Saturday, December 03, 2005

Support for EBM

David Jenkins, long-time friend, former fellow parishioner, and career psychology/public health academic – now retired – offers the following in support of Evidence-Based Medicine

Evidence-based care is in a stronger position than one contributor believes. The last 20 years has seen refined work on developing and using measures of health-related quality of life. Psychometrically developed scales can be used to make reliable and reasonably valid quantification of such variables as performance of activities of daily living, anger, depression, optimism, social participation, extent of self-care, categories of mental function, social networks, and a hundred more. All these can help quantify the outcomes of medical care or the lack thereof. Our research group at Boston University assessed the benefits of major cardiac surgery in terms of emotions, cognitive processing, occupational skills, physical activity, neurological functions, social interaction, and biomedical variables.(C. D. Jenkins et al. Physical, psychological, social and economic outcomes six-months after coronary bypass surgery. JAMA 250: 782-788;; 1983).

The MAPI Institute (Lyon, France) provides a library of quality of life measures equivalently translated in many languages, thus permitting standardized indices for international studies. (www.mapi-institute.com) Different scales have been developed to assess the effect of different diseases.

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