Emergency medicine Australasia : EMA
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Antifragility is a property of things that benefit from shocks, randomness and uncertainty and love adventure and risk. This describes emergency medicine. Improving evidence-based medicine requires a learning health system, where the whole system is constructed to advance patient care via research driven excellence. ⋯ Unfortunately, the human brain is hard wired for simplicity, making us disinclined to challenge the status quo. Yet probably <10% of our practice is supported by high-level evidence. Research is altruistic and a form of kindness for our patients, which includes having a culture of research within a learning health system, so that we can be thoughtful!
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Emerg Med Australas · Apr 2021
Is waiver of consent for the use of health information for research acceptable to emergency department patients?
Some emergency medicine research, especially retrospective studies using medical records review, rely on waiver of consent for use of personal health information (PHI) contained in clinical records. This is a secondary use of PHI and waiver of consent raises ethical, legal and practical issues. ⋯ In part, this involves a balancing of the public interest versus the risk to privacy and an evaluation of whether subjects would, mostly likely, have agreed to the use of their PHI had they been asked. To date, there are no robust data about whether use of PHI without consent for research would be acceptable to people who attend Australasian EDs for care.
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An increased awareness of the cognitive biases of clinical decision making over the last decade has not resulted in a corresponding decrease in clinician error. The inappropriate use of cognitive bias labels in adverse incident reviews can result in unintentional or intentional blame.