Evidence-Based Medicine
The Centre for Evidence-Based Medicine (CEBM) group provides teaching, support and resources to individuals and groups to facilitate Evidence-Based Practice. The EBM group undertakes research that focuses on both the general issues of implementation of Evidence-Based Practice and also specific disease related issues. Research interests include the barriers to practicing Evidence-Based Medicine in primary care. Ongoing studies conducted by the EBM group focus on the need for better recognition of information needs and access at the point of care which are critical to the better use of evidence in practice.
Evidence-Based approaches to monitoring in chronic disease are an interest of the group. Monitoring for chronic conditions is currently both expensive and poorly done. The wide variation in the percentage out-of-range between practices and between controlled trials indicates improvement is possible if "best practice" can be identified and disseminated, with the potential to improve health outcomes at minimal or even reduced costs. What elements of monitoring might be improved? A monitoring scheme consists of 3 main elements: (i) the measurements, (ii) the interval(s) and (iii) the action plan - the control limits and adjustment rules used. There is scope for improvement within each of these areas. There is also considerable scope for improvement through patient self-monitoring and self-adjustment, provided adequate tools and training are available. For some long term conditions there are well-developed and tested tools to improve control and patient outcomes, but these are often poorly known and used. For other long term conditions, the monitoring tools are poorly developed. The group undertakes methodological research in monitoring, and is compiling a library of monitoring tools. The group also has interests in self-monitoring; supported by a RCGP seed grant. A systematic review has been completed in self-monitoring of oral anticoagulation showing a significant reduction in thromboembolic events and mortality. Further interests in this area include the feasibility of self-monitoring and the methodology of assessing drop-out rates.
Research Staff
Administrative Staff
