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Document Typology: Research
Methodology addressed by the publication:Narrative medicine
Title of document: A local habitation and a name: how narrative evidence-based medicine transforms the translational research paradigm
Name of author(s): Rishi Goyal, Rita CHaron, Helen-Maria Lekas, Mindy Fullilove, Michael Devlin, Louise Falzon, Peter Wyer
Name of publisher: Journal of evalutation in clinical practice
Language of the publication: English
Language of the review: Italian
Rationale We propose narrative evidence-based medicine as a necessary elaboration of the
NIH translational research roadmap. The roadmap defined two complex obstacles, T1 and
T2, to the progress of research from the ‘bench’ or basic laboratory science to the ‘bedside’
or clinical application, the traversal of which requires emergence of complex transformative
relationships between the parties and stakeholders. It fails to encompass patient
interactions, hesitancies and alliances with medical care.
Aims and Objectives We suggest a third transformative or translational step, T3, that begins
at the point that practitioners have themselves elected to adopt and recommend strategies and
interventions based on high-level evidence and guidelines. In our model, T3 encompasses all
aspects of care that converge on the practitioner–patient relationship and ultimately determine
what therapies and choices patients actually make regarding their care.
Results Learning from the biopsychosocial model, patient-centred care and shared decision
making while attending to the ethical injunction of Emmanuel Levinas to know the other, we
have developed a medical practice and theory that unites the local and specific concerns of
narrative medicine with the generalizability and power of evidence-based medicine.
Conclusions We offer innovative approaches to study, teach and improve the therapeutic
intimacy and integrative effectiveness of the practitioner–patient relationship.
Reviewer's comments on the document:
Evidence-based medicine has been defined as "the integration of best research evidence with clinical expertise and patient values", while narrative medicine promotes and values the detail or the "near-by".
Where to find it: no pdf

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