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Closing the gap between research and practice

Published online by Cambridge University Press:  03 January 2018

John R. Geddes  and
Paul J. Harrison
John R. Geddes*
Affiliation:
University Department of Psychiatry, Warneford Hospital, Oxford
Paul J. Harrison
Affiliation:
University Department of Psychiatry, Warneford Hospital, Oxford
*
Dr J. Geddes, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX. Fax: 01865 793101; e-mail: john.geddes@psychiatry.oxford.ac.uk
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Extract

Has Mrs A got schizophrenia? Would Mr B do better with a tricyclic or a selective serotonin reuptake inhibitor? Is Miss C likely to be recovered in six months time? Is St John's wort an effective antidepressant? Clinical psychiatry involves making difficult decisions about diagnosis, therapy and prognosis. Sometimes we may be entirely confident about our decisions, but often we are uncomfortably aware that we are making a choice without being sure there is convincing evidence to justify it. Maybe we don't know or have forgotten what the evidence is, or perhaps there isn't any.

Type
Evidence-Based Psychiatry
Information
The British Journal of Psychiatry , Volume 171 , Issue 3 , September 1997 , pp. 220 - 225
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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Footnotes

†

See commentaries, pp. 226–227.

References

Anonymous (1995) Care-management: a disastrous mistake. Lancet. 345, 399–401.Google Scholar
Bennett, K. J., Sackett, D. L., Haynes, R. B., et al (1987) A controlled trial of teaching critical appraisal of the clinical literature to medical students. Journal of the American Medical Association, 257, 2451–2454.CrossRefGoogle ScholarPubMed
Beral, V., Hermon, C., Reeves, G., et al (1995) Sudden fall in breast cancer death rates in England and Wales. Lancet, 345, 1642–1643.CrossRefGoogle ScholarPubMed
Cochrane Collaboration (1996) The Cochrane Library. Oxford: Update Software.Google Scholar
Cook, R. J. & Sackett, D. L. (1995) The number needed to treat: a clinically useful measure of treatment effect. British Medical Journal, 310, 452–454.CrossRefGoogle Scholar
Davis, D. A., Thomson, M. A., Oxman, A. D., et al (1995) Changing physician performance. A systematic review of the effect of continuing medical education strategies. Journal of the American Medical Association, 274, 700–705.CrossRefGoogle ScholarPubMed
Eccles, M., Clapp, Z., Grimshaw, J., et al (1996) North of England evidence based guidelines development project: methods of guideline development. British Medical Journal, 312, 760–762.CrossRefGoogle ScholarPubMed
Eddy, D. M. (1990) Clinical decision making: from theory to practice. What do we do about costs? Journal of the American Medical Association, 264, 1161, 1165, 1169–1170.CrossRefGoogle ScholarPubMed
Eddy, D. M. (1992) Clinical decision making: from theory to practice. Cost-effectiveness analysis. Will it be accepted? Journal of the American Medical Association, 268, 132–136.CrossRefGoogle ScholarPubMed
Eddy, D. M. (1993) Clinical decision making: from theory to practice. Three battles to watch in the 1990s. Journal of the American Medical Association, 270, 520–526.CrossRefGoogle ScholarPubMed
Eddy, D. M. (1994) Clinical decision making: from theory to practice. Principles for making difficult decisions in difficult times. Journal of the American Medical Association, 271, 1792–1798.CrossRefGoogle ScholarPubMed
Egger, M. & Smith, G. D. (1995) Misleading meta-analysis. British Medical Journal, 310, 752–754.CrossRefGoogle ScholarPubMed
Ellis, J., Mulligan, I., Rowe, J., et al (1995) Inpatient general medicine is evidence based. Lancet, 346, 407–410.Google ScholarPubMed
Evidence-Based Medicine Working Group (1992) Evidence-based medicine. A new approach to teaching the practice of medicine. Journal of the American Medical Association, 260, 2420–2425.Google Scholar
Eysenck, H. J. (1994) Meta-analysis and its problems. British Medical Journal, 309, 789–792.CrossRefGoogle ScholarPubMed
Fahey, T., Griffiths, S. & Peters, T. J. (1995) Evidence based purchasing: understanding results of clinical trials and systematic reviews. British Medical Journal, 311, 1056–1059.CrossRefGoogle ScholarPubMed
Geddes, J. R., Christofi, G. & Sackett, D. L. (1996a) Commentary on “first-rank symptoms”. British Journal of Psychiatry, 169, 544–545.Google Scholar
Geddes, J. R., Game, D., Jenkins, N. E., et al (1996b) What proportion of primary psychiatric interventions are based on randomised evidence? Quality in Health Care, 5, 215–217.CrossRefGoogle Scholar
Gilbody, S. (1996) Evidence-based medicine: an improved format for Journal clubs. Psychiatric Bulletin, 20, 673–675.CrossRefGoogle Scholar
Glasziou, P. P. & Irwig, L. M. (1995) An evidence based approach to individualising treatment. British Medical Journal, 311, 1356–1359.CrossRefGoogle ScholarPubMed
Grahame Smith, D. (1995) Evidence based medicine: Socratic dissent. British Medical Journal, 310, 1126–1127.CrossRefGoogle ScholarPubMed
Greenhalgh, T. (1996) Is my practice evidence-based? British Medical Journal, 313, 957–958.CrossRefGoogle ScholarPubMed
Hermann, R. C., Dor wart, R. A., Hoover, C. W., et al (1995) variation in ECT use in the United States. American Journal of Psychiatry, 152, 869–875.Google ScholarPubMed
Hirsch, S. R. & Barnes, T. R. (1994) Clinical use of high-dose neuroleptics. British Journal of Psychiatry, 164, 94–96.CrossRefGoogle ScholarPubMed
Huston, P. & Moher, D. (1996) Redundancy, disaggregation, and the integrity of medical research. Lancet, 347, 1024–1026.CrossRefGoogle ScholarPubMed
Jackson, R. T. & Sackett, D. L. (1996) Guidelines for managing raised blood pressure. British Medical Journal, 313, 64–65.CrossRefGoogle ScholarPubMed
Kerr, M., Blizard, R. & Mann, A. (1995) General practitioners and psychiatrists: comparison of attitudes to depression using the depression attitude questionnaire. British Journal of General Practice, 45, 89–92.Google ScholarPubMed
Laupacis, A., Sackett, D. L. & Roberts, R. S. (1988) An assessment of clinically useful measures of the consequences of treatment. New England Journal of Medicine, 318, 1728–1733.CrossRefGoogle ScholarPubMed
Lewis, A. (1958) Between guesswork and uncertainty in psychiatry. Lancet, i, 171–175.CrossRefGoogle Scholar
Marshall, M., Gray, A., Lock wood, A., et al (1996) Case management for people with severe mental disorders. In Schizophrenia Module (eds Adams, C., Anderson, J. & De Jesus Mari, J.). Oxford: Update Software.Google Scholar
Meise, U., Kurz, M. & Fleischhacker, W. W. (1994) Antipsychotic maintenance treatment of schizophrenia patients: is there a consensus? Schizophrenia Bulletin, 20, 215–225.CrossRefGoogle ScholarPubMed
Mulrow, C. D. (1987) The medical review article: state of the science. Annals of Internal Medicine, 106, 485–488.CrossRefGoogle ScholarPubMed
Mulrow, C. D. (1994) Rationale for systematic reviews. British Medical Journal, 309, 597–599.CrossRefGoogle ScholarPubMed
Naylor, C. D. (1995) Grey zones of clinical practice: some limits to evidence-based medicine. Lancet, 345, 840–842.CrossRefGoogle ScholarPubMed
NHS Centre for Reviews and Dissemination (1994) Implementing Clinical Practice Guidelines. Effective Health Care, 8.Google Scholar
Oxman, A. D. & Guyatt, G. H. (1988) Guidelines for reading literature reviews. Canadian Medical Association Journal, 138, 697–703.Google ScholarPubMed
Pippard, J. (1992) Audit of electroconvuslive treatment in two national health service regions. British Journal of Psychiatry, 160, 621–637.CrossRefGoogle Scholar
Priest, R. G., Vize, C. Roberts, A., et al (1996) Lay people's attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch. British Medical Journal, 313, 858–859.CrossRefGoogle ScholarPubMed
Sackett, D. L., Rosenberg, W. M., Gray, J. A., et al (1996a) Evidence based medicine: what it is and what it isn't. British Medical Journal, 312, 71–72.CrossRefGoogle ScholarPubMed
Sackett, D. L., Deeks, J. J. & Altman, D. G. (1996b) Down with odds ratios! (EBM note). Evidence-Based Medicine, 1, 164–166.Google Scholar
Sackett, D. L., Richardson, S., Rosenberg, W., et al (1997) Evidence-Based Medicine: How to Practise and Teach EBM. London: Churchill -Livingstone.Google Scholar
Shahar, E. (1995) Evidence-based medicine. Lancet, 346, 1772.Google ScholarPubMed
Sheldon, T. A. (1996) Research intelligence for policy and practice: the role of the National Health Service Centre for Reviews and Dissemination (EBM note). Evidence-Based Medicine, 1, 167–168.Google Scholar
Shin, J. H., Haynes, R. B. & Johnston, M. E. (1993) Effect of problem-based, self-directed undergraduate education on life-long learning. Canadian Medical Association Journal, 148, 969–976.Google ScholarPubMed
Sim, I. & Hlatky, M. A. (1996) Growing pains of metaanalyses. British Medical Journal, 313, 702–703.CrossRefGoogle Scholar
Simon, G., Wagner, E. & Wonkorff, M. (1995) Cost-effectiveness comparisons using “real world” randomized trials: the case of new antidepressant drugs. Journal of Clinical Epidemiology, 48, 363–373.CrossRefGoogle ScholarPubMed
Smith, R. (1991) Where is the wisdom …? British Medical Journal, 303, 798–799.CrossRefGoogle ScholarPubMed
Smith, R. (1996) What clinical information do doctors need? British Medical Journal, 313, 1062–1068.CrossRefGoogle ScholarPubMed
Sullivan, F. M. & Macnaughton, R. J. (1996) Evidence in consultations: interpreted and individualised. Lancet, 348, 941–943.CrossRefGoogle ScholarPubMed
Summers, A. & Kehoe, R. F. (1996) Is psychiatric treatment evidence-based? Lancet, 347, 409–410.CrossRefGoogle ScholarPubMed
Tanenbaum, S. J. (1993) What physicians know. New England Journal of Medicine, 329, 1268–1271.CrossRefGoogle ScholarPubMed
Wells, K. B., Katon, W., Rogers, B., et al (1994) Use of minor tranquilizers and antidepressant medications by depressed outpatients: results from the medical outcomes study. American Journal of Psychiatry, 151, 694–700.Google ScholarPubMed
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