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Teaching Evidence-Based Neurology in Europe: Cochrane Systematic Reviews in Practice

Final Activity Report Summary - EBN COCHRANE (Teaching Evidence-Based Neurology in Europe: Cochrane Systematic Reviews in Practice)

This project aimed to train young European neurologists to use evidence-based neurology and systematic reviews in clinical practice. Primary emphasis was placed on increasing the number of new researchers participating in systematic reviews and evidence-based neurology, providing a uniform training outlet for professional neurologists across Europe, and experimenting with an innovative training technique that combined lectures with problem-based learning and critical-appraisal approaches. In the end it contributed to an increase in clinical efficiency and research potential of young neurologists, thereby facilitating improved health care for neurological patients across Europe.

Evidence-based medicine is an important means to improve the quality of medical care and has become increasingly influential in Europe. The principles of evidence-based medicine have a significant impact on the neurological speciality. Neurological diseases account for a substantial portion of health care expenditures and global disease burdens. Clinical decisions related to prevention, treatment and management of neurological patients are based on the results of increasing numbers of randomised clinical trials, and neurologists and physicians treating neurological patients have to be able to use in their clinical work the information retrieved from this type of research literature.

The need to have a reliable synthesis of results from clinical research has led to developments in the methodology of systematic reviews, which should provide credible and objective support to guide medical behaviour. Systematic reviews also have notable teaching potential since they require the acquisition of critical skills for the interpretation of scientific literature along with the use of methods that are explicit and able to be reproduced. Participants in this project learned all of these valuable skills.

Despite increased interest in this field, a gap remains between the amount and quality of evidence-based information available and its practical use by clinicians to solve individual patient problems. Evidence-based medicine has been used mostly by clinical epidemiologists in research. It has not been employed widely enough in medical practice where time constraints and lack of adequate technical knowledge reduce the motivation to use it. This gap could be eliminated with increased dissemination and training in evidence-based medicine and systematic reviews, such as the type included in this project.

This program spanned two years. It consisted of four training workshops that were held in four different European countries (UK, Spain, Portugal, and Italy). Each workshop addressed the more relevant aspects of prevention and treatment of a specific neurological disease (Stroke, Multiple Sclerosis, Parkinson's Disease, and Epilepsy). Each workshop included a minimum of four sections dedicated to different clinical questions. This valuable training, sustained over two years, contributed to an increase in evidence-based research in Europe. The participants were from different European countries, and this helped in the integration of clinical and research experiences.