Utiliser les bases bibliographiques bio-cliniques à bon escient (Medline, Embase, etc.)

• Les étudiants, les enseignants et les professionnels de santé peuvent consulter les bases bibliographiques : pour retrouver les références détaillées d’un article déjà connu; pour réaliser un travail universitaire (mémoire, thèse); pour préparer un cours en faculté ou une séance de formation continue; pour élaborer un protocole de recherche ou rédiger un article ou un ouvrage . • La base de données américaine Medline est loin d’indexer la totalité des journaux médicaux. Environ 90% de ces références bibliographiques renvoient à des articles publiés en anglais. • Une minorité de publications présentent des résultats directement transposables en clinique, tout en reposant sur un niveau de preuves suffisant. La qualité méthodologique des publications indexées est extrêmement variable. • Les résumés des articles (abstracts) sont en général trop peu informatifs pour juger de la fiabilité de l’étude originale et de sa réelle portée pratique. • Une synthèse de la littérature digne de ce nom nécessite une recherche simultanée dans plusieurs bases, choisies en fonction du sujet considéré. • Chaque base bibliographique comporte des documents indexés par une liste de mots-clés qui lui est propre. La syntaxe d’interrogation d’une base et les possibilités d’interrogation dépendent du fournisseur d’accès. • Une interrogation fructueuse requiert l’établissement préalable, base par base, d’une liste de mots adéquats, le plus souvent en anglais, et d’une stratégie de recherche documentaire consistant en une série de combinaisons bien pensées de ces termes entre eux.• Documenter une synthèse de la littérature ne s’ improvise pas : il faut soit se former à l’ interrogation des bases bibliographiques utilisées, soit recourir aux services d’un documentaliste professionnel

What cancer tells us about general practice. Birth of an hypothesis

We are presenting in this paper a study about general practitioners' behaviours and attitudes towards the cancer patients they take care of. To begin with, the approaching methods are presented in a critical way. The choice of these methods finds an explanation in the fact that we were looking for an information as near as possible to the real physicians' behaviours and supplying, at the same time, an important material, giving us the opportunity to undertake an interpretative analysis of the different medical cases about cancer patients (64) written by some (12) of the general practitioners (31) who had been interviewed before about cancer in their medical practice. We have tried, particularly, to point out and to illustrate with some examples the specific contribution of a chosen method compared with another one; for instance, the interviews compared to the written questionnaire, and the medical cancer cases written by the physicians compared to the interviews realized with the same general practitioners. In this paper we are also trying to report the preoccupations, the difficulties and the theoretical and methodological problems which appeared during the process of this research. Concerning the findings of this study, it is possible to assert that the main hypothesis seems coherent with the collected information: it really seems that cancer, with its social image in which fear for suffering and for dying prevail, is for the general practitioner a borderline situation in which his personal psychology and his feelings seem to play a more important part than his medical knowledge. In this 'drama', his previous relationship to his patient, the type of cancer involved, the patient's social and family background, the way in which he represents his profession, his medical experience, as well as his specialists network, also play an important part. If cancer is a challenge for the general practitioner, it seems that it is especially a challenge for the image he has of himself as a physician, but also as a human being, precisely because the part he can play concerning the therapeutics is very small. So, unlike the thesis of some authors, we think that the general practitioners (as a result also of a widely spread adhesion to values of a non-technical idea of his practice) can assume a determinant function, by advising the patient, by doing in the same time a good following up of the disease he suffers from, and by keeping with him a good relationship, which he often qualifies as 'interesting'.

Study design guide

Cochrane Consumers and Communication's methodological guide to study design

"Is Cybermedicine Killing You?" - The Story of a Cochrane Disaster

This editorial briefly reviews the series of unfortunate events that led to the publication, dissemination, and eventual retraction of a flawed Cochrane systematic review on interactive health communication applications (IHCAs), which was widely reported in the media with headlines such as "Internet Makes Us Sick," "Knowledge May Be Hazardous to Web Consumers' Health," "Too Much Advice Can Be Bad for Your Health," "Click to Get Sick?" and even "Is Cybermedicine Killing You?" While the media attention helped to speed up the identification of errors, leading to a retraction of the review after only 13 days, a paper published in this issue of JMIR by Rada shows that the retraction, in contrast to the original review, remained largely unnoticed by the public. We discuss the three flaws of the review, which include (1) data extraction and coding errors, (2) the pooling of heterogeneous studies, and (3) a problematic and ambiguous scope and, possibly, some overlooked studies. We then discuss "retraction ethics" for researchers, editors/publishers, and journalists. Researchers and editors should, in the case of retractions, match the aggressiveness of the original dissemination campaign if errors are detected. It is argued that researchers and their organizations may have an ethical obligation to track down journalists who reported stories on the basis of a flawed study and to specifically ask them to publish an article indicating the error. Journalists should respond to errors or retractions with reports that have the same prominence as the original story. Finally, we look at some of the lessons for the Cochrane Collaboration, which include (1) improving the peer-review system by routinely sending out pre-prints to authors of the original studies, (2) avoiding downplay of the magnitude of errors if they occur, (3) addressing the usability issues of RevMan, and (4) making critical articles such as retraction notices open access

Improving communication with cancer patients: A challenge for physicians

FLWINinfo:eu-repo/semantics/publishedCommunication with the Cancer Patient: Information and Trut