CITI Developers Meeting Seattle Washington USA October 4

CITI Developers Meeting Seattle, Washington USA October 4 -6. 2007 ---IHCAI Foundation – Centro America Branch of the Iberoamerican Cochrane Centre & Network Dr. Mario Tristán Director -General

What is IHCAI’s Mission? We Use Knowledge We generate new, and harness existing, knowledge to address the complex and difficult challenges of health care and access to health information by professionals and health consumers. We focus on reducing the disproportionate burden disease of poor people. Our major areas of work are research skill development, critical appraisal, analysis and translation of scientific knowledge into professional health care practice and community use We focus on the Medical Education and health professionals’ curriculum to enhance the future professionals’ competences and incorporate new knowledge and technology for improving the efficacy and effectiveness of new continuous medical education for current professionals’ improvement in order to improve the future and current physicians and health professionals’ competences.

We Are Global. We live the globalization process… While we do not--and cannot--have a presence everywhere, we want work intensively in Central America. We base our work on the benefits of globalization. However, our work recognizes and addresses the negative aspects of globalization such as injustice, inequalities and exclusion of many groups in the region. This exclusion encompasses basic sources of income and access to the benefits of knowledge, science and technology resulting in new forms of exploitation, trade patterns and consequently new diseases related to ecological damage and poverty. We collaborate in regional and international networks. We share our experience with other countries in South America, Africa and other developing regions. We also collaborate with partners in high income countries who have shown a genuine interest and affirmative actions for contributing with our mission, programs and tasks.

INTERNATIONAL COLLABORATIVE PARTNERSHIPS AND AFFILIATIONS: http: //www. ihcai. org/partnerships. htm

EVIDENCE BASED PRACTICE TRAINNING CENTRE

SYSTEMATIC REVIEWS PRODUCTION AND DISSIMINATION ACTIVITIES TO HEALLTH PROFESSIONALS AND HEALTH CONUSMERS

“Lo más difícil es establecer la verdad en tiempos en que todo puede ser verdad”. Most difficult it is to establish the truth in times in which everything can be truth (S. J. Lec)

THE COCHRANE COLLABORATION® Providing up to date evidence of the effects of health care Our vision is that healthcare decision-making around the world will be informed by high quality, timely research evidence, and that The Cochrane Collaboration will play a pivotal role in the production and dissemination of this evidence across all areas of health care http: //www. cochrane. org/index. htm

The Archie Cochrane Legacy

Originally published in 1972, Archie Cochrane's classic text has had a profound influence on the practice of medicine and on the evaluation of medical interventions. He was the first to set out clearly the vital importance of randomised controlled trials (RCTs) in assessing the effectiveness of treatments, and his work led directly to the setting-up of the Cochrane Collaboration, now a world-wide endeavour dedicated to tracking down, evaluating and synthesising RCTs in all areas of medicine.

Davis DA, Thompson MA, Oxman AD, Haynes RB: Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA 1995; 274: 700 -5. Sibley JC, Sackett DL, Neufeld V, et al: A randomised trial of continuing medical education. N Engl J Med 1982; 306: 511 -5. 1977; 24: 648.

The clinical literature is now so big that general physicians who want to keep abreast of the journals relevant to their practices have to examine 19 articles a day, 365 days a year Davidoff F, Haynes B, Sackett D, Smith R: Evidence based medicine: a new journal to help doctors identify the information they need. BMJ 1995; 310: 1085 -6.

Wait a minute! Aren't you sponsor by a pharmaceutical ?

A new concept for health consumers advocacy Disease Mongering: turns healthy people into patients, wastes precious resources, and causes iatrogenic harm. Like the marketing strategies that drive it, disease mongering poses a global challenge to those interested in public health, demanding in turn a global response Image taken with permission form “Moynihan R, Henry D PLo. S Medicine Vol. 3, No. 4, e 191 doi: 10. 1371/journal. pmed. 0030191

The Cochrane Collaboration Logo The Corticosteroids in pregnant women under risk of premature delivery reduced the child mortality. It was shown in RCT published in 1972, and several other published in short time. How many deaths could be prevented since it was accepted as clinical practice ?

The Cochrane Collaboration structure 1. Reviews Groups ( ie. Pulmonoloy, Lung Cancer, Health Policy) 2. Methods Group 3. Field or Networks i. e (Developing countries initiative) 4. Consumer Network) 5. Cochrane Centres regional network and branches

http: //bmj. bmjjournals. com/content/vol 329/issue 7473/

Presentation of a current case in the context of Costa Rica:

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Context sensitive research bioethics training curriculum is needed targeting the field of the law and create public health strong core of knowledge

The Seventh Annual Iberoamerican Cochrane Network Conference and the l. V Iberoamerican Evidence Based Clinical Guidelines will be held in San Jose Costa Rica Title of the Meeting RESEARCH AND CLINICAL PRACTICE BIOETHICS June 2008

www. ihcai. org