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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

Herrick

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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…

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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