t_304170_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F01%2Fblogscan-how-us-medicare-will-pay-for.html On the GoozNews blog, Merrill Goozner dissects the recent decision by the US Center for Medicare and Medicaid Services (CMS) to make more lenient the criteria it uses to decide which off-label anti-cancer drugs it will pay for. Now any drug rated favorably in at least one of several drug compendia will be approved. Yet it turns out that intricate, but important conflicts of interest may affect how drugs get positive reviews in some of the compendia. It does seem that nearly every piece of our fiendishly complex health care system is affected by conflicts of interest. To put the most positive interpretation on it, most US government agencies that deal with health care seem to have operated up to now in ignorant bliss when it comes to these conflicts.NB: see also the post by Dr Howard Brody ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2137521 Wed, 28 Jan 2009 02:26:00 +0100 2137521 http://www.medworm.com/index.php?rid=2774814&cid=t_304170_130_f&fid=38947&url=http%3A%2F%2Frealpt.blogspot.com%2F2009%2F01%2Fits-important-to-give-up-sometimes.html Reading the newest issue of Orthopaedic Physical Therapy Practice (the magazine of the Orthopaedic Section of the APTA) I found interesting the Editor's Message written by Christopher Hughes, PT, PhD, OCS. The letter titled "When All Else Fails...We Succeed!" relates that an episode of care from a Physical Therapist that does not end with hoped for gaols met, is not a waste. That, in fact, it is a valuable tool to help in the clinical decision making by MD's - especially in the arena of deciding on surgery or other invasive procedure.I agree with this view, and have educated a number of my clients that at the very least, their episode with me will make them better prepared for surgery and increase their prognosis after surgery. I would like to speak on a subject related to this: Over Utili... Evidence Based Rehab blogs http://www.medworm.com/rss/comments.php?id=2774814 Mon, 26 Jan 2009 16:11:00 +0100 2774814 http://www.medworm.com/index.php?rid=2132723&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F01%2Faustralian-physician-network%2F Multimedix is a secure, online community for registered Australian medical practitioners. MultiMedix.com.au is the first social and professional networking website designed for Australian physicians and has just been launched by Dr Stephen Barnett a GP practising in Bowral, NSW. The site is designed to allow doctors to search the database for friends, colleagues and contacts; let [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2132723 Sun, 25 Jan 2009 14:53:01 +0100 2132723 http://www.medworm.com/index.php?rid=2120913&cid=t_304170_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2009%2F01%2F21%2Fnew-tutorial-on-evidence-based-medicine%2F Yesterday at Our Bodies Our Blog, I linked to a free online workshop. on evidence-based medicine from the Consumers United for Evidence-based Healthcare (CUE). CUE is part of the US Cochrane Center, which my librarian/medical readers will recognize as affiliated with the Cochrane Collaboration - a producer of systematic reviews of medical evidence. Anyway, I haven’t worked through the online tool yet, but it looks like it might be an interesting resource for teaching and learning EBM. Posted in Free Stuff, Health       (Source: Women's Health News) Women's Health News blogs http://www.medworm.com/rss/comments.php?id=2120913 Wed, 21 Jan 2009 13:56:20 +0100 2120913 http://www.medworm.com/index.php?rid=2116029&cid=t_304170_125_f&fid=36046&url=http%3A%2F%2Fdentistrylibrary.blogspot.com%2F2009%2F01%2Fanswering-clinical-questions-in.html David Tovey, newly appointed Editor in Chief of the Cochrane Library will speak at Grand Rounds at the Children's Hospital at Westmead on "Answering clinical questions in practice" Where: Lorimer Dods Lecture Theatre, Children's Hospital at WestmeadWhen: Thursday 5th February 1-2pm.David Tovey qualified in Medicine from Bristol University in the UK. He was a GP in an urban practice in South London for 14 years, and combined this with work in continuing medical education. In 2003 he left general practice and moved to the BMJ, where he became Deputy Editor, then Editor of Clinical Evidence. For the last two years he has been Editorial Director of the BMJ Evidence Centre, with responsibility for Clinical Evidence, its sister product BestTreatments aimed at the public, and the development of b... DentistryLibrary@Sydney blogs http://www.medworm.com/rss/comments.php?id=2116029 Wed, 21 Jan 2009 00:33:00 +0100 2116029 http://www.medworm.com/index.php?rid=2110545&cid=t_304170_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F01%2F16%2Fclostridium-difficile-infection-how-to-deal-with-the-problem%2F outlines newer evidence and approaches to delivering good infection control and environmental hygiene and updates the 1994 DH/PHLS guidance (Clostridium difficile infection: Prevention and management). Posted in Evidence Based Practice, Grey Literature, Infection Control, NHS   Tagged: Clostridium Difficile, Evidence Based Practice, Grey Literature, Guidance, Infection Control    (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2110545 Fri, 16 Jan 2009 09:45:48 +0100 2110545 http://www.medworm.com/index.php?rid=2102383&cid=t_304170_88_f&fid=38129&url=http%3A%2F%2Fsandnsurf.medbrains.net%2F2009%2F01%2Fblogs-rankings-and-rounds%2F Being new to the MedBlog (Medical WebLog) arena it has taken a while for me to find my blogging feet. Thankfully there are some very handy and helpful articles for newbie MedBloggers, and in this post I attempt to synergistically collate some of the great resources that I have gathered during my foundling submersion in [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=2102383 Wed, 14 Jan 2009 04:04:47 +0100 2102383