ICML 2009: Great Hall 1 Session 3

Theme: Translating the Evidence

Time: 10.45-12.15
Date: Wednesday 2nd September 2009
Chair: Connie Schardt

Evidence-Based Plastic Surgery: Is it real and relevant?
Shymal C Dhar, The University of Melbourne, Australia

Dr. Dhar received his medical training in Canada before migrating to Australia to pursue a career in academic surgery. He has devoted much of his career to the Reconstructive Plastic Surgery Research Unit of The Royal Melbourne Hospital and is a Surgical Research Fellow at The University of Melbourne. He has recently moved to Brisbane and is in full time clinical practice.

Abstract:
Evidence-based clinical practice is the integration of individual clinical expertise with the best available external clinical evidence from systematic research while factoring patient values into clinical decision making. It is a life-long process of self-directed learning in which patient care creates the ever present need for clinically relevant information regarding diagnosis, prognosis and therapy. For ethical reasons, level 1 “best-evidence” is not always possible in surgery. In the past, the majority of studies in the plastic surgical literature lacked a proper study design and valid size estimation. A comprehensive review of the literature identifies several obstacles facing the plastic surgeon when trying to ensure that practice is evidence-based.

Despite the difficulties inherent in evidence-based plastic surgery, two fundamental principles exist. First, the evidence alone is never sufficient to make a clinical decision because plastic surgeons must always consider the benefits and the risks, inconvenience, and cost associated with alternative techniques. The patient’s values and preferences must always be taken into consideration. Second, evidence-based plastic surgery requires a hierarchy of evidence to guide surgical decision making. The difficulty in conducting surgical randomized control trials should not be an overwhelming dilemma in producing good quality evidence in plastic surgery. In recent years, the plastic surgery community has recognized the necessity of performing outcome studies designed to move practice away from empiricism and toward a foundation based on assessment by outcome. By increasing our critical appraisal skills, the clinician can begin to make best use of the current evidence available.

Getting Research Findings into Practice
Edith Clausen, Aarhus University Hospital, Aarhus Sygehus, The Research Library, Denmark

Edith Clausenis a Research Librarian and information professional working at the Research Library at Aarhus University Hospital in Denmark. She holds a degree in Information Science (cand.scient.bibl) and a Master in Humanistic Health (MHH).

Abstract
Background: Getting research findings into practice or closing the gap between knowledge and practice are problems health authorities have tried to solve in different ways with minimal success. Objective: Through an analysis of the concept of knowledge – both the explicit and the tacit – and based on the need for information in general practice the objective is to develop a practicable model for implementing research findings into practice.

Methods: Qualitative interviews with general practitioners were performed, and different dissemination models e.g. EBM, The ’Breakthrough Series’ Collaborative Method and The Chronic Care Model are analysed.

Result: A communication model is developed using: communication, dialogue and participation as the elements depending on the relation and the involvement between the researcher and the general practitioner.

Conclusion: Getting research into practice requires a very close co-operation between the researchers and the general practitioners, if it shall be successful. - But if the librarian or information professional takes over the task of getting research findings into general practice both by facilitating access to the right information and as a moderator in the dialogue between and the participation in research activities for the practitioner the success will be more probable. This is a very important object for our profession.

The information management of medical information professionals (MIPs) in evidence-based medicine (EBM) in Thailand
Somrux Sahapong, Ramathibodi Hospital Library. Mahidol University, Thailand

Abstract:
Objective: To study information management of medical information management professionals (MIPs) serving clinicians in the practice of evidence-based medicine (EBM) in Thailand

Methodology: Survey research using 54 questionnaires to MIPs serving clinicians in the practice of evidence-based medicine (EBM) in Thailand

Results: The 54 out of 54 respondents replied (100 %). The majority of respondents had no experienced in EBM training course (83.3%) Their competencies of information technology in internet and searching EBM databases were good to excellent (44.4%) and ( 53.7%). The most competence in using databases were PubMed and Cochrane Library (42.6%) and (40.7%) . The majority of MIPs didn’t have the basic knowledge of the EBM process (72.2%) but their organizations and technology infrastructure supported the information-seeking circumstance in excellence (48.0%) and (92.6%). For information provision, the majority of respondents acquired PubMed (98.2 %) and Cochrane library (74.1%). The most available information service was database subscription (83.3%). The cooperation between MIPs and clinicians in resources and databases evaluation were not good ( 57.4%). The great barriers of the majority of respondents were insufficient MIPs serving clinicians who were so busy on their duties.

Conclusion: Studies have shown that supporting the practice of EBM will challenge MIPs in Thailand by adjust their information management following Thai clinicians in the practice of evidence-based medicine (EBM) in Thailand.

Assessing the effectiveness of medical therapies – finding the right research for each patient: Medical Evidence
Matters Roger Tritton, Proquest, United Kingdom

Roger is the Director, Product Management, in the Dialog department at Proquest, based in the UK

Abstract:
The gap between how effective treatments for different medical conditions are seen to be and how effective they are proven to be remains tantalizing. This presentation describes the method used by Medical Evidence Matters, published by ProQuest, that enables researchers, clinicians, librarians, and decision-makers to assess therapy options by comparing outcomes from medical research presented in the peer-reviewed literature. The presentation will explain how research data is extracted and presented in a template that allows users to compare and contrast results and to find research relevant to a specific patient. We explain how charts and graphs are created to enable effective assessment of research results across a range of medical outcomes. And we explain how results can be customized to allow users to assess evidence from alternative therapies, specific patient characteristics, specific treatment characteristics, and specific research characteristics.