Shared decision making is integral to future surgical care. It is not possible without the organization and applications of knowledge. Evidence-based surgical practice is inevitable as practice and outcomes become patient centered. This issue will offer articles on developing skills for evidence-based surgery, the nature of surgical evidence, producing the evidence, and evidence-based decision making.

Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials. This book also explores EBM methodology and its relationship with other approaches used in medicine.

Now in its 7th edition this textbook is a must have for any health professional student. It provides a comprehensive overview of health research, in a concise and easy to read format using examples directly related to the health sciences. It helps students understand health research models, and how research goes on to inform and improve evidence-based clinical practice. For practitioners it provides guidance on published research in journals, providing an essential tool to keep their practice evidence based. Uses simple language and demystifies research jargon Covers both quantitative and qualitative research methodology, taking a very practical approach Provides an extensive glossary for better understanding of the language of research Fully updated online interactive self-assessment tests including MCQs, true or false questions and short answer questions.

Health systems should function in such a way that the amount of inappropriate care is minimized, while at the same time stinting as little as possible on appropriate and necessary care. The ability to determine and identify which care is overused and which is underused is essential to this functioning. To this end, the "RAND/UCLA Appropriateness Method" was developed in the 1980s. It has been further developed and refined in North America and, increasingly, in Europe. The rationale behind the method is that randomized clinical trials--the "gold standard" for evidence-based medicine--are generally either not available or cannot provide evidence at a level of detail sufficient to apply to the wide range of patients seen in everyday clinical practice. Although robust scientific evidence about the benefits of many procedures is lacking, physicians must nonetheless make decisions every day about when to use them. Consequently, a method was developed that combined the best available scientific evidence with the collective judgment of experts to yield a statement regarding the appropriateness of performing a procedure at the level of patient-specific symptoms, medical history, and test results. This manual presents step-by-step guidelines for conceptualising, designing, and carrying out a study of the appropriateness of medical or surgical procedures (for either diagnosis or treatment) using the RAND/UCLA Appropriateness Method. The manual distills the experience of many researchers in North America and Europe and presents current (as of the year 2000) thinking on the subject. Although the manual is self-contained and complete, the authors do not recommend that those unfamiliar with the RAND/UCLA Appropriateness Method independently conduct an appropriateness study; instead, they suggest "seeing one" before "doing one." To this end, contact information is provided to assist potential users of the method.

Manual dirigido a profesionales y estudiantes de las ciencias de la salud. El lector obtendrá conocimientos y habilidades en Medicina Basadas en la Evidencia (MBE) y en el análisis, interpretación y apreciación crítica de los diferentes diseños de investigación clínica, asimismo, podrá adquirir las herramientas básicas mediante el conocimiento de la estructura de los diferentes ensayos clínicos y de la estadística simple en la presentación de los resultados . Así podrá comenzar a realizar su propio proyecto de investigación.

Medical nihilism is the view that we should have little confidence in the effectiveness of medical interventions. Jacob Stegenga argues persuasively that this is how we should see modern medicine, and suggests that medical research must be modified, clinical practice should be less aggressive, and regulatory standards should be enhanced.

The firsd human society recognized to date is the Sumerian culture. It grew in the Middle East, on the banks of where the Tigris and Euphrates rivers meet, around the year 2500bce. This first society was alredy familiar with the concept of disease. It was defined as an "invasion and shutting in of a demon within sick persons body." The Sumerians tried to remove the demon by administering substances that would "confuse" it, and make it abandon the victims body. Thats why for many years it was thought that relief and curing had only a spititual or religious origin. Therefore, people depended on priests in organized societies (that had priestly orders) or on shamans ( in nomadic societies, or in thouse without priestly orders), the only ones capable of comunicating with the spirits in order to correct the problem. They were responsible for both their religious functions and for caring for health.