Solid organ transplantation and the probability of transmitting HIV, HBV, or HCV: a systematic review to support an evidence-based guideline

This systematic review addressed 10 Questions (middle column of Table 1) pertaining to solid organ transplantation and three bloodborne pathogens (HIV, HBV, and HCV). These questions were carefully developed by the Centers for Disease Control and Prevention in consultation with the Center for Evidence-based Practice at the University of Pennsylvania and ECRI Institute. These questions are not intended to encompass all important issues related to infectious diseases and organ transplantation. Instead, they were specifically focused to support the development of an evidence-based guideline. The leftmost column of the table shows which section of the guideline pertains to the questions, and the rightmost column provides explanatory comments.Introduction -- Methodology -- Overview of the evidence -- Evidence Reviews: I. Probability of transmission of HIV, HBV, or HCV through solid organ transplantation (SOT) -- Evidence Reviews: II. Methodology to better estimate donor infection with HIV, HBV, or HCV -- Evidence Reviews: III. Donor interventions to decrease transmission of HIV, HBV,or HCV from infected donors -- Evidence Reviews: IV. Potential risks and benefits of transplanting, or not transplanting, solid organs from donors positive for HIV, HBV, or HCV -- Evidence Reviews: V. Potential risks and benefits of transplanting, or not transplanting, solid organs from donors with risk factors for HIV, HBV, or HCV -- Gaps in the current literature -- References -- Appendix A. Details of literature search.Jonathan R. Treadwell, Meredith Noble.April 14, 2010.This report was funded by the Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, GA.Mode of access: World Wide Web as an Acrobat .pdf file (6.97 MB, 530 p.).References: p. 491-502

End-of-life care and outcomes. Summary.

6 pages.Evaluates the effectiveness of end-of-life care

Cancer care quality measures: symptoms and end-of-life care (Evidence report/technology assessment no. 137)

251 pagesEvaluates the quality of end-of-life care for cancer patients. The study was conducted using the medical literature

Evidence-based practice and practice-based evidence

This policy brief outlines the complexities involved in selecting interventions for early childhood services. It advocates for a broader method of assessing outcomes of interventions through incorporating practice-based evidence into our understanding of evidence-based practice. For services in the early childhood sector, choosing the most effective interventions for children and their families often involves a challenging examination and evaluation of the available evidence. Traditionally, researchers have looked to evidence stemming from trials that incorporate rigorous methodologies as a way of selecting the ‘best’ evidence for evaluation. However, this narrow approach is not the only way of identifying effective interventions, nor is it necessarily always the best way

Evidence-based policy as reflexive practice.

The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often

Evidence-Based Practice in Clinical Social Work

Evidence-based practice (EBP) is a major shaping influence in clinical social work practice, in relation to economic policies, and in professional education. The definition of EBP remains contested; professionals still fail to distinguish EBP as a practice decision-making process from a list of treatments that have some type of research support (which are correctly called empirically supported treatments). All mental health practitioners should understand what EBP is, what it is not, and how it shapes both client options and their own practice experiences. This book explores EBP in depth and in detail. Our focus includes case exemplars that show how the EBP decision-making process is done in practice. There are many recent books about evidence-based practice in social work and in other mental health professions. In reviewing these books, it appeared to us that most of the books on EBP have been written by researchers, bringing a particular point of view and expertise to the technicalities of EBP. These books are important to social workers and other mental health professionals because EBP involves a lot of technical details about research design, methods, and interpretation that are not always covered in other social work texts. On the other hand, the lack of a more direct practice and clinical viewpoint seemed to leave out a lot of the day-to-day realities clinical social workers confront in learning and using EBP in practice. Recent books also lacked much in the way of a broad and critical perspective on EBP as a social movement shaping policy, agency practice, and views of what constitutes “good” research. As we explored other books as resources for our students and for our own practice, we missed both a larger or meta-perspective on EBP and a lack of attention to doing it in clinical practice. This book seeks to illustrate through several cases how important clinical knowledge and expertise are in doing EBP well. We seek to introduce the core ideas and practice of EBP and then illustrate them by applying the concepts and processes to real-world cases. We also take a critical look at how EBP has been implemented in practice, education, and policy. Eight years after we wrote the first edition of this book, EBP continues to be a major influence on clinical practice. Some areas of the book, particularly the research evidence used in our case examples, needed to be updated and mad

Clinical experience as evidence in evidence-based practice

Background. This paper's starting point is the recognition (descriptive not normative) that, for the vast majority of day-to-day clinical decision-making situations, the 'evidence' for decision-making is experiential knowledge. Moreover, reliance on this knowledge base means that nurses must use cognitive shortcuts or heuristics for handling information when making decisions. These heuristics encourage systematic biases in decision-makers and deviations from the normative rules of 'good' decision-making. Aims. The aim of the paper is to explore three common heuristics and the biases that arise when handling complex information in clinical decision-making (overconfidence, hindsight and base rate neglect) and, in response to these biases, to illustrate some simple techniques for reducing the negative influence of heuristics. Discussion. Nurses face a limited range of types of uncertainty in their clinical decisions and draw primarily on experiential knowledge to handle these uncertainties. This paper argues that experiential knowledge is a necessary but not sufficient basis for clinical decision-making. It illustrates how overconfidence in one's knowledge base, being correct 'after the event' or with the benefit of hindsight, and ignoring the base rates associated with events, conditions or health states, can impact on professional judgements and decisions. The paper illustrates some simple strategies for minimizing the impact of heuristics on the real-life clinical decisions of nurses. Conclusion. The paper concludes that more research knowledge of the impact of heuristics and techniques to combat them in nursing decisions is needed

Applied and conceptual approaches to evidence-based practice in research and academic libraries

Evidence-based practice is an approach to professional practice that involves a structured process of collecting, interpreting and applying valid and reliable research and evidence to support decision-making and continuous service improvement in professional practice. This paper reports on emerging initiatives in evidence-based practice at the University of Southern Queensland (USQ) Library, a regional multi-campus university in Australia. It demonstrates how evidence-based practice forms part of our organisational strategy to engage with our community and society. The case study describes a new model of embedding evidence-based practice through a role explicitly dedicated to developing the library’s evidence base. While other libraries may have a person responsible for assessment, performance metrics or data analysis, the Coordinator (Evidence-Based Practice) has a broader mandate – to work with library staff to develop tools, skills and expertise in evidence-based practice. The paper will describe why this role was created and how the Coordinator is working to engage with library staff to understand their business and the evidence needed to support service improvement for the Library. By doing this, USQ Library is building the capacity to demonstrate value to stakeholders, gain a deeper understanding of clients’ needs and experiences, promote robust decision-making and improve service delivery. The paper also outlines an initiative led by the Coordinator (Evidence-Based Practice) to develop a conceptual model of evidence-based practice within academic libraries at the organisational, rather than individual level. Current models of evidence-based library and information practice apply predominantly to individuals. Informed by relevant literature and 16 semi-structured interviews with library professionals from Australian and New Zealand university libraries, three themes emerged to describe how evidence-based practice might be experienced at the organisational level. The lived experience at USQ Library and our research investigations suggest that being evidence-based provides benefits to an academic library’s culture, practice and impact