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  1. Fulltext. Are therapeutic decisions supported by evidence from health care research ?

    Article - En anglais

    Fulltext.

    Background 

    One of the most common decisions physicians face is deciding which therapeutic intervention is the most appropriate for their patients.

    In recent years much emphasis has been placed on making clinical decisions that are based on evidence from the medical literature.

    Despite the emphasis on incorporation of evidence-based medicine into the undergraduate curriculum and postgraduate medical training programs, there has been controversy regarding the proportion of interventions that are supported by health care research.

    Objective 

    To investigate the proportion of major therapeutic interventions at our institution that are justified by published evidence.

    Methods 

    One hundred fifty charts from the internal medicine department were reviewed retrospectively.

    The main diagnosis, therapy provided, and patient profile were identified and a literature search using MEDLINE was performed.

    A standardized search strategy was developed with high sensitivity and specificity for identifying publication quality.

    The level of evidence to support each clinical decision was ranked according to a predetermined classification.

    In this system there were 6 distinct levels, which are explained in the study.

    Results 

    Of the decisions studied, 20.9% could be supported by placebo-controlled randomized trials and 43.9% by head-to-head trials.

    Half of these were shown to be significantly superior to the treatment against which it was being compared. (...)

    Mots-clés Pascal : Décision, Choix, Modalité traitement, Recherche, Bibliographie, Rétrospective, Traitement, Homme, Etude comparative, Revue bibliographique

    Mots-clés Pascal anglais : Decision, Choice, Application method, Research, Bibliography, Retrospective, Treatment, Human, Comparative study, Bibliographic review

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0387979

    Code Inist : 002B30A09. Création : 25/01/1999.