2nd Conference of International Society for EBHC - 6th International Conference for EBHC Teachers and Developers Taormina- Italy 29 th Oct – 2 nd Nov; 2013
Nov 1 2013 Dr. Mazen Ferwana, MD, ABFM, JBFM, PhD Consultant & trainer Family Medicine Associate Prof. King Saud Bin Abdul Aziz University-HS Co-Director, NGCEBHP Chairman, COM EBM Committee
National & Gulf Center for Evidence Based Health Practice 3 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
National & Gulf Center for Evidence Based Health Practice National & Gulf Center for Evidence Based Health Practice 4 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
National & Gulf Center for Evidence Based Health Practice 5 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
FOUR FOUR QUESTION QUESTIONS Why? What? How? IMPACT? National & Gulf Center for Evidence Based Health Practice 6 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Introduction Many medical schools around the world have incorporated EBM teaching into their curricula National & Gulf Center for Evidence Based Health Practice 7 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
EBM? EBM?? Evidence-based medicine (EBM) is a movement which aims to increase the use of high quality clinical research in clinical decision making. National & Gulf Center for Evidence Based Health Practice 8 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Pr Practice actice Of Of Evidence Evidence Based Medicine Based Medicine 5 Ask Clinical Questions Acquire As As The Best Evidence Appraise The Evidence Apply the best Evidence Assess Your Performance National & Gulf Center for Evidence Based Health Practice King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Objectives of the integration Clinical Behavior Skills Knowledge & Attitude National & Gulf Center for Evidence Based Health Practice 10 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Why? National & Gulf Center for Evidence Based Health Practice 11 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Mana Managing ging Medical Medical Inf Infor orma mation tion Explosion Explosion Daily : 2000 medical articles 75 RCTs 11 SR PubMed: SR : > 5000 National & Gulf Center for Evidence Based Health Practice 12 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Incr Increas easing Inf ing Infor orma mation tion Example: HTN 8000 7000 6000 5000 4000 Articles 3000 2000 1000 0 1966 1976 1986 1996 National & Gulf Center for Evidence Based Health Practice 13 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Incr Increas easing Inf ing Infor orma mation tion Example: HTN 400000 350000 300000 250000 200000 Articles 150000 100000 50000 0 1966 1976 1986 1996 2013 National & Gulf Center for Evidence Based Health Practice 14 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Why hy EBM EBM a appr pproac oach? h? Doubling time: • in 1950, 50 years • in 1980, 7 years • in 2010, 3.5 years • In 2020, 73 days ! TRANSACTIONS OF THE AMERICAN CLINICAL AND CLIMATOLOGICAL ASSOCIATION, VOL. 122, 2011 National & Gulf Center for Evidence Based Health Practice 15 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Mana Managing ging Medical Medical Inf Infor orma mation tion Explosion Explosion At the individual level: 1. Which resources 2. Proper searching skills 3. Appraisal, Interpretation and use 4. Point of care 5. Mobile medicine 6. Push & Pull National & Gulf Center for Evidence Based Health Practice 16 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Med Medical Decision ical Decision Mak Making ing (MDM) (MDM) EBM approach Assists health professionals in guiding their decisions & manage uncertainty . National & Gulf Center for Evidence Based Health Practice 17 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Quality Quality Of Of Car Care e & & Patient tient Saf Safety ety EBM mandates the use of best current evidence practices that are effective, whilst eliminating those that are ineffective or harmful National & Gulf Center for Evidence Based Health Practice 18 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Major Major Accr Accredita editation tion Bodies Bodies ACGME (Accreditation Council for Graduate Medical Education) AAMC (Association of American Medical Colleges) GMC (General Medical Council) CanMEDS (Royal College of Physicians & Surgeons of Canada) National & Gulf Center for Evidence Based Health Practice 19 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
WH WHAT ? AT ? National & Gulf Center for Evidence Based Health Practice 20 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
EBM Curriculum Sicily statement 2005 National & Gulf Center for Evidence Based Health Practice 21 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Sicily Statement This statement was conceived by the delegates of the second international conference of EBHC Teachers and Developers held in Sicily in Sep 2003 "Signposting the future of EBHC“ GIMBE: http://www.ebhc.org National & Gulf Center for Evidence Based Health Practice 22 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Sicily Statement 5 EBM steps This five-step model forms the basis for both clinical practice and teaching EBP “An immediate attraction of evidence-based medicine is that it integrates medical education with clinical practice“ Rosenberg and Donald; BMJ, 1995 National & Gulf Center for Evidence Based Health Practice 23 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
Pr Practice actice Of Of Evidence Evidence Based Medicine Based Medicine 5 Ask Clinical Questions Acquire As As The Best Evidence Appraise The Evidence Apply the best Evidence Assess Your Performance National & Gulf Center for Evidence Based Health Practice King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
EBP Cur EBP Curriculum riculum Educa Educational tional Outcome Outcomes Translation of uncertainty into an answerable question 5 5 Search for and retrieval of evidence Educational Outcomes Critical appraisal of evidence for validity and clinical importance Application of appraised evidence to practice Evaluation of performance National & Gulf Center for Evidence Based Health Practice 25 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
What Researches Say? Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses. . . . their experience of evidence searching and critical appraisal of the evidence, in real time with real patient in front of them is not large Vrdoljak D: Teaching evidence based medicine in family medicine . Acta medica academica 2012, 41 (1):88-92 . National & Gulf Center for Evidence Based Health Practice 26 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
What Researches Say? Since its arrival to the scene of medicine and despite its worldwide incorporation into both undergraduate and postgraduate curricula, the implementation of evidence has been extremely slow National & Gulf Center for Evidence Based Health Practice 27 King Saud bin Abdulaziz University for Health Sciences Riyadh, Kingdom of Saudi Arabia
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