Quaternary Prevention and the Challenges to Develop a Good Practice; Comment on “Quaternary Prevention, an Answer of Family Doctors to Overmedicalization”

Document Type: Commentary

Author

Curitiba Health System Physician, Curitiba, Brazil

Abstract

The article analyzes literature problems using as a parameter the quaternary prevention concept, introducing guidelines to have good shared decisions that avoid overdiagnosis and overtreatment and improve the quality of life. The author proposes a four-step approach: reliable evidence, awareness about populations profile, independent research analysis, and an understandable format by ordinary people.

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  1. Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag 2015;4:61-4. doi:10.15171/ijhpm.2015.24
  2. Jamoulle M. Information et informatisation en medecine generale. Torisieme rounees de reflexion sur l’informatique. Presses Universitaires de Namur; 1986.
  3. Sackett DL, Richardson SR, Rosenberg W, et al. Evidence-Based Medicine: How to Practise and Teach EBM. Edinburgh: Churchill Livingstone; 1997.
  4. Gøtzche PC. Deadly medicines and organized crime, how does big pharma has corrupted health care. London: Radcliff; 2013.
  5. St-Onge JC. Tous fous? Québec: Écosocieté; 2013.
  6. Every-Palmer S, Howick J. How evidence-based medicine is failing due to biased trial and selective pubication. J Eval Clin Pract. 2014;20(6):908-914. doi:10.1111/jep.12147
  7. Greenhalgh T, Howick J, Maskrey N. Evidence based medicine: a movement in crisis? BMJ 2014;348:g3725. doi:10.1136/bmj.g3725
  8. Ioannidis JPA. Why most published research findings are false. PLoS Med. 2005;2:e124. doi:10.1371/journal.pmed.0020124
  9. Senn S. Three things that every medical writer should know about statistics. The Write Stuff 2009;18(3):159-162.
  10. AKST J. Dealing with irreproducibility. The Scientist. April 8, 2014. http://www.the-scientist.com/?articles.view/articleNo/39654/title/Dealing-with-Irreproducibility/
  11. Gérvas J, Fernández MP. Sano y Salvo y libre de intervenciones médicas innecessarias. Barcelona: Los Libros del Lince; 2013.
  12. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ 2010;182:E839-842. doi:10.1503/cmaj.090449
  13. Atkins D, Eccles M, Flottorp S, et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004;4:38. doi:10.1186/1472-6963-4-38
  14. Christie-Seely J, Ford J, Warner M. The healthy family. In: Chistie-Seely J, ed. Working with the family in primary care. Westport: Praeger; 1984.