Evidence based medicine manifesto for better healthcare

Heneghan, Carl; Mahtani, Kamal R; Goldacre, Ben; Godlee, Fiona; Macdonald, Helen; Jarvies, Duncan

doi:10.1136/ebmed-2017-j2973rep

Cited by 55 publications

(47 citation statements)

References 25 publications

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“…The Choosing Wisely movement (Malhotra et al, 2015) and the recent "The Evidence-Based Medicine Manifesto for Better Healthcare" are setting an agenda for a real EBM that favours a more comprehensive and holistic view of clinician-patient relationship and reduction of 'questionable research practices, bias, and conflicts of interests' (Heneghan et al, 2017). By shedding light on the misapplication of HRS as a mainstream preventive approach to the masses we echo and reaffirm the same voices.…”

Section: Final Remarksmentioning

confidence: 92%

Linking high-risk preventive strategy to biomedical-industry market: implications for public health

2017

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This paper takes Geoffrey Rose's concepts on preventive strategy as the basis for theoretical framework to critically analyse the current approach to disease prevention. Rose's "continuum of risk and severity" has widened the scope for preventive actions and underpins two approaches: high-risk strategy (HRS) and population strategy (PS). Both of them produce paradoxes: HRS, despite having a good harm-benefit ratio, offers little impact on public health; PS has greater impact on public health, but offers minimal benefit at individual level. We argue that HRS is being misapplied by reducing cut-off points for preventive interventions to impact morbimortality attributed to specific diseases. This tends to medicalize prevention, producing more disease related phenomena through screening techniques, and inducing individual affective reactions, which require action in the present to secure better future health. This context has paved the way for speculative preventive medicine, which perceives health as a commodity but ignores its implications for public health services.

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Section: Final Remarksmentioning

confidence: 92%

Linking high-risk preventive strategy to biomedical-industry market: implications for public health

2017

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“…As a response to "systematic bias, wastage, error and fraud relevant to patient care," a group of prominent individuals published the "EBM Manifesto for Better Health" (Table 5) [31]. Thus, the problems were not only identified, but an agenda for fixing EBM was proposed.…”

Section: What Can Be Done To Solve Problems With Ebm?mentioning

confidence: 99%

“…EBM Manifesto for better health [31] Ann Nutr Metab 2018;72(suppl 3):13-23 DOI: 10.1159/000487375 which they discussed: (1) setting research priorities so that funding is based on issues relevant to users of research [32]; (2) research design, conduct, and analysis (key problems include poor protocols and designs, poor utility of information, statistical power and outcome misconception, and insufficient consideration of other evidence) [33]; (3) biomedical research regulation and management [34]; (4) the role of fully accessible research information [35]; and (5) incomplete or unusable research [36].…”

Section: Standards For Conducting Researchmentioning

confidence: 99%

Evidence-Based Medicine and Clinical Research: Both Are Needed, Neither Is Perfect

Szajewska¹

2018

Ann Nutr Metab

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Currently, it is impossible to think of modern healthcare that ignores evidence-based medicine (EBM), a concept which relies on 3 pillars: individual clinical expertise, the values and desires of the patient, and the best available research. However, EBM is not perfect. Clinical research is also far from being perfect. This article provides an overview of the basic principles, opportunities, and controversies offered by EBM. It also summarizes current discussions on clinical research. Potential solutions to the problems of EBM and clinical research are discussed as well. If there were specific issues related to pediatric nutrition, an attempt was made to discuss the basic principles and limitations in this context. However, the conclusions are applicable to EBM and clinical research in general. In the future, considering that new ways of obtaining health data will continue to emerge, the world of EBM and clinical research is likely to change. The ultimate goal, however, will remain the same: improving health outcomes for patients.

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“…Problems with publication bias, particularly in relation to pharmaceuticals, are well documented 4. These problems have led to calls for inclusion of data from sources other than just the aggregative summaries in the published literature 2. Including individual participant or patient data may mitigate this to some degree 16.…”

Section: Defining ‘Complex Systematic Reviews’mentioning

confidence: 99%