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 critically looking at how these features of EBM can be implemented together. Other authors have also commented on this gap in the literature, for example, identifying the lack of clarity about how patient preferences and evidence from trials is supposed to be integrated in practice. In this paper, I look at this issue from an epistemological perspective, (looking at how different types of knowledge in EBM can be used to make sounds judgements). In particular, I introduce an epistemological issue for this integration problem, which I call the epistemic integration problem. This is essentially the problem of how we can use information that is both general (eg, about a population sample) and descriptive (eg, about what expected outcomes are) to reach clinical judgements that are individualized (applying to a particular patient) and normative (about what is best for their health).
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Lawson-Frost Sdoi
10.1111/jep.13109subject
Has Abstractpub_date
2019-12-01 00:00:00pages
938-942issue
6eissn
1356-1294issn
1365-2753journal_volume
25pub_type
杂志文章abstract:RATIONALE, AIMS AND OBJECTIVES:Wristbands are essential for accurate patient identification. Some evidence suggests that missing wristbands is not an infrequent occurrence in acute hospitals. The National Patient Safety Agency (NPSA) has developed guidance on patient identification for hospitals in England and Wales. H...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01004.x
更新日期:2009-04-01 00:00:00
abstract::This article reviews the methodological limitations identified in a recent authoritative US report by the Public Health Service, which provides the theoretical background to several other guidelines on cost effectiveness, such as those of the British Medical Journal. It places each limitation in context and discusses ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.1999.00179.x
更新日期:1999-11-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evid...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12760
更新日期:2017-12-01 00:00:00
abstract::A primary purpose of research is to generate new knowledge. Scientific advances have progressively identified optimal ways to achieve this purpose. Included in this evolution are the notions of evidence-based medicine, decision aids, shared decision making, measurement and evaluation as well as implementation. The imp...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01899.x
更新日期:2012-10-01 00:00:00
abstract:INTRODUCTION:Non-routine events (NREs) are atypical or unusual occurrences in a pre-defined process. Although some NREs in high-risk clinical settings have no adverse effects on patient care, others can potentially cause serious patient harm. A unified strategy for identifying and describing NREs in these domains will ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13456
更新日期:2020-08-16 00:00:00
abstract:OBJECTIVE:Quality of life (QoL) is an important consideration in the care of patients with chronic neuromuscular disorder (NMD). The current study sought to determine the factor structure of the Medical Outcomes Study Short-Form 36 (SF-36) version 2 in patients with NMD to determine the appropriateness of using this in...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01513.x
更新日期:2012-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Short-term intensive insulin therapy (IIT) early in the course of type 2 diabetes can improve pancreatic beta-cell function and even induce normoglycemia that persists post-therapy. In spite of this benefit, insulin is often delayed until late in the course of disease partly because of it...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01552.x
更新日期:2012-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Consistent links exist between male alcohol intake and male-perpetrated intimate partner violence (IPV) as well as female alcohol intake and female-perpetrated IPV. However, the nature of the relationship remains unclear. This study attempted to identify unique alcohol-violence patterns w...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/jep.12218
更新日期:2014-10-01 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:The study aims to identify key enablers fostering clinical risk management (CRM) in hospitals to guide health care in this vital area of patient safety. METHOD:A cross-sectional survey was conducted at the national level in 324 Swiss hospitals in 2007-2008 to assess the relationship between key elements and ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01836.x
更新日期:2013-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The onset of acute illness may be accompanied by a profound sense of disorientation for patients. Addressing this vulnerability is a key part of a physician's purview, yet well-intended efforts to do so may be impeded by myriad competing tasks in clinical practice. Resolving this dilemma ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13410
更新日期:2020-05-07 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Malnutrition screening is essential to detect and to treat patients with stunting or wasting. The aim was to evaluate the subjective perception of frequency and assessment of malnutrition by health care professionals. RESEARCH METHODS AND PROCEDURES:In a paediatric university hospital, a...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12412
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:Medication non-adherence is a major contributor to poor outcomes following discharge from psychiatric hospitals. It is therefore imperative that staff are able to accurately assess the extent to which patients have engaged with treatment. This study presents data on a new observer rating instrument of patien...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.00989.x
更新日期:2009-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Loss of situation awareness (SA) by health professionals during handover is a major threat to patient safety in perinatal care. SA refers to knowing what is going on around. Adequate handover communication and process may support situation assessment, a precursor of SA. This study describ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12103
更新日期:2014-04-01 00:00:00
abstract::Over the past two decades, the majority of medical schools in the USA have embarked upon curricular initiatives to enhance the teaching of ambulatory or office-based primary care. Identifying characteristics of these primary care experiences that make for the most effective learning is a top priority in medical educat...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2001.00288.x
更新日期:2001-08-01 00:00:00
abstract::A system approach termed P4 medicine has recently been proposed in the field of oncology. This approach has been advanced as an extension of what is usually called 'personalized' or 'genomic medicine'. P4 medicine creates effective predictive, personalized, preventive and participatory models to treat patients. In ord...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01709.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:Models for the structured delivery of care rely on organizational attributes of practice teams. The Survey of Organizational Attributes for Primary Care (SOAPC) is known to be a valid instrument to measure this aspect in the primary care setting. The aim of this study was to determine the validity of a transl...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01330.x
更新日期:2010-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Primary care visits often include a family member or friend. The purpose of this study was to determine the effect of the presence of a family member on the visit content and dynamics among diabetic patients in Family Medicine settings. METHOD:Encounters of patients with type 2 diabetes ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12028
更新日期:2013-12-01 00:00:00
abstract::A previous study (Stanhope et al. 1998) established that staff in two obstetric units reported less than a quarter of designated incidents to the units' risk managers. A questionnaire was administered to 42 obstetricians and 156 midwives at the same two obstetric units, exploring the reasons for low rates of reporting...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.1999.00147.x
更新日期:1999-02-01 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::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::Health care purchasers are facing increasing pressure to make the best use of their limited resources and to purchase only those services known to be clinically effective. This paper describes one health authority's experience of promoting clinical effectiveness through clinical audit and clinical guidelines. It highl...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.1997.tb00070.x
更新日期:1997-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Artificial intelligence and big data are more and more used in medicine, either in prevention, diagnosis or treatment, and are clearly modifying the way medicine is thought and practiced. Some authors argue that the use of artificial intelligence techniques to analyze big data would even ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13528
更新日期:2020-12-23 00:00:00
abstract:OBJECTIVE:To assess the association of the quality of allocation concealment with heterogeneity in age, the P value of the primary outcome and statistical significance of the primary outcome. STUDY DESIGN AND SETTING:We extracted data from articles published in four major medical journals in 2017 and 2018 that reporte...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/jep.13313
更新日期:2020-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical studies show equivalent health outcomes from interventional procedures and treatment with medication only for stable angina patients. However, patients may be subject to overuse or access barriers for interventional procedures and may exhibit suboptimal adherence to medications....
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13341
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM. MATERIAL AND METHODS:A cross-sectional multicentric ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/jep.13257
更新日期:2019-12-01 00:00:00
abstract::The types of diseases, or categories of suffering, referred to as medically unexplained symptoms or syndromes (MUS) are the focus for the following commentary. Such cases seem to invite reflection. The very nature of such complex patterns of disease and suffering raises a number of fundamental epistemological and onto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12430
更新日期:2016-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Health-care professions have long been considered prone to work-related stress, yet recent research in Bulgaria indicates alarmingly high levels of burnout. Cloninger's inventory is used to analyse and evaluate correlation between personality characteristics and degree of burnout syndrome...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01895.x
更新日期:2012-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:In 2011 the module cardiometabolic risk of the Prevention Consultation guideline was introduced in the Netherlands in order to prevent cardiometabolic diseases. We aimed to compare attitudes and working methods of Dutch general practitioners (GPs) towards selective prevention of cardiomet...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12179
更新日期:2014-08-01 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