Does case management work? The evidence and the abuse of evidence-based medicine.
OBJECTIVES: This study reviews typologies of psychiatric case management and then discusses the efficacy, effectiveness and cost effectiveness of psychiatric case management, with particular focus on evidence from Australia and the UK. Subsequently, it aims to examine the way such evidence has been...
| Publicado en: | Australian & New Zealand Journal of Psychiatry Vol. 35; no. 6; pp. 731 - 747 |
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| Autores principales: | , |
| Formato: | tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Dec2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106941151&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106941151 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048674 7ZU jtl: Australian & New Zealand Journal of Psychiatry issn: 00048674 maglogo: Y pubinfo: dt: Dec2001 vid: 35 iid: 6 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 106941151 106941151 2002076307 10.1046/j.1440-1614.2001.00956.x NLM11990883 106941151 ppf: 731 ppct: 16 formats: fmt: @attributes: type: P tig: atl: Does case management work? The evidence and the abuse of evidence-based medicine. aug: au: Rosen A Teesson M affil: Director, Royal North Shore Hospital and Community Mental Health Services sug: subj: Case Management Evaluation Professional Practice, Evidence-Based Psychiatry Cochrane Library Australia United Kingdom ab: OBJECTIVES: This study reviews typologies of psychiatric case management and then discusses the efficacy, effectiveness and cost effectiveness of psychiatric case management, with particular focus on evidence from Australia and the UK. Subsequently, it aims to examine the way such evidence has been interpreted in the context of UK psychiatric research and services. Finally it examines the ways in which, by the selective reviewing or editorializing of evidence, case management has been brought into disrepute in the UK. METHOD: This study reviews literature of the recent evidence for case management, and asks three questions of case management: has it been shown to be efficacious in controlled research, is it effective in applied settings, and is it cost effective? An examination is then made of the concurrent representations of the UK evidence in both the academic literature and the media. RESULTS: There is strong evidence for the efficacy effectiveness and cost-effectiveness of case management in psychiatry, the closer it conforms to active and assertive community treatment models. It appears, however, that studies and evidence-based reviews of case management have possibly been misused and misrepresented in a highly charged atmosphere of professional media debate. The potential for this abuse is not limited to psychiatry and remains a challenge for all evidence-based practice. CONCLUSION: On the evidence, assertive community treatment case management is one of the most effective interventions in psychiatry today. Despite improving the evidence base for practice (e.g. as has occurred for case-management in psychiatry), evidence-based medicine (EBM) is still susceptible to compromise and misrepresentation, due to unexamined or undeclared bias. Unless this potential for abuse is recognized and checked, EBM in psychiatry is in danger of being discredited at the hand of some of its own proponents. There is a need for more rigorous pursuit of evidence-based psychiatry, including more systematic declaration of bias in all research, whether quantitative or qualitative in design. pubtype: Academic Journal doctype: tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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