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The Bone & Joint Decade - India An IRACON 2003

Explore the relationship between incidence and prevalence, diagnosis, therapy, prognosis, and community effectiveness in clinical practice guidelines presented by experts in the field. Key messages and insights provided.

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The Bone & Joint Decade - India An IRACON 2003

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  1. The Bone & Joint Decade - India An IRACON 2003 Indian Rheumatology: New Horizons, New Hopes Artichoke of Population Studies & Clinical Practice Dr Rajesh Pandav, Dr. Denish Moorthy, Dr Binod Patro, Dr Hemant Shukla, Dr Chandrakant S Pandav

  2. Relationship between incidence & prevalence Incidence Prevalence Recovery Death

  3. Measurement Iterative Loop Burden of Illness (Assessment) Monitoring & Reassessment Etiology or Causation Diagnosis Prognosis Synthesis & Implementation of Program Community Effectiveness Therapy Policy Process Efficiency

  4. Outline of presentation • Key messages • HFA • Thoughtful physicians: Difficult Questions • EBM • Measurement Iterative Loop • COPCORD / WHO / ILAR Studies • In conclusion ……

  5. Clinical Practice Guidelines • Busy Clinician • Information overload • Wide variability in patient care • Need to develop CLINICAL PRACTICE GUIDELINES

  6. Practicing EBM: The Needs Evidence-based approach to patient care create the NEED for Clinical Practice Guidelines DIAGNOSIS THERAPY PROGNOSIS

  7. Artichoke of Population Studies and Clinical Medicine – 1 • Health of patients: • - individual patient • - patient groups • Physicians need to identify & address factors: • - patient’s family • - community • Community: • - A resource for physicians

  8. Artichoke of Population Studies and Clinical Medicine - 2 • To reduce burden of disease: • - Integration of disease prevention & • - health promotion • into routine medical care • Chronic diseases: • - multiple causes or exacerbating factors • - variety of interventions • - at multiple levels • A population-based perspective: • - helpful in chronic disease management

  9. Role of physicians in • preventive interventions • Provision of direct preventive services • Management & organization of preventive health services within medical care system • Advocacy within clinical settings, • communities & organized medicine

  10. Outline of presentation • Key messages • HFA • Thoughtful physicians: Difficult Questions • EBM • Measurement Iterative Loop • COPCORD / WHO / ILAR Studies • In conclusion ……

  11. Biological Behavioural Human rights Equity & social justice Environmental Communities Determinants of health Health for All Gender Health system Societies Families Individuals Information & communication Socio-economic Science & technology Socio-cultural Aging of the population

  12. Outline of presentation • Key messages • HFA • Thoughtful physicians: Difficult Questions • EBM • Measurement Iterative Loop • COPCORD / WHO / ILAR Studies • In conclusion ……

  13. Thoughtful Physicians : Difficult Questions - 1 1) How may I be thorough YET efficient when considering the possible causes of my patient’s problem? 2) How do I characterize the information I have gathered during the medical interview & physical examination? (Probability - Utility) 3) How should I interpret new diagnostic information? (Probability)

  14. Thoughtful Physicians : Difficult Questions - 2 4) How do I select the appropriate diagnostic test? (Treatment, Threshold, Probability) 5) How do I choose among several risky treatments? (Expected Value Decision Making) 6) How do I know, how is my patient doing?

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