Evaluation and Judgment using Internal and External Evidences - Essay Example

? Evaluation and Judgment using Internal and External Evidences Evaluation and Judgment using Internal and External Evidences The patients’ examination and judgment is an evidence based evaluation that leads to viable decision making process in provision of medical services to the involved patient. The required medication information can be obtained from patients through interviews that constitution external evidences and through diagnostic processes that are internal evidences (Wolberg, 1995). The evidence based decision making process can also be applied in other clinical processes especially by clinical experts towards improving the output services provided to the patients and also to improve relevant policy making processes that are effected by national and local government legislators in conjunction with health administrators (Wolberg, 1995). Nonetheless, the evidence based decision making process to addressed in this essay are those that involve patient diagnostic health concerns towards improving then health status of the involved patient. In the evidence based evaluation of the medical conditions of a patient, the doctor or involved practitioner is required to adopt both internal and external evidence based examinations. The internal evidence are usually based on the knowledge acquired from formal education experiences and trainings with accumulated practice experience obtained from daily practices and or specific experience individually gained from clinical patient relationship (Wolberg, 1995). In other words, the internal experiences in any practice or profession are those experience gained from educational and work backgrounds. On the other hand, external evidences are the knowledge acquired through extensive research on a particular field of interest. Nonetheless, both internal and external evidences should be examined critically towards evaluating patients’ medical conditions none of which quality medication may be difficult to come by from such evaluations (Wolberg, 1995). Additionally, determination and application of relevant methods of evaluation is vital towards effective judgment. All the issues affecting a patient must be examined closely from multiple sources. It is worth noting effective evidence based decision making in the medical practice can only be achieved through sound application of both internal and external evidence based decisions. In examining patients, the only sure ways of determining their medical conditions may be either asking questions or conducting diagnostic tests on them. The interviews aimed at determining medical conditions are usually structured and aim at determining health problems that the patient is undergoing. Notably, only with internal evidence that a doctor or involved practitioners can related to the answers provided by the patient to the actual medical condition the patient; otherwise, wrong decisions that may further affect the patient’s medical condition may emerge from such evidence based evaluations. Additionally, from the same interviews, the involved medical practitioner may use the information provided by the patient through answering questions and link them such answers with internal evidence and arrive at an amicable medical report (Wolberg, 1995). Medical conditions of similar characteristics usually related to nearly the same medical condition. However, if the doctor or the involved medical practitioner has some slightest doubt, he or she may embark on additional examination to ascertain his or her doubts. In essence, in the evidence based examinations, doctors among other medical practitioners must find the finest and relevant as well as accurate information towards arriving at the conclusive judgments. The other sure way of ascertaining the medical conditions or evidences that are provided by the patient in an interview is conducting medical testing (Wolberg, 1995). Medical testing also requires interval evidence practice experience; otherwise, wrong result may be reported from the test. Therefore, doctors among other medical practitioners must ensure that they are vast in knowledge in their areas of specialization so that they may provide accurate and effective medical reports at all the times that they interact with their patients. The results of external evidence usually apply to a varied range of medical conditions; therefore, optimum approaches in order to obtain optimum healthcare intervention effects. Understanding and applying external evidence approaches usually require critical evaluation skills to navigate the evidence and determine its relevancy and applicability in a clinical decision (Wolberg, 1995). Nonetheless, affecting the external evidence in the medical practices has become easy through the use of hierarchical “pyramid of evidence”. This criterion usually emphasizes on the use of randomized controlled clinical trials to promulgate the judgment approach. It assumed that this approach usually leads to quality decision making especially in relating the patient’s condition and external evidences. Application of Evidence Based Evidence to Patients Examining of a patient usually rely heavily on internal evidence. This is pegged on the notion that clinical medicines usually do best in patients when they are applied while considering demographic data of the patient and the disease under diagnosis (Wolberg, 1995). Nonetheless, the medical or health history of a patient usually provides objective information regarding the condition of the involved patient and what medical treatment should he or she be subjected. In some cases, such demographic data may be used to suggest change in the medicine or treatment mode to a patient if the information provided in their demographic data shows no medical improvement. However, it should be noted that regardless of the fact that demographic data provide subject data, the clinicians must base their medical judgment on accurate information. Notably, demographic data are usually stored in a patient’s medical records in hospitals; however, in cases where such records are lacking, patients should be diagnosed objectively and subjectively so that they may provide such information. However, the same data mining from certain patients may be difficult especially when patient is suffering from mental problems (Wolberg, 1995). In such cases, the clinician will have to combine his or her internal and external evidence based expertise towards determine the necessary and accurate medical treatment that such patients should be subjected to help in improving their health. Experienced clinicians among other medical practitioners are usually have vast internal and external evidence based evaluation and judgment of their patients. Different medical conditions usually require different medical attentions; therefore, medical practitioners must have intensive knowledge regarding all the medical conditions within their specialization (Wolberg, 1995). Research work usually widens the understanding, knowledge, and experience in the external evidence based medical applications; therefore, medical practitioners must embark on series of such research to widen their knowledge in the practice. Moreover, in cases of applying their expertise, medical practitioners must readily apply both internal and external evidences in administering medical assistance to their patients since application of two evidences usually lead to informed, subjective, and accurate judgment and medical assistance to patients. Miscellaneous Therapies The Zinc Supplement Zinc is a fundamental element in human body and it usually constitutes nearly 0.1 percent of the body weight. Regardless of the quantity, it is vital for the normal protein and nucleic acid metabolism. Increase in urinary zinc excretion and serum hypozincemia are usually common especially after the head injuries. Therefore, in such situations, there is usually need of adoptive response towards inhabiting the proliferation of the infective organisms. The serum albumin levels and the major zinc transport carriers are also depressed remarkably following injuries of the brain. These depressions usually help in explaining the reduction in the levels of serum zinc (Wolberg, 1995). In most cases, zinc urinary excretion is usually proportional to severe head injuries and its absence or deficiency is usually associated with the death of cells since it is a vital element in protein synthesis. The table below shows the zinc supplementation IBI levels in a patient Author and Year Place of publication Study design The PEDro Score Methods Outcomes McClain et al., (1986) USA RCT PEDro=1 26 patients with head-injuries were involved in the study. Their GSC scores ranged between 4 -12 prospectively. A longitudinal evaluation was performed on serum zinc concentrations. Zinc excretion that had lasted for 24 hours was studied for 15 patients. Patients were randomized to receive either parenteral or enteral support. There were no comparisons between-group reported. For the entire group, at least 1 post-of patients’ injury was recorded. These patients’ recorded lower levels of zinc serum with a mean of 40.2 µg/dl; however, the levels of zinc serum increased gradually over the 16-days of study. Notably, Patients with severe head injuries recorded greater urinary zinc content (p Read More