How do Clinicians choose the right treatment for each patient?
Planning and assigning a patient to a treatment that optimizes gains and fits the patient's needs is a shared objective among clinicians. However, selecting the most appropriate treatment for each patient can be a nebulous and unreliable task, varying by the clinician's biases and theoretical training and with uncertain or unmeasured results.
What makes a great clinician?
Be enthusiastic about your profession. Go above and beyond, research, gather, and disseminate knowledge. This is what makes a clinician great, and leads to the achievement and advancement of goals. There may be times when our patients may be lacking self-motivation for one reason or another.
What is cliclinical research?
Clinical research is much different from the medical treatment you receive in a Healthcare Provider's office. Answers specific questions through research involving numerous research volunteers. Address the needs of individual patients.
What are the different types of clinical research?
Different types of clinical research are used depending on what the researchers are studying. Below are descriptions of some different kinds of clinical research. Treatment Research generally involves an intervention such as medication, psychotherapy, new devices,...
What is a clinician researcher?
The clinician-researcher, an individual who both conducts research and provides direct services (also referred to as the clinical scientist and the scientist-practitioner), is considered to be an important figure in health research.
Who performs clinical studies?
The people responsible for conducting and administering trials are generally physicians and other medical personnel like nurses and lab technicians. Clinical trials also usually have a principal investigator who is a doctor with experience in that particular field.
What is considered clinical research?
Clinical research is the study of health and illness in people. It is the way we learn how to prevent, diagnose and treat illness. Clinical research describes many different elements of scientific investigation.
What does clinical research coordinator do?
Key responsibilities of the CRC include the planning and management of the study, enrollment, maintenance, training initiatives, and maintaining compliance with federal, state, and institutional regulations. In addition, they carry out experiments, clinical research, and medical studies.
What are the types of clinical research?
Types of clinical trialsPilot studies and feasibility studies.Prevention trials.Screening trials.Treatment trials.Multi-arm multi-stage (MAMS) trials.Cohort studies.Case control studies.Cross sectional studies.More items...•
What is clinical studies in medical?
Listen to pronunciation. (KLIH-nih-kul STUH-dee) A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease.
Why do we do clinical research?
Clinical research is vital to the National Institutes of Health (NIH) mission of enhancing health, lengthening life, and reducing the burdens of illness and disability. For instance, through clinical research we gain insights and answers about the safety and effectiveness of drugs and other therapies.
Is clinical research the practice of medicine?
Clinical research is much different from the medical treatment you receive in a Healthcare Provider's office. Answers specific questions through research involving numerous research volunteers. Address the needs of individual patients. Generally designed and intended to benefit future patients.
Is clinical research clinical experience?
As a clinical research coordinator, you can put it as clinical experience or as shadowing or research if you are involved in the research side of things. Being an admin in the research project doesn't mean you're involved in the research.
What is clinical research professional?
A clinical research professional's (CRP) practice is guided by one or more aspects of the principles of Good Clinical Practice (GCP). CRPs may have backgrounds in nursing, pharmacy, medical technology, business administration, health record management, statistics, science, education, or other areas.
What is a clinical coordinator?
The clinical coordinator performs a variety of clinical and managerial duties in a hospital or other large health care facility. He or she coordinates care for patients, acting as a liaison between departments as well as between patients and their families and health care professionals.
What does a clinical research nurse do?
Research Nurses, also referred to as Clinical Nurse Researchers or Nurse Researchers, develop and implement studies to investigate and provide information on new medications, vaccinations, and medical procedures. They assist in providing evidence-based research that is essential to safe and quality nursing care.
What is treatment research?
Treatment Research generally involves an intervention such as medication, psychotherapy, new devices, or new approaches to surgery or radiation therapy. Prevention Research looks for better ways to prevent disorders from developing or returning. Different kinds of prevention research may study medicines, vitamins, vaccines, minerals, ...
What are some examples of clinical research?
Examples of other kinds of clinical research#N#Many people believe that all clinical research involves testing of new medications or devices. This is not true, however. Some studies do not involve testing medications and a person’s regular medications may not need to be changed. Healthy volunteers are also needed so that researchers can compare their results to results of people with the illness being studied. Some examples of other kinds of research include the following: 1 A long-term study that involves psychological tests or brain scans 2 A genetic study that involves blood tests but no changes in medication 3 A study of family history that involves talking to family members to learn about people’s medical needs and history.
What is an inpatient study?
Some is “inpatient,” meaning that participants will need to stay for at least one night in the hospital or research center. Be sure to ask the researchers what their study requires. Clinical trials are a kind of clinical research designed to evaluate and test new interventions such as psychotherapy or medications.
How many phases are there in clinical trials?
Clinical trials are often conducted in four phases. The trials at each phase have a different purpose and help scientists answer different questions. Researchers test an experimental drug or treatment in a small group of people for the first time.
What is phase IV research?
Examples of other kinds of clinical research. Many people believe that all clinical research involves testing of new medications or devices .
What is epidemiological research?
Epidemiological studies seek to identify the patterns, causes, and control of disorders in groups of people. An important note: some clinical research is “outpatient,” meaning that participants do not stay overnight at the hospital. Some is “inpatient,” meaning that participants will need to stay for at least one night in ...
What is an experimental drug?
The experimental drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety. Phase III trials. The experimental study drug or treatment is given to large groups of people.
What is technical eclecticism?
Technical eclecticism is the effort to differentially apply a menu of relevant techniques to different patients in the effort to optimize treatments of well-suited clients (e.g., Beutler, 1983, Goldstein and Stein, 1976, Lazurus, 1967, Thorne, 1957 ). Among the touted benefits of technical eclecticism was that it enabled therapists to use diverse strategies which cut across theories to fit clients’ needs. The downside of this assumption as the failure of a systematic framework to emerge by which one could ensure that the various techniques were applied reliably. Also missing was a classification system that identified the indicators and contraindicators for the items on the technical menu. Concurrently, eclectic therapists, professing multiple theoretical allegiances, existed along side of therapists who advocated vociferously for one or another of them. Battles among theories and theorists heated up and the first comparison studies that were undertaken in the 1950s were welcomed and the idea caught fire in the 1960s and 70s.
When did psychotherapy start?
Psychotherapy research has an extensive history that extends to the early 1900's. And through most of this history, eclectic and integrative approaches have been part of the scene. Even the early common factors approach to psychotherapy has been touted as an integrated approach to psychotherapy.
What is STS in psychology?
The development of Systematic Treatment Selection (STS) relies on a long history of psychotherapy research conducted throughout North and South America and Europe. STS aims to identify both variables and approaches that are translatable across various cultures and individuals and those that are unique to each treatment or culture. Its foundational research is comprised of findings that have been extracted from studies using a variety of research designs. The compilation of findings from multiple methods is thought to ensure that the conclusion rest on sound scientific principles pertaining to how people are helped psychologically and emotionally.
How does STS work in clinical supervision?
STS, therefore, offers additional structure to such integrative practice by using common dimensions to help standardize the objectives and outcomes of supervision for training clinicians and serve as a foundation for theory-specific training regimens. Drawing upon the previous studies and the list of principles defined by Constantino et al. (In press), Holt and colleagues (Study #3) extracted 8 STS principles and trained clinical supervisors in their use in practice and supervision. This study addressed the disparity between the evidence-based practice focus of theories and the various personal models of therapy, demonstrating that STS principles transcend theoretical differences as well as supervisory styles to facility patient change. Indeed, STS assisted supervision outperformed Supervision as Usual and facilitated patient change.
What is the search for and articulation of principles of change and strategies of implementation?
The search for and articulation of principles of change and strategies of implementation represent contemporary integrationism. Identification of cross-cutting and empirically derived principles of change comprise a middle position between the technical focus of early eclecticism and the theoretical focus of early integrationism ( Goldfried, 1982 ). At one end of the contemporary Integrative Spectrum, Assimilative Integration (e.g., based on Psychodynamic Theory (e.g., Castonguay, Newman, Borkovec, Holtforth, & Maramba, 2005 ), one of the emerging models, for example, blends adherence is a modern rendition of the effort to combine adherence with a particular theoretic model but allows multi-method interventions. At the other end of the integrative spectrum STS eschews the adoption of any particular theoretical model. Instead, a foundation of empirically derived principles and strategies are framed as the means by which models are implemented.
What are the four epochs of integrative psychotherapy?
These epochs began with the search for common healing factors (Epoch #1) and then progressed to the exploration of tailoring the use of patient specific procedures or “technical eclecticism” (Epoch #2). The third epoch saw the introduction of integration/eclecticism as a formal school ( Lazurus, 1967 ), and in turn, the differentiation of eclecticism and integrationism. With these changes, there was a return to “schools” (Epoch #4) with a focus on finding evidence based treatments that reliably produced change. It is during this epoch of change, that the field of integrative psychotherapy has achieved a degree of formality as a distinct approach, as interest in it has been shown to be durable and stable.
How many principles are there in the treatment of depression?
From these patterns, iterations and re-iterations resulted in the articulation of 18 principles related to the treatment of depression ( Beutler et al., 2000 ). These principles expressed, in common language, the relationships among patient, context, intervention, and outcomes.
What did Joseph Breuer do to help with psychological symptoms?
3.1.34. Joseph Breuer's method of catharsis provided relief for psychological symptoms by helping patients to
Is 3.1.16 a cure?
3.1.16. _____ medication is used to treat many psychological conditions. It is generally effective, but it is not a "cure" for any disorder.
What are the different types of clinical questions?
Clinical questions can be narrowed down to four types: therapy, prognosis, diagnosis and economic/decision analysis. For example, if you are comparing two treatments such as amputation and reconstructive surgery, this is a therapy question. If you are interested in understanding the outcomes for older patients after breast reconstruction, this is a prognosis question. A diagnosis question might inquire about the accuracy of a new diagnostic test such as the use of ultrasound to detect silicone breast implant ruptures. If you are asking if a treatment results in lower costs and improved quality of life, this is an economic/decision analysis question.
What is evidence based medicine?
Evidence based medicine (EBM) involves the integration of the best scientific evidence available with physician experience and patient preferences. One of the first steps in EBM involves developing a question based on issues encountered with patients or a disease and finding evidence to answer the question. This paper is a guide to plastic surgeons in how to begin the practice of EBM by developing clinical questions and finding evidence to answer these questions.
How many citations are there in Medline?
MEDLINE is maintained by the National Library of Medicine, contains over 11 million citations from journals dating back to 1950 and is updated weekly.7Articles are referenced using medical subject headings (MeSH). PubMed has over 19 million citations from life science journals and MEDLINE. PubMed has several search options that can help simplify your literature search. You can search specific journals or a single citation. Another search option is called Clinical Queries, which allows the user to narrow their search by subject and clinical study category (e.g. therapy, diagnosis, prognosis) or limit the search to systematic reviews. EMBASE contains biomedical and pharmacological articles from 1947 to the present.8It contains more than 19 million records from more than 7000 journals. Although EMBASE and MEDLINE overlap in their coverage of the literature, EMBASE has a better coverage of European journals.9CINAHL (Cumulative Index to Nursing &Allied Health Literature) covers 2960 journals and other citations related to nursing and allied health from 1981 to present.10CINAHL has over 2 million records.
What is the Cochrane Collaboration?
The Cochrane Collaboration was founded in 1993 and produces the Cochrane Library.6The library consists of several EBM databases. Most notable is the Cochrane Database of Systematic Reviews, which consists of systematic reviews and meta-analyses. The library is updated on a quarterly basis and considered a reliable source of EBM. All systematic reviews must meet rigorous standards before publication. Because not every condition has been investigated with a systematic review, it is often necessary to look at other databases.
What is the next step in EBM?
The next step in practicing EBM is finding the best available literature to answer your question. This is accomplished by searching through electronic databases such as MEDLINE, EMBASE, CINAHL and the Cochrane Library.
What is the hierarchy of evidence?
(Figure 2) The hierarchy of evidence ranks study types from those with the highest evidence to lowest evidence. RCTs, systematic reviews and meta-analyses are at the top (highest evidence) and expert opinions and case reports at the bottom (lowest evidence). Systematic reviews and meta-analyses combine or pool data from multiple individual studies using systematic, predetermined methods. This pooling of data, if done correctly, allows the reader an unbiased summary of the available research. A systematic review of RCTs is considered higher in the hierarchy than a systematic review of observational studies. A narrative review or expert opinion is also a summary of studies but is done in a non-systematic manner and therefore more likely to be biased.
Can you scan a MEDLINE article?
You can access the articles electronically or have them pulled and copied if necessary. If you find an article of particular interest in MEDLINE or PubMed, you have the option to find related articles that may not have been identified by your search.
How to provide the highest quality care to your patient?
In order to provide the highest quality care to your patient, and to achieve the best outcomes, combining these skills is paramount. Work to build affinity with your patients, your colleagues, and your support staff. If things don’t seem to be going right, try to look at the situation from another “reality.” Strive for open and honest communication in all situations.
Why is flexibility important for clinicians?
Flexibility for clinicians leads to success with our patients. While there is always a plan in place for treatment sessions, remaining flexible is essential. You will get thrown curve balls, and adapting accordingly is what sets clinicians aside and ensures goals are being achieved.
How to treat advanced cancer?
Local therapies like surgery or radiation may also be appropriate for patients with advanced cancer. If the cancer has metastasized to the brain, for example, a patient may benefit from surgery or radiation directed to the tumor site because many systemic cancer drugs cannot reach the brain in high enough concentrations to shrink these tumors. Similarly, when a tumor mass is causing symptoms that need to be treated immediately, such as bleeding or difficulty breathing, local therapy targeting the problem are may do the job best. In addition, patients with metastatic disease may only have one or two tumors growing at a concerning rate. This situation, called oligo-metastatic disease ( oligo meaning “few”), is unusual but may call for a local treatment directed at that fast-growing tumor.
What is the most common method of staging a cancer?
The most common method of staging a cancer evaluates the size and invasiveness of where the cancer started -- the primary tumor -- as well as whether cancer cells have spread to draining lymph nodes in the region or have traveled through the bloodstream to more distant sites in the body -- advanced or metastatic disease. The contributions of the t umor, n odes, and m etastases define the TNM staging system.
How does immunotherapy work?
Systemic therapies, such as chemotherapy and immunotherapy, work throughout the entire body and can be given intravenously (IV), orally with a pill, or occasionally by injection. Immunotherapy, typically an IV treatment, helps stimulate a patient’s immune system to recognize and attack the cancer. The goal of systemic therapies is to treat the disease that’s visible on scans or a physical examination as well as any potential microscopic or invisible disease that a scan or exam cannot detect but that may grow over time.
When to use local therapy for cancer?
Doctors typically use local therapies when the primary tumor is not too large, has not invaded surrounding tissues, and the spread to lymph nodes is limited. In fact, for early stage cancers, local therapies like surgery or radiation can be curative.
What is the process of determining where the cancer is called?
To figure that out, oncologists must answer a critical question: Has the cancer spread to other parts of the body? The process of determining where the cancer is, called staging, gives doctors a clearer sense of the cancer’s biological behavior and prognosis, and it helps define the best treatment strategy.
Can systemic therapy help with metastatic cancer?
Over time, however, we have found that systemic therapies can also improve results for many high-risk but still earlier-stage cancers, and local therapies may be helpful for specific types of metastatic cancer.
Can you get chemotherapy before surgery?
For instance, in some patients with early-stage, localized cancer, chemotherapy may be given before surgery or at the same time as radiation. Combining systemic and local therapies can improve how well the local therapy works against the visible disease we can see and often helps catch the invisible disease before it can take hold. For many cancers, chemotherapy or immunotherapy has been shown to shrink tumors before surgery or during radiation and increase the chance that patients will be cancer free years after treatment.
What is observational study?
Observational studies help researchers understand a situation and come up with hypotheses that can be put to the test in clinical trials. Observational studies can find associations between things but can’t prove that one thing causes another. Types include:
What is the NIH?
Produced by the National Institutes of Health, the largest source of public funding for medical research in the world. NIH’s mission is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.
