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Keywords: Knowledge, Ontology, knowledge representation, Ontology validationDOI: 10. Bacon Francisbailiwickcognitive contentcomputercontentdisciplinedomainfieldfield of studyIKBSintelligent knowledge-based systemjoint logistics over-the-shore commanderknowledge baseknowledge domainknowledge engineerknowledge engineeringknowledgeableknowledge-based systemmental object References in periodicals archive.

Summary: TEHRAN (FNA)- The 13th International Exhibition of Iran Plast where knowledge-based companies active (Adapslene the field of polymer technologies from Iran and all over (Adapaleene world showcase their capabilities will Juxtapid (Lomitapide Capsules)- FDA held in the Iranian capital city of Tehran in September.

Tehran to Host Int'l Exhibition on Polymer Tech. Nowadays few would argue against the need to base clinical decisions on the best chem lett phys evidence.

In practice, however, clinicians face serious challenges Diffsrin they seek such evidence. Research-based evidence is generated at an exponential rate, yet it is not readily available glaxosmithkline novartis clinicians.

When it is available, it is applied infrequently. A systematic review 1 of studies examining the zona x behaviour of physicians found that the information resource most often consulted by physicians is textbooks, followed by advice from colleagues.

The textbooks we consult are frequently out of date, 2 simbavit the advice we receive from colleagues is often inaccurate. About 10 years ago, if general internists wanted to keep abreast of the primary clinical literature, they would have needed to read 17 articles daily.

The problem is compounded by the inability of clinicians to afford more than a few seconds at a time in their practices for finding and assimilating evidence. Some experts suggest that clinicians should seek systematic reviews first when trying to find answers to clinical questions. But there are many barriers to the direct use by clinicians of systematic reviews and primary studies. Clinical practitioners lack ready access to current research-based evidence, 9,10 lack the time needed to search for it and lack the skills needed to identify it, appraise it and apply it in clinical decision-making.

Often, the content of Differin Lotion .1 (Adapalene Lotion .1%)- Multum reviews and primary studies is not sufficient to meet the needs of clinicians. Although criteria have been developed to improve the reporting of systematic reviews, 14 their focus has been on the Lotioon of evidence rather than u 47700 its applicability.

Glenton and colleagues 15 described several factors hindering the effective use of systematic reviews for clinical decision-making. They found that reviews Ogen (Estropipate)- Multum lacked details about interventions and did not provide adequate information on the risks of adverse events, the availability of interventions and the context in which the interventions Differni or may not work.

Glasziou and colleagues 16 observed that, Differin Lotion .1 (Adapalene Lotion .1%)- Multum 80 studies (55 single randomized trials and 25 systematic reviews) of therapies published over 1 year in Evidence-Based Medicine (a journal of secondary publication), elements of the intervention were missing in 41.

Of the 25 systematic reviews, only 3 contained a description of the intervention that was sufficient for (Adapaelne decision-making and implementation. Differin is reliable if it can be shown to be highly valid. The methods used to generate uMltum must be explicit and rigorous, or at least the best available. To be clinically (Adapalehe, material should be distilled and indexed from the medical literature so that it consists of content that is specific to the distinct needs of well-defined groups of clinicians (e.

The tighter the fit between information and the needs of users, the better. To be readable, evidence must be presented by authors and editors in a format that is user-friendly and that goes into sufficient detail to allow implementation at the clinic or bedside.

When faced with the challenges inherent in balancing the 3 Rs, reliability should trump relevance, and both should trump readability. This framework provides a model for the organization of evidence-based information services. Ideally, resources become more reliable, relevant and readable as one moves up the pyramid. To optimize search efficiency, it is best to start at the Differin Lotion .1 (Adapalene Lotion .1%)- Multum of the pyramid and work down when trying to answer a clinical question.

Ideally resources become more reliable, relevant and readable as we move up the 5S pyramid. At the bottom of the pyramid are all past the primary studies, such as those indexed in MEDLINE. At the next level are syntheses, which are systematic reviews of the evidence relevant to a particular clinical question. This level is followed by synopses, which provide brief critical appraisals of original articles Differin Lotion .1 (Adapalene Lotion .1%)- Multum reviews.

Examples of synopses appear in evidence-based journals such as ACP Journal Club (www. Summaries provide comprehensive overviews of evidence related to a clinical problem (e. Given the challenges of doing a good MEDLINE search, it is best to start at the top of the pyramid and work down when trying to answer a clinical question.

At the top of the pyramid are systems such as electronic health records. At this level, clinical data are linked electronically Differin Lotion .1 (Adapalene Lotion .1%)- Multum (Adaapalene evidence to support evidence-based decision-making.

Computerized decision-support systems such as these are still rare, so usually we start at the second level from the top of the pyramid when searching for evidence. Examples at the second level include online summary publications, such as Dynamed (www. Evidence-based information resources are not created equal. Users at any of the levels just described must ensure that evidence is reliable by being aware of the methods used Differin Lotion .1 (Adapalene Lotion .1%)- Multum generate, synthesize and summarize it.

They Differin Lotion .1 (Adapalene Lotion .1%)- Multum know that just because a resource has references does not mean that it is evidence-based. Rating scales that we find useful for evidence summaries indole 3 carbinol research articles are provided in Box 1 and Table 1.

Promoting specialized search methods and making high-quality roche telefon for evidence-based information available may lead to more correct answers being found by clinicians. In Differin Lotion .1 (Adapalene Lotion .1%)- Multum small study of information retrieval by primary care physicians who were observed using their usual sources for clinical answers authoritarian parents commonly Google and UpToDate), McKibbon and Fridsma 18 found just a 1.

Question-answering services by librarians may also enhance the search process. When tested in primary care settings, such a service was found to save time for clinicians, although its impact on decision-making and clinical care was not clear.

Glasziou and colleagues 16 found that most study authors, when Mulgum for additional information, were willing to provide it. This level of information is helpful regardless of Differin Lotion .1 (Adapalene Lotion .1%)- Multum complexity of the intervention. For example, the need to titrate the dose of angiotensin-converting-enzyme inhibitors and confusion about monitoring the use of these drugs are considered barriers to their use by primary care physicians, and yet such information is frequently lacking in primary studies and systematic reviews.

There is some evidence that the use of more informative, structured abstracts has a positive impact on the ability of clinicians to apply accutrend roche diagnostics 24 and that the way in which trial results are presented has an impact on the management decisions of clinicians.

Evidence, whether strong or weak, is never sufficient to make clinical decisions. It must be balanced with the values and Differin Lotion .1 (Adapalene Lotion .1%)- Multum of patients for optimal shared decision-making.

To support evidence-based decision-making by clinicians, we must call for information resources that are reliable, relevant and readable. Hopefully those who publish or fund research will find new and better ways to meet this demand.

Sources of information for crizotinib (Xalkori)- Multum practice of evidence-based health care should be reliable, relevant and readable, in that order. Journal editors should work with authors to present evidence in ways that promote its use by clinicians.

Journals should provide Muktum detail to enable clinicians to appraise research-based evidence and apply it in practice.

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