Harnessing experience: exploring the gap between evidence‐based medicine and clinical practice

Hay, M. Cameron; Weisner, Thomas S.; Subramanian, Saskia; Duan, Naihua; Niedzinski, Edmund J.; Kravitz, Richard L.

doi:10.1111/j.1365-2753.2008.01009.x

Cited by 93 publications

(84 citation statements)

References 39 publications

(35 reference statements)

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“…Such an integrated investigator-practitioner role is recognized prominently in many disciplines such as education, agriculture, and engineering (Hay et al, 2008). The important distinction of a "top-down" model is that investigation addresses specific needs in an individual practice rather than producing universal knowledge or global evidence (Hay et al, 2008).…”

Section: The Basis Of the Conceptmentioning

confidence: 99%

“…The important distinction of a "top-down" model is that investigation addresses specific needs in an individual practice rather than producing universal knowledge or global evidence (Hay et al, 2008). Hay et al 2008 reported that improvements in patient care outcomes might be gained by balancing the global data of evidence-based medicine with locally relevant data through scientifically harnessing clinical experience.…”

Section: The Basis Of the Conceptmentioning

confidence: 99%

“…Ideally, practitioners would not simply function in the network as data collectors but would serve as investigators. Members should have a sense of ownership in the network, believing it belongs to them as a tool to benefit patients and the profession (Hay et al, 2008). Creating a cloud-based network/database system may be a promising venue for clinical dentistry and dental research because other social and clinical experience networks have been successful to some degree at communicating information to target communities, (Denucci, 2009;Gordan et al, 2011).…”

Section: Current Networking Models As They Relate To the Proposed Modelmentioning

confidence: 99%

“…What if a practitioner (or a participating group of practitioners) built a body of knowledge of what works or does not work with a particular population (or groups) or within different contexts? Conceptually, this model would enable member practitioners to contribute data to and/or participate in the analysis or retrieval of data, following the standards defined by the network (Hay et al, 2008).…”

Section: The Basis Of the Conceptmentioning

confidence: 99%

“…Evidence-based dentistry (EBD) represents the averaged data gathered from particular experiments, which is not necessarily relevant to local circumstances. Clinical experience and local evidences, while often established in a less structured fashion, often represents a more accessible and meaningful dataset for use with local patient populations (Hay et al, 2008;Horn et al, 2010;Valdes, 2010).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

An Idea for the Future of Dental Research: A Cloud-based Clinical Network and Database

Owtad¹,

Taichman²,

Park³

et al. 2013

JCT

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Evidence-based dentistry (EBD) is an approach to oral healthcare requiring systematic assessment of relevant scientific evidence to clinical practice and patients' needs. EBD attempts to globally establish personalized dental care based upon the most recent and highest order scientific evidence. However, some times the EBD does not consider local clinical circumstances, which represents a practitioner's actual patient population and experiences.The purpose of this study is to outline a design for a cloud-based clinical network/database model that is believed to be a valuable addition to the current clinical research models. This paper provides a rationale for the establishment of a network and makes recommendations as to how this format would bridge EBD and clinical practice. To do so would provide a significant advance for dental education, clinical research, and clinical practice.

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Section: The Basis Of the Conceptmentioning

confidence: 99%

Section: The Basis Of the Conceptmentioning

confidence: 99%

Section: Current Networking Models As They Relate To the Proposed Modelmentioning

confidence: 99%

Section: The Basis Of the Conceptmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

An Idea for the Future of Dental Research: A Cloud-based Clinical Network and Database

Owtad¹,

Taichman²,

Park³

et al. 2013

JCT

View full text Add to dashboard Cite

show abstract

Evidence‐Based Practice Knowledge, Perceptions, and Behavior: A Multi‐Institutional, Cross‐Sectional Study of a Population of U.S. Dental Students

Straub-Morarend

Wankiiri-Hale

Blanchette

et al. 2016

Journal of Dental Education

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The aim of this study was to help inform faculty and curriculum leaders in academic dental institutions about the knowledge, skills, perceptions, and behavior of an institutionally diverse population of dental students with respect to evidencebased practice (EBP). A survey utilizing the validated Knowledge, Attitudes, Access, and Confidence Evaluation instrument developed by Hendricson et al. was conducted in 2012 with fourth-year dental students at seven geographically dispersed U.S. dental schools. The survey addressed elements of EBP knowledge, attitudes toward EBP, behavior in accessing evidence, and perceptions of competence in statistical analysis. A total of 138 students from the seven schools participated. A slight majority of these students correctly responded to the knowledge of critical appraisal questions. While the students demonstrated positive attitudes about EBP, they did not report high levels of confidence in their critical appraisal skills. The findings also showed that the students accessed various sources of evidence with differing frequencies. The most frequently accessed resources were colleagues, the Internet (excluding Cochrane Database of Systematic Reviews), and textbooks. The results of this study help to identify areas for improvement in EBP education in order to advance dental students' preparation to become evidence-based practitioners.

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Current therapeutic options for Huntington's disease: Good clinical practice versus evidence‐based approaches?

Killoran

Biglan

2014

Movement Disorders

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Therapeutic decision-making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence-based medicine in relation to clinical practice.

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Harnessing experience: exploring the gap between evidence‐based medicine and clinical practice

Abstract: Clinical experience is relatively neglected by the EBM movement, but if that experience were systematically gathered through an approach such as EF, it would meet a need left unfulfilled by EBM.

Cited by 93 publications

References 39 publications

An Idea for the Future of Dental Research: A Cloud-based Clinical Network and Database

An Idea for the Future of Dental Research: A Cloud-based Clinical Network and Database

Evidence‐Based Practice Knowledge, Perceptions, and Behavior: A Multi‐Institutional, Cross‐Sectional Study of a Population of U.S. Dental Students

Current therapeutic options for Huntington's disease: Good clinical practice versus evidence‐based approaches?

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