Evidence Based Medicine in the trenches - Florida State 循证医学在战壕里-佛罗里达州.ppt

Evidence Based Medicine D.J. Van Durme, MD Evidence Based Medicine in the office and hospital Daniel J. Van Durme, MD Professor and Chair Dept. of Family Medicine and Rural Health Who is this guy and what does he know? Private practice in semi-rural Pasco county (north of Tampa) 1991-1996 Faculty at University of South Florida College of Medicine 1989-1991 and 1996-2004 Still seeing patients at Madison County Health Department Creator, Course Director, and lecturer for “Evidence Based Medicine” course at USF COM 40 hours of lecture and small group for Med 2’s I am NOT an EBM expert Expert – from Latin “ex” – has been “spurt” – a drip under pressure I struggle with stats I am often overwhelmed with the volume of medical information and the need to critically review the important stuff BUT – I can still provide high quality Evidence Based Care Learning Objectives for today At the conclusion of today’s session, the learner should be able to: Define evidence based medicine Demonstrate an ability to formulate a patient-oriented clinical question from a clinical scenario Discuss appropriate search strategies for finding answer(s) to clinical questions Demonstrate the use of PDA and computer resources for finding high quality evidence based answers Discuss how evidence based findings would be applied to the care of a patient EBM: Original “Official” Definition The explicit, conscientious, and judicious use of the current best evidence in making decisions about the care of individual patients (and populations) Problems with EBM definition EBM has been accused of being . . . Cookbook medicine “It takes away the art of medicine or the clinical judgment” WRONG – the research results may not be applicable or appropriate for a given patient Cost-Cutting medicine “It is all a plot by managed care companies to cut cost of care and increase their profit share” WRONG - When you find what is best for a given patient it may cost more OR it may save m