CEBAM The Belgian Centre for EvidenceBased Medicine

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CEBAMThe Belgian Centre for Evidence-Based
Medicine

• The Belgian branch of the Cochrane Collaboration
• Bert Aertgeerts, director

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• Only about 15 of medical interventions are
  supported by solid scientific evidence,
• BMJ editorial 1995

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• this would put 80 to 90 of accepted
  medical procedures in this country under the
  heading of quackery!
• What about 2006?

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Definition EBM

• Evidence-based medicine is the integration of
  best research evidence with clinical expertise
  and patient values.
• The integration of individual clinical expertise
  with the best available external evidence and
  patients values and expectations
• David Sacket 2000

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Clinical problem
Decision about diagnosis treatment
traditional
develop answerable question
Expertise, experience, pathophysiology
EB supported
Critical appraisal
Search obtain relevant articles
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Independent information and critical appraisal
Textbooks
Conferences
Journal articles
Internet
Pharmaceutical industry
T.V.
Newspaper
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Which evidence ?

• -Own experience
• -other colleagues
• -Expert opinion
• -Farmaceutical companies
• -Systematic reviews
• -EB guidelines

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Evidence-Based Practice serves

• Patient treatments that help
• Health Care provider CME
• Society priorities
• EBP needs independent Centres for EBM!

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CEBAM

• CAN 90, UK 92, USA 93, NL 93
• Belgium January 2002
• Independent multidisciplinary centre
• Funding government
• Support universities
• Aim
• To introduce and support evidence-based thinking
  and working
• For all parts of the country, all language
  groups, and all medical and paramedical
  disciplines

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Organigram

• All universities, all health care providers

Wetenschappelijke Adviesraad
Raad der Wijzen
Directieraad
Staf groep en administratie
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CEBAM objectives

• Teaching the content and techniques of EBM and
  providing the necessary information.
• Belgian branch of the Cochrane Collaboration
  Cochrane tasks
• Methodologically supporting the building of
  evidence-based guidelines.
• Virtual Medical Library

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1. EBM activities

• -Three day courses EBM
• One day seminars EBM
• Two day seminars EBM
• Discipline related workshops
• Articles HANU PICO reeks (Ann Van den Bruel!)
• Articles Revue Médical de Liège PICO reeks (F)

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2. Cochrane activities

• It is surely a great criticism of our profession
  that we have not organised a critical summary,,
  adapted periodically, of all relevant randomised
  controlled trials
• Archie Cochrane

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Cochrane Centres 1992
Nordic
Dutch
U.K.
San Francisco USA
German
Canadian
Italian
Spanish
New England, USA
San Antonio USA
Baltimore USA
Belgian Branch CC 2002
South African
Australian
Brazilian
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Preparing, maintaining and promoting the
accessibility of systematic reviews of the
effects of health care interventions
The Cochrane Library
? Cochrane Database of Systematic Reviews ?
Database of Abstracts of Reviews of Effectiveness
(DARE) ? Cochrane Controlled Trial Register (CCTR)
www.cochrane.org
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Cochrane activities

• Small group learning (SR)
• Developing SRs
• Cochrane Methodsgroup Diagnostic research
  Handbook (FB, BA)
• French Cochrane Branch SA, PC
• Cochrane methodsgroup IPD
• Cochrane methodsgroup Qualitative research

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3. Clinical Guidelines

• GOBSAT method
• Formal consensus techniques (consensus
  conference, Delphi technique, etc)
• Explicit linkage of recommendations and evidence

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Development process guidelines
www.sign.ac.uk
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• Support the methodological quality of EB
  guidelines and SR
• Independent validation of guidelines

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AGREE Instrument
Examines 6 domains/aspects and guideline
development

• Scope and purpose
• Stakeholder involvement
• Rigour of development
• Clarity and presentation
• Applicability
• Editorial independence

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Within universities
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After the university
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4. Virtual Library

• Workshops searching
• Contacts with different specialisms
• - Contacts with OVID,..
• Contacts similar projects other countries
• RIZIV-INAMI support

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CONTENT OF THE SMALL VIRTUAL MEDICAL LIBRARY
Factual databases
Core Collections in the primary literature
Cochrane Database for systematic reviews
Indexes (Medline, Invert, Inside)
Clinical Excellence
Research Search Engine
Guide to Guidelines
Practice Search Engine
UNI-QUE INTERFACE
EBM -CME Publications in the mother tongue
Clinical medical Librarian
Help line
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CEBAM connections

• International
• Cochrane Centre
• Universities (Oxford, leiden, Amsterdam)
• GIN founding member
• National
• BCFI, Minerva, Farmaka,
• Universities
• FOD, Virtual library
• RIZIV, INAMI

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EB platform in Belgium...

• Centre task funding
• KCE Centre of Excellence (NICE) OK
• BCFI Drug therapy (BNF) OK
• Minerva Evidence-Based journal (EBM) OK
• Farmaka Independent drug representatives OK
• CEBAM Methodological support (DCC,CEBM) ???
• Virtual Library EB literature (NELH) /-

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