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Some Thoughts on Evidence-Based Practice and Decision Making

Dr. Tricia Greenhlagh has been someone who has immensely influenced my thinking. She is a professor of primary care health sciences at the University of Oxford, and she wrote a great little book called “How to Read a Paper: The Basics of Evidence-Based Medicine.” (1) She now also adds a blog to her list...
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The Evidence Hierarchy Evolving

By now, we have all been exposed to the evidence pyramid. This is a graphic that demonstrates the apparen6t hierarchy of scientific papers, with those with the least rigor located at the bottom of the pyramid, and those with the most at the top. So, we have anecdote and case reports located near bottom,...
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Treatment options

Are supine high-velocity low-amplitude (HVLA) manipulative procedures appropriate for managing cases with symptomatic cervical disc herniation? Results from a study conducted in Switzerland provide evidence that supine HVLA procedures can be used safely and effectively. A clinical trial described in The Journal of Manipulative and Physiological Therapeutics reports on a study conducted with patients...
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Seminal Papers in Evidence-Based Medicine

There are simply thousands of papers on evidence-based practice, but sometimes it is good to see how it all started. Below are some of the seminal papers on EBM that were published in the early days of the movement. Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine....
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Surrogates are everywhere

Last month the British Medical Journal published a systematic review and meta-analysis on calcium intake and bone mineral density. It has long been hypothesized that adequate calcium in the diet is important for “healthy bones.” There has been quite a bit of research on the subject. In fact the authors identified 59 randomized controlled...
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Apps for Evidence-Based Practice

We live in a busy and mobile world where we have access to more information on our cell phones that earlier people did by visiting a library. And we live in a world where evidence is increasingly important to us in the practice of chiropractic. Can we yoke our developing technology to our practices?...
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