Tài liệu Evidence-Based Medicine and the Changing Nature of Health Care Meeting Summary (IOM Roundtable on Ev

Evidence-Based Medicine and the Changing Nature of Health Care: Meeting Summary (IOM Roundtable on Evidence-Based Medicine) (Learning Healthcare Systems)



Mark B. McClellan, J. Michael McGinnis,
Elizabeth G. Nabel, and LeighAnne M. Olsen
Publication Date: 8/6/2008
Pages: 202

Drawing on the work of the Round table on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and health care costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical.Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.





Summary p. 1
The Changing Nature of Health Care p. 33
Introduction p. 33
Evidence-based medicine and the IOM p. 35
Common themes from the 2007 IOM Annual Meeting p. 44
References p. 46
The Need for Better Medical Evidence p. 49
Introduction p. 49
Health care and the evidence base p. 50
The high price of the lack of evidence p. 62
References p. 68
Circumstances Accelerating the Need p. 71
Introduction p. 71
New healthcare product introduction p. 72
Rapidly developing insights into genetic variation p. 84
References p. 90
Contending with the Changes p. 93
Introduction p. 93
Beyond expert-based practice p. 94
The partnership imperative in an evidence-driven environment p. 105
References p. 107
The Promise of Information Technology p. 109
Introduction p. 109
Information technology tools to support best practices in health care p. 110
Information technology tools that inform and empower patients p. 115
Reference p. 125
Transforming the Speed and Reliability of New Evidence p. 127
Introduction p. 127
Electronic medical records and the prospect of real-time evidence development p. 128
Research methods to speed the development of better evidence-the registries example p. 132
Product innovation-the tailored therapies example p. 142
References p. 151
Policy Changes to Improve the Value We Need from Health Care p. 155
Introduction p. 155
Regulatory and healthcare financing reforms p. 156
Defining and introducing value in health care p. 161
References p. 172
Appendixes
Meeting Agenda p. 173
Biographical Sketches of Principals p. 177
IOM Roundtable on Evidence-Based Medicine Roster and Background p. 187
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