Clinical
Epidemiology
in
Primary
Care
Wari
Yamamoto
Department
of
Community
and
General
Medicine
School
of
Medicine
Sapporo
Medical
University
Sapporo,
Japan
General
physicians
are
often
faced
with
difficulty
in
formulating
an
explicit
plan
of
management.
For
example,
they
have
their
doubt
about
the
effectiveness
of
a
home
exercise
program
of
strength
and
balance
retraining
exercises
in
improving
medical
conditions
in
elderly
women.
In
such
a
case
they
generally
use
various
sources
of
information
to
answer
this
question:
their
own
experiences,
the
advice
of
their
colleagues
and
the
medical
literature.
However,
most
of
them
might
not
be
easily
accessible
to
the
valid
evidence.
It
reflects
upon
the
lack
of
appropriate
frameworks,
systems,
and
strategies
for
effectively
influencing
professional
behavior.
One
of
the
frameworks
corresponds
to
clinical
epidemiology.
Clinical
epidemiology
is
the
science
of
making
predictions
about
individual
patients
by
counting
clinical
events
in
similar
patients,
using
strong
scientific
methods
for
studies
of
groups
of
patients
to
ensure
that
the
predictions
accurate.
Its
purpose
is
to
develop
and
apply
methods
of
clinical
observation
that
will
lead
to
valid
conclusions
by
avoiding
being
misled
by
systematic
error
and
chance.
It
is
one
important
approach
to
obtaining
the
kind
of
information
physicians
need
to
make
good
decisions
in
the
care
of
patients.
By
relying
on
clinical
epidemiology,
physicians
of
all
backgrounds
are
on
a
more
equal
footing,
all
depending
mainly
on
the
interpretation
of
the
same
set
of
strong
studies.
There
is
still
a
need
to
refine
how
evidence
can
be
incorporated
into
the
complexity
of
the
physician-patient
relationship
in
general
practice.
In
that
respect
the
method
for
applying
clinical
epidemiology
into
practice
is
the
evidence-based
medicine.
It
has
a
five-step
process
for
using
evidence
based
approach
in
general
practice:
(1)
define
the
problem
(2)
track
down
the
information
sources
you
need
(3)
critically
appraise
the
information
(4)
apply
the
information
with
your
patients
(5)
Evaluate
how
it
is.
These
five
steps
about
the
effectiveness
of
a
home
exercise
program
in
elderly
women
would
be
shown
briefly
in
this
lecture.
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