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EBM Round-up: October 2010
  1. Richard Saitz
  1. Editor, Evidence-based Medicine
  1. Correspondence to Richard Saitz
    Section of General Internal Medicine, Boston Medical Center, Boston University Schools of Medicine and Public Health, 801 Massachusetts Avenue, 2nd floor (Crosstown 2), Boston, MA 02118–2335, USA; rsaitz{at}

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Noun (\ˈrau̇nd-ˌəp\) (1) the act or process of collecting animals by riding around them and driving them in; (2) a summary of information.

Transitive verb (1) to collect (as cattle) by means of a roundup; (2) to gather in or bring together from various quarters.1

In this occasional feature, we gather and summarise articles relevant to the practice, research and teaching of evidence-based medicine (EBM) that have been published elsewhere in the peer-reviewed medical literature. The primary criterion for selection is relevance to EBM. The round-up writer (an EBM editor) comments on each summary. This round-up considered articles from the Lancet, New England Journal of Medicine, Journal of the American Medical Association, Health Affairs and the British Medical Journal in 2010.

Patients don't understand what is meant by evidence-based healthcare; they think more is always better

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Patients' attitudes and beliefs about evidence-based medicine (EBM) have not been well described, yet consumers of care are increasingly involved in health and healthcare payment decisions. Researchers used qualitative and quantitative methods to better understand their views. They assembled focus groups and interviewed adults in the USA who had health insurance through an employer and had participated in coverage decisions for someone. Then they surveyed 1558 employees online who had employment-related health insurance, worked for a large company (2000 employees or more) and were their household's key healthcare-decision maker.

Several themes emerged from the qualitative research. People were confused by terms such as ‘medical evidence’ and ‘quality guidelines’. For example, some believed that medical evidence consisted of their physical and laboratory examination results. The survey found that only half had heard of research studies that help doctors know what works best. Only a third recalled a physician discussing what scientific research had shown about the best way to manage their care. They believed that medical guidelines were an inflexible, bargain-basement approach. They also believed that more, …

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