Abstract:
:Following my own involvement in the rise of evidence-based medicine in General Practice in the UK, and having seen how this tide has led to a relative devaluation of other kinds of knowing this paper sets out four alternative approaches to the problem of knowledge in a way which both undermines the predominance of a strictly evidence-based approach and re-emphasizes these other means through which we come to know the world. Philosophically, this brings together the works of Heidegger, Sebald, Bachelard and Gadamer and shows how these apparently disparate authors suggest that there is, underlying our empirical understanding of the world, a more primordial relationship between consciousness and world which supports empirical or evidence-based knowledge and without which evidence-based knowledge cannot be applied in practice. The implications for clinical practice of this kind of thinking should be a more cautious approach to the use of evidence and a greater emphasis and reliance on the discretion and judgement of clinical professionals.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Mitchell Ddoi
10.1111/j.1365-2753.2011.01724.xsubject
Has Abstractpub_date
2011-10-01 00:00:00pages
899-904issue
5eissn
1356-1294issn
1365-2753journal_volume
17pub_type
杂志文章abstract:BACKGROUND:Geographical inequalities in lung cancer treatment and patient survival have been described. We hypothesized that lung cancer patients' access to treatment may be influenced by deprivation and the pathway to care. METHODS:Case notes were reviewed for patients resident in south-east London who were registere...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00644.x
更新日期:2006-10-01 00:00:00
abstract:RATIONALE:There is growing interest in validating tools aimed at supporting the clinical decision-making process and research. However, an increased bureaucratization of clinical practice and redundancies in the measures collected have been reported by clinicians. Redundancies in clinical assessments affect negatively ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/jep.12539
更新日期:2016-10-01 00:00:00
abstract:RATIONALE:To describe the first phase of a global evaluation framework for the National Prescribing Service (NPS), with a focus on services for health professionals, and in particular highlight the lessons learnt from evaluation around the establishment and implementation of this national program. METHODS:The agreed e...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00620.x
更新日期:2006-04-01 00:00:00
abstract::Evidence-based medicine (EBM) calls for medical practitioners to "integrate" our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than cri...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13109
更新日期:2019-12-01 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::The aim of this study was to utilize an evaluation tool based on Prochaska's model of change in order to assess behaviour change as part of an evaluation process for a research transfer training programme (RTTP). The RTTP was a training programme offered to scientists in a psychiatry department and research institute ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2003.00407.x
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:We investigated whether providing participants in an exercise programme with regular feedback on their exercise progress affected their adherence to the programme regimen. METHOD:We conducted a randomized controlled trial. Adult men and women with borderline hypertension and a body mass index ≥ 25.0 were ran...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2009.01342.x
更新日期:2011-02-01 00:00:00
abstract:RATIONALE:This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. AIM AND OBJECTIVES:The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01870.x
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To assess the evidence for tai chi in reducing resting blood pressure (BP) in the elderly. METHODS:Databases were searched up to February 2009. All randomized clinical trials (RCTs) testing the effects of tai chi on resting BP in the elderly were considered. The selection of studies, data extraction and val...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2009.01210.x
更新日期:2010-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVE:Low back pain (LBP) care can involve many providers. The provider chosen for entry into care may predict future health care utilization and costs. The objective of this study was to explore associations between entry settings and future LBP-related utilization and costs. METHODS:A retrosp...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12464
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:Self-efficacy - the confidence to carry out certain behaviour in order to achieve a specific goal - has increasingly been recognized as an essential prerequisite of effective self-management of chronic diseases. Therefore, valid and reliable measures are needed to evaluate self-efficacy in both research and c...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01764.x
更新日期:2013-02-01 00:00:00
abstract::Parts 1 and 2 in this series of three articles have shown that and how strong evidence-based medicine has neither a coherent theoretical foundation nor creditable application to clinical practice. Because of its core commitment to the discredited positivist tradition it holds both a false concept of scientific knowled...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13512
更新日期:2020-12-04 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:It has been proposed that delivery should be accomplished within 30 minutes after diagnosis of fetal distress. The objective of this study was to determine the decision-to-delivery interval (DDI) in emergency caesarean delivery for non-reassuring fetal heart rate (FHR). METHODS:A total o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12613
更新日期:2016-12-01 00:00:00
abstract:RATIONALE AND OBJECTIVES:Quality of life has emerged as a crucial concept for the assessment of health and the planning of health care. Desirable features for the evaluation of quality of life include comprehensiveness, self-ratedness, cultural sensitivity, practicality and psychometric soundness. An attempt to meet th...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01609.x
更新日期:2011-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The management of rheumatoid arthritis (RA) usually entails regular hospital reviews with a specialist often when the patient is well rather than during a period of exacerbation. An alternative approach where patients initiate appointments when they need them can improve patient satisfact...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/jep.12505
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To identify and review evidence relating to the measurement properties of published multi-item outcome measures for the conservative management of lateral ligament injuries of the ankle. METHODS:Systematic literature searches were used to identify measures, which were then assessed against pre-defined criter...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2003.00435.x
更新日期:2004-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The prevailing view on implementation interventions to improve the organization and management of health care is that the interventions should be tailored to potential barriers. Ideally, possible barriers are analysed before the quality improvement interventions are developed to influence...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2006.00660.x
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:Venous thromboembolism (VTE) is a fatal complication and the most common preventable cause of death in hospitals. The risk-to-benefit ratio of thromboprophylaxis depends on the performance of the risk assessment model. A linear model, the Padua model, is recommended for medical inpatients in the United States...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13324
更新日期:2020-02-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The main purpose of this paper is to measure the efficiency and ranking of medical diagnostic laboratories by applying a network data envelopment analysis (NDEA). METHODS:In this study, each medical diagnostic laboratory is considered as a decision-making unit (DMU), and an NDEA model i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13337
更新日期:2020-10-01 00:00:00
abstract::Progressive improvements in antihypertensive drug therapy over the past four decades have provided clear benefits in limiting cardiovascular complications. Unfortunately, and largely inexplicably, the inclusion in meta-analyses of defective trials plus the employment of inappropriate diagnostic criteria for adverse co...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2001.00300.x
更新日期:2001-05-01 00:00:00
abstract::Doctors often use theory to inform medical practice. The current bio-psycho-social model of health may be advanced still further with theoretical rigour. Traditional fields of thermodynamics and newer fields of non-linear dynamics including chaos theory and complex systems science can inform our understanding of the c...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01227.x
更新日期:2009-08-01 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: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:RATIONALE, AIMS AND OBJECTIVES:To develop a reliable and valid questionnaire that can distinguish features of organizational culture for patient safety across subgroups such as hospitals, professions, management/non-management positions and units/wards. METHODS:We developed a Hospital Organizational Culture Questionna...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12123
更新日期:2014-06-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Traditional continuing medical education programmes that offer passive learning have been shown to be poorly effective at changing doctors' clinical behaviour. A multifaceted evidence-based medicine (EBM) intervention was conducted at the largest health maintenance organization (HMO) in I...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2007.00859.x
更新日期:2007-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Neonates with life-threatening conditions face complex clinical circumstances that confront parents and professionals with ethical decisions. Parents' participation in decision making has not gained sufficient attention in practice. Understanding factors affecting parents' participation ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13492
更新日期:2020-10-25 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: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, AIMS, AND OBJECTIVES:Current meta-analysis was conducted aiming to assess the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in the treatment of acute leukaemia (AL) patients with chemotherapy-induced thrombocytopenia (CIT). METHODS:We searched PubMed, Embase, Chinese National Knowledge I...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13152
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:The objectives of this paper were to investigate quality of care for individuals with osteoarthritis (OA) and to determine if those most in need had the outcome of a total joint replacement (TJR). Key quality indicators were involvement in treatment decisions, appropriate information provision and outcomes o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01616.x
更新日期:2012-06-01 00:00:00