How to use an article on therapy or prevention: Pneumonia prevention using subglottic secretion drainage

被引:25
作者
Cook, DJ
Hebert, PC
Heyland, DK
Guyatt, GH
BrunBuisson, C
Marshall, JC
Russell, J
Vincent, JL
Sprung, CL
Rutledge, F
机构
[1] MCMASTER UNIV, DEPT MED, DIV CRIT CARE, HAMILTON, NEW ZEALAND
[2] MCMASTER UNIV, DEPT MED, DIV CLIN EPIDEMIOL & BIOSTAT, HAMILTON, NEW ZEALAND
[3] UNIV OTTAWA, DEPT MED, DIV CRIT CARE, OTTAWA, ON, CANADA
[4] QUEENS UNIV, DEPT MED, DIV CRIT CARE, KINGSTON, ON K7L 3N6, CANADA
[5] UNIV PARIS 12, DEPT MED, DIV CRIT CARE, CRETEIL, FRANCE
[6] UNIV TORONTO, DEPT SURG, DIV CRIT CARE, TORONTO, ON, CANADA
[7] UNIV BRITISH COLUMBIA, DEPT MED, DIV CRIT CARE, VANCOUVER, BC, CANADA
[8] FREE UNIV BRUSSELS, DEPT INTENS CARE MED, BRUSSELS, BELGIUM
[9] HEBREW UNIV JERUSALEM, DEPT ANESTHESIOL & CRIT CARE MED, JERUSALEM, ISRAEL
[10] UNIV WESTERN ONTARIO, DEPT MED, DIV CRIT CARE, LONDON, ON, CANADA
关键词
therapy; randomized trial; random allocation; critical care; evidence based medicine;
D O I
10.1097/00003246-199709000-00017
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Evidence based critical care medicine involves integrating clinical experience, expertise, and patient preferences with explicit, systematic, and judicious use of current best evidence in making medical decisions. Published evidence has many sources: research from the basic sciences of medicine, and from patient-centered clinical research on the accuracy of diagnostic tests, the power of prognostic markers, and the effectiveness and safety of preventive, therapeutic, rehabilitative, and palliative interventions. When critically appraising a clinical article for potential use in intensive care unit (ICU) practice, the first question we ask ourselves is: Is this study valid? If examination of the study methods reveals that the design is rigorous, we can turn to the two other key questions: What are the results? and, Will the results help me care for my patients? This approach may aid in the interpretation of an article on therapy or prevention; in it we discuss a strategy designed to prevent ventilator associated pneumonia in critically ill patients.
引用
收藏
页码:1502 / 1513
页数:12
相关论文
共 79 条
  • [31] GUYATT G, 1995, CAN MED ASSOC J, V152, P169
  • [32] USERS GUIDES TO THE MEDICAL LITERATURE .9. A METHOD FOR GRADING HEALTH-CARE RECOMMENDATIONS
    GUYATT, GH
    SACKETT, DL
    SINCLAIR, JC
    HAYWARD, R
    COOK, DJ
    COOK, RJ
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 274 (22): : 1800 - 1804
  • [33] USERS GUIDES TO THE MEDICAL LITERATURE .2. HOW TO USE AN ARTICLE ABOUT THERAPY OR PREVENTION .B. WHAT WERE THE RESULTS AND WILL THEY HELP ME IN CARING FOR MY PATIENTS
    GUYATT, GH
    SACKETT, DL
    COOK, DJ
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 271 (01): : 59 - 63
  • [34] USERS GUIDES TO THE MEDICAL LITERATURE .2. HOW TO USE AN ARTICLE ABOUT THERAPY OR PREVENTION .A. ARE THE RESULTS OF THE STUDY VALID
    GUYATT, GH
    SACKETT, DL
    COOK, DJ
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 270 (21): : 2598 - 2601
  • [35] SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT - AN OVERVIEW
    HEYLAND, DK
    COOK, DJ
    JAESCHKE, R
    GRIFFITH, L
    LEE, HN
    GUYATT, GH
    [J]. CHEST, 1994, 105 (04) : 1221 - 1229
  • [36] HINSHAW LB, 1981, CIRC SHOCK, V8, P291
  • [37] REDUCTION OF MORTALITY IN CHLORAMPHENICOL-TREATED SEVERE TYPHOID-FEVER BY HIGH-DOSE DEXAMETHASONE
    HOFFMAN, SL
    PUNJABI, NH
    KUMALA, S
    MOECHTAR, MA
    PULUNGSIH, SP
    RIVAI, AR
    ROCKHILL, RC
    WOODWARD, TE
    LOEDIN, AA
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1984, 310 (02) : 82 - 88
  • [38] TREATMENT ADHERENCE AND RISK OF DEATH AFTER A MYOCARDIAL-INFARCTION
    HORWITZ, RI
    VISCOLI, CM
    BERKMAN, L
    DONALDSON, RM
    HORWITZ, SM
    MURRAY, CJ
    RANSOHOFF, DF
    SINDELAR, J
    [J]. LANCET, 1990, 336 (8714) : 542 - 545
  • [39] HOW DOUBLE-BLIND IS DOUBLE-BLIND - AND DOES IT MATTER
    HUSKISSON, EC
    SCOTT, J
    [J]. BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 1976, 3 (02) : 331 - 332
  • [40] JAESCHKE R, 1995, CAN MED ASSOC J, V152, P351