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تصميم‌سازی بالينی الگوهای طبابت

تصميم‌سازی بالينی الگوهای طبابت. دکتر پيام کبيری پزشک، اپيدميولوژيست بالينی رئيس مرکز توسعه و هماهنگی اطلاعات و انتشارات علمی معاونت تحقيقات و فن‌آوری وزارت بهداشت، درمان و آموزش پزشکی. منابع اطلاعاتی. دانش پا ي ه (Basic Knowledge) کتاب ‌ ها ( B ooks) دانش روزآمد (Updated Knowledge)

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تصميم‌سازی بالينی الگوهای طبابت

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  1. تصميم‌سازی بالينیالگوهای طبابت دکتر پيام کبيریپزشک، اپيدميولوژيست بالينیرئيس مرکز توسعه و هماهنگی اطلاعات و انتشارات علمیمعاونت تحقيقات و فن‌آوریوزارت بهداشت، درمان و آموزش پزشکی

  2. منابع اطلاعاتی • دانش پايه (Basic Knowledge) کتاب‌ها(Books) • دانش روزآمد (Updated Knowledge) مجلات و نشريات ادواری (Periodicals)

  3. انواع مقالات در علوم پزشکی • Original Article • Review Article • Case Reports • Editorial • Short Communication (short papers) • Letter to Editor • مقاله پژوهشی اصيل • مقاله مروری • مقاله گزارش مورد • سرمقاله (سخن سردبير) • مقاله کوتاه • نامه به سردبير

  4. تصميم‌سازی بالينی، الگوهای طبابت • Traditional Medicine • Evidence-Based Medicine • مدل سنتی • مدل مبتنی بر شواهد

  5. EBM تاريخچه • G. Guyatt from McMaster University in 90s • Sackett in 1995 defined EBM • “Our clinical decesion malking should be based on the best scientific avaiabe evidence”

  6. What is Evidence? Evidence is anything used to determine or demonstrate the truth of an assertion. Scientific evidence is evidence which serves to either support or counter a scientific theory or hypothesis. In scientific research evidence is accumulated through observations of phenomena occur in the natural world, or created as experiments in a laboratory

  7. What is ‘level of evidence’? • The extent to which one can be confident that an estimate of effect or association is correct(unbiased).

  8. Levels of Evidence Adapted from: Sackett DL et al. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. Churchill Livingstone; 2000.

  9. What is Evidence-Based Medicine? “Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values” - Sackett & Straus

  10. Clinical Expertise Research Evidence Patient Preferences EBM - What is it?

  11. Traditional medicine Experiences Pathophysiology, references,… Patient value

  12. By best research evidence • clinically relevant research • Unbiased research • Reproducible research • often from the basic sciences of medicine • especially from patient centered clinical research

  13. By clinical expertise • We mean the ability to use our clinical skills and past experience to rapidly identify each patient’s unique health state and diagnosis, their individual risks and benefits of potential interventions, and their personal values and expectations.

  14. By patient values • We mean the unique preferences, concerns and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient.

  15. When these three elements are integrated, clinicians and patients form a diagnostic and therapeutic alliance which optimizes clinical outcomes and quality of life

  16. جايگزين‌های طبابت مبتنی برشواهد Eminence based medicineعلووبزرگی Vehemence based medicine غیظ و غضب Eloquence based medicine فصاحت Providence based medicineمشیت الهی Nervousness based medicineعصبانیت Diffidence based medicine عدم اعتماد به نفس Confidence based medicine اعتماد به نفس

  17. Was it clear enough !

  18. بزنید ! Email اگر میل داشتید kabiri@research.ac.ir

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