Journal of evaluation in clinical practice
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The differentiation between association and causation is a significant challenge in medical research, often further complicated by cognitive biases that erroneously interpret coincidental observational data as indicative of causality. Such misinterpretations can lead to misguided clinical guidelines and healthcare practice, potentially endangering patient safety and leading to inefficient use of resources. ⋯ In many cases, misinterpretation of observational finding negatively affecting patient care and public health policies. Addressing and rectifying the observational interpretation fallacy is crucial for the progression of medical research and the maintenance of safe and effective clinical practice. It is imperative for health policymakers, clinicians, and the lay public to critically assess research outcomes and make health-related decisions based on a foundation of evidence-based medicine. This approach ensures the alignment of medical practices with the most current and robust scientific evidence, safeguarding patient welfare and optimising resource allocation.
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Antibiotic prescription, its nature and its duration are a very common decision-making situation in primary care practice. Clinical practice guidelines (CPGs) are regularly emitted by various organisations on this topic. ⋯ There is a lack of quality in the development process of the current French guidelines in primary care infectiology. This process should be reconsidered, with higher insistence as to its quality.
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Review
More Than a Sense: The Sense of Smell and Its Reflection in Mother and Baby: A Comprehensive Review.
The sense of smell is one of the most developed and important senses that forms the bond between the newborn and the mother and allows the newborn to reach the mother's breast. The sense of smell begins to form during intrauterine life, and the sense of smell can be a marking tool for a newborn baby, so that the baby can recognize both his mother and his immediate environment and develop his behaviour accordingly. This is necessary not only for feeding babies but also for them to feel safe and peaceful in their new environment. In the early stages of life, olfactory stimulation (maternal odour, breast milk odour, amniotic fluid odour, smell of people or different environments) plays an important role in adapting to the environment. Smell stimulation, in particular, is critical for newborns' postnatal survival because it supports a wide range of early regulatory functions and motor responses. This review also aims to examine the current evidence in the field of olfactory skills in mother and infant in the development and care of the infant. Another aim is to summarize the research conducted to determine the effect of the sense of smell on the life of the mother and baby. ⋯ However, more well-designed experimental studies are needed in this regard. We look forward to future studies that closely examine various aspects of how olfactory stimulation affects both mother and baby.
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The incorporation of economic considerations in clinical practice guidelines (CPGs) could help promote cost-conscious decision-making in healthcare. Though healthcare expenditures increase, and resources are becoming scarcer, the extent to which economic considerations are incorporated into CPGs remains limited. This scoping review aims to identify the challenges and potential stimulating factors to incorporate economic considerations in CPGs. ⋯ These findings reflect the complexity of incorporating economic considerations in CPGs. The identified challenges highlight the need for clearer guidance (i.e. by training) and standardised methodologies for incorporating economic considerations in CPGs. The potential stimulating factors provide a roadmap for future efforts to enhance the integration of economic evidence in CPGs. Collaborative initiatives between health economists, CPG developers, and other stakeholders are essential to drive progress in this area and promote cost-conscious decision-making in healthcare.
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Appropriate patient reassurance is an essential feature of clinical practice. My recent experience as a patient, interpreted via my expertise as a health services researcher, led me to insights on ideal and suboptimal reassurance styles in the context of worrisome symptoms. Reassurance is complex: often poorly defined in the scientific literature, rarely rigorously studied, imperfectly understood, and requiring some adaptation to each patient situation. ⋯ Explicit medically appropriate reassurance notably reduced my concerns and anxiety. Interactions devoid of key reassurance components (acknowledging concerns, contextualising the problem, providing information on risk and next steps and incorporating discussion) exacted an unnecessary psychic toll. The striking differences among my clinicians' approaches illustrate how more thoughtful and salubrious interactions can occur using straightforward existing guidance on best reassurance practices, even without burdensome training, time, or resources.