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121. How does evidence affect clinical decision-making?

How does evidence affect clinical decision-making? How does evidence affect clinical decision-making? | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search (...) for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here How does evidence affect clinical decision-making? Article Text Original EBM Research How does evidence affect clinical decision-making? Paul Fontelo , Fang Liu , Raymonde C Uy Statistics from Altmetric.com Extract In 1998, the ‘Evidence Cart’ was introduced to provide decision support tools

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2015 Evidence-Based Medicine (Requires free registration)

122. A SHARED study-the benefits and costs of setting up a health research study involving lay co-researchers and how we overcame the challenges (PubMed)

has been to develop recommendations led by service users for health and social care professionals to use at hospital discharge and in care planning for people living with memory loss and their carers. This article is about how the study started and the benefits, costs and challenges we encountered as the lead and lay co-researchers. Once we were successful with the grant application, we had to recruit and train the lay co-researchers and obtain various approvals before we could start the project (...) A SHARED study-the benefits and costs of setting up a health research study involving lay co-researchers and how we overcame the challenges In the United Kingdom (UK), official bodies such as the Department of Health and research funders such as the National Institute for Health Research support and encourage lay involvement in all stages of research studies. The SHARED study has had substantial patient and public involvement (PPI) from developing the idea to dissemination. The aim of the study

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2016 Research involvement and engagement

123. My BMJ editorial: how can we stop academic press releases misleading the public?

My BMJ editorial: how can we stop academic press releases misleading the public? My BMJ editorial: how can we stop academic press releases misleading the public? – Bad Science Search TED Talk Collected Journalism This Nerdy Book This Great Book T-shirts Categories (3) (4) (6) (45) (28) (6) (16) (190) (5) (20) (52) (88) (2) (1) (2) (1) (677) (4) (14) (2) (37) (4) (9) (3) (11) (6) (3) (16) (13) (1) (6) (8) (6) (6) (3) (13) (2) (2) (27) (1) (2) (6) (1) (7) (8) (3) (1) (4) (12) (1) (3) (20) (2) (13 (...) press release from Great Ormond Street Hospital, the head of that institution wrote a paranoid and misguided defense (which I have proudly reprinted, in my , in full). Anyway, I wrote an editorial in the BMJ to accompany this new research paper, and I make a series of recommendations about how we can stop academics and their institutions misleading the public. These ideas revolve largely around transparency and shame. The research paper is free to access, my editorial is paywalled for now

2014 Bad Science

124. My BMJ editorial: how can we stop academic press releases misleading the public?

My BMJ editorial: how can we stop academic press releases misleading the public? My BMJ editorial: how can we stop academic press releases misleading the public? – Bad Science Search TED Talk Collected Journalism This Nerdy Book This Great Book T-shirts Categories (3) (4) (6) (45) (28) (6) (16) (190) (5) (20) (52) (88) (2) (1) (2) (1) (677) (4) (14) (2) (37) (4) (9) (3) (11) (6) (3) (16) (13) (1) (6) (8) (6) (6) (3) (13) (2) (2) (27) (1) (2) (6) (1) (7) (8) (3) (1) (4) (12) (1) (3) (20) (2) (13 (...) press release from Great Ormond Street Hospital, the head of that institution wrote a paranoid and misguided defense (which I have proudly reprinted, in my , in full). Anyway, I wrote an editorial in the BMJ to accompany this new research paper, and I make a series of recommendations about how we can stop academics and their institutions misleading the public. These ideas revolve largely around transparency and shame. The research paper is free to access, my editorial is paywalled for now

2014 Bad Science

125. How to do it. Apply for a research grant. (PubMed)

How to do it. Apply for a research grant. 728716 1979 03 28 2016 11 23 0007-1447 2 6151 1978 Dec 02 British medical journal Br Med J How to do it. Apply for a research grant. 1553-4 Howie J J eng Journal Article England Br Med J 0372673 0007-1447 AIM IM Research Support as Topic United Kingdom 1978 12 2 1978 12 2 0 1 1978 12 2 0 0 ppublish 728716 PMC1608768

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1978 British medical journal

126. Negative affect, message reactance and perceived risk: how do pictorial cigarette pack warnings change quit intentions? (PubMed)

Negative affect, message reactance and perceived risk: how do pictorial cigarette pack warnings change quit intentions? Pictorial warnings on cigarette packs increase motivation to quit smoking. We sought to examine the potential mediating role of negative affect, message reactance (ie, an oppositional reaction to a message) and perceived risk in shaping quit intentions.In 2014 and 2015, we randomly assigned 2149 adult US smokers to receive either pictorial warnings or text-only warnings (...) by increasing negative affect. Message reactance partially attenuated this increase in intentions. The opposing associations of negative affect and reactance on perceived risk may explain why pictorial warnings did not lead to observable changes in perceived risk.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

2018 Tobacco Control

127. How do time trends in inhospital mortality compare? A retrospective study of England and Scotland over 17 years using administrative data. (PubMed)

How do time trends in inhospital mortality compare? A retrospective study of England and Scotland over 17 years using administrative data. To examine the trends in inhospital mortality for England and Scotland over a 17-year period to determine whether and if so to what extent the time trends differ after controlling for differences in the patients treated.Analysis of retrospective administrative hospital data using descriptive aggregate statistics of trends in inhospital mortality (...) (elective and emergency), we examine aggregate time trends of the proportion of patients who die in hospital and a binary variable indicating whether an individual patient died in hospital or survived, and how that indicator is influenced by the patient's characteristics, the year and the country (England or Scotland) in which they were admitted.Inhospital mortality has declined in both countries over the period studied, for both elective and emergency admissions, but has declined more in England than

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2018 BMJ open

128. How Does Orthopaedic Research Affect Patient Care? (PubMed)

How Does Orthopaedic Research Affect Patient Care? Academic medicine hinges on high-quality results from research. Surgeon scientists spend their career acquiring grants, writing papers, and educating a next generation of scientists. The real question is how well are we at playing this game? Does our research change surgical practice or affect patient care or government policy? Ideally, published research does and will continue to shape the way care is delivered. Key questions remain, however (...) ; what is the return on research investment in orthopaedics? How can surgeons decide which "evidence" matters, and does practice-change only refer to Level I evidence (randomized trials)? This review considers all these questions.

2018 Journal of Orthopaedic Trauma

129. How can emergency physicians harness the power of new technologies in clinical practice and education? (PubMed)

to the emergency clinician. This paper outlines areas of our practice that are already changing and speculates on how we might need to prepare our workforce for a technologically enhanced future.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. (...) How can emergency physicians harness the power of new technologies in clinical practice and education? As the Royal College of Emergency Medicine looks back on 50 years of progress towards the future it is clear that new and emerging technologies have the potential to substantially change the practice of emergency medicine. Education, diagnostics, therapeutics are all likely to change as algorithms, personalised medicine and insights into complexity become more readily available

2018 Emergency Medicine Journal

130. Undergraduate medical students' behavioural intentions towards medical errors and how to handle them: a qualitative vignette study. (PubMed)

to adequately deal with errors. Educators need to introduce knowledge and skills on how to deal with errors and emotional preparedness for errors into undergraduate medical education.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. (...) Undergraduate medical students' behavioural intentions towards medical errors and how to handle them: a qualitative vignette study. In undergraduate medical education, the topics of errors in medicine and patient safety are under-represented. The aim of this study was to explore undergraduate medical students' behavioural intentions when confronted with an error.A qualitative case vignette survey was conducted including one of six randomly distributed case scenarios in which a hypothetical

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2018 BMJ open

131. How does the outcome of research training fellowships funded via the NHS compare with that from competitively funded fellowships from the MRC and other charities: a cross-sectional retrospective survey of trainees undertaking research training in the West (PubMed)

How does the outcome of research training fellowships funded via the NHS compare with that from competitively funded fellowships from the MRC and other charities: a cross-sectional retrospective survey of trainees undertaking research training in the West This study aimed to investigate the impact of research training funded via the National Health Service (NHS) on medical trainees compared with traditional clinical research training fellowships (CRTFs).Online survey of 221 clinical trainees (...) participants to successfully achieve a higher degree.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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2018 BMJ open

132. How a symbol influenced this patient encounter

to begin my line of questioning. I smiled at the boy and asked how he was doing. He responded with an indifferent, “Fine.” I then began to ask him the usual questions essential for an HPI (history of present illness), but I couldn’t take my mind off the fact that he was wearing a symbol that I felt characterized a tradition filled with rebellion and hatred. What troubled me even more was that as a kid, he had already been exposed to and taught to support what the Confederacy stood for. Granted, I may (...) How a symbol influenced this patient encounter How a symbol influenced this patient encounter How a symbol influenced this patient encounter | | February 1, 2018 151 Shares I lightly knocked on the door of the next patient that I was set to obtain a history from. It was late in the morning in the middle of the week, and my mind was becoming increasingly preoccupied with deciding what to eat for lunch. My preceptor had allowed me to practice my history-taking skills with every patient that had

2018 KevinMD blog

133. The story of how this physician got into debt

The story of how this physician got into debt The story of how this physician got into debt The story of how this physician got into debt | | January 19, 2018 97 Shares When I was a young lad, just heading off to college, I had no debt. I had no credit cards. My family didn’t use debt for purchases other than buying our house. I really didn’t have any knowledge about how to best use debt. My student loan package included a scholarship, a work-study program and $1,500 a year in student loans. I (...) where that was heading so I joined the Navy, and Uncle Sam paid for the remaining three years of medical school expenses, with enough extra to pay for the necessities of life. I also took on a part-time job in the evenings covering the phones at a local multi-specialty clinic. Life was good, and I was temporarily broke. At that time, my student loan payments were in deferment and not accumulating any interest. I borrowed money, but didn’t need to pay anything back yet. How sweet. During my residency

2018 KevinMD blog

134. End-of-life care in the Western world: where are we now and how did we get here? (PubMed)

End-of-life care in the Western world: where are we now and how did we get here? Recent movements in end-of-life care emphasise community care for the dying; however, integrating community with medical care continues to be a work in progress. Historically tracing brain hemispheric dominance, Ian McGilchrist believes we are overemphasising functionality, domination and categorisation to the detriment of symbolism, empathy and connectedness with others. The aim of this historical review (...) of what seems a rather simple change in end-of-life care.We must question whether it is possible to hand death responsibilities back to the community when medical services have largely assumed this responsibility in countries supporting individualism, secularism and materialism.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

2018 BMJ Supportive & Palliative Care

135. Resident Autonomy in the Operating Room: How Faculty Assess Real-time Entrustability. (PubMed)

Resident Autonomy in the Operating Room: How Faculty Assess Real-time Entrustability. This study aimed to identify the empirical processes and evidence that expert surgical teachers use to determine whether to take over certain steps or entrust the resident with autonomy to proceed during an operation.Assessing real-time entrustability is inherent in attending surgeons' determinations of residents' intraoperative autonomy in the operating room. To promote residents' autonomy, it is necessary (...) to understand how attending surgeons evaluate residents' performance and support opportunities for independent practice based on the assessment of their entrustability.We conducted qualitative semi-structured interviews with 43 expert surgical teachers from 21 institutions across 4 regions of the United States, using purposeful and snowball sampling. Participants represented a range of program types, program size, and clinical expertise. We applied the Framework Method of content analysis to iteratively

2018 Annals of Surgery

136. How Participants Perceive Biomedical Research in Pulmonology

How Participants Perceive Biomedical Research in Pulmonology How Participants Perceive Biomedical Research in Pulmonology - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. How Participants Perceive Biomedical (...) Hospital, Montpellier Information provided by (Responsible Party): University Hospital, Montpellier Study Details Study Description Go to Brief Summary: The primary objective of this study is to determine how biomedical research is perceived by patients already participating in a pulmonology research project. Condition or disease Intervention/treatment Biomedical Research Other: Questionnaire Detailed Description: Over time, clinical research has become a challenge both in terms of public health

2018 Clinical Trials

137. How do iLead? Validation of a scale measuring active and passive implementation leadership in Swedish healthcare. (PubMed)

How do iLead? Validation of a scale measuring active and passive implementation leadership in Swedish healthcare. This study aims to describe the creation of a scale-the iLead scale-through adaptations of existing domain-specific scales that measure active and passive implementation leadership, and to describe the psychometric properties of this scale.Data collected from a leadership intervention were used in this validation study. Respondents were 336 healthcare professionals (90% female (...) consistency and convergent, discriminant and criterion-related validity were all satisfactory.The iLead scale is a valid measure of implementation leadership and is a tool for understanding how active and passive leader behaviours influence an implementation process. This brief scale may be particularly valuable to apply in training focusing on facilitating implementation, and in evaluating leader training. Moreover, the scale can be useful in evaluating various leader behaviours associated

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2018 BMJ open

138. How do ED patients with criminal justice contact compare with other ED users? A retrospective analysis of ED visits in California. (PubMed)

How do ED patients with criminal justice contact compare with other ED users? A retrospective analysis of ED visits in California. To assess the patterns of emergency department (ED) utilisation among those with and without criminal justice contact in California in 2014, comparing variation in ED use, visit frequency, diagnoses and insurance coverage.Retrospective, cross-sectional study.Analyses included ED visits to all licensed hospitals in California using statewide data on all ED encounters (...) utilisation among this group.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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2018 BMJ open

139. How writing fiction can free physicians

a physician reacts to stress; I can explore how he or she deals with a missed diagnosis that may be haunting, or manages an especially difficult patient. After all, a simple sore throat can be a sign of leukemia, and a depressed patient may cause self-harm. Though such scenarios are rare, giving them consideration in story form can allow doctors to better deal with such issues in the real world. Making doctors real Fiction grants physicians the opportunity to show sides of their lives that patients don’t (...) How writing fiction can free physicians How writing fiction can free physicians How writing fiction can free physicians | | April 12, 2018 33 Shares Every person working in medicine has stories to tell, and sharing those stories is a great way to process grief or stress, celebrate triumphs, vent, move on or think more deeply. Occasionally, writing about an experience helps others facing a similar situation. True narratives of and reflections on medicine are now encouraged, honored, promoted

2018 KevinMD blog

140. From in vivo to in vitro: How the Guatemala STD Experiments Transformed Bodies Into Biospecimens. (PubMed)

From in vivo to in vitro: How the Guatemala STD Experiments Transformed Bodies Into Biospecimens. Policy Points: While most scholarship regarding the US Public Health Service's STD experiments in Guatemala during the 1940s has focused on the intentional exposure experiments, secondary research was also conducted on biospecimens collected from these subjects. These biospecimen experiments continued after the Guatemala grant ended, and the specimens were used in conjunction with those from

2018 Milbank Quarterly

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