Skip to main content

Evidence-based medicine as a strategy for improving the quality of clinical decision making for dialysis patients

  • Chapter
Quality Assurance in Dialysis

Part of the book series: Developments in Nephrology ((DINE,volume 39))

  • 155 Accesses

Abstract

Traditional clinical decision making has been based on information provided by clinical experts, usually during undergraduate and post graduate training, and then supplemented by formal continuing medical education and informally through consultations. There is an implicit assumption that the need for scientific information is satisfied by this process. However, there is convincing evidence that this assumption is incorrect [1]. The opinion of experts is often inconsistent with scientific evidence [2]. In response to this unsatisfactory situation, the concept of evidence-based medicine has evolved [3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Williamson JW, German PS, Weiss R, Skinner EA and Bowes F. Health science information management and continuing education of physicians: a survey of US primary dare physicians and their opinion leaders. Ann Intern Med 1989; 110:151–60

    PubMed  CAS  Google Scholar 

  2. Antman EM, Lao J, Kupelnick B, Mosteller F and Chalmers TC. A comparison of results of meta-analysies of randomized control trials and recommendations of clinical experts; treatments for myocardial infarction. JAMA 1992; 268:240–8

    Article  PubMed  CAS  Google Scholar 

  3. Evidence-Based Medicine Working Group. Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA 1992; 268:2420–5.

    Article  Google Scholar 

  4. Kuhn TS. The structure of scientific revolutions. Chicago, Ill: University of Chicago Press; 1970.

    Google Scholar 

  5. Carruthers SG, Larochelle P, Haynes RB, Petrasovits A and Schiffrin EL. Report of the Canadian hypertension society concensus conference: 1. Introduction. Can Med Asoc J 1993; 149:289–93

    CAS  Google Scholar 

  6. Oxman AD, Sackett DL, Guyatt GH for the Evidence-Based Medicine Working Group.Users guides to the medical literature. 1. How to get started. JAMA 1993; 270:2093–5.

    Article  PubMed  CAS  Google Scholar 

  7. Haynes RB, McKibbon K.A, Fitzgerald D, Guyatt GH, Walker CJ and Sackett DL. How to keep up with the medical literature, V access by personal computer to the medical literature. Ann Intern Med 1990; 112:78–84.

    PubMed  CAS  Google Scholar 

  8. Guyatt GH, Sackett DL, Cook DJ for the Evidence-Based Medicine Working Group. Users guides to the medical literature. II How to use an article about therapy or prevention. A. Are the results of the study valid? JAMA 1993; 270: 2598–601.

    Article  PubMed  CAS  Google Scholar 

  9. Guyatt GH, Sackett DL, Cook DL for the Evidence-Based Medicine Working Group. Users guides to the medical literature. II How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? JAMA 1994; 271:59–63.

    Article  PubMed  CAS  Google Scholar 

  10. Chalmers TC, Celano P, Sacks HS and Smith H Jr. Bias in treatment assignments in controlled clinical trials. N Engl J Med 1983; 309:1358–61.

    Article  PubMed  CAS  Google Scholar 

  11. Colditz GA, Miller JN and Mosteller F. How study design affects outcomes in comparisons of therapy, I. Medical. Stat Med 1989; 8:441–54.

    Article  CAS  Google Scholar 

  12. Haynes RB, Mukherjee J, Sackett DL, Taylor DW, Barnett HJM and Peerless SJ. Functional status changes following medical or surgical treatment for cerebral ischemia: results in the EC/IC Bypass Study. JAMA 1987; 257:2043–6.

    Article  PubMed  CAS  Google Scholar 

  13. Oxman AD and Guyatt GH. A consumer’s guide to subgroup analysis. Ann Intern Med 1992; 116: 78–84.

    PubMed  CAS  Google Scholar 

  14. Oxman AD, Cook DJ, Guyatt GH for the Evidence-Based Medicine Working Group. Users’ guides to the medical literature. VI. How to use an overview. JAMA 1994; 272:1367–71.

    Article  PubMed  CAS  Google Scholar 

  15. Chalmers TC, Berrier J, Sacks HS et al: Meta-analysis of clinical trials as a scientific discipline, II: replicate variability and comparison of studies that agree and disagree. Stat Med 1987; 6: 733–44.

    Article  PubMed  CAS  Google Scholar 

  16. Klahr S, Levey AD, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW, Striker G for the Modification of Diet in Renal Disease Study Group. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. N Engl J Med 1994; 330: 877–44

    Article  PubMed  CAS  Google Scholar 

  17. Mehta R, McDonald B, Gabbi F, Pahl M, Farkas A, Pascual M, Fowler W for the ARF Collaborative Study Group. Continuous versus intermittent dialysis for acute renal failure in the ICU. J Am Soc Nephrol 1996; 7:1457 (abstract).

    Google Scholar 

  18. Levey AS, Adler S, Caggiula AW, England BK, Greene T, Hunsicker LG et al. Effects of dietary protein restriction on the progression of advanced renal disease in the Modification of Diet in Renal Disease Study. Am J Kidney Dis 1996; 27:652–63.

    PubMed  CAS  Google Scholar 

  19. Pedrini MT, Levey AS, Lau J, Chalmers TC and Wang PH. The effect of dietary protein restriction on the progression of diabetic and non-diabetic renal diseases: a meta-analysis. Ann Intern Med 1996; 124:627–32.

    PubMed  CAS  Google Scholar 

  20. Browman GP, Levine MN, Mohide EA, Hayward RS, Pritchard KJ, Gafni A et al: The practice guidelines developement cycle: a conceptual tool for practice guidelines development and implementation. J Clin Oncol 1995; 13:502–12

    PubMed  CAS  Google Scholar 

  21. Davis DA and Taylor-Vaisey A. Translating guidelines into practice: a systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. Can Med Assoc J 1997; 157:408–16.

    CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Kluwer Academic Publishers

About this chapter

Cite this chapter

Churchill, D.N. (1999). Evidence-based medicine as a strategy for improving the quality of clinical decision making for dialysis patients. In: Henderson, L.W., Thuma, R.S. (eds) Quality Assurance in Dialysis. Developments in Nephrology, vol 39. Springer, Dordrecht. https://doi.org/10.1007/978-0-585-28312-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-0-585-28312-8_1

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-0-7923-5281-5

  • Online ISBN: 978-0-585-28312-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics