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Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
This book presents a logical system of critical appraisal, to allow readers to evaluate studies and to carry out their own studies more effectively. This system emphasizes the central importance of cause and effect relationships. Its great strength is that it is applicable to a wide range of issues, and both to intervention trials and observational studies. This system unifies the often different approaches used in epidemiology, health services research, clinical trials, and evidence-based medicine, starting from a logical consideration of cause and effect. The author's approach to the issues of study design, selection of subjects, bias, confounding, and the place of statistical methods has been praised for its clarity and interest. Systematic reviews, meta-analysis, and the applications of this logic to evidence-based medicine, knowledge-based health care, and health practice and policy are discussed. Current and often controversial examples are used, including screening for prostate cancer, publication bias in psychiatry, public health issues in developing countries, and conflicts between observational studies and randomized trials. Statistical issues are explained clearly without complex mathematics, and the most useful methods are summarized in the appendix. The final chapters give six applications of the critical appraisal of major studies: randomized trials of medical treatment and prevention, a prospective and a retrospective cohort study, a small matched case-control study, and a large case-control study. In these chapters, sections of the original papers are reproduced and the original studies placed in context by a summary of current developments.
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
This book is open access under a CC BY license. This book is the first to develop explicit methods for evaluating evidence of mechanisms in the field of medicine. It explains why it can be important to make this evidence explicit, and describes how to take such evidence into account in the evidence appraisal process. In addition, it develops procedures for seeking evidence of mechanisms, for evaluating evidence of mechanisms, and for combining this evaluation with evidence of association in order to yield an overall assessment of effectiveness. Evidence-based medicine seeks to achieve improved health outcomes by making evidence explicit and by developing explicit methods for evaluating it. To date, evidence-based medicine has largely focused on evidence of association produced by clinical studies. As such, it has tended to overlook evidence of pathophysiological mechanisms and evidence of the mechanisms of action of interventions. The book offers a useful guide for all those whose work involves evaluating evidence in the health sciences, including those who need to determine the effectiveness of health interventions and those who need to ascertain the effects of environmental exposures.
The best-selling introduction to evidence-based medicine In a clear and engaging style, How to Read a Paper demystifies evidence-based medicine and explains how to critically appraise published research and also put the findings into practice. An ideal introduction to evidence-based medicine, How to Read a Paper explains what to look for in different types of papers and how best to evaluate the literature and then implement the findings in an evidence-based, patient-centred way. Helpful checklist summaries of the key points in each chapter provide a useful framework for applying the principles of evidence-based medicine in everyday practice. This fifth edition has been fully updated with new examples and references to reflect recent developments and current practice. It also includes two new chapters on applying evidence-based medicine with patients and on the common criticisms of evidence-based medicine and responses. How to Read a Paper is a standard text for medical and nursing schools as well as a friendly guide for everyone wanting to teach or learn the basics of evidence-based medicine.
Publisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice, 4th Edition Bernadette Mazurek Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN and Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN Enhance your clinical decision-making capabilities and improve patient outcomes through evidence-based practice. Develop the skills and knowledge you need to make evidence-based practice (EBP) an integral part of your clinical decision-making and everyday nursing practice with this proven, approachable text. Written in a straightforward, conversational style, Evidence-Based Practice in Nursing & Healthcare delivers real-world examples and meaningful strategies in every chapter to help you confidently meet today’s clinical challenges and ensure positive patient outcomes. NEW! Making Connections: An EBP Exemplar opens each unit, immersing you in an unfolding case study of EBP in real-life practice. NEW! Chapters reflect the most current implications of EBP on health policy and the context, content, and outcomes of implementing EBP competencies in clinical and academic settings. NEW! Learning objectives and EBP Terms to Learn at both the unit and chapter levels help you study efficiently and stay focused on essential concepts and vocabulary. Making EBP Real features continue to end each unit with real-world examples that demonstrate the principles of EBP applied. EBP Fast Facts reinforce key points at a glance. Clinical Scenarios clarify the EBP process and enhance your rapid appraisal capabilities.
"Appendix F_Nonresearch Evidence Appraisal Tool"--"Appendix G_Individual Evidence Summary Tool"--"Appendix H_Synthesis Process and Recommendations Tool" -- "Appendix I_Action Planning Tool" -- "Appendix J_Dissemination Tool
- NEW Mixed Methods Research chapter and emphasis covers this increasingly popular approach to research. - NEW! Expanded emphasis on qualitative research provides more balanced coverage of qualitative and quantitative methods, addressing the qualitative research methodologies that are often the starting point of research projects, particularly in magnet hospitals and DNP programs. - ENHANCED emphasis on evidence-based practice addresses this key graduate-level QSEN competency. - UPDATED emphasis on the most currently used research methodologies focuses on the methods used in both quantitative research and qualitative research, as well as outcomes research and mixed methods research. - NEW! Quick-reference summaries are located inside the book's covers, including a table of research methods on the inside front cover and a list of types of research syntheses (with definitions) inside the back cover. - NEW student resources on the Evolve companion website include 400 interactive review questions along with a library of 10 Elsevier research articles. - NEW! Colorful design highlights key information such as tables and research examples
Evidence Based Nursing is written in response to numerous requests by nurse practitioners and other graduate faculty for a nursing literature resource. This reader-friendly, accessible guide features plentiful examples from the nursing literature and the addition of specific nursing issues such as qualitative research, with direct application for clinical practice. The guide enables nurses to: frame their clinical questions in a way that will help them find the evidence to support their opinions; distinguish between strong and weak evidence; clearly understand study results; weigh the risks and benefits of management options; and apply the evidence to their individual patients to improve outcomes. Part One provides a basic approach to the problems faced by nurses when determining optimal care, predicting patient progress, and protecting patients from potentially harmful side effects, in addition to including a literature assessment summary and management recommendations. Part Two expands on Part One, providing concrete examples through case studies. This is the only book of its kind that helps nurses use the nursing literature effectively to solve patient problems. Three-step approach to dissecting a problem - to help find the best evidence and improve patient care, most questions can be divided into three parts: (1) Are the results valid? (2) What are the results? and (3) How can I apply the results to patient care? Part One - The Basics: Using the Nursing Literature provides a basic approach to the problems faced by nurses when determining optimal care, predicting patient progress, and protecting patients from potentially harmful side effects and includes a literature assessment summary and management recommendations. Part Two - Beyond the Basics: Using and Teaching the Principles of Evidence-Based Nursing expands on Part One, providing concrete examples through the presentation of cases. Two-part organization helps both beginners and those more accomplished at using the nursing literature. Clinical Scenario provides a brief but detailed description of a clinical situation that requires the application of research through a critical thinking process. Using the Guide examines a clinical scenario, and then evaluates the way in which research findings are collected, analyzed, and applied to the resolution of the problem presented in the scenario. Free CD-ROM contains everything found in the book, allowing for electronic outlining, content filtering, full-text searching, and alternative content organizations.
The accompanying CD-ROM contains clinical examples, critical appraisals and background papers.