This 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.
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/