Talk:Evidence-based medicine/Draft

I will be gad to help author here, and would like to go over a plan for the article. I think that, as this article covers a a special sort of medical field that we should discuss "audience". Please, fellow editors, argue with any of these points if they differ from your understanding. Evidence based medicine is certainly all about clinical care of patients- but, unlike an article on dermatology, say, it really is about a way of thinking about medicine, an approach. Reading what is written so far- it is really meaty and presents that approach, but, in my mind suffers from 2 faults, one is that there is too much technical language without explanation, and (2) the history of medicine (in a way) has to be presented so that the naive reader understands that actually, "regualar medicine" is not evidenced based. I tyhink also, that including some real examples of changes in clinical practice that are based on evidence based medicine, may be helpful. I am going to add some of this and am open to discussion, especially from Supten. Nancy Sculerati 09:35, 15 May 2007 (CDT)

References-with notes

O'Malley P. Order no harm: evidence-based methods to reduce prescribing errors for the clinical nurse specialist. [Review] [17 refs] [Journal Article. Review] Clinical Nurse Specialist. 21(2):68-70, 2007 Mar-Apr. UI: 17308440 Classed under evidenced based medicine by Ovid (Medline) , his article reviews actual sources of medication errors.

Doumit G. Gattellari M. Grimshaw J. O'Brien MA. Local opinion leaders: effects on professional practice and health care outcomes.[update of Cochrane Database Syst Rev. 2000;(2):CD000125; PMID: 10796491]. [Review] [54 refs] [Journal Article. Review] Cochrane Database of Systematic Reviews. (1):CD000125, 2007. UI: 17253445

Lorenz LB. Wild RA. Polycystic ovarian syndrome: an evidence-based approach to evaluation and management of diabetes and cardiovascular risks for today's clinician. [Review] [60 refs] [Journal Article. Review] Clinical Obstetrics & Gynecology. 50(1):226-43, 2007 Mar. UI: 17304038

Jordan A. McDonagh JE. Transition: getting it right for young people. [Review] [29 refs] [Journal Article. Review] Clinical Medicine. 6(5):497-500, 2006 Sep-Oct. UI: 17080900

Thanigaraj S. Wollmuth JR. Zajarias A. Chemmalakuzhy J. Lasala JM. From randomized trials to routine clinical practice: an evidence-based approach for the use of drug-eluting stents. [Review] [48 refs] [Journal Article. Review] Coronary Artery Disease. 17(8):673-9, 2006 Dec. UI: 17119375

Stanley K. Design of randomized controlled trials. [Review] [9 refs] [Journal Article. Review] Circulation. 115(9):1164-9, 2007 Mar 6. UI: 17339574

Sectioning

Are there perhaps more sections than are useful here? CZ:Article Mechanics recommends against many relatively short sections in favor of relatively few, longer sections. But I don't think we have any very hard-and-fast rules about this.

Glad to see you here, Dr. Badgett! --Larry Sanger 22:01, 23 October 2007 (CDT)

Thanks - Robert Badgett 22:37, 31 October 2007 (CDT)

'Main' template not working

I added a new call to the main template, and now all three calls are not displaying correctly. - Robert Badgett 22:37, 31 October 2007 (CDT)

Misuses of EBM

The article ignores the misuses of EBM in the real world. Very few of the methods actually used in medicine have ever been validated by independent prospective randomized double-blind studies, or are likely to be. The main use of EBM is by HMOs and other prepaid managed care organizations, as an excuse to refuse to pay for expensive studies or treatments, while happily paying for inexpensive, untested, unproven treatments, such as herbal and other "alternative" medicines. I do not think this misuse of EBM should be ignored in this otherwise wholly laudatory article. Harvey Frey 17:20, 12 November 2007 (CST)

Hi!

The use of the "there is no evidence that" is becoming a little too frequent in clinical medicine. I suggest these two articles for inclusion; unfortunately I cannot access them (full text) right now.

J Med Ethics 2004;30:141-145 Evidence based medicine and justice: a framework for looking at the impact of EBM upon vulnerable or disadvantaged groups. W A Rogers

S I Saarni and H A Gylling Evidence based medicine guidelines: a solution to rationing or politics disguised as science?

J. Med. Ethics, Apr 2004; 30: 171 - 175.

May I summarize the two abstracts in the Criticisms section?

Pierre-Alain Gouanvic 23:34, 12 November 2007 (CST)