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The Bone & Joint Decade - India An IRACON 2003

The Bone & Joint Decade - India An IRACON 2003 Indian Rheumatology: New Horizons, New Hopes Artichoke of Population Studies & Clinical Practice

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The Bone & Joint Decade - India An IRACON 2003

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  1. The Bone & Joint Decade - India An IRACON 2003 Indian Rheumatology: New Horizons, New Hopes Artichoke of Population Studies & Clinical Practice Dr Rajesh Pandav, Dr. Denish Moorthy, Dr Binod Patro, Dr Hemant Shukla, Dr Chandrakant S Pandav

  2. Relationship between incidence & prevalence Incidence Prevalence Recovery Death

  3. Measurement Iterative Loop Burden of Illness (Assessment) Monitoring & Reassessment Etiology or Causation Diagnosis Prognosis Synthesis & Implementation of Program Community Effectiveness Therapy Policy Process Efficiency

  4. Outline of presentation • Key messages • HFA • Thoughtful physicians: Difficult Questions • EBM • Measurement Iterative Loop • COPCORD / WHO / ILAR Studies • In conclusion ……

  5. Clinical Practice Guidelines • Busy Clinician • Information overload • Wide variability in patient care • Need to develop CLINICAL PRACTICE GUIDELINES

  6. Practicing EBM: The Needs Evidence-based approach to patient care create the NEED for Clinical Practice Guidelines DIAGNOSIS THERAPY PROGNOSIS

  7. Artichoke of Population Studies and Clinical Medicine – 1 • Health of patients: • - individual patient • - patient groups • Physicians need to identify & address factors: • - patient’s family • - community • Community: • - A resource for physicians

  8. Artichoke of Population Studies and Clinical Medicine - 2 • To reduce burden of disease: • - Integration of disease prevention & • - health promotion • into routine medical care • Chronic diseases: • - multiple causes or exacerbating factors • - variety of interventions • - at multiple levels • A population-based perspective: • - helpful in chronic disease management

  9. Role of physicians in • preventive interventions • Provision of direct preventive services • Management & organization of preventive health services within medical care system • Advocacy within clinical settings, • communities & organized medicine

  10. Outline of presentation • Key messages • HFA • Thoughtful physicians: Difficult Questions • EBM • Measurement Iterative Loop • COPCORD / WHO / ILAR Studies • In conclusion ……

  11. Biological Behavioural Human rights Equity & social justice Environmental Communities Determinants of health Health for All Gender Health system Societies Families Individuals Information & communication Socio-economic Science & technology Socio-cultural Aging of the population

  12. Outline of presentation • Key messages • HFA • Thoughtful physicians: Difficult Questions • EBM • Measurement Iterative Loop • COPCORD / WHO / ILAR Studies • In conclusion ……

  13. Thoughtful Physicians : Difficult Questions - 1 1) How may I be thorough YET efficient when considering the possible causes of my patient’s problem? 2) How do I characterize the information I have gathered during the medical interview & physical examination? (Probability - Utility) 3) How should I interpret new diagnostic information? (Probability)

  14. Thoughtful Physicians : Difficult Questions - 2 4) How do I select the appropriate diagnostic test? (Treatment, Threshold, Probability) 5) How do I choose among several risky treatments? (Expected Value Decision Making) 6) How do I know, how is my patient doing?

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