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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…

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…

Trigeminal neuralgia – gaps in evidence

14 May, 15 | by BMJ Clinical Evidence

by Joanna M. Zakrzewska and Mark E. Linskey

Trigem imageTrigeminal neuralgia is a rare condition that causes excruciating intermittent short-lasting, usually unilateral facial pain especially provoked by light touch.
Although the criteria for diagnosis appear to be clear cut, there have been no case control studies to validate them, and there is no cohort data on progression of the disorder. This is especially important as—while the disorder is generally progressive over time—in more than 50% of cases this progression is interspersed with unpredictable remissions that can last 6 months or longer. more…

Clinical Evidence for the Brave New World on Multimorbidity

12 Mar, 15 | by BMJ Clinical Evidence

by Victor Montori

The most common chronic condition worldwide is, or will soon be, multimorbidity. Previously a concern reserved to the very old, multimorbidity increasingly affects younger people. A prevalence study in Scotland found that the average middle age person is no longer a healthy one, but a patient with at least one chronic condition; 1 in 4 had two chronic conditions. As the population ages, the proportion with multimorbidity approaches universality. As the evidence, often obtained in people with a paucity of comorbidities, gets incorporated into practice guidelines, guideline panels face a key task. more…

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