Vox sanguinis
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Some of the basic principles behind evidence-based medicine have been known for many years; however, the concept and approach to integrating evidenced-based decision making into clinical practice on a day-to-day basis has only evolved over the past 15 years. This paper focuses on five important steps in evidence-based decision making: (1) the importance of a well-defined question; (2) ways to effectively search the scientific literature; (3) the process of critical appraisal for an article about therapy; (4) the role of clinical expertise, patient values, clinical circumstances and society's expectations in the decision-making process; and (5) continuous quality improvement of the process.
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The demand for transfusions has increased rapidly in southern Taiwan. Between 1993 and 2003, requests for fresh-frozen plasma (FFP) in particular rose dramatically at Kaohsiung Medical University Hospital (KMUH). Transfusion orders were not tightly regulated, and inappropriate use of blood products was common. ⋯ Hospital policy, computerized transfusion guidelines and periodic audits greatly reduced inappropriate FFP transfusions. An educational campaign had a more limited effect.