Action plan – 10 things you can do

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  • Format Audio, Texts
  • Language/s English
  • Target Audience Self-directed learning
  • EBM Stage 0 - Why EBM?
  • Duration 5-15 mins
  • Difficulty Introductory

Details

  1. Identify questions about the effects of treatment that are important to you.
  2. Learn to recognize uncertainty; speak up; ask questions; seek honest answers.
  3. Don’t be afraid to ask your doctor what treatments are available; what may happen if you choose a particular treatment; AND what might happen if you don’t.
  4. When thinking about possible treatments, you may find the Ottawa information on decision aids helpful.
  5. Use reliable websites such as NHS Choices . See also: “So what makes for better healthcare”.
  6. Be a healthy sceptic about unfounded claims and media reports of treatment ‘breakthroughs’; about the way that ‘numbers’ are reported in the media – especially large numbers in headline claims!
  7. Challenge treatments offered to you or your family on the basis of beliefs and dogmas, but unsubstantiated by reliable evidence. Be wary of unnecessary disease ‘labelling’ and over-investigation – find out if the disease in question is considered high risk or low risk for you. Ask what would happen if nothing immediate is done.
  8. Agree to participate in a clinical trial only on condition (i) that the study protocol has been registered and made publicly available (ii) that the protocol refers to systematic reviews of existing evidence showing that the trial is justified; and (iii) that you receive a written assurance that the full study results will be published, and sent to all participants who indicate that they wish to receive them.
  9. Encourage and work with health professionals, researchers, research funders, and others who are trying to promote research addressing inadequately answered questions about the effects of treatment which you regard as important.
  10. Encourage wider education about the effects of biases and the play of chance, and lobby your elected political representative and others about doing more to emphasize this in school curricula, beginning in primary schools.

Review of the Key points:

  • Ask the right [getit]research[/getit] questions
  • Design and conduct research properly
  • Publish all the results and make them accessible
  • Produce unbiased and useful research reports

MoreReferences (Section 13)

Discussion

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3 Comments

K991 18:05pm Sun 04 Aug 2013

Ian Chalmers may be able to negotiate this sort of thing with his doctors, but in the seven minute consultation I get with my NHS GP a discussion of the evidence is simply a fantasy, and challenging the evidence is likely to end the consultation there and then.

Iain Chalmers 09:03am Wed 26 Mar 2014

@Iain Chalmers Don't despair, K991! Many of yesterday's fantasies have become today's realities. If you care enough about getting clear answers to some of the questions that are most important to you, you'll be more likely to be successful in getting them, even within a 7-minute consultation.

Dr. Amy Price 12:55pm Wed 07 Aug 2013

Book a double appointment so these needs can be addressed. Your GP wouldn't consider treatment on her/himself without considering these questions why should you? Also many of these questions can be answered by you finding information yourself online through sites like NHS choices and the treatments may also be ones that are not offered via the healthcare system so all the more reason to check out the details to avoid being hurt or scammed. The first three questions should be part of any info pack about your treatment. It is important to find a GP you trust with your health questions and who respects your values. It is reported that listening to the patient only takes an extra 90 seconds of time on average.

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