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How systematic reviews can reduce waste in research

11 Feb, 16 | by BMJ Clinical Evidence

Paul Glasziou

Iain ChalmersBy Paul Glasziou and Iain Chalmers

This blog was originally written for thebmj and posted on bmj.com/blogs

 

If you asked a member of the public “Should researchers review relevant, existing research systematically before embarking on further research?” they would probably be puzzled. Why would you ask a question with such an obvious answer? But in the current research system, researchers are only rarely required by research funders and regulators to do this. more…

Is 85% of health research really “wasted”?

11 Feb, 16 | by BMJ Clinical Evidence

Paul GlasziouIain ChalmersBy Paul Glasziou and Iain Chalmers

This blog was originally written for thebmj and posted on bmj.com/blogs

 

Our estimate that 85% of all health research is being avoidably “wasted” commonly elicits disbelief. Our own first reaction was similar: “that can’t be right?” Not only did 85% sound too much, but given that $200 billion per year is spent globally on health and medical research, it implied an annual waste of $170 billion. That amount ranks somewhere between the GDPs of Kuwait and Hungary. It seems a problem worthy of serious analysis and attention. But how can we estimate the waste? more…

PACK: Practical Approach to Care Kit – Bridging the EBM/local policy divide in Primary Care

14 Jan, 16 | by BMJ Clinical Evidence

Tracy Eastmanx150By Tracy Eastman

Primary health care is key to achieving the Millennium Development Goals and the broader goal of “health for all” by providing accessible, affordable and effective health care. Yet in many low and middle income countries (LMIC’s), primary health care is constrained by a lack of adequately skilled and supervised health workers.

The Knowledge Translation Unit (“KTU”) is a clinical research unit within the University of Cape Town Lung Institute (“UCTLI”) which has spent 15 years developing the Practical Approach to Care Kit (“PACK programme”) to support and empower nurses, doctors and other health workers working in primary healthcare. The programme has been scaled up countrywide in South Africa and is now used across more than 2000 clinics by more than 20,000 clinical staff. BMJ has partnered with the KTU to make the PACK programme available to assist in improving primary care services world-wide, and especially in underserved communities. more…

The Skeptics’ Guide to Emergency Medicine (SGEM)

16 Jul, 15 | by BMJ Clinical Evidence

By Ken Milne

Ken Milne

“It takes 50 years to get a wrong idea out of medicine, and 100 years a right one into medicine”. (Dr. John Hughlings Jackson – British Neurologist)

Dr. Jackson’s quote points out how long it can take for knowledge translation (KT) in medicine. More recent data suggests it can take an average of 17 years for 14% of medical information to reach the patient’s bedside.

This is far too long in the age of social media. Don’t panic! The goal of the Skeptics’ Guide to Emergency Medicine (SGEM) is to shorten that KT window down from over ten years to less than one year. more…

Fetal cell or stem cell derived treatment for Parkinson´s disease

4 Jun, 15 | by BMJ Clinical Evidence

by Arnar Astradsson and Tipu Z. Aziz

Arnar Astradsson pictureTipu Aziz.crop

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by the selective loss of nigrostriatal dopaminergic neurons which results in the cardinal symptoms of tremor, rigidity, bradykinesia and postural instability. The mainstay of therapy has been pharmacological substitution of dopamine using levodopa. However, after years of pharmacological therapy eventually the benefits may wear off and side effects such as dyskinesias may develop. Deep brain stimulation of the pallidum or subthalamic nucleus is also being used, which effectively controls the motor symptoms of Parkinson’s disease. As an alternative to pharmacological therapy or electrostimulation, cell-based therapies that reconstruct the nigrostriatal pathways have been developed with the transplantation of fetal ventral midbrain neurons into the striatum of PD patients. more…

A brief introduction to the concept of Evidence-Based Research

7 May, 15 | by BMJ Clinical Evidence

 

by Hans Lund

The scientific ideal
On 15th of February 1676, in a letter to his colleague (and rival) Robert Hooke, Sir Isaac Newton wrote the following well-known sentence: “If I have seen farther it is by standing on the shoulders of giants”. Newton referred to influential scientists before him such as Copernicus, Galilei and Kepler and emphasised one of the fundamental aspects of science – science is cumulative with each new discovery dependent on previous knowledge. more…

Evidence-Based Practice in Nursing in 2015: The Challenges

30 Apr, 15 | by BMJ Clinical Evidence

Alison Twycrossby Alison Twycross

I have been editor of Evidence-Based Nursing for the past five years.

Earlier this month I presented a paper at Evidence Live 2015 reflecting on my views about the challenges for evidence-based nursing in 2015. This Blog is a summary of that paper. more…

An EBM Challenge: When randomized trials are difficult, and belief is strong and hopeful

16 Apr, 15 | by BMJ Clinical Evidence

The case of so-called “moderate” drinking

by Richard Saitz

It is “bad” enough when we have randomized trials to guide practice. What I mean is, of course solid consistent evidence from numerous trials should be used to inform practice, but even then it is challenging: do the benefits outweigh the risks? Do the benefits in tightly controlled trials persist in practice? more…

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