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How to Write an Evidence-Based Clinical Review Article. JAY SIWEK, M.D., and MARGARET L. GOURLAY, M.D., Georgetown University Medical Center, Washington D.C. DAVID C. SLAWSON, M.D., University of Virginia Health System, Charlottesville, Virginia. ALLEN F. Dbq Essays On The Industrial Revolution? SHAUGHNESSY, PHARM.D., Harrisburg Family Practice Residency, Harrisburg, Pennsylvania. Am Fam Physician. 2002 Jan 15;65(2):251-258.

Traditional clinical review articles, also known as updates, differ from systematic reviews and essay, meta-analyses. Dbq Essays Revolution? Updates selectively review the medical literature while discussing a topic broadly. Nonquantitative systematic reviews comprehensively examine the border essay, medical literature, seeking to identify and synthesize all relevant information to formulate the best approach to diagnosis or treatment. Meta-analyses (quantitative systematic reviews) seek to answer a focused clinical question, using rigorous statistical analysis of pooled research studies. This article presents guidelines for writing an evidence-based clinical review article for American Family Physician . Dbq Essays On The Industrial Revolution? First, the topic should be of common interest and relevance to family practice. Include a table of the continuing medical education objectives of the review. State how the literature search was done and in the workplace, include several sources of evidence-based reviews, such as the Cochrane Collaboration, BMJ's Clinical Evidence , or the on the revolution, InfoRetriever Web site. Where possible, use evidence based on clinical outcomes relating to morbidity, mortality, or quality of life, and issues essay, studies of primary care populations.

In articles submitted to American Family Physician , rate the level of evidence for key recommendations according to on the revolution, the following scale: level A (randomized controlled trial [RCT], meta-analysis); level B (other evidence); level C (consensus/expert opinion). Finally, provide a table of key summary points. American Family Physician is particularly interested in receiving clinical review articles that follow an evidence-based format. Clinical review articles, also known as updates, differ from systematic reviews and meta-analyses in important ways.1 Updates selectively review the medical literature while discussing a topic broadly. Dissertation? An example of such a topic is, #x201c;The diagnosis and treatment of myocardial ischemia.#x201d; Systematic reviews comprehensively examine the medical literature, seeking to identify and synthesize all relevant information to formulate the best approach to diagnosis or treatment. Dbq Essays On The Industrial Revolution? Examples are many of the systematic reviews of the Cochrane Collaboration or BMJ's Clinical Evidence compendium.

Meta-analyses are a special type of thesis on real systematic review. They use quantitative methods to analyze the dbq essays industrial, literature and seek to answer a focused clinical question, using rigorous statistical analysis of pooled research studies. An example is, #x201c;Do beta blockers reduce mortality following myocardial infarction?#x201d; The best clinical review articles base the discussion on existing systematic reviews and meta-analyses, and incorporate all relevant research findings about the management of a given disorder. Such evidence-based updates provide readers with powerful summaries and sound clinical guidance. In this article, we present guidelines for writing an evidence-based clinical review article, especially one designed for and international relations continuing medical education (CME) and incorporating CME objectives into on the industrial, its format. This article may be read as a companion piece to three backs, a previous article and accompanying editorial about reading and evaluating clinical review articles.1 , 2 Some articles may not be appropriate for an evidence-based format because of the nature of the on the, topic, the slant of the article, a lack of sufficient supporting evidence, or other factors. We encourage authors to review the literature and, wherever possible, rate key points of evidence.

This process will help emphasize the summary points of the article and strengthen its teaching value. Choose a common clinical problem and romance, avoid topics that are rarities or unusual manifestations of on the disease or that have curiosity value only. Whenever possible, choose common problems for which there is new information about diagnosis or treatment. Emphasize new information that, if valid, should prompt a change in clinical practice, such as the recent evidence that spironolactone therapy improves survival in patients who have severe congestive heart failure.3 Similarly, new evidence showing that a standard treatment is no longer helpful, but may be harmful, would also be important to report. For example, patching most traumatic corneal abrasions may actually cause more symptoms and delay healing compared with no patching.4. When searching the literature on your topic, please consult several sources of evidence-based reviews (Table 1) . Romance Workplace? Look for pertinent guidelines on the diagnosis, treatment, or prevention of the dbq essays industrial revolution, disorder being discussed. Incorporate all high-quality recommendations that are relevant to the topic. Backs Essay? When reviewing the dbq essays on the industrial, first draft, look for romance workplace all key recommendations about diagnosis and, especially, treatment. Try to ensure that all recommendations are based on the highest level of evidence available. If you are not sure about the on the industrial, source or strength of the recommendation, return to romance in the workplace, the literature, seeking out the basis for the recommendation.

Some Sources of Evidence-Based Medicine. Agency for Healthcare Research and Quality (AHRQ), formerly known as the Agency for Health Care Policy and on the, Research (AHCPR): Clinical Guidelines and ann dunham dissertation, Evidence Reports* The AHRQ Web site includes links to the National Guideline Clearinghouse, Evidence Reports from the AHRQ's 12 Evidence-based Practice Centers (EPC), and Preventive Services. The AHCPR released 19 Clinical Practice Guidelines between 1992 and1996 that were not subsequently updated. American College of industrial revolution Physicians Journal Club (ACPJC) ACP Journal Club evaluates evidence in essays workplace individual articles. Commentary by on the industrial revolution, ACP author offers clinical recommendations. Access to the online version of ACPJC is a benefit for members of the ACP-ASIM, but will be open to all until at least the end of 2001. Features short evaluations/discussions of individual articles dealing with evidence-based clinical practice.

Centre for Evidence Based Medicine (CEBM) The University of Oxford/Oxford Radcliffe Hospital Clinical School Web site includes links to CEBM within the Faculty of Medicine, a CATbank (Critically Appraised Topics), links to evidence-based journals, and EBM-related teaching materials. Center for Research Support, TRIP Database. The AHRQ began the Translating Research into Practice (TRIP) initiative in 1990 to implement evidence-based tools and information. Border Issues Essay? The TRIP Database features hyperlinks to dbq essays industrial, the largest collection of EBM materials on gender and international the internet, including NGC, POEM, DARE, Cochrane Library, CATbank, and individual articles. Dbq Essays? A good starting place for an EBM literature search. Clinical Evidence , BMJ Publishing Group* Searches BMJ's Clinical Evidence compendium for up-to-date evidence regarding effective health care. Lists available topics and describes the supporting body of evidence to date (e.g., number of relevant randomized controlled trials published to date).

Concludes with interventions #x201c;likely to be beneficial#x201d; versus those with #x201c;unknown effectiveness.#x201d; Individuals who have received a free copy of Clinical Evidence Issue 5 from the United Health Foundation are also entitled to free access to the full online content. Cochrane Database of Systematic Reviews* Systematic evidence reviews that are updated periodically by the Cochrane Group. Thesis On Real Estate? Reviewers discuss whether adequate data are available for the development of EBM guidelines for diagnosis or management. Database of Abstracts of revolution Reviews of Effectiveness (DARE)*

Structured abstracts written by University of York CRD reviewers (see NHS CRD). Abstract summaries review articles on diagnostic or treatment interventions and discuss clinical implications. Effective Health Care* Bi-monthly, peer-reviewed bulletin for medical decision-makers. Based on systematic reviews and synthesis of research on the clinical effectiveness, cost-effectiveness and acceptability of estate health service interventions. Bimonthly publication launched in dbq essays 1995 by the BMJ Publishing Group. Article summaries include commentaries by clinical experts. Subscription is required.

Evidence-Based Practice Newsletter (including JFP Patient-Oriented Evidence that Matters [POEM])* This JFP newsletter features up-to-date POEM, Disease-Oriented Evidence (DOE), and tests approved for and international relations Category 1 CME credit. Subscription required. Includes the dbq essays on the industrial revolution, InfoRetriever search system for thesis the complete POEMs database and six additional evidence-based databases. Subscription is required. Institute for Clinical Systems Improvement (ICSI)* ICSI is an revolution, independent, nonprofit collaboration of health care organizations, including the Mayo Clinic, Rochester, Minn.

Web site includes the ICSI guidelines for preventive services and disease management. National Guideline Clearinghouse (NGC) Comprehensive database of evidence-based clinical practice guidelines from government agencies and health care organizations. Describes and compares guideline statements with respect to and international, objectives, methods, outcomes, evidence rating scheme, and major recommendations. National Health Service (NHS) Centre for Reviews and Dissemination (CRD) Searches CRD Databases (includes DARE, NHS Economic Evaluation Database, Health Technology Assessment Database) for EBM reviews.

More limited than TRIP Database. Primary Care Clinical Practice Guidelines. University of dbq essays industrial California, San Francisco, Web site that includes links to NGC, CEBM, AHRQ, individual articles, and organizations. U.S. Preventive Services Task Force (USPSTF)*

This Web site features updated recommendations for clinical preventive services based on systematic evidence reviews by the U.S. Preventive Services Task Force. EBM = evidence-based medicine . *#x2014; These Web sites are AAFP-approved sources of gender and international systematic evidence reviews. When these sources are used to prepare continuing medical education clinical content according to guidelines issued by the AAFP Commission of Continuing Medical Education, the content will qualify for the special designation of evidence-based CME. See the AAFP Web site for additional information about preparing evidence-based CME . Some Sources of Evidence-Based Medicine. Agency for Healthcare Research and Quality (AHRQ), formerly known as the Agency for Health Care Policy and Research (AHCPR): Clinical Guidelines and Evidence Reports* The AHRQ Web site includes links to the National Guideline Clearinghouse, Evidence Reports from the AHRQ's 12 Evidence-based Practice Centers (EPC), and dbq essays, Preventive Services. Romance Essays? The AHCPR released 19 Clinical Practice Guidelines between 1992 and1996 that were not subsequently updated.

American College of Physicians Journal Club (ACPJC) ACP Journal Club evaluates evidence in individual articles. Commentary by ACP author offers clinical recommendations. On The Industrial? Access to the online version of ACPJC is a benefit for members of the ACP-ASIM, but will be open to with three backs essay, all until at least the end of 2001. Features short evaluations/discussions of individual articles dealing with evidence-based clinical practice. Centre for Evidence Based Medicine (CEBM) The University of Oxford/Oxford Radcliffe Hospital Clinical School Web site includes links to CEBM within the Faculty of Medicine, a CATbank (Critically Appraised Topics), links to evidence-based journals, and EBM-related teaching materials. Center for Research Support, TRIP Database.

The AHRQ began the dbq essays industrial, Translating Research into ann dunham, Practice (TRIP) initiative in 1990 to dbq essays industrial, implement evidence-based tools and information. The TRIP Database features hyperlinks to the largest collection of EBM materials on the internet, including NGC, POEM, DARE, Cochrane Library, CATbank, and individual articles. Romance Essays In The Workplace? A good starting place for an EBM literature search. Clinical Evidence , BMJ Publishing Group* Searches BMJ's Clinical Evidence compendium for up-to-date evidence regarding effective health care. Lists available topics and describes the supporting body of evidence to date (e.g., number of dbq essays on the industrial relevant randomized controlled trials published to with, date). Industrial Revolution? Concludes with interventions #x201c;likely to be beneficial#x201d; versus those with #x201c;unknown effectiveness.#x201d; Individuals who have received a free copy of Clinical Evidence Issue 5 from the three backs essay, United Health Foundation are also entitled to free access to the full online content. Cochrane Database of Systematic Reviews*

Systematic evidence reviews that are updated periodically by the Cochrane Group. Reviewers discuss whether adequate data are available for on the the development of EBM guidelines for diagnosis or management. Database of Abstracts of Reviews of Effectiveness (DARE)* Structured abstracts written by thesis estate, University of York CRD reviewers (see NHS CRD). Abstract summaries review articles on diagnostic or treatment interventions and discuss clinical implications. Effective Health Care* Bi-monthly, peer-reviewed bulletin for medical decision-makers. Based on systematic reviews and synthesis of research on the clinical effectiveness, cost-effectiveness and acceptability of health service interventions.

Bimonthly publication launched in 1995 by the BMJ Publishing Group. Article summaries include commentaries by clinical experts. Dbq Essays On The? Subscription is required. Evidence-Based Practice Newsletter (including JFP Patient-Oriented Evidence that Matters [POEM])* This JFP newsletter features up-to-date POEM, Disease-Oriented Evidence (DOE), and tests approved for Category 1 CME credit.

Subscription required. Includes the InfoRetriever search system for the complete POEMs database and six additional evidence-based databases. Subscription is required. Institute for gender and international essay Clinical Systems Improvement (ICSI)* ICSI is an independent, nonprofit collaboration of health care organizations, including the Mayo Clinic, Rochester, Minn.

Web site includes the ICSI guidelines for preventive services and disease management. National Guideline Clearinghouse (NGC) Comprehensive database of evidence-based clinical practice guidelines from government agencies and dbq essays industrial, health care organizations. Describes and ann dunham soetoro dissertation, compares guideline statements with respect to objectives, methods, outcomes, evidence rating scheme, and major recommendations. National Health Service (NHS) Centre for Reviews and dbq essays industrial revolution, Dissemination (CRD) Searches CRD Databases (includes DARE, NHS Economic Evaluation Database, Health Technology Assessment Database) for EBM reviews.

More limited than TRIP Database. Primary Care Clinical Practice Guidelines. University of California, San Francisco, Web site that includes links to NGC, CEBM, AHRQ, individual articles, and organizations. U.S. Preventive Services Task Force (USPSTF)* This Web site features updated recommendations for issues essay clinical preventive services based on on the systematic evidence reviews by the U.S. Preventive Services Task Force.

EBM = evidence-based medicine . *#x2014; These Web sites are AAFP-approved sources of relations essay systematic evidence reviews. When these sources are used to prepare continuing medical education clinical content according to guidelines issued by the AAFP Commission of dbq essays industrial revolution Continuing Medical Education, the content will qualify for border issues the special designation of evidence-based CME. On The Revolution? See the AAFP Web site for additional information about preparing evidence-based CME . In particular, try to find the answer in an authoritative compendium of evidence-based reviews, or at three backs essay, least try to find a meta-analysis or well-designed randomized controlled trial (RCT) to support it. If none appears to be available, try to cite an authoritative consensus statement or clinical guideline, such as a National Institutes of Health Consensus Development Conference statement or a clinical guideline published by a major medical organization. If no strong evidence exists to support the dbq essays on the industrial revolution, conventional approach to managing a given clinical situation, point this out in the text, especially for ann dunham key recommendations.

Keep in mind that much of traditional medical practice has not yet undergone rigorous scientific study, and dbq essays industrial, high-quality evidence may not exist to support conventional knowledge or practice. Patient-Oriented vs. Essays In The? Disease-Oriented Evidence. With regard to types of dbq essays on the evidence, Shaughnessy and Slawson5 #x2013; 7 developed the concept of soetoro Patient-Oriented Evidence that Matters (POEM), in distinction to Disease-Oriented Evidence (DOE). POEM deals with outcomes of importance to dbq essays, patients, such as changes in morbidity, mortality, or quality of life. DOE deals with surrogate end points, such as changes in laboratory values or other measures of response. Although the issues essay, results of DOE sometimes parallel the results of POEM, they do not always correspond (Table 2) .2 When possible, use POEM-type evidence rather than DOE. When DOE is the only guidance available, indicate that key clinical recommendations lack the support of outcomes evidence.

Here is an example of how the latter situation might appear in the text: #x201c;Although prostate-specific antigen (PSA) testing identifies prostate cancer at an early stage, it has not yet been proved that PSA screening improves patient survival.#x201d; (Note: PSA testing is an example of DOE, a surrogate marker for the true outcomes of importance#x2014;improved survival, decreased morbidity, and improved quality of life.) Antiarrhythmic drug X decreases the incidence of PVCs on ECGs. Antiarrhythmic drug X is associated with an increase in mortality. POEM results are contrary to DOE implications. Antihypertensive drug treatment lowers blood pressure. Antihypertensive drug treatment is associated with a decrease in dbq essays on the industrial revolution mortality. POEM results are in concordance with DOE implications. Screening for prostate cancer.

PSA screening detects prostate cancer at the beast with backs, an early stage. Whether PSA screening reduces mortality from prostate cancer is revolution, currently unknown. Although DOE exists, the important POEM is currently unknown. DOE = disease-oriented evidence; POEM = patient-oriented evidence that matters; PVCs = premature ventricular contractions; ECGs = electrocardiograms; PSA = prostate-specific antigen . Adapted with permission from Shaughnessy AF, Slawson DC. Getting the most from review articles: a guide for readers and writers. Am Fam Physician 1997;55:2155#x2013;60 . Antiarrhythmic drug X decreases the research, incidence of PVCs on ECGs.

Antiarrhythmic drug X is associated with an increase in on the industrial revolution mortality. POEM results are contrary to border essay, DOE implications. Antihypertensive drug treatment lowers blood pressure. Antihypertensive drug treatment is dbq essays on the industrial revolution, associated with a decrease in mortality. POEM results are in concordance with DOE implications. Screening for prostate cancer. PSA screening detects prostate cancer at an early stage. Whether PSA screening reduces mortality from prostate cancer is currently unknown. Although DOE exists, the important POEM is currently unknown. DOE = disease-oriented evidence; POEM = patient-oriented evidence that matters; PVCs = premature ventricular contractions; ECGs = electrocardiograms; PSA = prostate-specific antigen . Adapted with permission from romance essays in the Shaughnessy AF, Slawson DC.

Getting the most from dbq essays on the revolution review articles: a guide for readers and writers. Am Fam Physician 1997;55:2155#x2013;60 . Evaluate the strength and validity of the science fair research paper, literature that supports the discussion (see the revolution, following section, Levels of Evidence). Essays Workplace? Look for dbq essays on the revolution meta-analyses, high-quality, randomized clinical trials with important outcomes (POEM), or well-designed, nonrandomized clinical trials, clinical cohort studies, or case-controlled studies with consistent findings. In some cases, high-quality, historical, uncontrolled studies are appropriate (e.g., the evidence supporting the efficacy of Papanicolaou smear screening). Avoid anecdotal reports or repeating the hearsay of conventional wisdom, which may not stand up to romance in the workplace, the scrutiny of scientific study (e.g., prescribing prolonged bed rest for on the revolution low back pain). Look for studies that describe patient populations that are likely to be seen in primary care rather than subspecialty referral populations. Shaughnessy and Slawson's guide for writers of clinical review articles includes a section on information and validity traps to avoid.2. Readers need to know the strength of the evidence supporting the key clinical recommendations on diagnosis and treatment. Many different rating systems of varying complexity and clinical relevance are described in the medical literature.

Recently, the third U.S. Preventive Services Task Force (USPSTF) emphasized the gender relations, importance of rating not only the study type (RCT, cohort study, case-control study, etc.), but also the study quality as measured by internal validity and dbq essays revolution, the quality of the entire body of evidence on a topic.8. While it is ann dunham soetoro, important to industrial revolution, appreciate these evolving concepts, we find that a simplified grading system is more useful in AFP . We have adopted the romance essays, following convention, using an ABC rating scale. Criteria for dbq essays high-quality studies are discussed in several sources.8 , 9 See the AFP Web site (www.aafp.org/afp/authors) for romance in the additional information about levels of evidence and see the accompanying editorial in this issue discussing the potential pitfalls and industrial, limitations of any rating system. Level A (randomized controlled trial/meta-analysis): High-quality randomized controlled trial (RCT) that considers all important outcomes. High-quality meta-analysis (quantitative systematic review) using comprehensive search strategies. Level B (other evidence): A well-designed, nonrandomized clinical trial. A nonquantitative systematic review with appropriate search strategies and fair bibliography, well-substantiated conclusions. Includes lower quality RCTs, clinical cohort studies, and on the revolution, case-controlled studies with non-biased selection of study participants and consistent findings. Other evidence, such as high-quality, historical, uncontrolled studies, or well-designed epidemiologic studies with compelling findings, is also included. Level C (consensus/expert opinion): Consensus viewpoint or expert opinion.

Each rating is applied to a single reference in the article, not to the entire body of evidence that exists on a topic. Each label should include the letter rating (A, B, C), followed by the specific type of study for the beast essay that reference. Revolution? For example, following a level B rating, include one of these descriptors: (1) nonrandomized clinical trial; (2) nonquantitative systematic review; (3) lower quality RCT; (4) clinical cohort study; (5) case-controlled study; (6) historical uncontrolled study; (7) epidemiologic study. Here are some examples of the way evidence ratings should appear in the text: #x201c;To improve morbidity and mortality, most patients in congestive heart failure should be treated with an gender relations, angiotensin-converting enzyme inhibitor. [Evidence level A, RCT]#x201d; #x201c;The USPSTF recommends that clinicians routinely screen asymptomatic pregnant women 25 years and younger for chlamydial infection. [Evidence level B, non-randomized clinical trial]#x201d; #x201c;The American Diabetes Association recommends screening for dbq essays on the industrial revolution diabetes every three years in all patients at high risk of the disease, including all adults 45 years and older. [Evidence level C, expert opinion]#x201d; When scientifically strong evidence does not exist to support a given clinical recommendation, you can point this out in the following way: #x201c;Physical therapy is traditionally prescribed for the treatment of adhesive capsulitis (frozen shoulder), although there are no randomized outcomes studies of thesis on real this approach.#x201d; The introduction should define the topic and purpose of the review and describe its relevance to family practice. The traditional way of doing this is to discuss the epidemiology of the condition, stating how many people have it at one point in time (prevalence) or what percentage of the population is expected to develop it over a given period of time (incidence). A more engaging way of doing this is to indicate how often a typical family physician is industrial, likely to encounter this problem during a week, month, year, or career. Emphasize the key CME objectives of the on real estate, review and summarize them in a separate table entitled #x201c;CME Objectives.#x201d; The methods section should briefly indicate how the dbq essays industrial, literature search was conducted and what major sources of evidence were used. Ideally, indicate what predetermined criteria were used to fair paper, include or exclude studies (e.g., studies had to be independently rated as being high quality by an established evaluation process, such as the Cochrane Collaboration).

Be comprehensive in trying to on the, identify all major relevant research. Critically evaluate the on real estate, quality of research reviewed. Avoid selective referencing of only information that supports your conclusions. If there is controversy on a topic, address the full scope of the controversy. The discussion can then follow the typical format of a clinical review article.

It should touch on one or more of the following subtopics: etiology, pathophysiology, clinical presentation (signs and symptoms), diagnostic evaluation (history, physical examination, laboratory evaluation, and diagnostic imaging), differential diagnosis, treatment (goals, medical/surgical therapy, laboratory testing, patient education, and dbq essays, follow-up), prognosis, prevention, and future directions. The review will be comprehensive and essays workplace, balanced if it acknowledges controversies, unresolved questions, recent developments, other viewpoints, and dbq essays industrial, any apparent conflicts of interest or instances of bias that might affect the strength of the evidence presented. Emphasize an evidence-supported approach or, where little evidence exists, a consensus viewpoint. On Real Estate? In the absence of a consensus viewpoint, you may describe generally accepted practices or discuss one or more reasoned approaches, but acknowledge that solid support for these recommendations is lacking. In some cases, cost-effectiveness analyses may be important in deciding how to implement health care services, especially preventive services.10 When relevant, mention high-quality cost-effectiveness analyses to dbq essays on the revolution, help clarify the costs and health benefits associated with alternative interventions to achieve a given health outcome. Gender Relations Essay? Highlight key points about diagnosis and treatment in dbq essays on the industrial the discussion and include a summary table of the the beast three, key take-home points. These points are not necessarily the same as the key recommendations, whose level of evidence is rated, although some of them will be. Use tables, figures, and illustrations to highlight key points, and present a step-wise, algorithmic approach to diagnosis or treatment when possible. Rate the revolution, evidence for key statements, especially treatment recommendations. We expect that most articles will have at most two to with backs essay, four key statements; some will have none. Dbq Essays Revolution? Rate only those statements that have corresponding references and romance essays in the workplace, base the rating on the quality and level of evidence presented in the supporting citations.

Use primary sources (original research, RCTs, meta-analyses, and dbq essays revolution, systematic reviews) as the thesis, basis for determining the level of evidence. In other words, the dbq essays industrial, supporting citation should be a primary research source of the information, not a secondary source (such as a nonsystematic review article or a textbook) that simply cites the original source. Systematic reviews that analyze multiple RCTs are good sources for paper determining ratings of evidence. The references should include the most current and important sources of revolution support for key statements (i.e., studies referred to, new information, controversial material, specific quantitative data, and information that would not usually be found in most general reference textbooks). Generally, these references will be key evidence-based recommendations, meta-analyses, or landmark articles. Although some journals publish exhaustive lists of reference citations, AFP prefers to include a succinct list of the beast three backs key references. (We will make more extensive reference lists available on our Web site or provide links to your personal reference list.)

You may use the following checklist to dbq essays on the, ensure the completeness of your evidence-based review article; use the source list of reviews to in the, identify important sources of evidence-based medicine materials. Checklist for an Evidence-Based Clinical Review Article. The topic is common in family practice, especially topics in which there is new, important information about diagnosis or treatment. The introduction defines the topic and the purpose of the review, and describes its relevance to family practice. A table of CME objectives for the review is included. The review states how you did your literature search and on the revolution, indicates what sources you checked to ensure a comprehensive assessment of relevant studies (e.g., MEDLINE, the Cochrane Collaboration Database, the gender and international relations essay, Center for Research Support, TRIP Database). Several sources of on the revolution evidence-based reviews on the topic are evaluated (Table 1) . Where possible, POEM (dealing with changes in romance essays workplace morbidity, mortality, or quality of dbq essays revolution life) rather than DOE (dealing with mechanistic explanations or surrogate end points, such as changes in laboratory tests) is used to support key clinical recommendations (Table 2) . Studies of thesis on real patients likely to be representative of those in primary care practices, rather than subspecialty referral centers, are emphasized. Studies that are not only on the industrial, statistically significant but also clinically significant are emphasized; e.g., interventions with meaningful changes in absolute risk reduction and romance essays in the, low numbers needed to treat. (Seehttp://www.cebm.net/index.aspx?o=1116.)11. The level of on the evidence for key clinical recommendations is and international, labeled using the following rating scale: level A (RCT/meta-analysis), level B (other evidence), and level C (consensus/expert opinion). Acknowledge controversies, recent developments, other viewpoints, and dbq essays on the industrial, any apparent conflicts of interest or instances of ann dunham dissertation bias that might affect the dbq essays on the industrial, strength of the evidence presented. Highlight key points about diagnosis and three essay, treatment in the discussion and include a summary table of key take-home points.

Use tables, figures, and illustrations to highlight key points and present a step-wise, algorithmic approach to diagnosis or treatment when possible. Emphasize evidence-based guidelines and primary research studies, rather than other review articles, unless they are systematic reviews. The essential elements of this checklist are summarized in dbq essays on the Table 3 . Essential Steps in Writing an Evidence-Based Clinical Review Article. Choose a common, important topic in family practice. Provide a table with a list of continuing medical education (CME) objectives for the review. State how the literature search and reference selection were done. Use several sources of thesis on real estate evidence-based reviews on the topic. Rate the on the, level of evidence for key recommendations in the text. Provide a table of key summary points (not necessarily the the beast three, same as key recommendations that are rated). Essential Steps in industrial Writing an Evidence-Based Clinical Review Article.

Choose a common, important topic in family practice. Provide a table with a list of continuing medical education (CME) objectives for the review. State how the literature search and reference selection were done. Use several sources of evidence-based reviews on on real estate the topic. Rate the level of revolution evidence for thesis key recommendations in the text. Provide a table of key summary points (not necessarily the dbq essays revolution, same as key recommendations that are rated).

Read the full article. Get immediate access, anytime, anywhere. Choose a single article, issue, or full-access subscription. With Backs Essay? Earn up to dbq essays, 6 CME credits per issue. Already a member or subscriber? Log in. Get Full Access. Includes: Immediate, unlimited access to all AFP content More than 130 CME credits per year Access to the AFP app Print delivery option. Access This Issue. Includes: Immediate access to this issue CME credits in this issue. Access This Article.

JAY SIWEK, M.D., is professor and chair of the Department of Family Medicine at Georgetown University Medical Center, Washington, D.C. He is also editor of American Family Physician. A graduate of the beast with three backs essay Georgetown University School of Medicine, Dr. Dbq Essays On The Revolution? Siwek completed his family practice residency at Middlesex Hospital in Middletown, Conn. Border? . MARGARET L. GOURLAY, M.D., is dbq essays on the, currently the American Family Physician Medical Editing Fellow at science research paper bibliography, Georgetown University Medical Center. A graduate of dbq essays Rush Medical College, Chicago, she completed a residency in family medicine at the University of California, San Diego, Medical Center. DAVID C. SLAWSON, M.D., is the thesis on real estate, B. Dbq Essays On The? Lewis Barnett, Jr. professor of gender and international family medicine at the University of Virginia Health System in dbq essays industrial Charlottesville, Va. He is director and with three backs essay, founder of the Center for Information Mastery and serves as section editor for The Journal of Family Practice POEMs. Dr. Slawson is dbq essays on the, a graduate of the University of Michigan School of romance in the workplace Medicine, Ann Arbor, Mich., and he completed postdoctoral training in family medicine at the University of Virginia. ALLEN F. SHAUGHNESSY, PHARM.D., is director of research and associate director of the Harrisburg Family Practice Residency, Harrisburg, Pa. He completed his doctorate and fellowship training at the Medical University of South Carolina, Charleston.

Address correspondence to Jay Siwek, M.D., Department of Family Medicine, Georgetown University Medical Center, 215 Kober-Cogan Hall, 3750 Reservoir Rd. NW, Washington DC 20007 (e-mail:[email protected]). Reprints are not available from the authors . The authors thank Ted Ganiats, M.D. for a helpful review and industrial revolution, conceptual contributions to border issues essay, the manuscript . The authors indicate that they do not have any conflicts of interest. Sources of dbq essays on the industrial funding: none reported . 1. Siwek J. Reading and evaluating clinical review articles. Am Fam Physician . 1997;55:2064,2069#x2013;70,2072. . 2. Shaughnessy AF, Slawson DC. Getting the most from review articles: a guide for thesis on real readers and dbq essays on the, writers. Am Fam Physician . 1997;55:2155#x2013;60. 3. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, et al. for the Randomized Aldactone Evaluation Study Investigators.

The effect of spironolactone on morbidity and mortality in patients with severe heart failure. The Beast With Three Essay? N Engl J Med . 1999;341:709#x2013;17. 4. Flynn CA, D'Amico F, Smith G. Should we patch corneal abrasions? A meta-analysis. J Fam Pract . 1998;47:264#x2013;70. 5. Slawson DC, Shaughnessy AF, Bennett JH.

Becoming a medical information master: feeling good about not knowing everything. J Fam Pract . 1994;38:505#x2013;13. 6. Shaughnessy AF, Slawson DC, Bennett JH. Becoming an information master: a guidebook to the medical information jungle. J Fam Pract . 1994;39:489#x2013;99. 7. Slawson DC, Shaughnessy AF. Becoming an information master: using POEMs to change practice with confidence.

Patient-oriented evidence that matters. J Fam Pract . 2000;49:63#x2013;7. 8. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, et al. Methods Work Group, Third U.S. Preventive Services Task Force. Current methods of the on the industrial, U.S. Preventive Services Task Force. A review of the process. Am J Prev Med . Gender And International? 2001;20(3 suppl):21#x2013;35. 9. CATbank topics: levels of evidence and grades of recommendations. Retrieved November 2001, from: http://www.cebm.net/.

10. Saha S, Hoerger TJ, Pignone MP, Teutsch SM, Helfand M, Mandelblatt JS. for the Cost Work Group of the Third U.S. Dbq Essays On The Industrial Revolution? Preventive Services Task Force. The art and science of incorporating cost effectiveness into evidence-based recommendations for clinical preventive services. Am J Prev Med . On Real? 2001;20(3 suppl):36#x2013;43. 11. Evidence-based medicine glossary. Retrieved November 2001, from: http://www.cebm.net/index.aspx?o=1116. Copyright © 2002 by the American Academy of dbq essays revolution Family Physicians. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.

This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in gender any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact [email protected] for copyright questions and/or permission requests. This page will be removed from your Favorites Links. Are you sure? Want to use this article elsewhere? Get Permissions. MOST RECENT ISSUE. Access the latest issue of American Family Physician.

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Drug Testing on People on Probation. Dez Yarbrough Comparative Criminal Justice Term Paper July 21, 2013 Policing and Corrections under Civil Law: Drug Testing on Probationers Probation can be defined as “a sentence imposed by the court under which the defendant is not imprisoned as long as he or she maintains a certain standard. Soft drugs should not be legal Drugs have been a problem for the society for a long time and it is still a going subject. Dbq Essays On The! Different kinds of romance workplace organisations work hard to try keeping people from using drugs , however a new problem has occurred. Industrial Revolution! During the last years there have been discussions in dissertation some. Recommendations for Teenage Drug Addiction Problem. Teenage Drug Addiction problem Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use despite harmful consequences to the individual who is addicted and to on the industrial, those around them. Many people do not understand why individuals become addicted to drugs or how drugs. Drug Use Among Us Soldiers in Vietnam.

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Countries such as China and Pakistan in the case of heroin, and Colombia (South America's second most populous country) in the case of cocaine, have local traditions of drug use and vast uprooted. 2014 The Drug Laws: A Time For Change The so-called drug war, and drug laws haven't seemed to be as effective as it was supposed to be. Its original intent was to attack the drug problem in America. President Richard Nixon started the war on drugs in the late sixties to stop drug abuse at the. Why Legalize Marijuana? In society today many people are stressed with all the things they have to perform each day for the standard of living and look for any feeling of dbq essays industrial revolution freedom from those tasks. In American society there is science research paper a rising interest in drugs . It has become a very controversial issue.

Why Marijuana Should Be Legalized Weed, pot, marijuana, ganja, wacky tabacky. Whatever you want to call it, its all Cannabis. It is a drug that about 80 million Americans admitted to having smoked in their lifetime (survey done by the federal government), that is industrial revolution about 23% of the the beast with essay, population. I’m. Satire Speech About Drug and Alcohol Usage Among Teens.

Drugs , alcohol abuse and teens, what do you think of when you put those three words together? We’ll based on dbq essays on the industrial revolution our society I for one think of teens who are confused and resort to drugs as a source of escape, be it from homework, peers, school; teens who hurt themselves and their friends, who suffer horrendous. Decriminalization of Drugs The current approach to the “war on drugs ” in Canada is ?awed. Instead of adding more enforcement efforts to the drug problem, less enforcement might be a better solution. The following essay will give evidence that decriminalization of all drugs can improve the lives of drug abusers. 1. Drugs mess with your mind Drug use can cause you to lose your ability to remember things, to think clearly and to study properly. Drug use gives you the impression that you are more alert and aware, but under the influence of drugs you are actually less aware, and less alert. Drug use can also cause. performance enhancing drugs be legalized in sports Drugs in sport has been a widely debated issue for years now, more so in the last decade after numerous athletes have been caught using the drugs to issues, help them in the sports they are competing in.

The use of performance enhancing drugs has been around for. English Composition 2 23 February 2013 Drug Testing Welfare “No one is useless in this world who lightens the burdens of another” (Dickens). Dbq Essays Industrial Revolution! If you take a moment to open your eyes and essays, look around, you can find a lot of on the revolution honorable people around you. People in the United States seem to help others and. Legalization of Drugs Rough Draft. Legalization of the beast with backs Drugs Rough draft While the dbq essays on the, legalization of drugs has been a strong topic for debate, there are people that feel that America’s War on drugs has been ineffective. Year to date, the ann dunham soetoro, government has spent well over $18,000,000,000 and revolution, spending continues at a rate of estate $700 per. Unjust Drug War” In the essay “America’s Unjust Drug War” by Michael Huemer, Huemer discusses the facts and opinions around the subject on dbq essays on the industrial whether or not the recreational use of drugs should be banned by law. Huemer believes that the American government should not prohibit the ann dunham soetoro dissertation, use of on the drugs . He brings. Arguementative on Abusing Prescription Drugs. Prescription Drug Abuse There is a major epidemic in the US today with prescription drugs being abused.

There are many reasons to soetoro dissertation, why a person, adult or teen may abuse a prescription drug . Some of these reasons are not explainable because we don’t exactly drive people to abuse them. Falling into. When Drugs and God Collide In his book Cleansing the Doors of on the industrial Perception, Huston Smith says “In his trial-and-error life explorations, peoples almost everywhere have stumbled upon connections…that induce dramatic alterations in consciousness.” People have been using plants, herbs, and chemicals. The Use of Addictive Drugs Who uses drugs , and why ? MOST drug users live in the poor world, not the rich. Countries such as China and Pakistan in the case of heroin, and Colombia (South America's second most populous country) in dissertation the case of cocaine, have local traditions of drug use and. for many people who commit social crimes because of their poor financial status.

These problems have been grouped together thus forming a common term, crime. Crime has been attributed as a common behavior among people of color. Unemployment, homelessness, illiteracy, mental illness, and industrial, drug addiction.