Evidence-based medicine and evidence-based occupational health

Evidence base for pre-employment medical screening

“…It has been argued that evidence alone is often not a sufficient guide for action in occupational health. 41 According to Franco, "the occupational health physician must have skills to identify the problem in its context correctly". 41 Accordingly, it is recommended that a job-demands analysis should be available for inspection by the physician.…”

“…41 According to Franco, "the occupational health physician must have skills to identify the problem in its context correctly". 41 Accordingly, it is recommended that a job-demands analysis should be available for inspection by the physician. Medical examiners should be able to request additional testing or data as is deemed necessary, especially in consideration of certain international assignments.…”

Evaluation of medical decisions’ effectiveness: a 4-year evidence-based study in a health care setting

“…In the present study evidence was searched and appraised according to the paradigm of the Evidence-Based Occupational Health through a process reviewing, in addition to the scientiWc evidence, the workers' condition, the preferences and values of workers and other stakeholders, the speciWc setting, and by taking into account the diVerent and sometimes contrasting needs (Franco 2003). Therefore, the decision making process resulted in a decision founded on both science (an updated knowledge based on scientiWc evidence) (Verbeek et al 2004) and conscience (engagement, seriousness, impartiality), as required by the code of the International Commission on Occupational Health for occupational health professionals (2002).…”

Developing search strategies in Medline on the occupational origin of diseases

“…To limit the number of articles to screen to some extent, the minimum precision was set at 5% (NNR 20), under the condition that the sensitivity is at least 90%, consistent to what is recommended in the literature [Haynes et al, 1994;, 2003, 2004Haynes and Wilczynski, 2004;Wilczynski et al, 2004;Verbeek et al, 2005]. The practitioner who may have less time available wants to find a substantial number of relevant articles without too much non-relevant information.…”

“…In addition, the validity of traditional information sources such as textbooks and colleagues has been questioned [Slawson and Shaughnessy, 1997]. ''EvidenceBased Medicine,'' has also been advocated in occupational health [Carter, 2000;Verbeek et al, 2002Verbeek et al, , 2004Franco, 2003;Schaafsma et al, 2004] and necessitates use of powerful search mechanisms such as Medline.…”