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Evidence-based medicine

Index Evidence-based medicine

Evidence-based medicine (EBM) is an approach to medical practice intended to optimize decision-making by emphasizing the use of evidence from well-designed and well-conducted research. [1]

72 relations: Alternative medicine, Alvan Feinstein, Anecdotal evidence, Archie Cochrane, Availability heuristic, Avicenna, Bandolier (journal), Bayes' theorem, Best practice, Case-control study, Clinical decision support system, Clinical trial, Clinician, Cochrane (organisation), Cohort study, Conflict of interest, Conventional wisdom, David M. Eddy, David Sackett, Decision-making, Empirical evidence, Epidemiology, Epistemology, Evidence, Evidence-based dentistry, Evidence-based design, Evidence-based management, Evidence-based nursing, Evidence-based policy, Evidence-based practice, Evidence-based research, Exegesis, Gold standard (test), Gordon Guyatt, Governmentality, Health care, Hepatocellular carcinoma, Hypocognition, Internal validity, Jack Wennberg, JAMA (journal), McMaster University, Medical consensus, Medicine, Meta-analysis, Number needed to harm, Number needed to treat, Personalized medicine, Placebo-controlled study, Policy-based evidence making, ..., Power (statistics), Pre- and post-test probability, Precision medicine, Protestantism, Psoriasis, Publication bias, RAND Corporation, Randomization, Randomized controlled trial, Randomness, Receiver operating characteristic, Reformation, Research, Science, Scientific literature, Sensitivity and specificity, Systematic review, Tacit assumption, The BMJ, The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, Time series, Value (ethics). Expand index (22 more) »

Alternative medicine

Alternative medicine, fringe medicine, pseudomedicine or simply questionable medicine is the use and promotion of practices which are unproven, disproven, impossible to prove, or excessively harmful in relation to their effect — in the attempt to achieve the healing effects of medicine.--> --> --> They differ from experimental medicine in that the latter employs responsible investigation, and accepts results that show it to be ineffective. The scientific consensus is that alternative therapies either do not, or cannot, work. In some cases laws of nature are violated by their basic claims; in some the treatment is so much worse that its use is unethical. Alternative practices, products, and therapies range from only ineffective to having known harmful and toxic effects.--> Alternative therapies may be credited for perceived improvement through placebo effects, decreased use or effect of medical treatment (and therefore either decreased side effects; or nocebo effects towards standard treatment),--> or the natural course of the condition or disease. Alternative treatment is not the same as experimental treatment or traditional medicine, although both can be misused in ways that are alternative. Alternative or complementary medicine is dangerous because it may discourage people from getting the best possible treatment, and may lead to a false understanding of the body and of science.-->---> Alternative medicine is used by a significant number of people, though its popularity is often overstated.--> Large amounts of funding go to testing alternative medicine, with more than US$2.5 billion spent by the United States government alone.--> Almost none show any effect beyond that of false treatment,--> and most studies showing any effect have been statistical flukes. Alternative medicine is a highly profitable industry, with a strong lobby. This fact is often overlooked by media or intentionally kept hidden, with alternative practice being portrayed positively when compared to "big pharma". --> The lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine.--> Alternative therapies may even be allowed to promote use when there is demonstrably no effect, only a tradition of use. Regulation and licensing of alternative medicine and health care providers varies between and within countries. Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them.--> Alternative medicine is criticized for taking advantage of the weakest members of society.--! Terminology has shifted over time, reflecting the preferred branding of practitioners.. Science Based Medicine--> For example, the United States National Institutes of Health department studying alternative medicine, currently named National Center for Complementary and Integrative Health, was established as the Office of Alternative Medicine and was renamed the National Center for Complementary and Alternative Medicine before obtaining its current name. Therapies are often framed as "natural" or "holistic", in apparent opposition to conventional medicine which is "artificial" and "narrow in scope", statements which are intentionally misleading. --> When used together with functional medical treatment, alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) treatment.--> Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment, making it less effective, notably in cancer.--> Alternative diagnoses and treatments are not part of medicine, or of science-based curricula in medical schools, nor are they used in any practice based on scientific knowledge or experience.--> Alternative therapies are often based on religious belief, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or lies.--> Alternative medicine is based on misleading statements, quackery, pseudoscience, antiscience, fraud, and poor scientific methodology. Promoting alternative medicine has been called dangerous and unethical.--> Testing alternative medicine that has no scientific basis has been called a waste of scarce research resources.--> Critics state that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't",--> that the very idea of "alternative" treatments is paradoxical, as any treatment proven to work is by definition "medicine".-->.

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Alvan Feinstein

Alvan R. Feinstein (December 4, 1925 – October 25, 2001) was a clinician, a researcher and an epidemiologist who made significant impact on clinical investigation, especially on the field of clinical epidemiology that he helped define.

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Anecdotal evidence

Anecdotal evidence is evidence from anecdotes, i.e., evidence collected in a casual or informal manner and relying heavily or entirely on personal testimony.

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Archie Cochrane

Archibald Leman Cochrane CBE (12 January 1909 – 18 June 1988) was a Scottish doctor noted for his book Effectiveness and Efficiency: Random Reflections on Health Services.

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Availability heuristic

The availability heuristic is a mental shortcut that relies on immediate examples that come to a given person's mind when evaluating a specific topic, concept, method or decision.

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Avicenna (also Ibn Sīnā or Abu Ali Sina; ابن سینا; – June 1037) was a Persian polymath who is regarded as one of the most significant physicians, astronomers, thinkers and writers of the Islamic Golden Age.

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Bandolier (journal)

Bandolier was an independent healthcare journal about evidence-based healthcare, written by Oxford University scientists.

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Bayes' theorem

In probability theory and statistics, Bayes’ theorem (alternatively Bayes’ law or Bayes' rule, also written as Bayes’s theorem) describes the probability of an event, based on prior knowledge of conditions that might be related to the event.

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Best practice

A best practice is a method or technique that has been generally accepted as superior to any alternatives because it produces results that are superior to those achieved by other means or because it has become a standard way of doing things, e.g., a standard way of complying with legal or ethical requirements.

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Case-control study

A case-control study is a type of observational study in which two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute.

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Clinical decision support system

A clinical decision support system (CDSS) is a health information technology system that is designed to provide physicians and other health professionals with clinical decision support (CDS), that is, assistance with clinical decision-making tasks.

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Clinical trial

Clinical trials are experiments or observations done in clinical research.

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A clinician is a health care professional that works as a primary care giver of a patient in a hospital, skilled nursing facility, clinic, or patient's home.

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Cochrane (organisation)

Cochrane is a non-profit, non-governmental organization formed to organize medical research findings so as to facilitate evidence-based choices about health interventions faced by health professionals, patients, and policy makers.

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Cohort study

A cohort study is a particular form of longitudinal study that sample a cohort (a group of people who share a defining characteristic, typically those who experienced a common event in a selected period, such as birth or graduation), performing a cross-section at intervals through time.

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Conflict of interest

A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another.

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Conventional wisdom

Conventional wisdom is the body of ideas or explanations generally accepted as true by the public and/or by experts in a field.

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David M. Eddy

David M. Eddy is an American physician, mathematician, and healthcare analyst who has done seminal work in mathematical modeling of diseases, clinical practice guidelines, and evidence-based medicine.

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David Sackett

David Lawrence Sackett, (November 17, 1934 – May 13, 2015) was an American-Canadian medical doctor and a pioneer in evidence-based medicine.

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In psychology, decision-making (also spelled decision making and decisionmaking) is regarded as the cognitive process resulting in the selection of a belief or a course of action among several alternative possibilities.

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Empirical evidence

Empirical evidence, also known as sensory experience, is the information received by means of the senses, particularly by observation and documentation of patterns and behavior through experimentation.

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Epidemiology is the study and analysis of the distribution (who, when, and where) and determinants of health and disease conditions in defined populations.

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Epistemology is the branch of philosophy concerned with the theory of knowledge.

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Evidence, broadly construed, is anything presented in support of an assertion.

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Evidence-based dentistry

Evidence-based dentistry (EBD) uses current scientific evidence to guide decision-making in dentistry.

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Evidence-based design

Evidence-based design, or EBD, is defined as the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.

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Evidence-based management

Evidence-based management (EBMgt) is an emerging movement to explicitly use the current, best evidence in management and decision-making.

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Evidence-based nursing

Evidence-based nursing (EBN) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic.

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Evidence-based policy

Evidence-based policy is a term often applied in multiple fields of public policy to refer to situations whereby policy decisions are informed by rigorously established objective evidence.

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Evidence-based practice

Evidence-based practice (EBP) is an interdisciplinary approach to clinical practice that has been gaining ground following its formal introduction in 1992.

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Evidence-based research

Evidence-based research (EBR) is "the use of prior research in a systematic and transparent way to inform a new study so that it is answering questions that matter in a valid, efficient and accessible manner".

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Exegesis (from the Greek ἐξήγησις from ἐξηγεῖσθαι, "to lead out") is a critical explanation or interpretation of a text, particularly a religious text.

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Gold standard (test)

In medicine and statistics, gold standard test is usually diagnostic test or benchmark that is the best available under reasonable conditions.

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Gordon Guyatt

Gordon Henry Guyatt, MD, MSc, FRCP, OC born November 11, 1953) is a Canadian physician and Distinguished University Professor in the Departments of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology & Biostatistics) and Medicine at McMaster University in Hamilton, Ontario. He is known for his leadership in evidence-based medicine, a term that first appeared in a single-author paper he published in 1991. Subsequently, a 1992 JAMA article that Guyatt led proved instrumental in bringing the concept of evidence-based medicine to the worlds attention. In 2007, The BMJ launched an international election for the most important contributions to healthcare. Evidence-based medicine came 7th, ahead of the computer and medical imaging. Guyatt’s concerns with the role of the medical system, social justice, and medical reform remain central issues that he promoted in tandem with his medical work. On October 9, 2015, he was named to the Canadian Medical Hall of Fame. ----.

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Governmentality is a concept first developed by the French philosopher Michel Foucault in the later years of his life, roughly between 1977 and his death in 1984, particularly in his lectures at the Collège de France during this time.

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Health care

Health care or healthcare is the maintenance or improvement of health via the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in human beings.

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Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer in adults, and is the most common cause of death in people with cirrhosis.

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Hypocognition, in cognitive linguistics, means missing and being unable to communicate cognitive and linguistic representations because there are no words for particular concepts.

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Internal validity

In scientific research, internal validity is the extent to which a causal conclusion based on a study is warranted, which is determined by the degree to which a study minimizes systematic error (or 'bias').

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Jack Wennberg

John E. "Jack" Wennberg (born June 2, 1934) is the pioneer and leading researcher of unwarranted variation in the healthcare industry.

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JAMA (journal)

JAMA: The Journal of the American Medical Association is a peer-reviewed medical journal published 48 times a year by the American Medical Association.

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McMaster University

McMaster University (commonly referred to as McMaster or Mac) is a public research university in Hamilton, Ontario, Canada.

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Medical consensus

Medical consensus is a public statement on a particular aspect of medical knowledge at the time the statement is made that a representative group of experts agree to be evidence-based and state-of-the-art (state-of-the-science) knowledge.

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Medicine is the science and practice of the diagnosis, treatment, and prevention of disease.

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A meta-analysis is a statistical analysis that combines the results of multiple scientific studies.

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Number needed to harm

The number needed to harm (NNH) is an epidemiological measure that indicates how many patients on average need to be exposed to a risk-factor over a specific period to cause harm in an average of one patient who would not otherwise have been harmed.

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Number needed to treat

The number needed to treat (NNT) is an epidemiological measure used in communicating the effectiveness of a health-care intervention, typically a treatment with medication.

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Personalized medicine

Personalized medicine, also termed precision medicine, is a medical procedure that separates patients into different groups—with medical decisions, practices, interventions and/or products being tailored to the individual patient based on their predicted response or risk of disease.

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Placebo-controlled study

Placebo-controlled studies are a way of testing a medical therapy in which, in addition to a group of subjects that receives the treatment to be evaluated, a separate control group receives a sham "placebo" treatment which is specifically designed to have no real effect.

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Policy-based evidence making

"Policy-based evidence making" is a pejorative term which refers to the commissioning of research in order to support a policy which has already been decided upon.

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Power (statistics)

The power of a binary hypothesis test is the probability that the test correctly rejects the null hypothesis (H0) when a specific alternative hypothesis (H1) is true.

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Pre- and post-test probability

Pre-test probability and post-test probability (alternatively spelled pretest and posttest probability) are the probabilities of the presence of a condition (such as a disease) before and after a diagnostic test, respectively.

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Precision medicine

Precision medicine (PM) is a medical model that proposes the customization of healthcare, with medical decisions, treatments, practices, or products being tailored to the individual patient.

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Protestantism is the second largest form of Christianity with collectively more than 900 million adherents worldwide or nearly 40% of all Christians.

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Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin.

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Publication bias

Publication bias is a type of bias that occurs in published academic research.

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RAND Corporation

RAND Corporation ("Research ANd Development") is an American nonprofit global policy think tank created in 1948 by Douglas Aircraft Company to offer research and analysis to the United States Armed Forces.

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Randomization is the process of making something random; in various contexts this involves, for example.

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Randomized controlled trial

A randomized controlled trial (or randomized control trial; RCT) is a type of scientific (often medical) experiment which aims to reduce bias when testing a new treatment.

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Randomness is the lack of pattern or predictability in events.

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Receiver operating characteristic

In statistics, a receiver operating characteristic curve, i.e. ROC curve, is a graphical plot that illustrates the diagnostic ability of a binary classifier system as its discrimination threshold is varied.

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The Reformation (or, more fully, the Protestant Reformation; also, the European Reformation) was a schism in Western Christianity initiated by Martin Luther and continued by Huldrych Zwingli, John Calvin and other Protestant Reformers in 16th century Europe.

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Research comprises "creative and systematic work undertaken to increase the stock of knowledge, including knowledge of humans, culture and society, and the use of this stock of knowledge to devise new applications." It is used to establish or confirm facts, reaffirm the results of previous work, solve new or existing problems, support theorems, or develop new theories.

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R. P. Feynman, The Feynman Lectures on Physics, Vol.1, Chaps.1,2,&3.

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Scientific literature

Scientific literature comprises scholarly publications that report original empirical and theoretical work in the natural and social sciences, and within an academic field, often abbreviated as the literature.

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Sensitivity and specificity

Sensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as a classification function.

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Systematic review

Systematic reviews are a type of literature review that uses systematic methods to collect secondary data, critically appraise research studies, and synthesize studies.

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Tacit assumption

A tacit assumption or implicit assumption is an assumption that includes the underlying agreements or statements made in the development of a logical argument, course of action, decision, or judgment that are not explicitly voiced nor necessarily understood by the decision maker or judge.

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The BMJ is a weekly peer-reviewed medical journal.

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The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach

The GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) is a method of assessing the certainty in evidence (also known as quality of evidence or confidence in effect estimates) and the strength of recommendations in health care.

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Time series

A time series is a series of data points indexed (or listed or graphed) in time order.

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Value (ethics)

In ethics, value denotes the degree of importance of some thing or action, with the aim of determining what actions are best to do or what way is best to live (normative ethics), or to describe the significance of different actions.

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[1] https://en.wikipedia.org/wiki/Evidence-based_medicine

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