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Dive into the research topics where Allen F. Shaughnessy is active.

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Featured researches published by Allen F. Shaughnessy.


Academic Medicine | 2005

Teaching evidence-based medicine: should we be teaching information management instead?

David C. Slawson; Allen F. Shaughnessy

To encourage high-quality patient care guided by the best evidence, many medical schools and residencies are teaching techniques for critically evaluating the medical literature. While a large step forward, these skills of evidence-based medicine are necessary but not sufficient for the practice of contemporary medicine. Incorporating the best evidence into the real world of busy clinical practice requires the applied science of information management. Clinicians must learn the techniques and skills to focus on finding, evaluating, and using information at the point of care. This information must be both relevant to themselves and their patients as well as being valid. The authors discuss the need to teach the applied science of information management along with, or perhaps even instead of, teaching the basic science of evidence-based medicine. All students, residents, and practicing physicians need three skills to practice the best medicine: the ability to select foraging—“keeping up”—tools that filter information for relevance and validity, the skill to select and use a hunting—“just in time”—information tool that presents prefiltered information easily and in a quickly accessible form at the point of care, and the ability to make decisions by combining the best patient-oriented evidence with patient-centered care, placing the evidence in perspective with the needs and desires of the patient. This teaching of information management skills will prepare students and residents for a practice of medicine that requires lifelong learning.


BMJ | 1997

Obtaining useful information from expert based sources

David C. Slawson; Allen F. Shaughnessy

Abstract Clinicians rely heavily on expert based systems– consultation with colleagues, journal reviews and textbooks, and continuing education activities–to obtain new information. The usefulness of sources such as these depends on the relevance and validity of the information and the work it takes to obtain it. Useful information can be distinguished from the useless by asking three questions: Does the information focus on an outcome that my patients care about? Is the issue common to my practice, and is the intervention feasible? If the information is true, will it require me to change my practice? If the answer to all three questions is yes, then the information is a common POEM (patient oriented evidence that matters), capable of improving the lives of your patients and must be evaluated for validity. Conclusions based on results of well designed clinical trials are more likely to be valid than those drawn from observations based on experience in clinical practice. Both members of the team, clinicians and experts, must take responsibility for their respective roles.


BMJ | 2003

What happened to the valid POEMs? A survey of review articles on the treatment of type 2 diabetes

Allen F. Shaughnessy; David C. Slawson

Objective To evaluate systematically the review literature on type 2 diabetes to assess transmission of the findings of the United Kingdom prospective diabetes study (UKPDS), an important source of recent valid patient oriented evidence that matters (POEMs). Design Inception cohort analysis of the recent medical literature. Studies reviewed Thirty five reviews on treatment of type 2 diabetes. Main outcome measures Presentation of three types of information from UKPDS in review articles: recommendations based on patient oriented outcomes of study; recommendations contradicted by patient oriented outcomes of study; and recommendations based on disease oriented outcomes for which no patient oriented evidence exists. Results Only six of the reviews included the POEM that tight blood glucose control had no effect on diabetes related or overall mortality. Just seven mentioned that metformin treatment was associated with decreased mortality. Most (30) of the reviews did not report that diabetic patients with hypertension benefit more from good blood pressure control than good blood glucose control. No review pointed out that treatment of overweight patients with type 2 diabetes with insulin or sulphonylurea drugs had no effect on microvascular or macrovascular outcomes. Thirteen reviews recommended drugs as first line treatment for which we do not have patient oriented outcomes data. The average validity assessment score was 1.3 out of a possible score of 15 (95% confidence interval 0.9 to 1.8). Conclusions Review articles on the treatment of type 2 diabetes have not accurately transmitted the valid POEM results of the UKPDS to clinicians. Clinicians relying on review articles written by experts as a source of valid POEMs may be misled.


BMJ | 2012

Monoclonal antibodies: magic bullets with a hefty price tag

Allen F. Shaughnessy

Sales of monoclonal antibodies are projected to reach more than


BMJ | 2011

Old drugs, new tricks

Allen F. Shaughnessy

160bn in the US alone over the next few years so is it any wonder that drug companies fiercely protect their profits? Allen Shaughnessy considers why these unique and complex drugs are so eyewateringly expensive


Annals of Pharmacotherapy | 1985

Potential Uses for Metoclopramide

Allen F. Shaughnessy

Allen Shaughnessy explains how computer power is expanding our pharmaceutical armoury


Medical Teacher | 2014

Student–teacher education programme (STEP) by step: Transforming medical students into competent, confident teachers

Deborah R. Erlich; Allen F. Shaughnessy

Metoclopramide, a dopamine antagonist, is approved in the U.S. for the treatment of various gastrointestinal disorders. Its use has been investigated in a wide variety of diseases, including those not involving the intestinal tract. Although more study is required before routine clinical use of metoclopramide can be advocated, it may be effective in the treatment of tardive dyskinesia, in decreasing the risk factors associated with anesthetic-related aspiration, and as an adjunct in the treatment of gastric bezoars. It also may be used safely in patients with Parkinsons disease. The use of metoclopramide in the treatment of neurogenic bladder, orthostatic hypotension, tumor-associated gastroparesis, nonprolactinemic amenorrhea, failure to thrive, Tourettes syndrome, anorexia nervosa, and hiccups, as well as an adjunct to migraine therapy, has been investigated, but sufficient evidence has not been accumulated to advocate the use of metoclopramide in these disorders.


Accountability in Research | 2016

Under the Influence: The Interplay among Industry, Publishing, and Drug Regulation.

Lisa Cosgrove; Steven Vannoy; Barbara Mintzes; Allen F. Shaughnessy

Abstract Background: While most medical schools have students teach other students, few offer formal education in teaching skills, and fewer provide teaching theory together with experiential teaching practice. Furthermore, curriculum evaluation of teaching education is lacking. Aim: This study aimed to examine effects of a novel didactic teaching curriculum for students embedded in a practical teaching experience. Methods: A longitudinal 12-week curriculum with complementary didactic and practical components for final-year students learning how to teach was developed, implemented and evaluated using a multi-level evaluation based on the Kirkpatrick approach with qualitative and quantitative methods. Results: Thirteen student–teachers acquired measureable knowledge, skills and attitudes necessary for teaching excellence. Confidence in teaching increased (p < 0.001), particularly in four key areas: oral feedback, written feedback, mentoring, and the difficult learner. Student–teachers demonstrated teaching competence as determined by self-assessment, student feedback, and faculty observation. Top teachers impacted their first-year students’ performance in patient interviewing as measured by Objective Structured Clinical Examination (OSCE). Conclusions: Reinforcing educational theory with practical teaching experience under direct faculty supervision promotes teaching competency for graduating medical students. The intertwined didactic plus practical model can be applied to various teaching contexts to fulfil the mandate that medical schools train graduates in core teaching knowledge, skills and attitudes in preparation for their future roles as clinical teachers.


International Journal of Medical Informatics | 2010

Updating clinical knowledge: an evaluation of current information alerting services.

Scott M. Strayer; Allen F. Shaughnessy; Kenneth S. Yew; Mark B. Stephens; David C. Slawson

ABSTRACT The relationships among academe, publishing, and industry can facilitate commercial bias in how drug efficacy and safety data are obtained, interpreted, and presented to regulatory bodies and prescribers. Through a critique of published and unpublished trials submitted to the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for approval of a new antidepressant, vortioxetine, we present a case study of the “ghost management” of the information delivery process. We argue that currently accepted practices undermine regulatory safeguards aimed at protecting the public from unsafe or ineffective medicines. The economies of influence that may intentionally and unintentionally produce evidence-biased—rather than evidence-based—medicine are identified. This is not a simple story of author financial conflicts of interest, but rather a complex tale of ghost management of the entire process of bringing a drug to market. This case study shows how weak regulatory policies allow for design choices and reporting strategies that can make marginal products look novel, more effective, and safer than they are, and how the selective and imbalanced reporting of clinical trial data in medical journals results in the marketing of expensive “me-too” drugs with questionable risk/benefit profiles. We offer solutions for neutralizing these economies of influence.


BMJ | 2008

Should we treat subclinical hypothyroidism

Cung B Pham; Allen F. Shaughnessy

PURPOSE Clinicians are overwhelmed by the sheer magnitude of new clinical information that is available on a daily basis. Despite the availability of information tools for finding this information and for updating clinical knowledge, no study has examined the quality of current information alerting services. METHODS We developed a 7-item checklist based on the principles of evidence-based medicine and assessed content validity with experts and face validity with practicing clinicians and clinician researchers. A list of clinical information updating tools (push tools) was generated in a systematic fashion and the checklist was used to rate the quality of these tools by two independent raters. Prior to rating all instruments, the raters were trained to achieve good agreement (>80%) by applying the checklist to two sets of three randomly selected tools. Descriptive statistics were used to describe the quality of the identified tools and inter-rater reliability was assessed using Intraclass Correlation (ICC). RESULTS Eighteen tools were identified using our systematic search. The average quality of these tools was 2.72 (range 0-7). Only two tools met all suggested criteria for quality. Inter-rater reliability for the 7-item checklist was .82 (ICC). CONCLUSIONS We developed a checklist that can be used to reliably assess the quality of clinical information updating tools. We found many shortcomings in currently available clinical knowledge updating tools. Ideally, these tools will evolve in the direction of applying basic evidence-based medicine principles to new medical information in order to increase their usefulness to clinicians.

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Slawson Dc

University of Virginia Health System

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Henry C. Barry

Michigan State University

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Lisa Cosgrove

University of Massachusetts Boston

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Emily E. Wheeler

University of Massachusetts Boston

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