Clinical expertise in the era of evidence-based medicine and patient choice

Rb, Haynes; Devereaux, PJ; Gh, Guyatt

doi:10.7326/acpjc-2002-136-2-a11

Cited by 182 publications

(6 citation statements)

References 6 publications

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“…As one moves down the pyramid, there is more evidence, but the quality may decrease [18]. There are different versions of the evidence pyramid, including the 4S [19], 5S [20], 6S [21], or 9S pyramid [18], which can lead to confusion. The multitude of different pyramid models highlights the need for clarity in understanding and navigating these models.…”

Section: Evidence-based Practice: Unfolding the Mapmentioning

confidence: 99%

“…Practitioners play a critical role in translating research findings into practice because they can use their knowledge and experience to select the most relevant and reliable information for their practice. They can then use their expertise to tailor research findings to the unique needs and situations of individual clients [19].…”

Section: The Pursuit Of Expertise In Evidence-based Practicementioning

confidence: 99%

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Knowledge in Motion: A Comprehensive Review of Evidence-Based Human Kinetics

Ramalho

Petrica

2023

IJERPH

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This comprehensive review examines critical aspects of evidence-based human kinetics, focusing on bridging the gap between scientific evidence and practical implementation. To bridge this gap, the development of tailored education and training programs is essential, providing practitioners with the expertise and skills to effectively apply evidence-based programs and interventions. The effectiveness of these programs in improving physical fitness across all age groups has been widely demonstrated. In addition, integrating artificial intelligence and the principles of slow science into evidence-based practice promises to identify gaps in knowledge and stimulate further research in human kinetics. The purpose of this review is to provide researchers and practitioners with comprehensive information on the application of scientific principles in human kinetics. By highlighting the importance of evidence-based practice, this review is intended to promote the adoption of effective interventions to optimize physical health and enhance performance.

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Section: Evidence-based Practice: Unfolding the Mapmentioning

confidence: 99%

Section: The Pursuit Of Expertise In Evidence-based Practicementioning

confidence: 99%

Knowledge in Motion: A Comprehensive Review of Evidence-Based Human Kinetics

Ramalho

Petrica

2023

IJERPH

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“…Practice in psychiatry may not always resonate with EBM assumptions (eg, about the nature of disease or the diagnostic categories), such that clinical decision-making is often characterised by uncertainty involving imperfect information and incomplete data. 23 While revised EBM models suggest integrating evidence with patient values and context, 24 the objective uncertainty is a primary reason why psychiatry historically has been considered less scientifically rigorous by its biomedical counterparts.…”

Section: Ebm Clinical Judgement and Aimentioning

confidence: 99%

Evidence, ethics and the promise of artificial intelligence in psychiatry

2022

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Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry.

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“…It is worth noting that most of the primary studies published to date and included in these three previous meta-analyses [ 12 , 13 , 79 ] had significant limitations. For example, most of them did not have an adequate control group or did not control for potential confounders ( Supplementary Materials ), all of which may affect the real effect of the exposition or intervention [ 80 , 81 , 82 , 83 ]; therefore, we excluded more than 50 of these studies in our systematic review [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ,…”

Section: Discussionmentioning

confidence: 99%

Acute Coronary Syndrome, Stroke, and Mortality after Community-Acquired Pneumonia: Systematic Review and Meta-Analysis

Meregildo-Rodríguez

Asmat-Rubio

Rojas-Benites

et al. 2023

JCM

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One-third of adult inpatients with community-acquired pneumonia (CAP) develop acute coronary syndrome (ACS), stroke, heart failure (HF), arrhythmias, or die. The evidence linking CAP to cardiovascular disease (CVD) events is contradictory. We aimed to systematically review the role of CAP as a CVD risk factor. We registered the protocol (CRD42022352910) and searched for six databases from inception to 31 December 2022. We included 13 observational studies, 276,109 participants, 18,298 first ACS events, 12,421 first stroke events, 119 arrhythmic events, 75 episodes of new onset or worsening HF, 3379 deaths, and 218 incident CVD events. CAP increased the odds of ACS (OR 3.02; 95% CI 1.88–4.86), stroke (OR 2.88; 95% CI 2.09–3.96), mortality (OR 3.22; 95% CI 2.42–4.27), and all CVD events (OR 3.37; 95% CI 2.51–4.53). Heterogeneity was significant (I2 = 97%, p < 0.001). Subgroup analysis found differences according to the continent of origin of the study, the follow-up length, and the sample size (I2 > 40.0%, p < 0.10). CAP is a significant risk factor for all major CVD events including ACS, stroke, and mortality. However, these findings should be taken with caution due to the substantial heterogeneity and the possible publication bias.

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Clinical expertise in the era of evidence-based medicine and patient choice

Cited by 182 publications

References 6 publications

Knowledge in Motion: A Comprehensive Review of Evidence-Based Human Kinetics

Knowledge in Motion: A Comprehensive Review of Evidence-Based Human Kinetics

Evidence, ethics and the promise of artificial intelligence in psychiatry

Acute Coronary Syndrome, Stroke, and Mortality after Community-Acquired Pneumonia: Systematic Review and Meta-Analysis

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