Abstract:
:In many developed nations, the state of publicly administered health care is increasingly precarious as a result of escalating numbers of chronically ill patients, inadequate medical personnel and hospital facilities, as well as sparse funding for ongoing upgrades to state-of-the-art diagnostic and therapeutic technology - an increased emphasis on aetiology-centred medicine should be considered in order to achieve improved health for patients and populations. Medical practice patterns which are designed to provide quick and effective amelioration of signs and symptoms are frequently not an enduring solution to many health afflictions and chronic disease states. Recent scientific discovery has rendered the drug-oriented algorithmic paradigm commonly found in contemporary evidence-based medicine to be a reductionist approach to clinical practice. Unfolding evidence appears to support a genetic predisposition model of health and illness rather than a fatalistic predestination construct - modifiable epigenetic and environmental factors have enormous potential to influence clinical outcomes. By understanding and applying fundamental clinical principles relating to the emerging fields of molecular medicine, nutrigenomics and human exposure assessment, doctors will be empowered to address causality of affliction when possible and achieve sustained reprieve for many suffering patients.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Genuis SJdoi
10.1111/j.1365-2753.2007.00808.xsubject
Has Abstractpub_date
2008-02-01 00:00:00pages
94-102issue
1eissn
1356-1294issn
1365-2753pii
JEP808journal_volume
14pub_type
杂志文章,评审abstract::The whole spectrum of medicine consists of complex non-linear systems that are balanced and interact with each other. How non-linearity confers stability on a system and explains variation and uncertainty in clinical medicine is discussed. A major theme is that a small alteration in initial conditions may have a major...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2003.00344.x
更新日期:2003-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:A valid tool to measure clinical competency early in medical school could identify students who may require special educational attention. The overall aim is to assess the relationship between students' scores on an objective structured clinical examination (OSCE) given in the second year...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00768.x
更新日期:2007-12-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Focusing on the implementation of clinical practice guidelines (CPGs) for the management of adult cancers, the objectives of this study were to (a) describe the intrinsic elements known to influence CPG use; (b) identify the ways in which CPGs are implemented; and (c) explore how CPG cha...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13073
更新日期:2019-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:We developed a novel Internet-based blended learning programme that allows busy health care professionals to attain core competency in clinical research. This study details the educational strategies and learning outcomes of the programme. METHOD:This study was conducted at Kyoto Univers...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01808.x
更新日期:2013-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:In the UK fewer than 15% of familial hypercholesterolemia (FH) cases are diagnosed, representing a major gap in coronary heart disease prevention. We wished to support primary care doctors within the Medway Clinical Commissioning Group (CCG) to implement NICE guidance (CG71) and consider ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12481
更新日期:2016-06-01 00:00:00
abstract:RATIONALE:Recent reports indicate that approximately 10% of in-patients in UK hospitals are involved in an adverse event (these reports also state that 50% of these events are preventable). This is indeed a worrying finding, and indicates the need to look at how these incidents are handled or indeed, what is done to mi...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01759.x
更新日期:2012-12-01 00:00:00
abstract::Patient non-adherence is a common and important concern in clinical medicine. Some cases of patient non-adherence are cases in which the patient disagrees with the physician's recommended treatment based on particular reasons. Drawing upon science and technology studies literature, specifically the discussion by Colli...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12561
更新日期:2016-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The patient-centred medical home (PCMH) is an innovative approach to health care reform. Despite a well-established process for recognizing PCMH practices, fidelity to, and/or adaptation of, the PCMH model can limit health care and population health improvements. This study explored the ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13136
更新日期:2019-12-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The way in which care providers describe incapacitated elderly people is not without implications. The different ways in which they describe their patients-client, patient, or a sick human being-have consequences for their relationships with these patients and the decision-making process...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13357
更新日期:2020-04-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Measures of safety climate are increasingly used to guide safety improvement initiatives. However, cost and respondent burden may limit the use of safety climate surveys. The purpose of this study was to develop a 15- to 20-item safety climate survey based on the Patient Safety Climate i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12731
更新日期:2017-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) endeavour to incorporate the best available research evidence together with the clinically informed opinions of leading experts in order to guide clinical practice when dealing with a given condition. There has been increased interest in CPGs that are ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13026
更新日期:2019-08-01 00:00:00
abstract::Identified as a mental disorder by Emil Kraepelin and Eugen Bleuler (1858-1939), schizophrenia has been subject to various criticisms, on both political and scientific grounds. Still, until the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, as the'Spectrum of Schizophrenia and Othe...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12608
更新日期:2017-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Chronic disorders of consciousness (CDoC) pose significant problems of understanding for both medical professionals and the relatives and friends of the patient. This paper explores the tensions between the different interpretative resources that are drawn upon by lay people and professio...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12220
更新日期:2015-06-01 00:00:00
abstract:AIMS AND OBJECTIVES:We report findings from a qualitative study to identify patient views of community hospital care. We consider how far these were in accord with the hospital staffs' views. This constituted part of a wider randomized controlled trial (RCT). The methodological challenges in seeking to identify patient...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2006.00653.x
更新日期:2007-02-01 00:00:00
abstract:RATIONALE:In Canada, Aboriginal people, particularly First Nations experience significant health disparities and a lower health status compared with the non-Aboriginal population. AIMS AND OBJECTIVES:The purpose of this study was to examine the demographic and clinical characteristics of First Nations patients admitte...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12601
更新日期:2017-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Mortality prediction models using logistic regression analysis play a pivotal role in intensive care quality evaluation, allowing a hospital's performance to be compared with a standard. However, when a difference between predicted and observed mortality exists, that is, the numerator of ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01240.x
更新日期:2010-10-01 00:00:00
abstract::Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervised weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, mul...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2002.00320.x
更新日期:2002-02-01 00:00:00
abstract::Strand and Parkkinen criticize our dispositional account of causation in evidence-based medicine for failing to provide a proper epistemology of causal knowledge. In particular, they claim that we do not explain how causal inferences should be drawn. In response, we point out that dispositionalism does indeed have an ...
journal_title:Journal of evaluation in clinical practice
pub_type: 评论,杂志文章
doi:10.1111/jep.12189
更新日期:2014-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Guidelines for stroke management should improve quality of care. Dissemination of guidelines, however, does not guarantee guideline adherence. The aim of this paper is to investigate barriers for guideline adherence to bring about suggestions for possible implementation strategies. METHO...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2003.00460.x
更新日期:2004-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Following increased interest in having inter-professional (IP) health care teams engage patients in decision making, we developed a conceptual model for an IP approach to shared decision making (SDM) in primary care. We assessed the validity of the model with stakeholders in Canada. METH...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01515.x
更新日期:2011-08-01 00:00:00
abstract:INTRODUCTION:How shared decision making (SDM) works with indigenous patient values and preferences is not well understood. Colonization has affected indigenous peoples' levels of trust with institutions, and their world view tends to be distinct from that of nonindigenous people. Building on a programme theory for SDM,...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13307
更新日期:2020-04-01 00:00:00
abstract::Several philosophers of medicine have attempted to answer the question "what is disease?" In current clinical practice, an umbrella term "chronic kidney disease" (CKD) encompasses a wide range of kidney health states from commonly prevalent subclinical, asymptomatic disease to rare end-stage renal disease requiring tr...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13018
更新日期:2018-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Clinical guidelines are tools that systematize scientific evidence and help to achieve proper care. Several difficulties are reported regarding the effective use, such as the shortcomings in the level of knowledge and attitudes by the professionals, the service structure and the preferenc...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01681.x
更新日期:2011-08-01 00:00:00
abstract::Work on resilience in health and illness has been approached from a number of perspectives. These are the biological and psychosocial with a focus on the individual's responses to cope and adapt to changing circumstances wrought by changing physical health states. This we argue has a place but is far too narrow emphas...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12955
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 mo...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01541.x
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Few randomized clinical trials focus on patients' symptoms of the first post-operative week following outpatient (OPS) versus inpatient (IPS) laparoscopic cholecystectomy (LC). The objective was to compare these treatment modalities with regard to patients' perceptions of pain and other post-operative sympto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2007.00920.x
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Child psychoanalytic psychotherapy has been criticized for its reluctance to embrace evidence-based practice. This study aims to explore the historical narrative of a sample of child psychoanalytic psychotherapists about progress in developing the evidence base. METHODS:Fourteen psychotherapists were interv...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01638.x
更新日期:2013-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:To evaluate adherence to guidelines for prophylactic antibiotic use in total knee replacement (TKR) and total hip replacement (THR) procedures and to examine the associations between guideline adherence and health care outcomes. METHODS:Using nationwide health insurance claims data, all ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01182.x
更新日期:2009-12-01 00:00:00
abstract:AIM:To measure the impact of French national consensus guidelines on the clinical practices of primary care paediatricians and general practitioners. DESIGN:Non-randomized intervention study, with a first survey 1 year before the consensus development conference and a second survey 1 year after. INTERVENTION:Implemen...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2007.00781.x
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:To determine IMR trends and regional variations among 47 prefectures in Japan and to identify associated population-based factors. METHODS:We conducted an ecological study of infant mortality rate (IMR) by analyzing publicly available data from the Ministry of Health, Labour and Welfare of Japan. Outcome me...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01862.x
更新日期:2013-10-01 00:00:00