Evidence-Based Medicine

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• Evidence-based medicine presupposes that we keep up-to-date, and makes it worthwhile to take trips around the perimeter of our knowledge; • Evidence-based medicine opens decision making processes to patients. EBM forms part of the multifaceted process of assuring clinical effectiveness, the main elements of which are: - Production of evidence through research and scientific review. - Production and dissemination of evidence-based clinical guidelines. - Implementation of evidence-based, cost-effective practice through education and management of change. - Evaluation of compliance with agreed practice guidance and patient outcomes – this process includes clinical audit. Disadvantages • It takes time to learn the methods and to put them into practice; • There is the financial cost of buying and maintaining equipment; • Medline and other electronic databases are not always comprehensive; • Authoritarian practitioners may find these methods threatening. • How do we balance cost and quality in healthcare • Where should investments be made that improve care in a cost effective way • How do we engage patients more responsibility in their care • How do we maintain and enhance the professional integrity of the caring professions • How do we narrow the gap between knowledge and practice The practice of evidence-based medicine is the starting point for answering these overarching questions. Evidence-based medicine is not cookbook medicine; it is a basis for the next generation of health delivery in the Gulf States. -24-
(Suggestive Guideline) STRATEGIC PLANNING IN THE GCC STATES FOR EVIDENCE-BASED MEDICINE Strategies Considering possible strategies to be adopted in promoting evidence-based health care (EBHC) in the GCC states, the following theoretical frameworks can be helpful in setting up activities at the central and peripheral levels of health care delivery: • Establishment of a national committee for EBM. • Advocacy (seek legal and political support for EBM). • Identify sources of financial support (government, organized private sector, donor agencies etc.). • Establishment of a reference e-library. • Launching of a local website dedicated to EBM. • Training (trainers, trainees). • Organize workshops and courses on EBM. At the Central Level: I- Establishment of a reference e-library: a) Vital introductory books (10-15 classical books) on how to practice and teach EBM. b) Basic important sources of evidence online and in print viz. the Cochrane library; Best Evidence; ACP Journal Club, Diagnostic Strategies for common medical problems (ed. Black et al) and Clinical Evidence. c) EBM websites; electronic databases (Medline, EMBASE, SAM, UP TO DATE etc.); electronic journals (JAMA, New England Journal of Medicine, The Lancet, British Medical Journal, etc.). II- Develop a local EBM website which is updated regularly. III- Establish a core of national and regional trainers. Can be facilitated by international, regional and national experts in the field of EBM. At the Peripheral (Regional/ District/ PHCC) level: I- Provide easy access to the e-library within the locality, with travel time not exceeding 15-30 minutes. -25-
Page 1 and 2: Highlights On Evidence-Based Medici
Page 3 and 4: -3-
Page 5 and 6: Index Contents Page No. - Preface t
Page 7 and 8: Preface to the Sixth Edition Praise
Page 9 and 10: EVIDENCE-BASED MEDICINE Introductio
Page 11 and 12: The practice of evidence-based medi
Page 13 and 14: A systematic review is a critical a
Page 15 and 16: Strength of Recommendation Taxonomy
Page 17 and 18: TABLE 2. Assessing Quality of Evide
Page 19 and 20: Strength of Recommendation Based on
Page 21 and 22: In order to obtain the best evidenc
Page 23: The following are all common source
Page 27 and 28: GLOSSARY OF TERMS IN EVIDENCE-BASED
Page 29 and 30: 9. Where the condition is acute and
Page 31 and 32: Cohort studies should not be includ
Page 33 and 34: Crossver-sectional Study The observ
Page 35 and 36: Experimental study A study in which
Page 37 and 38: I Incidence The number of new cases
Page 39 and 40: until the clinician and patient are
Page 41 and 42: O Observational studies Observation
Page 43 and 44: patients. POEMs are selected from r
Page 45 and 46: Prevalence The proportion of people
Page 47 and 48: Relative risk (RR) The number of ti
Page 49 and 50: Standardised mean difference (SMD)
Page 51 and 52: W Weighted mean difference (WMD) A
Page 53 and 54: Evidence-Based Medicine Resources A
Page 55 and 56: (with ACP Journal Club). The Cochra
Page 57 and 58: C- Resources that will help you to
Page 59 and 60: References For further readings 1.
Page 61 and 62: 28. Mulrow C, Cook D. Integrating h
Page 63 and 64: 58. Khoja TA. Glossary of Health Ca
Page 65 and 66: 85. Lorenz KA, Ryan GW, Morton CS.
Page 67 and 68: -67-

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