Name:
Introduction to JAMAevidence: Drummond Rennie, MD, discusses the impetus and authorship behind JAMAevidence, which provides fundamental tools for dealing with the medical literature and making clinical diagnoses.
Description:
Introduction to JAMAevidence: Drummond Rennie, MD, discusses the impetus and authorship behind JAMAevidence, which provides fundamental tools for dealing with the medical literature and making clinical diagnoses.
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/ddc1f69c-f1b1-4b85-8703-3995b85ba74d/thumbnails/ddc1f69c-f1b1-4b85-8703-3995b85ba74d.jpg?sv=2019-02-02&sr=c&sig=KHwAwhshsBIrFLUq7GxCrRjuTCbpgN8%2BVmzASZb1I20%3D&st=2024-12-22T06%3A22%3A36Z&se=2024-12-22T10%3A27%3A36Z&sp=r
Duration:
T00H08M02S
Embed URL:
https://stream.cadmore.media/player/ddc1f69c-f1b1-4b85-8703-3995b85ba74d
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/ddc1f69c-f1b1-4b85-8703-3995b85ba74d/6830446.mp3?sv=2019-02-02&sr=c&sig=o4jiTUfMY%2Fq%2FJpMsWhXr1a49NIgW8tYVOeL2n%2Bn6Tx4%3D&st=2024-12-22T06%3A22%3A36Z&se=2024-12-22T08%3A27%3A36Z&sp=r
Upload Date:
2022-02-28T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
>> Welcome to JAMAevidence. My name is Drummond Rennie. I'm Deputy Editor at JAMA, and I'm Professor of Medicine at the University of California San Francisco. And I'm here to introduce you to JAMAevidence, which is going to be a way whereby you're given the tools to deal with medicine, the fundamental tools for dealing with the literature, the fundamental tools for dealing with making diagnoses and getting to know your patients.
We've just come up with the second edition of a book called the "Users Guides to the Medical Literature." I grew up in wartime Britain, and I well remember that you could gaze across the channel from near Dover, and you could see what was occupied territory. It was France, and it was full at that time of Germans who were occupying it. There wasn't any doubt in my mind that I would never, ever be there.
And at the same time at school I was being taught French. So, of course, it was a purely intellectual process. I never really learnt French, because I knew I would never be in France, and I'd never actually have to use it. Well, it's exactly the same with the medical literature and most physicians. Most physicians don't know how to read and particularly criticize and see whether they can make use of articles.
And yet the whole of our therapies are based on articles that appear in the medical literature. And what they do is that they tend, if they can't make a reasonable criticism of these articles, they tend to fall back on reviews. And so we know from a great number of studies that they're biased in their results. Now, it isn't a very good idea to base your treatment of patients on biased results.
And so each chapter of this book deals with how to approach studies, how to find the literature that's relevant to your patient, how to get hold of this literature to compare articles one with another to see how solid the evidence is. And in the end, for you to reach your own decision about the best treatment that you can advise the patient to have. Now, that is called evidence-based medicine.
And Gordon Guyatt, who is the lead author of all these chapters and my co-editor, invented the term "evidence-based medicine" to indicate this rigorous process of looking at all the evidence behind how we treat patients and seeing whether it's worth anything, worth a great deal. What should we keep and adopt? What should we just completely throw out? And it depends, of course, on the literature, the stuff that comes out in journals.
And what we're aiming to do from this series is to show you how to get on top of this, how to get completely in charge. Now, that's the first book of which there'll be a large manual, which will deal with every sort of article that you're ever likely to meet. And then there will be an essentials or a sort of thing you can carry around with you on rounds. The other book that we've got is just coming out.
And it is "The Rational Clinical Exam." This comes also from the series that we've been running in JAMA. Like the "Users' Guide," this was a series that I started with a great man of medicine, Dave Sackett, who is head of medicine at McMaster and a very original man. And in this case, the mantle of head of this series was taken on by Dave Simel, who's a professor of medicine at Duke.
And what we aim to do here is to look at something totally fundamental in medicine. And that is, what is the evidence behind items in the history and the physical examination? Now, we're taking what is, we think, a pretty original approach. And that is to regard every item as a test. Now, most people think a test, well, it's a blood test or it's an electrocardiogram.
So have I got a normal heart? Well, get an electrocardiogram. But an electrocardiogram is not nearly as predictive and useful as the answer to this question. Do you get crushing pain across the chest early in the morning, when you're exercising, say shoveling snow? If the answer to that is yes, you've got a very, very high probability of a diagnosis of coronary artery disease, far higher than an electrocardiogram can give.
The idea is to split up all aspects of the history, all aspects of the physical examination. So an enlarged spleen or is it enlarged? What is the evidence behind papers on this? And to look at everything that's been published on this and to critique all this and then finally to lay it out to help the doctor. So that we discard all sorts of signs and symptoms which are found to be, in fact, useless, but which I was taught as being holy writ.
And just concentrate on those that seem to be important, that are and have been shown to be, in other words, by the evidence, have shown to be important now. That's the series called "The Rational Clinical Exam" or "Examination Series." All the articles that we published in JAMA, all 51 of them, have been updated so that they're current now. But updated, that is, by Dave Simel and his colleagues.
Together the two books will give everybody a very powerful basis in medicine. A control over and an understanding of the medical literature and an understanding of how to get to know your patient. What are the meaning of symptoms? And what are the meanings of signs? When you go back into the JAMAevidence site, you'll find all sorts of useful features to help you.
For example, calculators, say to calculate odds ratios and probabilities and so on. All sorts of questions, question wizards. Eventually it will be possible to have your own diary, as it were, that these are the searches that you've done for this sort of patient. And through this process, you'll also be able to get PowerPoint slides and, to enhance the classroom or the conference teaching that can you get.
I'm very excited by this, and I hope you will be too.
