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Policy, practice, and politics

21 Apr, 16 | by BMJ Clinical Evidence

Van photoBy Van Charles Lansingh

In the advent of the Zika scare, it is clear that the need for evidence and sensationalism are difficult to balance, and due to the pressure from the media, many governments and various entities, responded in haste and with probably very little time to analyze their recommendations. A similar case was seen in the wake of the Ebola outbreak. The global community has seen and experienced the consequences: fear and confusion of managing and controlling a disease that has limited evidence and knowledge base, and lack of historical antecedents to support the actions taken.

However, we often do have the evidence more or less readily available to respond to the health information needs and to the requests from policy makers. Unfortunately, more often than not, this information is too complex and difficult to determine what is correct and what is simply popular belief. The plethora of publications makes it difficult to sift through and summarize, so that there is an adequate process of translation from evidence generated by researchers, to policy and practice. more…

Health research into practice – the role of social media

4 Feb, 16 | by BMJ Clinical Evidence

Stephen MaloneyBy Stephen Maloney

I found it interesting to  learn that the inspiration behind Twitter was when one of the founders, Jack Dorsey, thought it would be revolutionary to be able to send a text message to one number, and have it broadcast to many. I wonder if he could have envisaged the range of content that Twitter would end up disseminating, from valuable clinical evidence, to what celebrities are considering for breakfast. more…

GATE – a Graphic Appraisal Tool for Epidemiological studies

12 Nov, 15 | by BMJ Clinical Evidence

Rod Jackson head shotBy Rod Jackson

The Graphic Appraisal Tool for Epidemiological studies (GATE) is a simple, easily remembered toolkit to help you critically appraise epidemiological studies that includes one picture, two equations and three acronyms. GATE uses a picture of a triangle, circle, square and two arrows to represent the generic structure of epidemiological studies. We call this picture ‘the GATE frame.’ All common epidemiological study designs, from randomised controlled trials to case-control studies, can be illustrated using a GATE frame. While the GATE approach to critical appraisal covers the same ground as other critical appraisal guides, its point of difference is its generic graphic framework that emphasises the similarities between all study designs. With GATE, your goal is to ‘hang’ a study on the GATE frame as follows: more…

A gap in the evidence – What is the role of surgery in the patient with severe (secondary) Raynaud’s phenomenon?

21 May, 15 | by BMJ Clinical Evidence

by Ariane Herrick and Lindsay Muir




People with Raynaud’s phenomenon secondary to an underlying disease or condition (the best researched one being systemic sclerosis) can progress to irreversible tissue injury with ulceration and/or critical ischaemia and gangrene. Although there has been increasing interest in recent years in identifying new drug therapies for severe Raynaud’s phenomenon with randomised controlled trials (RCTs) of, for example, phosphodiesterase inhibitors and endothelin receptor antagonists, the recent BMJ Clinical Evidence overview identified no RCTs of any of the surgical procedures that  have been advocated for advanced peripheral vascular disease. more…

The way forward from ‘rubbish’ to ‘real’ EBM in the wake of Evidence Live 2015

24 Apr, 15 | by BMJ Clinical Evidence

by Huw LlewelynHuw Llewelyn

At Evidence Live, Iona Heath (video) reminded us that EBM should not interfere with wisdom and common sense. Trish Greenhalgh (video) gave a hilarious example of ‘rubbish EBM’ when a ‘falls protocols for elders’ was invoked after she went over her bicycle handlebars at speed! The answer is to arrive at initial impressions and decisions based on one’s current knowledge and then AFTERWARDS to check them against transparent reasoning and evidence. more…

Addressing gaps in evidence

9 Apr, 15 | by BMJ Clinical Evidence

?????????????????????????????????????????????????????????????????????????Evidence-based medicine (EBM) is an approach that—in addition to clinical experience and patient preferences—takes into account existing research evidence to draw conclusions on the best approach for the care of individual patients. It is a key tool for clinical decision making as the need to balance research, new tests and treatments, and available resources with clinical experience and patient requirements continues to be an important focus in healthcare. more…

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