Impact of clinical trials on clinical practice: example of thrombolysis for acute myocardial infarction

Ketley, Diane; Woods, K L

doi:10.1016/0140-6736(93)91945-i

Cited by 189 publications

(97 citation statements)

References 13 publications

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“…But the influence of reading journal articles on clinical decision making is not clear [5,6,7,8,9,10]. This could be due to the perception that clinical research is not appropriate enough [11], critical appraisal skills are not sufficient, or there could be other problems with interpreting medical articles [12,13,14,15,16].…”

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confidence: 99%

Information management and reading habits of German diabetologists: a questionnaire survey

Trelle

2002

Diabetologia

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Aims/hypothesis. Journals play an important part in continuing medical education and in influencing the prescription of drugs. Because little is known about reading habits and information management of specialists a questionnaire survey among German diabetologists was conducted. Subjects and methods. A non-randomised sample of 461 German diabetologists was selected from a database of German diabetologists (n=1585). A questionnaire was developed (92 items) which consisted of eight sections: continuing education in general, decision making and problem solving, use of databases, reading habits, knowledge of technical terms and critical appraisal skills, personal data. Results. The adjusted response rate was 57% (crude 52%). Most influential factors for therapeutic decision making were due to own experience, continuing education events, published material, and colleagues. The influence of industry related factors was perceived low. A relatively high rate of respondents (39%) perceived the influence by patients as rather low. Overall 90% had convenient access to the internet, MedLine or EMBASE but only 45% searched databases regularly (three searches per month). Median time for reading journals was 3 h a week. Five journals were read regularly, 25% of which were diabetological journals and 47% of the respondents did not read English written journals regularly. The methods section of an article was seldom read whereas the abstract and the discussion were almost always read. Most respondents had some understanding of technical terms but reported practices of appraising articles were inadequate. Conclusion/interpretation. It could be shown that reading expenditures and critical appraisal skills of diabetologists are slightly higher compared with nonspecialists. But the concept of evidence-based medicine still does not seem to be incorporated in clinical practice. [Diabetologia (2002) 45:764-774]

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Information management and reading habits of German diabetologists: a questionnaire survey

Trelle

2002

Diabetologia

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“…In major clinical areas, such as the treatment of myocardial infarction, it has long been acknowledged that the findings of research studies into what is effective often do not translate into actual practice (Antman, Lau, Kupelnick, et al 1992;Ketley and Woods 1993). There is no doubt that many patients receive suboptimal care as a result, and some of them suffer serious, avoidable harm to their health.…”

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Evidence‐based Management: From Theory to Practice in Health Care

2001

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The rise of evidence‐based clinical practice in health care has caused some people to start questioning how health care managers and policymakers make decisions, and what role evidence plays in the process. Though managers and policymakers have been quick to encourage clinicians to adopt an evidence‐based approach, they have been slower to apply the same ideas to their own practice. Yet, there is evidence that the same problems (of the underuse of effective interventions and the overuse of ineffective ones) are as widespread in health care management as they are in clinical practice. Because there are important differences between the culture, research base, and decision‐making processes of clinicians and managers, the ideas of evidence‐based practice, while relevant, need to be translated for management rather than simply transferred. The experience of the Center for Health Management Research (CHMR) is used to explore how to bring managers and researchers together and promote the use of evidence in managerial decision‐making. However, health care funders, health care organizations, research funders, and academic centers need wider and more concerted action to promote the development of evidence‐based managerial practice.

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“…While evidence from such systematic reviews is now accumulating as to the treatment strategies most likely to be effective, there is also evidence to suggest that in general health care, even when there are clearly effective clinical interventions, health professionals may not practise in the best way (Ketley & Woods, 1993). Potential barriers to effective obesity management may include knowledge about effective treatment strategies and access to appropriate support to implement changes in practice.…”

Section: The Current Management Of Obesitymentioning

confidence: 99%

Treatment of obesity: Theory into practice

Kirk

1999

Proc. Nutr. Soc.

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The purpose of the present paper is to outline the current situation in the management of obesity in adults, and to make some suggestions as to how health professionals involved in obesity treatment can best address this growing problem. Dietitians and nutritionists have long been involved in the treatment of obesity, and have a vital role to play in the battle to reverse the increasing prevalence of this major public health problem. However, the current management of obesity is far from ideal. There is evidence to suggest that in general health care, even when there are clearly effective clinical interventions, health professionals may not practise in the best way. Furthermore, some professionals may also hold negative attitudes towards the obese. These are the subject of a systematic review on improving health professionals' practice and organization of care in obesity treatment, the preliminary findings of which will be discussed in the present paper (Harvey et al. 1998a, b). A new approach to obesity is required, encompassing effective treatment and prevention strategies. A greater understanding of the problems faced by the obese individual in attempting to lose weight is also needed, with a range of treatment approaches on offer to acknowledge the heterogeneity of obesity. Those health professionals involved in obesity treatment must consider the impact of dietary advice given in a consultation against the impact of environmental cues that assail the patient as soon as they leave the room. Tackling the obesity epidemic requires action at the individual and population level if we are to see any reduction in prevalence.

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Impact of clinical trials on clinical practice: example of thrombolysis for acute myocardial infarction

Cited by 189 publications

References 13 publications

Information management and reading habits of German diabetologists: a questionnaire survey

Information management and reading habits of German diabetologists: a questionnaire survey

Evidence‐based Management: From Theory to Practice in Health Care

Treatment of obesity: Theory into practice

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