Evidence-based medicine — a term that is firmly entrenched in the lexicon of doctors in the world. Historical and methodological foundations of the implementation of an evidence-based approach in modern medical practice and health care presented in the article. The principles of clinical epidemiology, the concept of evidence, controlled clinical trials, systematic reviews, meta-analysis. Provides information about the main schools of evidence-based medicine and the activities of centres for evidence-based practices. Indicates the leading role of physicians in making clinical decisions on the basis of an evidence-based approach, the ratio of clinical experience and tradition with evidence-informed and conscious choice of patients. The illuminated position of the who experts on compliance with an evidence-based approach as part of reforming the health systems in the priority development of primary health care and focus on the value of people.
The main goal of the state policy in the field of health is to improve the health status of the population by ensuring access to quality medical care. The introduction of low-cost technologies, the development of hospital-replacing forms of rendering of medical aid and the redistribution of the volumes of the stationary link in outpatients has been identified as a separate direction of work in 1997, the concept of health care development and medical science, approved by the decree of the RF government dated 05.11.1997 No. 1387. The article presents the main principles of work of a day hospital.
Vascular diseases of the brain because of the high prevalence and serious consequences for public health are major medical and social problem. It is reasonable to consider that acute cerebrovascular disease is easier to prevent than to restore lost functions. The article presents the basic principles of organization of medical care for patients with acute disorders of cerebral circulation.
4-5 December 2017 in the business center "Radisson Slavyanskaya" was held X anniversary all-Russian scientific-practical conference with international participation "Medicine and quality — 2017" is an annual event of the Federal service for supervision in the sphere of health, which summarizes the development of the system of Russian healthcare. The program of the Congress, apart from the plenary session includes a panel of the Federal service for supervision in the sphere of health, breakout sessions, scientific symposia, round tables, master classes. According to official statistics, in the event took part 821 specialist from 4 countries, 127 cities, 85 subjects of the Russian Federation.
In the Eurasian economic Union common rules of good clinical practice (Good Clinical Practice — GCP) came into force on 6 may 2017 These rules relate primarily to the sale of pharmaceuticals and, along with good manufacturing practices (GMP) and good laboratory practices (GLP) are fundamental for standardization of quality of rendering of medical aid to the population. The scope of these regulations covers clinical trials of medicinal products, where the subject is a man, and affects the ethical and moral aspects of carrying out such tests [4]. Compliance with these rules is necessary when conducting clinical studies, data are scheduled to be submitted to the competent authorities of member States of the Eurasian economic Union (EEU).
Distal symmetrical polyneuropathy (DPN) is a complication of diabetes, which manifests itself as a significant symmetrical decrease in sensitivity, discomfort (tingling) and pain, often progressing up to the occurrence of a diabetic foot. The pathogenesis of this condition has not yet been fully clarified, but the dominant theory suggests that oxidative and inflammatory stress cause damage to nerve cells. Late diagnosis of this disease complicates treatment and contributes to the progression of pathological processes. This pathology leads to a significant decrease in the quality of life of the patient. The most effective method of correction is preventive measures, as well as relief of pain.
The article presents the main sources of evidence which are an integral part of modern medical practice — above all, controlled clinical trials. Presents the concept of research hypotheses, studied factors, the systematic and random errors. The classification of errors described the design of their main varieties. Discusses the methodological level of planning, execution and evaluation of research results, their presentation in peer-reviewed medical publication. Special attention is paid to the problems of external and internal validity of the research, statistical and clinical significance of their results.
Evidence-based medicine entered the health care system of Western European countries 10-15 years ago, and in Russia this concept is not new. The conscious and consistent application in clinical practice of interventions, in terms of usefulness and effectiveness which there is convincing evidence, is the classic definition of evidence-based medicine. Extensive involvement of practicing physicians to the introduction of the principles of evidence-based medicine is the basis for improving the quality of care.
The Cochrane collaboration (cochrane collaboration) is an international organization of clinicians, epidemiologists, patients and other individuals whose goal is to help in making informed decisions about health care by preparing systematic reviews on the effects of medical interventions and maintaining their relevance by spreading these reviews and ensure their availability. Cochrane reviews are prepared and updated by the group of collaborating authors with details of the described methods that minimize the impact of systematic errors.
The canadian health care system has not such a rich history as the European one, but is considered one of the most developed. An important indicator is the successful establishment of this system are indicators of the health of the population. The life expectancy of Canadians is quite high — an average of 82.6 years (84.0 years for women and 80.0 years for men).
To date, it still seems unlikely that robots could completely replace the doctor — to diagnose, prescribe treatment, conduct complex manipulations. However, a few decades ago, humanity still had no idea about mobile phones and personal computers, and today almost everyone has the opportunity to enjoy these benefits of civilization. There is an opinion that everything that can be imagined can be reproduced in the future. Therefore it is impossible to exclude that in the near future the patient in hospital will be met not by Ivan Petrovich, the therapist of the highest category, and the BSL-153 robot, the specialist in the field of propaedeutics of internal diseases of class IA.
