MedGenMed : Medscape general medicine
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Editorial Review
MedGenMed's selection of the top 10 medical/health stories of 2002.
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Practice Guideline Guideline
Expert commentary--evidence-based guidelines for the treatment of irritable bowel syndrome in North America.
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Evidence-based medicine (EBM) seeks to improve clinical practice by evaluating the quality of clinical evidence and ensuring that only the "best" evidence from clinical research is used in the management of individual patients. EBM has contributed to our understanding of the meaning of the benefit and harm of treatment as reported in the literature, and it is often promoted as an aid to clinical decision making. However, EBM therapeutic summary measures reflect only a single dimension of clinical decision making. The purpose of this work is to show how EBM therapeutic summary measures can be effectively incorporated into medical decision making. ⋯ In the setting of clinical decision making, EBM summary measures derived from population studies can be effectively used to define diagnostic and therapeutic action thresholds that may help in the management of individual patients.
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The ritual of taking an oath upon graduating from medical school is, with a few exceptions, a routine requirement for graduation. Albeit that many students believe that they have taken the Hippocratic Oath, this is virtually never the case. Very often students themselves write many of these oaths, and taking such an oath impresses the student as well as the public, who are potential patients. ⋯ This becomes impossible when uninsured patients are sent away at the front desk long before the physician can interact with them. Furthermore, the current fact that physicians often are confronted with not doing what they consider a necessary test (or prescribe what they think would be the best medication) raises the problem of either lying or suggesting to the patient that he/she do so--a fact that in the long run cannot help but damage the physician's veracity and the trust which patients put in their physicians. That virtually all codes of the American Medical Association (AMA) as well as the various specialties insist that physicians work toward universal access is stressed.
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Children's exposure to violence, sexual themes, profanity, and the depiction of substances in movies remains a source of parental and public health concern. However, limited research quantifies the correlations between movie content, ratings, and economics or addresses the issue of ratings "creep." ⋯ Parents and physicians should be aware that movies with the same rating can differ significantly in the amount and types of potentially objectionable content. Age-based ratings alone do not provide good information about the depiction of violence, sex, profanity, and other content, and the criteria for rating movies became less stringent over the last decade. The MPAA rating reasons provide important information about content, but they do not identify all types of content found in films and they may particularly miss the depiction of substances.