1. EBM has been around for years. Why is EBM so hard to implemet? According to Mohammad and Salahshoor (2018) “Despite the emergence and development of evidence-based practice (EBP) in recent years, its adoption continues to be limited.” (p. 25). By use of used Rogers's diffusion of innovation theory, they were able to identify several factors that affect the adoption of Evidence based medicine, including individual innovation, attitude, knowledge, and the perception of evidence based medicine. In my own experience, I have found that attitude of providers greatly affected their adoption of EBM. When providers feel they are losing control of the care of their patients or they feel that guidelines and evidence based practice are being force
…show more content…
In the Video, Dr. Abda point out the importance of not only using clinical research information but also rely of shared decision making, the …show more content…
RCT have however raise many ethical issues. One of these issues according Shamey (2015) is “How should clinicians decide whether it is ethically justifiable to enroll their patients into randomized clinical trials (RCTs)” ( p. 2). In the past it was felt that by blinding the study, providers would not know which treatment was given and that there was no way to determine if one treatment was better than the other. This was known as equipoise. Based on equipoise provider can ethically place patient in trials because they do not know which treatment is better. Today many providers have opinions about treatment and they are reluctant to place patient into trials because they feel one arm to be inforero to the other. Shamey discussed the concept of fallibility, where he points out that all provider opinions are sufficiently uncertain which therefore begs the need of the trial and enrolled therein. Another area of ethical concerns is what to do when the trials are leaning excessively one way or another. In the Early NSAB trial. 3 arms were established to determine the best treatment of breast cancer. Mastectomy, lumpectomy, or lumpectomy with radiation. The study early on showed such poor outcome in the lumpectomy only group that this arm of the trial was stopped early. The other too arms were completed and from this we know that the surgive of
In the Video, Dr. Abda point out the importance of not only using clinical research information but also rely of shared decision making, the …show more content…
RCT have however raise many ethical issues. One of these issues according Shamey (2015) is “How should clinicians decide whether it is ethically justifiable to enroll their patients into randomized clinical trials (RCTs)” ( p. 2). In the past it was felt that by blinding the study, providers would not know which treatment was given and that there was no way to determine if one treatment was better than the other. This was known as equipoise. Based on equipoise provider can ethically place patient in trials because they do not know which treatment is better. Today many providers have opinions about treatment and they are reluctant to place patient into trials because they feel one arm to be inforero to the other. Shamey discussed the concept of fallibility, where he points out that all provider opinions are sufficiently uncertain which therefore begs the need of the trial and enrolled therein. Another area of ethical concerns is what to do when the trials are leaning excessively one way or another. In the Early NSAB trial. 3 arms were established to determine the best treatment of breast cancer. Mastectomy, lumpectomy, or lumpectomy with radiation. The study early on showed such poor outcome in the lumpectomy only group that this arm of the trial was stopped early. The other too arms were completed and from this we know that the surgive of