1,720,998 research outputs found
Proposal for a continuing medical education e-learning programme based on cochrane systematic reviews
No full textObjective: To design and pilot a Continuing Medical Education e-learning programme based on Cochrane systematic reviews. Our previous experience provided us a positive background to develop educational distance òearning intervention using standardized clinical vignettes to assess knowledge and to influence clinical practice.
Summary: In the first part we will present the Italian Cochrane Centre’s experience within a national e-learning programme. The programme has several elements: the translation and provision of a free copy of Clinical Evidence to all Italian physicians (n=248000); and the development of a free-access e-learning system (ECCE) for continuing medical education (CME), based on Clinical Evidence. Via ECCE doctors voluntarily subscribed to ECCE (11.8%). To have a better insight of this experience, please refer to: L. Moja, I. moschetti. A. Liberati et al. (2007) Using Clinical Evidence in a national continuing medical education programme in Italy. PLoS Med 4(5): e113.
In the second part of the workshop participants will be asked to discuss the feasibility of a CME programme based on Cochrane systematic reviews (SRs). Issues to be discussed are related to both organizational and methodological aspects: differences in CME legislation across countries; potential health professional targets, policies of access, how to transform a free from passion SR into a entertaining patient story, and how to involve SR authors in writing clinical vignettes.
In the last part of the workshop we will discuss if an e-learning programme may help the rapid dissemination of pivotal Cochrane SRs. The use of written case simulation transforms passive reading into a more interactive learning experience. We anticipated that such a CME programme could be an importante step in bringing evidence based medicine to the forefront of health professionals’ practice.
Intended audience: Representatives of Cochrane centres, branches and other entities who may have editorial interest in publishing e-learning educational programmes based on systematic review to target mass audiences. Intermediate knowledge of Cochrane reviews and evidence-based medicine teaching is expected
The future of clinical research : why do we need an ecological approach?
No full textIn this paper we try to define the future goals of the clinical research, with particular reference to methodological and policy issues. There is an increasing tension between the real drivers of clinical research and its scientific and ethical aims. To consumers the goal is to strengthen the relevance and usefulness of clinical research. This is possible only if consumers are empowered and actively involved. For the health care systems it is mandatory to re-engineer the process, enforcing national and international legislation. This should help to fill the research-clinical practice gap and to balance the research agenda, better reflecting health priorities. Finally the scientific community should reflect on its own conflicts of interests and analyse the causes of the ethical divide between the needs and the market. Scientists too often seem to loose sight of the original cumulative nature of research and of the idea of research as a collective good. More non-commercial research is needed, integrated with the health care systems, to support a transparent, more realistic and valid information useful for patient care, scientific information
Transferability of evidence based information driver by Clinical Evidence through an Italian continuing education programme on the web: a qualitative study
No full textManaging severe cancer pain: the role of transdermal buprenorphine : a systematic review
No full textPain is a frequent and important symptom in cancer patients. Among the available strong opioids, transdermal buprenorphine has been licensed in Europe since 2002, and results from a few clinical studies suggest that it may be a good alternative to the other oral or transdermal opioids. To assess the best available evidence on its efficacy and safety, we carried out a systematic literature review with the aim of pooling relevant studies. We identified 19 eligible papers describing 12 clinical studies (6 randomized controlled trials and 6 observational prospective studies), including a total of about 5000 cancer patients. Given the poor quality of reports and the heterogeneity of methods and outcomes, pooling was not feasible as the type of data was not appropriate for combining the results statistically. A meta-analysis based on individual data is ongoing in the context of the Cochrane Collaboration. In conclusion, although the narrative appraisal of each study suggests a positive risk benefit profile, well designed and statistically powered controlled clinical trials are needed to confirm this preliminary evidence
Online evidence-based practice point of care information sommaries : a content evaluation cross-sectional study
No full textBackground: Busy clinicians should have easy access to evidence-based information during their clinical practice. Publishing groups and institutions designed specific tools to meet doctor’s need, the so called ‘point of care’ products. Clinicians may strongly rely on these information resources and it is therefore important to assess their relevance and validity. Objectives: To describe online evidence-based practice point of care summaries and evaluate their broadness, content development, and editorial policy against their claims as ‘evidence-based’. Data Sources: To identify evidence based practice summaries we searched MEDLINE, Google, librarian association websites and scientific information conferences’ proceedings from January to December 2008. Summary Selection: We included English web-based summaries specifically designed to deliver pre-digested, rapidly accessible, comprehensive, periodically up-dated, and evidence-based information to clinicians. Data Extraction: Two investigators independently extracted data on general characteristics and content presentation of summaries. We assessed and ranked point of care products according to: coverage of medical conditions, editorial quality, and evidence-based methodology. The correlation among quality and quantity factors was explored. Data Synthesis: We retrieved 30 eligible evidence-based practice summaries. Eighteen products met our inclusion criteria and were qualitatively described and 16 provided sufficient data for the quantitative evaluation. The median coverage volume was 80.6% (interquartile range: 68.9 to 84.2%). The median editorial and evidence-based methodology scores were 8.0 (interquartile range: 5.8 to 10.3) and 10.0 (interquartile range: 1.0 to 12.8) according to a 15-point scale. None of the correlations analysed
– editorial quality, evidence-based methodology and volume – turned out to be significantly associated. Conclusions: Doctors can now have access to many different points of care summaries to support their clinical practice at the point of care. Some are at the top rank in one or two desirable aspects but none completely satisfied our criteria
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