Best practice & research. Clinical rheumatology
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Among the most important reasons for the increased use of ultrasound by rheumatologists is its feasibility to guide injections. Correct positioning of the needle in the targeted structure occurs much more frequently with ultrasound guidance than with conventional positioning without imaging. The sonographer can mark the skin above the structure, using ultrasound to localize this point and to estimate the depth of the structure. ⋯ Education involves training to coordinate probe and needle in sponges, chicken, cheese and other objects. Knowledge of anatomy, probe positioning and the ability to coordinate probe and needle are necessary when injecting patients with sonographic guidance. The rheumatologist might start with easy approaches in which the needle is parallel to the probe.
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The aims, structure, methods and educational experiences employed in the training of rheumatologists vary from one national programme to another, according to traditions, rules and resources. Mutual recognition of titles, the free movement of labour and the striving towards for high-quality standards in medical care in Europe demand that efforts and progress are made to ensure that similar competencies are achieved by different programmes. ⋯ The European Rheumatology Curriculum Framework has now been endorsed by scientific and educational bodies in 17 member countries. It has been provided with a contextualized review of good practice in curriculum planning and development - the European Board of Rheumatology Educational Guide.
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Best Pract Res Clin Rheumatol · Apr 2009
ReviewHow to perform a critical analysis of a randomised controlled trial.
Given the large amount of medical literature of varying methodological quality, care must be taken when translating the results of randomised controlled trials into clinical practice. To assist in this translation process, we provide a method that involves answering three main questions: 'Can I trust the results?' 'How do I understand the results?' and 'To whom do the results apply?' To answer the first question, we describe important items that help in judging the reliability of the findings. For the second question, we address the clinical and statistical significance of results by looking at the size and precision of the effect. Finally, we raise the issue of external validity and of reporting adverse effects to determine which patients may best benefit from the new intervention.