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How do we encourage clinicians to practice EBM when we also need practice based evidence to further justify the need for more evaluation of guidelines and recommendations?
How do we move toward accreditation when we are looking at guidelines set from other countries?
May 11, 2011

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  • Carlos Soares Pernambuco · Universidade Federal do Estado do Rio de Janeiro (UNIRIO)
    There are many guidelines equivocated, the researches must doing your job and demonstrate the evidences
    May 11, 2011
  • Estrella Evangelista
    I agree that as a clinician our job is to practice according to what is recommended but I think that there should be more training for bedside clinicians to learn about data transparency and outcomes evaluation before we can continue on using the evidence that is presented to us. To me it is just like the blind leading the blind. In my practice, I advocate for intelligent consumerism as well as proactive clinical practice. As a group we can address this issue but have to look at the bigger picture.
    Thanks for the response and feedback. Star
    May 11, 2011
  • Brian Harper · Health Nexxus
    Quite a challenge. EBM is a supporting element for clinical decisions. Guidelines emanating from different jurisdictions are a double edged knife, where one ideal is to provide the best treatment possible while limiting the ossible negative effects of such treatment. This fine balancing of evidence with in vivo action requires attention to current knowledge informed by your own experience. Musing about the tractability of EBM in rapidly changing additive knowledge frames suggests that new ways of acquiring and interpreting information may have to be deployed.
    May 11, 2011
  • Estrella Evangelista
    Love your response Brian. Now if only we can get these ideas down and forward them to major decision makers in our field.
    May 12, 2011
  • Brian Harper · Health Nexxus
    Yes. Each of us is part of the collective intelligence of our field so change occurs even when one person decides to do things differently.in his speech to the AMA in 2009 President Obama drew from one of my studies on new technology adoption within clinical care. my report explored among other technologies the acceptance of the use of the insulin infusion pump for type one diabetics. In that report the adoption cycle for broad acceptance of the benefits indicated it took 17 years from first innovation to full implementation. As the pace of change in medical technologies accelerates this cycle will have to become shorter.You can facilitate that by openly exploring new ideas in your field and become an innovation proactor.
    May 12, 2011
  • Estrella Evangelista
    Very well said! I know we are offered opportunities to lead change in organizations, yet the chosen leaders are chosen for the wrong reasons. Most do not even know or understand EBM or any type of clinical or scholarly inquiry. There are open forums for healthcare providers to participate in the creation of a better healthcare delivery system. But do you know of anyone who has actually participated in those forums?
    May 12, 2011
  • Brian Harper · Health Nexxus
    I have one contact at McMaster who has been involved in one forum. I will send him an email and see if he would let me share his contact info with you. You may also want to check out their online repository of evidence based medicine which is A peer reviewed forum model.
    May 12, 2011
  • Brian Harper · Health Nexxus
    Here is link that might help you to one repository . http://hiru.mcmaster.ca/more/ hope it helps.
    May 12, 2011

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