The concept of evidence-based medicine was launched in 1991 as a new paradigm to inform medical practice and has risen to be regarded as the gold standard. It rapidly gained the attention of medics, health service managers and the general media as it presented a means to improve efficiency and effectiveness of service delivery. Despite its stunning success in capturing the health agenda, the campaign that launched evidence-based medicine has also attracted criticism, particularly from clinicians and philosophers concerned about its selective views of knowledge and evidence, and for its denigration of reasoning, clinical experience and judgement.Evidence-Based Medicine traces this movement from its launch to its meteoric rise, examining what it has done for healthcare and medicine in the context of changes in science policy and the long-running criticism held against the movement for its inherent weaknesses.As evidence-based medicine will remain an important feature of healthcare in the decades to come, this book is perfect for healthcare professionals, medical scientists, health service managers and public health experts looking for a critical examination of the topic.

Clinicians and patients know the importance of correct diagnosis for proper treatment. So important – a correct diagnosis – it is the first theme of this book. Several other themes are also important. A second theme is established as “cause and effect,” common or peculiar linked entities in at least some humans. A third theme deals with probabilities, both objective and statistical and/or subjective probabilities. The fourth theme covers the inhomogeneity among all humans. That is, all people are unique. Is science a theme? Not of this kind. Instead, science encompasses all of the themes above and others. Logic holds their framework. The diagnostic model above has been modified by allowing wider scope of inference similar to the earlier “differential diagnoses” model. A quite radical model called “Evidence-Based Medicine (EBM),” was created about thirty years ago. Its advocates depend largely on statistics, with little interest in science. Discussion and comparisons with traditional and EBM models argue here undesirable shortcomings of the latter. Far from dismissing science, but robust medical science, knowledge, experience and professional clinicians continues in caring her/his individual patients.

This is the first monograph to deal with medicine as a form of hermeneutics, now in a thoroughly revised and updated edition, including a whole new chapter on medical ethics. The book offers a comprehensive philosophical argument why good medical practice cannot be curtailed to scientific investigations of the body but is a form of clinical hermeneutics performed by health-care professionals in dialogue with their patients. Medical hermeneutics is rooted in a phenomenology of illness which acknowledges and proceeds from the ill party’s bodily feelings, everyday life-world circumstances and self-understanding in aiming to restore health. The author shows how the works of classical phenomenologists and hermeneuticians – Martin Heidegger, Maurice Merleau-Ponty, Hans-Georg Gadamer and Paul Ricoeur – may be employed to understand how medical diagnosis is enveloped by professional empathy and clinical judgement and developed by scientific investigations of the patient’s bodily condition. Health and illness are ultimately considered to be ways of feeling at home or not at home in the world, and such experiences are the starting point of medical hermeneutics when aiming to make best use of scientific knowledge. The book is aimed at researchers and teachers in philosophy of medicine and medical ethics, and at physicians, nurses and other health-care professionals meeting with patients in ethically complex and challenging situations. Phenomenology and hermeneutics, most often considered as methods belonging to the humanities, are shown to be of vital importance for the understanding of medical practice and ethical dilemmas of health care.

This open access book sets out the stress-system model for functional somatic symptoms in children and adolescents. The book begins by exploring the initial encounter between the paediatrician, child, and family, moves through the assessment process, including the formulation and the treatment contract, and then describes the various forms of treatment that are designed to settle the child’s dysregulated stress system. This approach both provides a new understanding of how such symptoms emerge – typically, through a history of recurrent or chronic stress, either physical or psychological – and points the way to effective assessment, management, and treatment that put the child (and family) back on the road to health and well-being.

Encapsulating security : pharmaceutical defenses against biological danger -- Discovering a virus's achilles heel : flu fighting at molecular scale -- The pill always wins: Gilead Sciences, Roche and the birth of Tamiflu -- What a difference a day makes : the margin call for regulatory agencies -- Virtual blockbuster : bird flu and the pandemic of preparedness planning -- In the eye of the storm : global access, generics and intellectual property -- 'Ode to Tamiflu' : side effects, teenage 'suicides' and corporate liabilities -- Data backlash : Roche and Cochrane square up over clinical trial data -- 'To boldly go ... ' : pharmaceutical enterprises and global health security -- Epilogue : pharmaceuticals, security and molecular life

Generalism is a key approach to healthcare organisation and delivery that enables person-centred, dynamic and cost-effective patient care. With its emphasis on adaptability, generalism requires expansive, nurturing and personalised approaches to clinical education in which a generalist attends to and explores patient priorities when problem-setting and co-creating management plans. Generalism in Clinical Practice and Education outlines a generalist philosophy of practice which is brought to life through interleaved examples. Written by a range of international clinicians, patients and academics this book does not prescribe one ‘right’ way to do generalism. Rather, it seeks to inspire readers’ future engagement with generalism in practice and learning through sharing underpinning concepts, values and principles. This ‘big picture’ attention to generalism across public health, social determinants of health and clinical care is at the heart of sustainable and efficient use of resources to prioritise those in need. The book explores four key principles which in practice aim to achieve creative, inclusive and agile approaches to clinical care. The goal is to support generalism in clinical practice and education, and to produce clinical practitioners and learners that enjoy, embrace and enhance future clinical care.

Evidence-Based Ophthalmology offers a unique approach to managing eye disease. From systematic reviewing of evidence, this book provides an overview of techniques for optimum management in key areas, including glaucoma, cataract and retinal disease – an invaluable reference source for practitioners worldwide representing an important contribution to the literature. Key Features International authorship by leading Cochrane participants An unbiased method for summarising and disseminating the evidence Identifies gaps in evidence, and therefore research opportunities Free-access update website giving the latest trial data and recommendations for implementation in practice Includes a free fully searchable CD-ROM

Written at the clerkship level, this book is a comprehensive introduction to family medicine. It is organized into three sections—principles of family medicine, preventive care, and common problems—and includes chapters on evidence-based medicine and complementary therapies. The text has a user-friendly writing style, focuses on common clinical problems, and uses case studies to show practical applications of key concepts. This edition features an updated art program, more illustrations, summaries, consistent headings, greater emphasis on evidence-based care, and more diverse family physician profiles representing varied practice settings. A companion Website offers the fully searchable text, 75 study questions, and an ExamKit of more than 300 questions with which faculty can generate tests.

This is an ideal introductory text on Evidence Based Medicine (EBM) for medical students and all health-care professionals.