A 15th grand challenge for global public health.
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Delivery of Health Care↗
Biomedical subjects
Muir Gray
Publications and source records attributed to Muir Gray.
Evidence-based surgical practice and patient-centered care: inevitable.
Evidence-based medicine provides a well-developed framework for evaluation of clinical research. Well-designed and adequately powered randomized controlled trials provide the best information on therapeutic efficacy; however, extrapolation of the trials' conclusions to individual patients may be difficult, and for many important surgical problems, trial data are unavailable. A complementary approach of inferential decision-making helps address these limitations, and increases the clinician's confidence in the safety of an approach of unknown efficacy. Experience establishes norms and expectations, and emphasizes events that are uncommon but clinically important. Although it cannot eliminate uncertainty or controversy, the integration of analytic techniques of evidence, inference, and experience provides the surgeon with the best means of adapting treatment to the unique circumstances of the individual patient.
Delivery of Health Care↗
Problems of evidence-based patient choice in screening programmes.
A screening programme is a coordinated set of services for a defined population. Its purpose is to reduce the risk of dying, for example, of breast cancer. But testing does harm as well. For all potential screening programmes policies were developed in the UK during the last ten years: For 22 programmes there are national standards and annual reports, for 17 standards are missing and for 68 cases there is a policy not to screen. Screening is a population based programme, but it is the individual's informed choice whether to take part or not.
Choice Behavior↗