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Posts Tagged ‘evidence based medicine’

Sailing the Osler’s ship of medicine in the third millennium

Posted in bio ethics, Cardiology -Patient page, cardiology -Therapeutics, Clinical cardiology, general medicine, Medical education, Medical ethics, medical quotes, Two line sermons in cardiology, tagged , , , , , , , on March 31, 2021|

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Why evidence-based medicine continue to have a turbulent course?

Posted in Cardiology quotes, cardiology-ethics, tagged , , , , , , , , , , on February 13, 2021|

Because . . . its current course is not always in the right direction &  not everyone is ready for course correction as well!

Reference

1.Hasnain-Wynia R. Is evidence-based medicine patient-centered and is patient-centered care evidence-based? Health Serv Res. 2006;41(1):1- 

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Five cardinal principles of practicing “Modern Medicine” (un)successfully

Posted in Uncategorized, tagged , , , , , , , on May 19, 2019|

Somehow the concept of  Evidence based medicine (EBM )never excited me in spite of great strides it has made. Probably the main reason for this is, EBMs origin, quality, and credibility is currently severely compromised. (Though It appears to ooze science 24/7 and make us believe in it too !) Herewith, sharing some of the forbidden thoughts(with lots of pun)  for a (un)successful practice of EBM. This is definitely not meant for young and novice medical professionals. Strictly for the ones who can segregate sense from non (S)

Evidence-based Doubting 

 

Reference

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What ails the “Noble” profession ?… Is it the “erring” medical Intellect !

Posted in Uncategorized, tagged , , , , on January 31, 2016| 1 Comment »

medical education critics cardiology evdnce based medicine growth ethics

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I am confused sir , what is the hierarchy of medical advisories ?

Posted in Cardiology -guidelines, Infrequently asked questions in cardiology (iFAQs), tagged , , , , on February 21, 2015| Leave a Comment »

In this era of synthesized evidence base,  one of my  intellectually aberrant  student asked  How can we indulge in  a popular coronary procedure   with  class 1 indication backed by level C evidence  ?   (As defined by  the seemingly invincible  guideline committee  of various  International cardiology organizations .)

medical ethics silence guidelines

I told him ,

  • Institutional protocols are to be followed
  • Guidelines are to be respected
  • Recommendations are to be considered
  • Please be reminded  all of the  above can be rejected  outright !

Finally , realise  Individual  decisions based on sound scientific understanding with zero non academic intrusions  will be revered forever !

*Caution : If you  think  you haven’t  yet reached that the level of  individuality , come what may ,  you are  expected follow these  advisories  which are primarily aimed at  providing quality care and  you will be pardoned of any adversaries as well  !

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A new “Null Hypothesis” in medical research !

Posted in bio ethics, medical quotes, Two line sermons in cardiology, tagged , , , , , on December 21, 2014| Leave a Comment »

 

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After nearly three decades of , treating patients , teaching students and little involvement in research , I have consciously created a new  null hypothesis in medical research  !

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Learning Medicine from Mahatma Gandhi !

Posted in bio ethics, medical quotes, Two line sermons in cardiology, tagged , , , , , , , , , on November 1, 2014| Leave a Comment »

Mohandas Karam Chand Gandhi ,  father of my country , India , made these observations in year 1925  about the  fundamental constituents of  violence in society . These words of monumental wisdom came when he was  addressing young Indians in a country- side rally .

mahatma gandhi quotes medical science humanity

Note, his finger points to , what  exactly is relevant to our profession ! He emphasized this  nearly  100 years ago, when medical science was at its infancy .One can only guess what would be Mahatma’s comment about our profession in it’s  current form !

Should we include moral, behavioral and ethical classes  right from the first year of medical  school along with Anatomy , physiology and bio chemistry.Medical council of India obviously need to burn more mid night oil , I wish it happens in my life time. !

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Best solution to all your complex medical problems !

Posted in bio ethics, Cardiology -Mechnisms of disease, Cardiology -Therapeutic dilemma, cardiology -Therapeutics, Cardiology -unresolved questions, medical quotes, tagged , , , , , , , , , , , , , , , , , , on June 8, 2014| Leave a Comment »

critical decision making cardiology cath lab tricks coronary angiogram primary angioplasty ptca vs cabg acc aha guidelines esc guidelines

Answer

While our brain perceives  whatever option  we  choose is the best for the patient  , in reality it is rarely true !

The only comment I wish to make,  there is nothing called standard guidelines for complex and unusual problems .We need not be obsessed with protocols  !

Please remember , If you apply standard guidelines  in  non-standard situations  9/10 times we  are going to err !

So my  choice  would be, to  go with your gut feeling , of course  your gut should  be alive ,  up to date and periodically maintained !

If you don’t have the guts  . . . don’t worry  you have plenty of other options !

 

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You are a foolish cardiologist . . . don’t corrput young minds !

Posted in bio ethics, cardiology-ethics, Land mark articles in cardiology, medical quotes, tagged , , , , , , , , , , , on November 26, 2013| Leave a Comment »

In one of my  meetings , I told a small gathering  , that regular exercise can shrink atherosclerotic plaques and regress CAD. I also quoted , a recent  large  study which  has proven this fact convincingly !

I concluded, simple  exercise  and other life style changes,risk factor correction  may convert a 90% lesion to 70 or even 50 % . I stressed the importance of this study and asked my colleagues to avoid misuse of  Angioplasties .

When many  seemed to agree with me , one  angry  Interventional cardiologist questioned me, and  asked  the name of the  study, and in which journal  it came , What was quality of the paper ?

evidence based medicine ebm experince

I told him , It is an Imaginary study done  in my back yard . It never got published in print. You may call it as E-journal* , not exactly though.It is not available in any websites , but located in the  biological servers, and  neuronal circuits as digital imprints in learned brains !

*Journal of experience

You may call it , a scientific  forgery , to quote a non-existent study,

“But this study  benefits whole lot of my  patients”.

He was amused , and became agitated !

He told over the mike , “You are making  foolish statement. . . don’t corrupt young minds” !

May be , he is true !

I asked him to be calm and  requested  to listen to another study which I was about  to quote  . . .

He couldn’t sit any more  and rushed  out of the hall !

Final message

We  are ready to believe all those  rubbish stories about a fourth  generation   self disappearing BVS that is  able to scaffold a coronary artery and maintain a MLD by 2.5mm  and TVR by 20 % and prevent near MAZE  at 30 days  by 9 % and improve long term survival  by 6 months at  the cost of 100, 000 Rs  per month  .Only to realise, it may be a farce  . . .  5 years down the lane !

How to cleanse the darkened face of science ?

When falsehoods come with evidence and harm people , Good deeds can  be preached without evidence to save our fellow human beings !

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Modern medical quotes: Why evidence based medicine is sufferring ?

Posted in bio ethics, cardiology journals, Cardiology quotes, cardiology-ethics, tagged , , , , , , on June 14, 2012| Leave a Comment »

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