The Political Contexts of Evidence Based Medicine : Policymaking for Daily Hemodialysis  

Oleh:

Gordon, Elisa Jill

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 11 (Jun. 2006), page 2707-2719.
Topik: EVIDENCE; USA; evidence based medicine; health policy; end stage renal disease; daily hemodialysis; ethics

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.4 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Policymakers and clinicians increasingly rely on evidence based medicine (EBM) to make decisions about insurance coverage and clinical treatment. Conflicting value judgements about evidence and pressures exerted by stakeholders gender health policymaking a political process. This paper examines how value judgements become embedded on the process of improving medical outcomes by focusing on health policymaking. Specifically this paper highlights how EBM is variably used as a standard for decision making depending on perceived risks any policymakers and what is on the competing agenda. I draw upon the case study of the policymaking process for the recent US bill. H. R. 1004 : Kidney Patient Daily Dialysis. Act, which would legislate daily hemodialysis (DHD) as a new renal replacement therapy modality, and provide explore the political underpinnings of EBM. The interpretation of substantial outcome data showing medical, quality of life and hypotherical economic imporvements of DHD over conventional dialysis are currently being contested in the medical and political spheres. Accordingly the drive for what some stakeholders view as better evidence through randomized clinical trials is central to the debate and policymaking process. This paper underscores how the demand for, the interpretations, the funding for and the cause of evidende render EBM a political endeavor with vital ethical implications for clinical care.

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