Audit of therapeutic interventions in inpatient children using two scores: are they evidence-based in developing countries?

Carreazo, Nilton Yhuri; Bada, Carlos; Chalco, Juan Pablo; Huicho, Luis

doi:10.1186/1472-6963-4-40

Cited by 6 publications

(6 citation statements)

References 40 publications

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“…One of these examined evidence-based intervention rates,19 whereas another estimated rates of adverse events using a national drug information database 20. A Brazilian study examined the process of infection control practices after a Salmonella outbreak,21 and a Chinese study measured unsafe injection rates and disposal of needles and syringes 22…”

Section: Resultsmentioning

confidence: 99%

“…Studies examining the safety of specific treatment processes22 26–28 or mortality rates for a particular age segment23 24 were conducted at single hospitals. Taking a somewhat broader perspective, a Peruvian study examined all patient safety-related interventions that were documented in the medical record over a 1-month period, albeit at a single healthcare facility; however, the study's measure of utilisation of evidence-based practices might be considered more in the realm of quality improvement than patient safety 19. None of the retrospective studies assessed patient safety across national borders.…”

Section: Resultsmentioning

confidence: 99%

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Measures of patient safety in developing and emerging countries: a review of the literature

Carpenter

Duevel

Lee

et al. 2010

Quality and Safety in Health Care

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Investigation of patient safety in developing and emerging countries has been infrequent and limited in scope. Establishing fundamental safe patient practices, integrating those processes into routine health services delivery and developing patients' expectations that such processes be present are necessary prerequisites to measuring and monitoring progress towards safe patient care in emerging and developing countries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Measures of patient safety in developing and emerging countries: a review of the literature

Carpenter

Duevel

Lee

et al. 2010

Quality and Safety in Health Care

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“…In considering the generalisability of our findings, we can compare it with primary care surveys in other countries. Starting in the late twentieth century, there have been several studies of the practice of EBM in different countries and in different areas of health care (10–20). In the following section, we discuss how our findings compare with those of previous research in primary care (21, 23–27), using the structure we used in our Results section.…”

Section: Discussionmentioning

confidence: 99%

“…Previous articles have discussed the cost effectiveness of evidence-based medicine (EBM) and continuous training (4)(5)(6)(7)(8)(9), and assessed the use of EBM in a wide variety of health care settings outside of primary care. For example, a search of the Cochrane Methodology Register (www.thecochranelibrary.com) revealed many such studies through the last decade or more (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). We focus here on the relationship between EBM and clinical decisions in primary care in Turkey, and how EBM should be a basic element in both training and the clinical implementation of family medicine.…”

Section: Introductionmentioning

confidence: 99%

Is primary care evidence‐based in Turkey?

Kahveci

Meads

2009

J Evidence Based Medicine

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Objective Family medicine (also called general practice) is a specialty with a focus on primary care. In Turkey, not all primary care is provided by specialists. Efforts are underway to improve primary care by improving the provision of primary care, establishing referral chains, and having care provided by general practitioners after transition training or by family medicine specialists. We investigated the relationship between evidence-based medicine (EBM) and primary care in Turkey, to provide a snapshot of the current situation and baseline data to assess the effects of current and future reforms. Methods A cross-sectional survey was done of 375 primary care physicians: 138 general practitioners (GPs), 121 family medicine (FM) trainees, and 116 FM specialists. They were asked 30 questions assessing general characteristics, knowledge, and training in EBM; general attitudes towards EBM; resources used to support clinical decisions; possible barriers to EBM practice; and opinions on future practice of EBM. Data were analyzed with SPSS 12.0. Results Compared with the other physicians, FM specialists had significantly more Internet access, used the Internet for medical purposes more often and for longer hours, had published more scientific papers, searched MEDLINE or similar databases more often, and were more confident about conducting literature searches. FM specialists had significantly higher rates of training in EBM and critical appraisal. For all types of physicians surveyed, the main reported barrier to practicing EBM was lack of training in EBM. Conclusions Attitudes toward EBM differ significantly between GPs and FM specialists working in primary care in Turkey, which we believe results in variation in medical provision. The differences between these two groups of physicians should be investigated further, and means of improving the provision of care should be reported to policy makers.

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“…Tenemos todavía un problema adicional que enfrentar y vencer, cual es, el de no solamente consumir literatura científica producida en otras latitudes, sino también producirla, a partir de nuestra experiencia clínica cotidiana (15)(16)(17) y, además por supuesto, a partir de los esfuerzos y las experiencias que ocurren en la salud pública nacional (18)(19)(20) . Esta deuda de investigación la compartimos todos, en todos los niveles, desde el estado hasta las universidades y los docentes y estudiantes.…”

Section: El Escenario Localunclassified

La Medicina Basada en la Evidencia: ¿mejoró la medicina que practicamos y enseñamos?

2013

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ResumenEn los últimos años la práctica y la enseñanza médica han incorporado en forma progresiva y creciente el concepto de medicina basada en la evidencia (MBE). La misma se define como la utilización de la mejor evidencia proveniente de la investigación clínica para la toma de decisiones en el manejo del paciente individual. Esta propuesta de cambio en la manera de practicar y enseñar la medicina clínica es, en parte, consecuencia del vertiginoso avance de la investigación científica, particularmente en las últimas décadas, aunque el costo creciente involucrado en la atención de los pacientes ha jugado también un rol importante en su desarrollo y consolidación. La MBE implica la integración de la preparación y experiencia del médico con la mejor evidencia clínica externa accesible, proveniente de la investigación sistemática, proporcionando una visión más crítica en la toma de decisiones clínicas, para ofrecer atención de calidad óptima al paciente, evitando errores en cada una de las diferentes etapas del proceso de diagnóstico y tratamiento. En ausencia de información recolectada sistemáticamente, no es fácil llegar a una conclusión sobre los efectos de la MBE en la práctica y la enseñanza de la medicina en nuestro medio. Sin duda contamos hoy con mayor evidencia científica, incluyendo aquella relacionada a los problemas de salud infantil, y también se ha producido un avance vertiginoso en la tecnología que nos permite acceder a dicha información en tiempo real, a la cabecera del paciente. Sin embargo, si deseamos de veras lograr una mejor medicina, basada en la ciencia y en el respeto a la salud como un derecho que nos asiste a todos, hay necesidad de romper definitivamente con el paradigma predominante de una medicina jerárquica, poco dada a la discusión y a la justificación de las decisiones clínicas, de aprovechar la mejora sustancial ocurrida en el acceso a la evidencia disponible, y de mostrar mayor disposición a compartir amigable y respetuosamente dicha justificación con nuestros pacientes. Del mismo modo, hay la necesidad imperiosa de promover la investigación, la creatividad y el espíritu crítico en todos los niveles de la educación, para contribuir a la evidencia global que permita que la medicina clínica y la salud pública continúen avanzando. Palabras clave: Medicina basada en la evidencia, enseñanza, práctica, medicina. Abstract The concept of evidence-based medicine (EBM) has been increasingly incorporated in medicine practice and teaching. In the clinical arena it is defined as the use of the best available scientific evidence coming from clinical research for decision-making purposes, when facing individual patients. This paradigm change in the way medicine is taught and practiced has been due in part to the accelerated progress in scientific research, particularly in the last few decades, albeit the increasing costs involved in care of patients also played an important role in its development and consolidation. EBM involves integration of clinical expertise with the available external evide...

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Audit of therapeutic interventions in inpatient children using two scores: are they evidence-based in developing countries?

Abstract: Background: The evidence base of clinical interventions in paediatric hospitals of developing countries has not been formally assessed. We performed this study to determine the proportion of evidence-based therapeutic interventions in a paediatric referral hospital of a developing country

Cited by 6 publications

References 40 publications

Measures of patient safety in developing and emerging countries: a review of the literature

Measures of patient safety in developing and emerging countries: a review of the literature

Is primary care evidence‐based in Turkey?

La Medicina Basada en la Evidencia: ¿mejoró la medicina que practicamos y enseñamos?

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