Evidence-based public health: a critical perspective

Yamada, Seiji; Slingsby, Brian Taylor; Inada, Megan; Derauf, David

doi:10.1007/s10389-007-0156-7

Cited by 10 publications

(4 citation statements)

References 5 publications

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“…There are few well-designed diagnostic studies that evaluate alternative strategies for evidence-based medicine, which makes the adoption of a better approach more difficult to achieve. YAMADA et al [151] consider that physicians who properly practice evidence-based medicine use both individual clinical expertise and the best available external evidence, not one to the exclusion of the other. ''Without clinical expertise, practice risks becoming tyrannized by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient.…”

Section: Limitations Of the Current Workmentioning

confidence: 99%

The management of work-related asthma guidelines: a broader perspective

Baur

Tb²,

Burge³

et al. 2012

European Respiratory Review

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The aim of the European Respiratory Society work-related asthma guidelines is to present the management and prevention options of work-related asthma and their effectiveness. Work-related asthma accounts for 5-25% of all adult asthma cases and is responsible for a significant socioeconomic burden. Several hundred occupational agents, mainly allergens but also irritants and substances with unknown pathological mechanisms, have been identified as causing work-related asthma. The essential message of these guidelines is that the management of work-related asthma can be considerably optimised based on the present knowledge of causes, risk factors, pathomechanisms, and realistic and effective interventions. To reach this goal we urgently require greatly intensified primary preventive measures and improved case management. There is now a substantial body of evidence supporting the implementation of comprehensive medical surveillance programmes for workers at risk. Those workers who fail surveillance programmes need to be referred to a clinician who can confirm or exclude an occupational cause. Once work-related asthma is confirmed, a revised risk assessment in the workplace is needed to prevent further cases. These new guidelines confirm and extend already existing statements and recommendations. We hope that these guidelines will initiate the much-needed research that is required to fill the gaps in our knowledge and to initiate substantial improvements in preventative measures.

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Section: Limitations Of the Current Workmentioning

confidence: 99%

The management of work-related asthma guidelines: a broader perspective

Baur

Tb²,

Burge³

et al. 2012

European Respiratory Review

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show abstract

“…Moreover, if a context could be controlled for in medicine, that is not possible for public health approaches where context is intertwined with conditions and interventions. The questions about the role and meaning of 'evidence' thus become even more intricate for evidencebasing in areas of more complexity and with other aims than guiding healthcare practitioners about effectiveness of specific treatments (McGuire, 2005;Yamada et al, 2008;Wieringa et al, 2018).…”

Section: Tensions Between Public Health and Ebmmentioning

confidence: 99%

Epistemological deliberation: the challenges of producing evidence-based guidelines on lifestyle habits

Lagerlöf

Zuiderent‐Jerak

Sager

2021

Evidence &Amp; Policy

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Background: Promotion of healthy behaviour is increasingly highlighted worldwide as a way to improve public health, prevent disease incidence, and decrease long-term costs for healthcare. In Sweden the National Board of Health and Welfare (NBHW) used the well-established format of national guidelines to facilitate a more widespread use of approaches for promotion of healthy lifestyle habits in healthcare.Aims and objectives: The aim of this case study was to explore the tensions between public health knowledge and the tenets of evidence-based medicine (EBM) in the creation of national guidelines on lifestyle habits.Methods: Based on data from interviews with guideline professionals and the collected documents of the national guidelines, we examine how NBHW negotiated the conflicts between public health knowledge and the format of national guidelines. An analytical model based on approaches from the sociology of standardisation is used to explore the ramifications of these negotiations.Findings: In line with findings in the sociology of standardisation, we show how conflicts between public health knowledge and the format of national guidelines result in both having to yield on certain points. This, we claim, results in compromise, but perhaps also compromised notions of validity and causality.Discussion and conclusion: This case offers important learning about the general compatibility of public health and currently dominant methods of EBM. Important crossroads are outlined, concerning how validity and causality are configured in public health guidelines and how these require extensive epistemological deliberation.<br />Key messages<br /><ul><li>Epistemological commitments on validity and causality within public health have been compromised to fit the format of national guidelines;</li><br /><li>Similarly, the format of national guidelines has been subordinated to the public health valuation of risk assessments;</li><br /><li>Integrating public health into an EBM format requires extensive epistemological deliberation.</li></ul>

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“…Podobnie jak indywidualne interwencje medyczne, środki zdrowia publicznego powinny opierać się na dowodach, tj. na najlepszej dostępnej wiedzy [41].…”

Section: Dowody Naukoweunclassified

Zdrowie publiczne oparte na dowodach na przykładzie szczepień ochronnych – teoria i praktyka

Wrześniewska-Wal

Kobuszewski

2021

J Educ Health Sport

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Celem przeglądu było przedstawienie jednego z podstawowych narzędzi zdrowia publicznego, jakim są szczepienia, z punktu widzenia dowodów naukowych dotyczących ich bezpieczeństwa. Problem ten jest ściśle związany z bezpieczeństwem zdrowotnym i konstytucyjnym obowiązkiem państwa zapewnienia ochrony zdrowia i życia (art. 68 Konstytucji RP). Ważne jest, aby w przeciwieństwie do innych leków, szczepienia były podawane osobom zdrowym, a wiele z nich dzieciom. W pierwszej części artykułu przedstawiono wpływ odkryć naukowych z zakresu chorób zakaźnych, w tym odkryć z zakresu szczepień, na profilaktykę zakażeń oraz rozwój regulacji prawnych zapewniających bezpieczeństwo pacjentów. Pokrótce przedstawiono także historię ustawodawstwa dotyczącego zdrowia publicznego oraz aktualne rozwiązania prawne Unii Europejskiej i Polski. Część druga przedstawia praktykę zdrowia publicznego opartego na dowodach (EBPH), obejmującą złożone procesy mające na celu poprawę zdrowia populacji i zmniejszenie obciążenia chorobami. Ostatnim elementem pracy jest ilościowa analiza niepożądanych reakcji poszczepiennych (NOP) zgłaszanych w ostatnich latach w Polsce, której monitorowanie jest podstawowym narzędziem oceny bezpieczeństwa szczepionek w rzeczywistej praktyce klinicznej. Przedstawiono również obecną procedurę raportowania.

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Evidence-based public health: a critical perspective

Cited by 10 publications

References 5 publications

The management of work-related asthma guidelines: a broader perspective

The management of work-related asthma guidelines: a broader perspective

Epistemological deliberation: the challenges of producing evidence-based guidelines on lifestyle habits

Zdrowie publiczne oparte na dowodach na przykładzie szczepień ochronnych – teoria i praktyka

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