Connecting patients to the best-evidence through technology: An effective sol...
Die Ideen Archie Cochranes – wo stehen wir heute aus der Sicht des Klinikers
1. Die Ideen Archie Cochrane‘s Wo stehen wir heute aus der Sicht des Klinikers? Johannes Forster St. Josefskrankenhaus 10 Jahre Deutsches Cochrane Zentrum Freiburg i. Brsg.
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3. It is surely a great criticism of our profession that we have not organised a critical summary, by specialty or subspecialty, updated periodically, of all relevant randomised controlled trials. Archie Cochrane, 1979
4. Als Arzt in Gefangenschaft (Thessaloniki) I expected hundreds to die from diphtheria alone .. Only four deaths …. demonstrated very clearly …. the relative unimportance of therapy in comparison with the recuperative power of the human body.
7. Efficiency The results obtained when a therapy (screening, diagnosis, place of treatment …) is applied in routine clincal practice in a defined community
10. Random Reflections on the Health Services (I) … to add a little humanity to my approach: … „Equality“. The difference in the medical care of the rich and the poor was sufficient to touch the hardest-hearted student in the 1930‘s.
15. abnehmend Gleicher Zugang Gleichheit Mangelnde Wissenschaft-lichkeit Wirksamkeit, wenig Nachteile Versorgung Bemühen - größtenteils Wirksamkeit, wenig Nachteile Vorsorge Ist Soll Idee zu
16. Als Arzt in Gefangenschaft (Elsterhorst) A young soviet prisoner … was moribund. … I felt desperate. I knew very little Russian then and there was no one in the ward who did. I finally instinctively sat down on the bed and took him in my arms, and the screaming stopped almost at once. He died peacefully in my arms a few hours later. It was not the pleurisy that caused the screaming but loneliness. It was a wonderful education about the care of the dying. I was ashamed of my misdiagnosis and kept the story secret.
17. Random Reflections on the Health Services (II) In particular I believe that cure is rare, while the need for care is widespread, and that the pursuit of cure at all costs may restrict the supply of care.
18. Steue-rungs-EbM Bedside EbM Nationale Versorgungs-LL Fachgesellschafts-LL Krankenhaus-Behandlungspfad Praxis-LL
19. Langsames Verständnis E + Patienten-Interesse + Arzt-Erfahrung Evidence based medicine abnehmend Gleicher Zugang Gleichheit Mangelnde Wissenschaft-lichkeit Wirksamkeit, wenig Nachteile Versorgung Bemühen - größtenteils Wirksamkeit, wenig Nachteile Vorsorge Ist Soll Idee zu
20. Genetik Since barbiturates and sulphonamides can provoke acute attacks of porphyria, Archie encouraged family members to be tested for the condition. He held a sherry party for Cochrane relatives, gave a little talk about porphyria, and handed out kits to collect urine and feces samples for testing. When the Cochrane side tested negative, Archie mailed a do-it-yourself sample kit around the world to his mother’s relatives. True to his passion for high response rates, he eventually examined 152 of 153 living descendants on the affected side of the family. Archie published various papers on porphyria. After presenting one, he concluded by stating that “My stool is likely to become more famous than my (university) chair.” http://www.smj.org.uk/0802/cochrane.htm
25. Langsame Aufarbeitung (neue Instrumente) verständliche Aufklärung, wenig Nachteile Genetik Langsames Verständnis E + Patienten-Interesse + Arzt-Erfahrung Evidence based medicine abnehmend Gleicher Zugang Gleichheit Mangelnde Wissenschaftlichkeit Wirksamkeit, wenig Nachteile Versorgung Bemühen - größtenteils Wirksamkeit, wenig Nachteile Vorsorge Ist Soll Idee zu
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27. He was not a real success as a professor, either as a teacher or on the senate, though his kindness to students was proverbial. ALC. BMJ 1988