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Mark H Ebell

Publications and source records attributed to Mark H Ebell.

13 recordsLinked to original sources
PubMed2004

Simplifying the language of evidence to improve patient care: Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in medical literature.

Several taxonomies exist for rating individual studies and the strength of recommendations, making the analysis of evidence confusing for practitioners. A new grading scale-the Strength of Recommendation Taxonomy (SORT)-will be used by several family medicine and primary care journals (required or optional), allowing readers to learn 1 consistently applied taxonomy of evidence. SORT is built around the information mastery framework, which emphasizes the use of patient-oriented outcomes that measure changes in morbidity or mortality. Levels of evidence from 1 to 3 for individual studies also are defined. An A-level recommendation is based on consistent and good-quality patient-oriented evidence; a B-level recommendation is based on inconsistent or limited-quality patient-oriented evidence; and a C-level recommendation is based on consensus, usual practice, opinion, disease-oriented evidence, or case series for studies of diagnosis, treatment, prevention, or screening.

Algorithms↗
PubMed2003

Strep throat.

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Adolescent↗
PubMed2003

Information mastery: integrating continuing medical education with the information needs of clinicians.

Traditional continuing medical education (CME) has been disconnected from the actual practice of medicine and has not focused on providing the most useful information in the most efficient way. Physicians have different information needs at different times. When asked at the end of a day of patient care, physicians will typically report having had one question for every four or five patients. However, direct observation during patient care reveals many more questions. In the outpatient primary care setting, most studies have found, on average, that about two clinical questions are generated during every three patient encounters, with even higher numbers reported in the inpatient teaching setting. Thus, a physician seeing 25 patients in a typical day of outpatient care may have 15 clinical questions. Because clinical questions are the result of critical reflection by a clinician on his or her practice, they are central, to physician learning. This connection between "need" and learning is consistent with generally accepted theories of adult learning. When applied to continuing education, this connection suggests that physicians will learn best when learning is in the context of patient care, answers their questions, does not take too much time, and is directly applicable to their work. Pursuing answers to these questions and answering them with the best available evidence, at the time the answer is needed, may well change the physician's general approach to patient care.

Education, Medical, Continuing↗
PubMed2002

Obstacles to answering doctors' questions about patient care with evidence: qualitative study.

OBJECTIVE: To describe the obstacles encountered when attempting to answer doctors' questions with evidence. DESIGN: Qualitative study. SETTING: General practices in Iowa. PARTICIPANTS: 9 academic generalist doctors, 14 family doctors, and 2 medical librarians. MAIN OUTCOME MEASURE: A taxonomy of obstacles encountered while searching for evidence based answers to doctors' questions. RESULTS: 59 obstacles were encountered and organised according to the five steps in asking and answering questions: recognise a gap in knowledge, formulate a question, search for relevant information, formulate an answer, and use the answer to direct patient care. Six obstacles were considered particularly salient by the investigators and practising doctors: the excessive time required to find information; difficulty modifying the original question, which was often vague and open to interpretation; difficulty selecting an optimal strategy to search for information; failure of a seemingly appropriate resource to cover the topic; uncertainty about how to know when all the relevant evidence has been found so that the search can stop; and inadequate synthesis of multiple bits of evidence into a clinically useful statement. CONCLUSIONS: Many obstacles are encountered when asking and answering questions about how to care for patients. Addressing these obstacles could lead to better patient care by improving clinically oriented information resources.

Clinical Competence↗
PubMedDate not supplied

Evaluating online EBM.

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Education, Medical, Continuing↗