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Clinical Informatics Board Review and Self Assessment pp 71–90Cite as

2.2 Evidence-Based Patient Care

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Abstract

Many sources of evidence exist between the anecdotal experience of expert clinicians and quality studies that are done at individual institutions. This chapter deals primarily with published sources of evidence, such as journal articles and books. When faced with a journal article or textbook chapter, the informaticist must be able to critically analyze the presented information to assess its value.

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Notes

  1. 1.

    Unlike most other chapters, you will note that this one and the next one, Sect. 2.2.2 Evidence Grading, are full of references. Most are available for free on PubMed Central.

  2. 2.

    Some people refer to this as journal club nihilism which is the belief that nothing could ever be learned from published scientific research.

  3. 3.

    Chipman AD, Ferrier DEK, Brena C, Qu J, Hughes DST, Schröder R, et al. (2014) The First Myriapod Genome Sequence Reveals Conservative Arthropod Gene Content and Genome Organisation in the Centipede Strigamia maritima. PLoS Biol 12(11): e1002005.

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    Nah, F, “A Study on Tolerable Waiting Time: How Long Are Web Users Willing to Wait?” (2003). AMCIS 2003 Proceedings. Paper 285.

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    Kudenchuk PJ, Cobb LA, Copass MK, Cummins RO, Doherty AM, Fahrenbruch CE, Hallstrom AP, Murray WA, Olsufka M, Walsh T. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med. 1999 Sep 16;341(12):871–8.

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    Komatsu R, You J, Mascha EJ, Sessler DI, Kasuya Y, Turan A. Anesthetic induction with etomidate, rather than propofol, is associated with increased 30-day mortality and cardiovascular morbidity after noncardiac surgery. Anesth Analg. 2013 Dec;117(6):1329–37.

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    Tekwani KL, Watts HF, Sweis RT, Rzechula KH, Kulstad EB. A comparison of the effects of etomidate and midazolam on hospital length of stay in patients with suspected sepsis: a prospective, randomized study. Ann Emerg Med. 2010;56:481–489.

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    Gu WJ, Wang F, Tang L, Liu JC. Single-dose etomidate does not increase mortality in patients with sepsis: a systematic review and meta-analysis of randomized controlled trials and observational studies. Chest. 2015 Feb;147(2):335–46.

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    Chan CM1, Mitchell AL, Shorr AF. Etomidate is associated with mortality and adrenal insufficiency in sepsis: a meta-analysis. Crit Care Med. 2012 Nov;40(11):2945–53.

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    Verweij KE, van Buuren H. Oriental cholangiohepatitis (recurrent pyogenic cholangitis): a case series from the Netherlands and brief review of the literature. Neth J Med. 2016 Nov;74(9):401–405.

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    Colli JL, Colli A. International comparisons of prostate cancer mortality rates with dietary practices and sunlight levels. Urologic Oncology 2006:24;184–194.

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    Boisjoly H, Gresset J, Fontaine N, et al. The VF-14 index of functional visual impairment in candidates for a corneal graft. Am J Ophthalmol. 1999 Jul;128(1):38–44.

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    Othman N, Vitry A, Roughead EE. Quality of Pharmaceutical Advertisements in Medical Journals: A Systematic Review. PLoS One. 2009; 4(7): e6350.

  14. 14.

    Calculation of p-values and confidence intervals is beyond the scope of the exam, but you should know what they mean and how to use them.

  15. 15.

    http://sumed.sun.ac.za/Portals/0/Repository/Medical-Statistics-Made-Easy.3f8ceb88-f35b-4f29-8d70-17e78ce071d8.pdf

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    Loiselle F1, Mahabir RC, Harrop AR. Levels of evidence in plastic surgery research over 20 years. Plast Reconstr Surg. 2008 Apr;121(4):207e–11e.

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    Grading quality of evidence and strength of recommendations. GRADE Working Group. BMJ. 2004 Jun 19; 328(7454): 1490.

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    The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels. Sacks FM, Pfeffer MA, Moye LA, et al. N Engl J Med 1996; 335:1001–1009.

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    Echt DS, Liebson PR, Mitchell LB, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The cardiac arrhythmia suppression trial. N Engl J Med 1991;324: 781–8

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    Tanne, JH. Mortality higher at for-profit hospitals. BMJ. 2002 Jun 8; 324(7350): 1351.

  21. 21.

    Consensus report, Institute of Medicine. Clinical practice guidelines we can trust. March 23, 2011. http://www.iom.edu/Reports/2011/Clinical-Practice-Guidelines-We-Can-Trust.aspx (Accessed on January 13, 2012).

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    Graham R, Mancher M, Wolman DM, Greenfield S, Steinberg E, Eds. Clinical practice guidelines we can trust. Institute of Medicine. 2011. National Academies Press, Washington, DC.

  23. 23.

    Sox HC. Defining comparative effectiveness research: the importance of getting it right. Med Care. 2010 Jun;48(6 Suppl):S7–8.

  24. 24.

    Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ 2010; 182:E839.

  25. 25.

    Moulding NT, Silagy CA, Weller DP. A framework for effective management of change in clinical practice: dissemination and implementation of clinical practice guidelines, Qual Health Care. 1999 Sep; 8(3): 177–183.

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    Macdonald G. Communication theory and health promotion. In: Bunton R, Macdonald G, editors. Health promotion: disciplines and diversity. London: Routledge, 1992.

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    Wise CG, Billi JE. A model for practice guideline adaptation and implementation: empowerment of the physician. Jt Comm J Qual Improv. 1995 Sep;21(9):465–76.

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    Oxman AD, Thomson MA, Davis DA, Haynes RB. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ. 1995 Nov 15;153(10):1423–31.

  29. 29.

    Factors influencing the implementation of clinical guidelines for health care professionals: A systematic meta-review. Anneke L Francke, Marieke C Smit, Anke JE de Veer, Patriek Mistiaen, BMC Medical Informatics and Decision Making 2008 8:38.

  30. 30.

    With approximately 40,000 searches per second, Google is the most famous IR company in the world.

  31. 31.

    See https://www.nlm.nih.gov/bsd/medline_lang_distr.html

  32. 32.

    Suomela BP, Andrade MA. Ranking the whole MEDLINE database according to a large training set using text indexing. BMC Bioinformatics. 2005; 6: 75.

  33. 33.

    It is also possible to start with the 2343 documents which contain renal disease and then weed out those that do not carry the hypertension tag, however, this can also create additional complexity which is beyond the scope of this book. For much more information, see https://docs.oracle.com/database/121/TGSQL/tgsql_optcncpt.htm

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  1. East Orange General Hospital, East Orange, New Jersey, USA

    Scott Mankowitz

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Correspondence to Scott Mankowitz .

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  1. East Orange General Hospital, East Orange, NJ, USA

    Scott Mankowitz

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Mankowitz, S. (2018). 2.2 Evidence-Based Patient Care. In: Mankowitz, S. (eds) Clinical Informatics Board Review and Self Assessment. Springer, Cham. https://doi.org/10.1007/978-3-319-63766-2_4

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  • DOI: https://doi.org/10.1007/978-3-319-63766-2_4

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