The systematic review: “A social movement”

internet-and-womanThis blog was founded more than four years ago with the a focus on one key idea: Today, there more research available than ever before. So we set out to help readers separate the good scientific information from the bad. One great resource for that is the systematic review.

Last week, we were fascinated to see a column in the New York Times by Weill Cornell Medical professor Dr. Kent A. Sepkowitz, an expert in infectious disease and the head the infection control program at  Memorial Sloan Kettering Hospital.  He wrote about how systematic reviews are impacting clinical practice.

Sepkowitz describes how the practice of evaluating and collating all of the data on a given topic is impacting the decisions doctors make on a daily basis.

“In 20 years, the field of evidence-based medicine has grown from a few true believers to an international movement in health care that touches countless patients every day,” he writes.

When doctors are debating the best treatment for a patient, the mention of a review from the Cochrane Collaboration will typically end the debate, he explains, because doctors are most likely to follow the review’s recommendation.

Sepkowitz points out the downsides of relying only on the evidence – that every patient is an individual with unique circumstances that require consideration. Still,  he advocates for evidence-based medicine that is ethical and meticulous. His take-home message is a strong one: the systematic review is an important component in the medical decision-making process.  We agree heartily.

Comments

  1. Mike Fraumeni says:

    An interesting and evolving idea -Standardized Clinical Assessment And Management Plans (SCAMPs) provide a better alternative to clinical practice guidelines.

    Health Aff (Millwood). 2013 May;32(5):911-20. doi: 10.1377/hlthaff.2012.0667.
    Standardized Clinical Assessment And Management Plans (SCAMPs) provide a better
    alternative to clinical practice guidelines.

    Farias M(1), Jenkins K, Lock J, Rathod R, Newburger J, Bates DW, Safran DG,
    Friedman K, Greenberg J.

    Author information:
    (1)Boston Children’s Hospital, Massachusetts, USA.
    michael.farias@childrens.harvard.edu

    Variability in medical practice in the United States leads to higher costs
    without achieving better patient outcomes. Clinical practice guidelines, which
    are intended to reduce variation and improve care, have several drawbacks that
    limit the extent of buy-in by clinicians. In contrast, standardized clinical
    assessment and management plans (SCAMPs) offer a clinician-designed approach to
    promoting care standardization that accommodates patients’ individual
    differences, respects providers’ clinical acumen, and keeps pace with the rapid
    growth of medical knowledge. Since early 2009 more than 12,000 patients have been
    enrolled in forty-nine SCAMPs in nine states and Washington, D.C. In one example,
    a SCAMP was credited with increasing clinicians’ rate of compliance with a
    recommended specialist referral for children from 19.6 percent to 75 percent. In
    another example, SCAMPs were associated with an 11-51 percent decrease in total
    medical expenses for six conditions when compared with a historical cohort.
    Innovative tools such as SCAMPs should be carefully examined by policy makers
    searching for methods to promote the delivery of high-quality, cost-effective
    care.
    PMCID: PMC3990928
    PMID: 23650325 [PubMed – indexed for MEDLINE]

    Free fulltext article from PMC at – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990928/

Speak Your Mind

*

Skip to toolbar