Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-23T20:30:22.387Z Has data issue: false hasContentIssue false
  • English
  • Français

Progress in Clinical Neurosciences: Evidence Based Care in the Neurosciences

Published online by Cambridge University Press:  14 September 2018

Samuel Wiebe  and
Bart Demaerschalk
Samuel Wiebe*
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
Bart Demaerschalk
Affiliation:
Stroke Centre, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA
*
Samuel Wiebe, London Health Sciences Centre, University Campus, 339 Windermere Rd., London, Ontario, Canada N6A5A5
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

We examine the relevance of Evidence Based Care (EBC) to the field of clinical neurosciences, with particular emphasis on feasible methods of implementing EBC in clinical practice. By using pre-appraised EBC summaries, busy clinicians can move toward EBC without engaging in the laborious process of searching and critically appraising the literature. After reviewing the neurological content, accessibility and ease of use of current sources of EBC summaries, we find them substantially lacking in coverage of the neurosciences, and therefore of limited use to clinicians in this field. We emphasize a particular type of EBC summary, the critically appraised topic, and comment on its usefulness and limitations as a tool to assist clinical decision-making in the neurosciences. Finally, we propose that a collection of easily accessible, good quality, peer reviewed critically appraised topics, covering a breadth of relevant topics, is a reasonable way of moving toward EBC in the clinical neurosciences.

Résumé:

Résumé:

Nous examinons la pertinence des soins basés sur des preuves (evidence-based care – EBC) en neurosciences cliniques, en mettant l’accent sur des méthodes concrètes pour appliquer l’EBC en pratique clinique. Le clinicien occupé peut instaurer l’application de l’EBC en utilisant des sommaires d’EBC préévalués, sans avoir à faire lui-même le processus laborieux de recherche et de critique de la littérature. Après avoir révisé le contenu neurologique, l’accessibilité et la facilité d’utilisation de sources à jour de sommaires d’EBC, nous constatons que la couverture dans le domaine des neurosciences est très déficiente et donc d’utilité limitée pour le clinicien travaillant dans ce domaine. Nous mettons l’accent sur un type particulier de sommaire d’EBC, le critically appraised topic (CAT), et nous commentons son utilité et ses limites comme outil d’aide à la décision clinique en neurosciences. Finalement, nous proposons qu’un recueil de CATs facilement accessibles, de bonne qualité et révisés par des pairs, couvrant une gamme de sujets pertinents, est une façon raisonnable d’instaurer l’EBC en neurosciences cliniques.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 2 , May 2002 , pp. 115 - 119
Copyright
Copyright © Canadian Neurological Sciences Federation 2002

References

1. Saint, S, Christakis, DA, Saha, S, et al. Journal reading habits of internists. J Gen Intern Med 2000; 15: 881-884.Google Scholar
2. Vickery, CE, Cotugna, N. Journal reading habits of dietitians. J Am Diet Assoc 1992; 92: 1510-1512.Google Scholar
3. Schein, M, Paladugu, R, Sutija, VG, Wise, L. What American surgeons read: a survey of a thousand Fellows of the American College of Surgeons. Curr Surg 2000; 57: 252-258.Google Scholar
4. Demaerschalk, B, Wiebe, S, Jenkins, M. Evaluating the impact of an evidence based medicine curriculum in a neurology training programme. Can J Neurol Sci 1999; 26: S52Google Scholar
5. Smith, R. What clinical information do doctors need? Br Med J 1996; 313: 1062-1068.Google Scholar
6. Smith, R. Where is the wisdom...? Br Med J 1991; 303: 798-799.Google Scholar
7. Wyatt, J. Use and sources of medical knowledge. Lancet 1991; 338: 1368-1373.Google Scholar
8. Sackett, DL, Richardson, WS, Rosenberg, W, Haynes, RB. Introduction: On the need for evidence-based medicine. In: Sackett, DL, Richardson, WS, Rosenberg, W, Haynes, RB (eds). Evidence-based Medicine: How to Practice & Teach EBM. New York: Churchill Livingstone, 1997: 1–20.Google Scholar
9. Ramsey, PG, Carline, JD, Inui, TS, et al. Changes over time in the knowledge base of practicing internists. JAMA 1991; 266: 1103-1107.Google Scholar
10. Sibley, JC, Sackett, DL, Neufeld, V, et al. A randomized trial of continuing medical education. N Engl J Med 1982; 306: 511-515.Google Scholar
11. Evans, CE, Haynes, RB, Birkett, NJ, et al. Does a mailed continuing education program improve physician performance? Results of a randomized trial in antihypertensive care. JAMA 1986; 255: 501-504.Google Scholar
12. Davis, DA, Thomson, MA, Oxman, AD, Haynes, RB. Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA 1995; 274: 700-705.Google Scholar
13. Oxman, AD, Guyatt, GH. The science of reviewing research. Ann NY Acad Sci 1993; 703: 125-133.Google Scholar
14. Antman, EM, Lau, J, Kupelnick, B, Mosteller, F, Chalmers, TC. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA 1992; 268: 240-248.Google Scholar
15. Sackett, DL, Rosenberg, WM, Gray, JA, Haynes, RB, Richardson, WS. Evidence based medicine: what it is and what it isn’t [editorial]. Br Med J 1996; 312: 71-72.Google Scholar
16. Davidoff, F, Haynes, B, Sackett, D, Smith, R. Evidence based medicine [editorial; comment]. Br Med J 1995; 310: 1085-1086.Google Scholar
17. Wiebe, S, Demaerschalk, B, Jenkins, M. Development and introduction of a formal evidence based medicine curriculum in a neurology training programme. Can J Neurol Sci 1999; 26: S23.Google Scholar
18. Demaerschalk, B, Wiebe, S. Evaluating the relevance of evidence based medicine in a neurology residence programme. Can J Neurol Sci 1998; 25: S79.Google Scholar
19. McColl, A, Smith, H, White, P, Field, J. General practitioners’ perceptions of the route to evidence based medicine: a questionnaire survey. Br Med J 1998; 316: 361-365.Google Scholar
20. Guyatt, GH, Meade, MO, Jaeschke, RZ, Cook, DJ, Haynes, RB. Practitioners of evidence based care. Not all clinicians need to appraise evidence from scratch but all need some skills. Br Med J 2000; 320: 954-955.Google Scholar
21. Straus, SE, McAlister, FA. Evidence-based medicine: a commentary on common criticisms. CMAJ 2000; 163: 837-841.Google Scholar