introduction to evidence based medicine (ebm)
TRANSCRIPT
Introduction to Evidence- Based Medicine (EBM)
Dr. Khalid Bashir GhalibMBBS- Gezira University 2002Registrar of Medicine- SMSB
MRCP1&2 (UK) 2015Secretary General of Sudan Evidence- Based
Medicine Association (SEBMA)Medical Director of AlTababa Specialized Clinics
Mob. 0912569966 - E.mail [email protected]
سورة الفاتحة
العالمين الحمد لله ربحيم حمـن الر الر مالك يوم الدين إياك نعبد وإياك
نستعينراط اهدنــــا الص
المستقيمصراط الذين أنعمت
عليهم غيرالمغضوب عليهم وال
الين الض
The OpeningPraise be to Allah, the
Cherisher and Sustainer of the
worlds; Most Gracious, Most
Merciful; Master of the Day of Judgment. Thee do we worship,
and Thine aid we seek.
Show us the straight path
The way of those on whom Thou hast
bestowed Thy Grace, those whose (portion) is not wrath, and who
go not astray.
الرحيم الرحمن الله بسمIn the name of Allah, Most Gracious, Most
Merciful.
?
One• How many of you did the Fajr prayer ركعات ?ثالث
Two• How many would agree that next year all Muslims
should fast Ramadan during the winter months?
Three
• How many would agree that Zakat rate should be changed (reduced) ?
Four• How many would agree that Physicians should
regularly have a small amount of alcohol to reduce their risk of a heart attack?
فقط المسند
Evidence-Based Medicine:Why?
EBM Improves the quality of patient care
EBM Standardizes the delivery of healthcare
EBM decreases medical errors
EBM reduces the expense of healthcare
EBM enhances Keeping current with literature
Oxygen good or bad?
• However, another theory argues that oxygen may increase microvascular resistance, leading to reduced coronary blood flow thus reducing cardiac output and increasing radical oxygen species, which can have multiple negative effects including increased risk for arrhythmias and cell damage leading to heart failure.[2,3]
Shall we divorce “MONA”?
How do you manage HTN?
Patient in normal labour“Routine episiotomy”
It is time to change our practice
• Restrictive episiotomy policies appeared to give a number of benefits compared with using routine episiotomy. Women experienced less severe perineal trauma, less posterior perineal trauma, less suturing and fewer healing complications at seven days (reducing the risks by from 12% to 31%)
We cannot rely on our clinical experience alone
Gets worse with “duration in practice”
Bridging the Gaps
Knowledge practice
Bridging the Gaps
Resources Expenditure
What is Evidence-based Medicine?• “ Evidence-based medicine is the • integration of:
What is Evidence-based Medicine?• “ Evidence-based medicine is the • integration of:– best available research evidence with
What is Evidence-based Medicine?• “ Evidence-based medicine is the • integration of:– best available research evidence with – clinical expertise and
What is Evidence-based Medicine?• “ Evidence-based medicine is the • integration of:– best available research evidence with – clinical expertise and –patient values”
• Sackett, et al 2001
How to practice EBM?
How to practice EBM?
5 As
How to practice EBM?
Ask 5 As
How to practice EBM?
Acquire 5 As
How to practice EBM?
Appraise
5 As
How to practice EBM?
Apply
5 As
How to practice EBM?
Assess
5 As
Human Development Index (HDI)
• The HDI is a summary measure for assessing long-term progress in three basic dimensions of human development:
• 1. a long and healthy life, • 2. access to knowledge and• 3. a decent standard of living.
Sudan’s 2014 HDI is 0.479
Can Evidence be the Solution?
• Bridging the GAP between Expenditure and Resources:
• Making the best use of Resources– Healthcare– Agriculture– Livestock– Water
Future Plan
• • Increase awareness about effective interventions and the potential gains from using research based knowledge in policy and practice
Blair
• Evidence-based policymaking (EBP) has gained political currency since 1997 under the Blair administrations.
نـفـــــر من نحـن الناس أيهاقطنوا حيثما األرض عمروا
