The Need for Evidence-Based Medicine

Sackett, David L.; Rosenberg, William

doi:10.1177/014107689508801105

Cited by 362 publications

(28 citation statements)

References 15 publications

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“…As described earlier, there are many variables that need consideration to arrive at scientifically based recommendations for the optimal intake of any nutrient. Some investigators [ 131 ] believe that for determining iodine and selenium recommendations, the whole of evidence should be used as originally defined for Evidence Based Medicine (EBM) by David Sackett [ 132 ]. Only evaluating randomized controlled trials (RCTs) or meta-analyses, is a limitation not supported by the original definition.…”

Section: Considerations Pertaining To Iodine and Selenium Dietary Ref...mentioning

confidence: 99%

Thyroidal and Extrathyroidal Requirements for Iodine and Selenium: A Combined Evolutionary and (Patho)Physiological Approach

Dijck-Brouwer

Muskiet²,

Verheesen³

et al. 2022

Nutrients

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Iodide is an antioxidant, oxidant and thyroid hormone constituent. Selenoproteins are needed for triiodothyronine synthesis, its deactivation and iodine release. They also protect thyroidal and extrathyroidal tissues from hydrogen peroxide used in the ‘peroxidase partner system’. This system produces thyroid hormone and reactive iodine in exocrine glands to kill microbes. Exocrine glands recycle iodine and with high urinary clearance require constant dietary supply, unlike the thyroid. Disbalanced iodine-selenium explains relations between thyroid autoimmune disease (TAD) and cancer of thyroid and exocrine organs, notably stomach, breast, and prostate. Seafood is iodine unconstrained, but selenium constrained. Terrestrial food contains little iodine while selenium ranges from highly deficient to highly toxic. Iodine vs. TAD is U-shaped, but only low selenium relates to TAD. Oxidative stress from low selenium, and infection from disbalanced iodine-selenium, may generate cancer of thyroid and exocrine glands. Traditional Japanese diet resembles our ancient seashore-based diet and relates to aforementioned diseases. Adequate iodine might be in the milligram range but is toxic at low selenium. Optimal selenoprotein-P at 105 µg selenium/day agrees with Japanese intakes. Selenium upper limit may remain at 300–400 µg/day. Seafood combines iodine, selenium and other critical nutrients. It brings us back to the seashore diet that made us what we currently still are.

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Section: Considerations Pertaining To Iodine and Selenium Dietary Ref...mentioning

confidence: 99%

Thyroidal and Extrathyroidal Requirements for Iodine and Selenium: A Combined Evolutionary and (Patho)Physiological Approach

Dijck-Brouwer

Muskiet²,

Verheesen³

et al. 2022

Nutrients

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“…An established approach in the medical community to address the increasing burden of MSD is improved patient treatment through the full integration of evidence-based practice (EBP). The key ideas of using "current best evidence from clinical research in the management of individual patients" dates back as far as the renaissance [11][12][13][14][15][16][17][18][19]. Since then, the potential of EBP to effectively manage health disorders including LBP and NP has increased tremendously.…”

Section: Introductionmentioning

confidence: 99%

Self-reported attitudes, skills and use of evidence-based practice among Swiss chiropractors: a national survey

et al. 2022

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Study Objectives The high burden of disease associated with musculoskeletal disorders severely impacts patients’ well-being. As primary care providers, Swiss chiropractors ought to contribute towards identifying and using effective treatment strategies. An established approach is the full integration of evidence-based practice (EBP). This study aimed to investigate the attitudes, skills and use of EBP among Swiss chiropractors, as well as investigating potential facilitators and barriers for its adoption. Methods and material All 329 members of the Swiss Association of Chiropractic (ChiroSuisse) were invited in March 2021 to participate in this cross-sectional survey. Data were acquired anonymously online, using the Evidence-Based practice Attitude and utilization SurvEy (EBASE). The survey encompassed 55 questions measuring attitudes (n = 8, response range 1–5; total score range of 8–40), skills (n = 13, response range 1–5; total score range of range of 13–65) and use of EBP (n = 6, response range 0–4; total score range of 0–24). Results 228 (69.3%) chiropractors returned complete EBASE questionnaires. This sample was representative of all ChiroSuisse members with respect to gender, age groups and proportion of chiropractic residents. Respondents generally held positive attitudes towards EBP, as indicated by the high mean (31.2) and median (31) attitude sub-score (range 11–40). Self-reported skills had a mean sub-score of 40.2 and median of 40 (range 13–65). Knowledge about EBP-based clinical practice had been primarily obtained in chiropractic under- or postgraduate education (33.8% and 26.3%, respectively). Use of EBP achieved a lower sub-score, with mean and median values of 7.4 and 6, respectively (range 0–24). The most commonly identified barriers preventing EBP uptake were lack of time (67.9%) and lack of clinical evidence in chiropractic/manual therapy-related health fields (45.1%). Conclusion Swiss chiropractors held favourable attitudes and reported moderate to moderate-high skill levels in EBP. Nevertheless, similar to chiropractors in other countries, the self-reported use of EBP was relatively low, with lack of time and lack of clinical evidence being the most named barriers.

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“…Such standards are obviously of particular relevance when they have an impact on legal decisions that involve children, such as parenting arrangements after divorce and child protection measures. Ideally, such standards would be based on scientific evidence, comparable to evidence-based practice in medicine (Sackett and Rosenberg, 1995;Sackett et al, 1996). Yet, concerns have been raised about values and ideologies guiding decisions on children's best interests, rather than empirical research (Cascardi et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

International perspective on guidelines and policies for child custody and child maltreatment risk evaluations: A preliminary comparative analysis across selected countries in Europe and North America

et al. 2022

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Little knowledge exists on how evaluators in child custody and child maltreatment cases are informed by guidelines, the kinds of qualifications required and the types of training provided in different countries. The purpose of this paper is to provide an international preliminary comparison on how child custody and child maltreatment risk assessments are conducted in selected Western countries, and how the assessments are informed by best practice guidelines. Another aim is to increase knowledge on how the guidelines and best-practice standards could be developed further to reflect recent research findings. A total number of 18 guidelines were included in the analyses: four from Canada, five from the United States, three from the United Kingdom, three from the Netherlands, two from Finland, and one from Germany. We conducted a content analysis of the included guidelines in the database, focusing on how the guidelines address the best interest of the child criteria, guidelines for conducting the assessments, considerations for evaluative criteria, and specific guidance for conducting specific assessment procedures (e.g., interviews and observations). Findings show that the qualifications of and training provided to evaluators in child custody and child maltreatment risk evaluations are largely heterogeneous across the countries represented. Guidelines differ in whether and how they highlight the importance of evidence-based practices and scientifically validated assessment measures. Implications are drawn from the review and contextualized by international expert authors in the fields of forensic psychology, and family law. After the content analysis, discussion sessions within the expert group were held. The authors provide both commentaries and suggestions to improve the development of standard methods for conducting both child custody and child maltreatment risk evaluations and to consider a more transparent and judicious use of social science research to guide methods and the recommendations offered within these assessments.

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The Need for Evidence-Based Medicine

Cited by 362 publications

References 15 publications

Thyroidal and Extrathyroidal Requirements for Iodine and Selenium: A Combined Evolutionary and (Patho)Physiological Approach

Thyroidal and Extrathyroidal Requirements for Iodine and Selenium: A Combined Evolutionary and (Patho)Physiological Approach

Self-reported attitudes, skills and use of evidence-based practice among Swiss chiropractors: a national survey

International perspective on guidelines and policies for child custody and child maltreatment risk evaluations: A preliminary comparative analysis across selected countries in Europe and North America

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