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See detailEvidence-based early clinical detection of emerging diseases in food animals and zoonoses: two cases.
Saegerman, Claude ULg; Humblet, Marie-France ULg; Porter, Sarah ULg et al

in Veterinary Clinics of North America. Food Animal Practice (2012), 28(1), 121-131

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See detailEvidence-based guidelines for the pharmacological treatment of postmenopausal osteoporosis: a consensus document by the Belgian Bone Club.
Body, J. J.; Bergmann, P.; Boonen, S. et al

in Osteoporosis International (2010), 21(10), 1657-80

Several drugs are available for the management of postmenopausal osteoporosis. This may, in daily practice, confuse the clinician. This manuscript offers an evidence-based update of previous treatment ... [more ▼]

Several drugs are available for the management of postmenopausal osteoporosis. This may, in daily practice, confuse the clinician. This manuscript offers an evidence-based update of previous treatment guidelines, with a critical assessment of the currently available efficacy data on all new chemical entities which were granted a marketing authorization. Osteoporosis is widely recognized as a major public health concern. The availability of new therapeutic agents makes clinical decision-making in osteoporosis more complex. Nation-specific guidelines are needed to take into consideration the specificities of each and every health care environment. The present manuscript is the result of a National Consensus, based on a systematic review and a critical appraisal of the currently available literature. It offers an evidence-based update of previous treatment guidelines, with the aim of providing clinicians with an unbiased assessment of osteoporosis treatment effect. [less ▲]

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See detailEvidence-based guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis: a consensus document of the Belgian Bone Club
Devogelaer, J. P.; Goemaere, S.; Boonen, S. et al

in Osteoporosis International (2006), 17(1), 8-19

Glucocorticoids (GCs) are frequently prescribed for various inflammatory and/or life-threatening conditions concerning many systems in the body. However, they can provoke many aftereffects, of which ... [more ▼]

Glucocorticoids (GCs) are frequently prescribed for various inflammatory and/or life-threatening conditions concerning many systems in the body. However, they can provoke many aftereffects, of which osteoporosis (OP) is one of the most crippling complications, with its host of fractures. The dramatic increase in bone fragility is mainly attributable to the GC-induced rapid bone loss in all skeletal compartments. We have reviewed the meta-analyses and randomized controlled studies reporting medical therapeutic interventions currently registered in Belgium for the management of GC-OP comparatively with a placebo. Based on this research, an expert meeting developed a consensus on the prevention and therapy of GC-OP. The pathophysiology of GC-OP is complex. Several factors, acting separately or synergistically, have been described. Their great number could help to understand the rapidity of bone loss and of bone fragility occurrence, indicating that a rapid therapeutic intervention should be implemented to avoid complications. All patients on GCs are threatened with OP, so the prevention and/or therapy of GC-OP should be considered not only for postmenopausal females, but also for osteopenic premenopausal females and for males put on a daily dose of at least 7.5 mg equivalent prednisolone that is expected to last at least 3 months. Non-pharmacological interventions, such as exercise and avoidance of tobacco and alcohol, should be recommended, even if their role is not definitely settled in GC-OP prevention. Supplemental calcium and vitamin D should be considered as the first-line therapy because of the decrease in intestinal calcium absorption provoked by GCs. They also could be considered either as isolated therapy in patients taking less than 7.5 mg prednisolone daily and/or for a predicted period shorter than 3 months or as adjuvant therapy to other more potent drugs. Hormone replacement therapy could be considered in young postmenopausal females on GC, such as in postmenopausal OP, or in men with low androgen levels. Calcitonin appears to have a protective effect on trabecular bone in GC-OP, just as in postmenopausal OP. There is an increasing body of evidence supporting the antifracture efficacy of bisphosphonates, notably alendronate and risedronate. Preventative and curative therapy of GC-OP should be maintained as long as the patient is on GC treatment and could be stopped after weaning from GC, because there is more than circumstantial evidence of some recovery of BMD when GCs are stopped. There is no indication in GC-OP for any combination of two antiresorptive agents (except for calcium and vitamin D) or for an antiresorptive and an anabolic agent. There is indeed no proof that the increased costs of combined treatments will translate into increased therapeutic efficacy. [less ▲]

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See detailEvidence-based guidelines for the treatment of postmenopausal osteoporosis: a consensus document of the Belgian Bone Club
Boonen, S.; Body, Jean-Jacques; Boutsen, Y. et al

in Osteoporosis International (2005), 16(3), 239-254

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See detailEvidence-based guidelines for the use of biochemical markers of bone turnover in the selection and monitoring of bisphosphonate treatment in osteoporosis: a consensus document of the Belgian Bone Club.
Bergmann, Pierre; Body, Jean-Jacques; Boonen, Steven et al

in International Journal of Clinical Practice (2009), 63(1), 19-26

OBJECTIVES: To review the clinical value of bone turnover markers (BTM), to initiate and/or monitor anti-resorptive treatment for osteoporosis compared with bone mineral density (BMD) and to evaluate ... [more ▼]

OBJECTIVES: To review the clinical value of bone turnover markers (BTM), to initiate and/or monitor anti-resorptive treatment for osteoporosis compared with bone mineral density (BMD) and to evaluate suitable BTM and changes in BTM levels for significance of treatment efficiency. METHODOLOGY: Consensus meeting generating guidelines for clinical practice after review and discussion of the randomised controlled trials or meta-analyses on the management of osteoporosis in postmenopausal women. RESULTS: Although the correlation between BMD and BTM is statistically significant, BTM cannot be used as predictive markers of BMD in an individual patient. Both are independent predictors of fracture risk, but BTM can only be used as an additional risk factor in the decision to treat. Current data do not support the use of BTM to select the optimal treatment. However, they can be used to monitor treatment efficiency before BMD changes can be evaluated. Early changes in BTM can be used to measure the clinical efficacy of an anti-resorptive treatment and to reinforce patient compliance. DISCUSSION: Determining a threshold of BTM reflecting an optimal long-term effect is not obvious. The objective should be the return to the premenopausal range and/or a decrease at least equal to the least significant change (30%). Preanalytical and analytical variability of BTM is an important limitation to their use. Serum C-terminal cross-linked telopeptide of type I collagen (CTX), procollagen 1 N terminal extension peptide and bone specific alkaline phosphatase (BSALP) appear to be the most suitable. Conclusion: Consensus regarding the use of BTM resulted in guidelines for clinical practice. BMD determines the indication to treat osteoporosis. BTM reflect treatment efficiency and can be used to motivate patients to persist with their medication. [less ▲]

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See detailEvidence-Based Medicine
Krzesinski, Jean-Marie ULg

Learning material (2001)

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See detailEvidence-based medicine. Apport des essais cliniques controles.
Scheen, André ULg

in Revue Médicale de Liège (2000), 55(4), 216-9

Controlled clinical trials are the support of Evidence-Based Medicine. In most instances, only them can indeed provide the demonstration of both the efficacy and safety of a pharmacological treatment ... [more ▼]

Controlled clinical trials are the support of Evidence-Based Medicine. In most instances, only them can indeed provide the demonstration of both the efficacy and safety of a pharmacological treatment, based upon rigorous scientific experimental observations avoiding potential bias due to subjective interpretation. In order to be able to extrapolate conclusions of drug trials to clinical practice and to positively influence physician's attitudes, "explanatory" trials, which aim at proving the intrinsic activity of the molecule, should be completed by "pragmatic" trials, which aim at demonstrating the clinical utility of the drug. [less ▲]

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See detailEvidence-based medicine. Apport des etudes epidemiologiques.
REGINSTER, Jean-Yves ULg; BETZ, Romain ULg

in Revue Médicale de Liège (2000), 55(4), 211-5

Epidemiological studies, more specifically those related to analytical epidemiology are a major determinant of evidence-based medicine. When classifying the value of the different epidemiological studies ... [more ▼]

Epidemiological studies, more specifically those related to analytical epidemiology are a major determinant of evidence-based medicine. When classifying the value of the different epidemiological studies, based on their level of causality, cohort studies are ranked higher than case-control studies, mainly due to the fact that they allow direct collection of information on exposition to risk factors and health consequences. However, case-control studies can also provide an important information, if a specific effort is dedicated to the analyses of the circumstances of the exposition. Meta-analysis increases, by pooling them, the statistical power of individual studies of limited size. Meta-analysis can also be considered as an important source of evidence in the perspective of evidence-based medicine. [less ▲]

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See detailEvidence-Based Medicine: traitement de l'hépatite chronique C. GLEVHE. Groupe Liégeois d'Etude des Virus Hépatotropes.
Delwaide, Jean ULg; Gerard, Christiane ULg; Belaiche, Jacques ULg et al

in Revue Médicale de Liège (2000), 55(5), 337-340

The Hepatitis C virus (HCV) infects nearly 170 million people in the world. The major characteristic of virus C is its tendency to chronicity in more than 85% of cases. Generally asymptomatic, HCV ... [more ▼]

The Hepatitis C virus (HCV) infects nearly 170 million people in the world. The major characteristic of virus C is its tendency to chronicity in more than 85% of cases. Generally asymptomatic, HCV infection may also evolve with time to cirrhosis and hepatocellular carcinoma. During the last few years, HCV-related end-stage cirrhosis has become the first cause of liver transplantation. In 10 years only, very significant progress has been made in the knowledge of the virus, not only in the field of diagnosis but also in therapy. Several consensus conferences taking last discoveries into account have been organized in order to promote recommendations useful for the management of hepatitis C patients. The aim of this short overview is to summarize practical recommendations that emerged recently from consensus meetings. [less ▲]

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See detailEvidence-Based Model Calibration for Efficient Building Energy Services
Bertagnolio, Stéphane ULg

Doctoral thesis (2012)

Energy services play a growing role in the control of energy consumption and the improvement of energy efficiency in non-residential buildings. Most of the energy use analyses involved in the energy ... [more ▼]

Energy services play a growing role in the control of energy consumption and the improvement of energy efficiency in non-residential buildings. Most of the energy use analyses involved in the energy efficiency service process require on-field measurements and energy use analysis. Today, while detailed on-field measurements and energy counting stay generally expensive and time-consuming, energy simulations are increasingly cheaper due to the continuous improvement of computer speed. This work consists in the development of a simulation-based approach dedicated to whole-building energy use analysis for use in the frame of an energy efficiency service process. Focus is given to the development of a new simplified dynamic hourly building energy simulation tool adapted to energy use analysis of existing buildings, its calibration by means of available energy use data and to the integration of the calibration process into the Energy Service Process. The proposed evidence-based calibration methodology is deeply related to on-field inspection and data collection issues and is developed to fit with the audit/inspection process. After calibration, the model can be used to support the other steps of the Energy Services Process, such as ECOs selection and evaluation and continuous performance verification. The new systematic calibration methodology gives priority to the physical identification of the model’s parameters (i.e. to the direct measurement) and relies on the notion of hierarchy among the source of information (as a function of their reliability) used to identify the value of the parameters. The improved Morris’ sensitivity analysis method is used for “factor fixing” (i.e. distinction between non-influential model’s parameters) and “parameters screening” (i.e. classification of influential parameters by order of importance) in order to orient the data collection work and guide the parameters adjustment process. At the end of the calibration process, the Latin Hypercube Monte Carlo sampling is used to quantify the uncertainty on the final outputs of the calibrated model. The developed simulation tool and the associated calibration method are applied to a synthetic case (“Virtual Calibration Test Bed”) and to real case study building located in Brussels, Belgium. Both applications (real and synthetic cases) allow highlighting the complexity and the limits of calibration as it is used today. Calibration remains a highly underdetermined problem and a compromise has to be found between data collection and modeling efforts and model’s requirements in order to proceed to efficient energy use analysis. At the end of these applications, it is believed that partially manual methods remain more efficient and the best quality assurance when proceeding to calibration of a building energy simulation model. The use of an evidence-based method ensures sticking to reality and avoids bad representation and hazardous adjustment of the parameters. Moreover, it is shown that the intensive use of a sensitivity analysis method is of a great help to orient data collection and parameters adjustment processes. Defining confidence/uncertainty ranges for each parameter, in addition to a “best-guess” value, also allowed quantifying the uncertainty on the final outputs of the model and helped the user in evaluating the quality of the calibrated model. [less ▲]

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See detailL’evidence-based practice à portée des orthophonistes : intérêt des recommandations pour la pratique clinique
Maillart, Christelle ULg; Durieux, Nancy ULg

in Rééducation Orthophonique (2014), 257

La démarche evidence-based practice (EBP) littéralement « pratique basée sur des preuves », a pour objectif d’aider le clinicien à optimiser ses choix thérapeutiques en s’appuyant sur des données ... [more ▼]

La démarche evidence-based practice (EBP) littéralement « pratique basée sur des preuves », a pour objectif d’aider le clinicien à optimiser ses choix thérapeutiques en s’appuyant sur des données objectives issues de la recherche tout en tenant compte de la situation clinique. Néanmoins, la méthodologie complète de récolte et d’analyse des données est complexe et chronophage, ce qui est un frein réel pour son application en clinique. Pour remédier à cela, des synthèses scientifiquement motivées, appelées des recommandations de pratique clinique (RPC) ou guidelines, se développent et jouent alors un rôle essentiel pour l’actualisation des connaissances des professionnels. Cet article s’intéresse particulièrement aux recommandations pour la pratique clinique et au rôle qu’elles peuvent jouer dans la sensibilisation des cliniciens au recours à une démarche EBP. [less ▲]

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See detailEvidence-based Practice et dysphasie
Maillart, Christelle ULg

Conference given outside the academic context (2012)

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See detailL’Evidence-Based Practice et les logopèdes en Communauté française de Belgique : résultats préliminaires d'une enquête
Durieux, Nancy ULg; Pasleau, Françoise ULg; Vandenput, Sandrina ULg et al

in Cahiers de l'ASELF (2012), 9(4), 30-35

L’Evidence-Based Practice (EBP) est une démarche qui prend de plus en plus d’importance dans le domaine de la logopédie. Qu’en est-il cependant concrètement sur le terrain en Belgique ? Une enquête ... [more ▼]

L’Evidence-Based Practice (EBP) est une démarche qui prend de plus en plus d’importance dans le domaine de la logopédie. Qu’en est-il cependant concrètement sur le terrain en Belgique ? Une enquête exploratoire a été lancée en mars 2012 avec le soutien de l’Association scientifique et éthique des logopèdes francophones (ASELF) et de l’Union Professionnelle des Logopèdes Francophones (UPLF). L’objectif de cette enquête est d’avoir une idée précise de la manière dont les professionnels procèdent lorsqu’ils sont confrontés à un problème clinique et plus précisément, comment ils recherchent de l’information scientifique le cas échéant. Ces données seront la pierre angulaire d’une réflexion indispensable sur la formation des logopèdes, au cours de leur cursus et dans la vie active. Ce présent article présente les premiers résultats de cette étude. [less ▲]

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See detailL’Evidence-Based Practice et les logopèdes en Communauté française de Belgique : résultats préliminaires d'une enquête
Durieux, Nancy ULg; Pasleau, Françoise ULg; Vandenput, Sandrina ULg et al

in UPLF-Info (2012), XXIV(5),

L’Evidence-Based Practice (EBP) est une démarche qui prend de plus en plus d’importance dans le domaine de la logopédie. Qu’en est-il cependant concrètement sur le terrain en Belgique ? Une enquête ... [more ▼]

L’Evidence-Based Practice (EBP) est une démarche qui prend de plus en plus d’importance dans le domaine de la logopédie. Qu’en est-il cependant concrètement sur le terrain en Belgique ? Une enquête exploratoire a été lancée en mars 2012 avec le soutien de l’Association scientifique et éthique des logopèdes francophones (ASELF) et de l’Union Professionnelle des Logopèdes Francophones (UPLF). L’objectif de cette enquête est d’avoir une idée précise de la manière dont les professionnels procèdent lorsqu’ils sont confrontés à un problème clinique et plus précisément, comment ils recherchent de l’information scientifique le cas échéant. Ces données seront la pierre angulaire d’une réflexion indispensable sur la formation des logopèdes, au cours de leur cursus et dans la vie active. Ce présent article présente les premiers résultats de cette étude. [less ▲]

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See detailEvidence-based practice et orthophonie
Maillart, Christelle ULg

Scientific conference (2013, October 15)

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See detailEvidence-Based Practice et orthophonie : application aux troubles développementaux du langage
Maillart, Christelle ULg; Durieux, Nancy ULg

Conference (2013, July 01)

L’objectif de cet atelier est de familiariser les orthophonistes avec l’Evidence-Based Practice (EBP). Chaque clinicien est de façon régulière confronté à des incertitudes quant aux choix thérapeutiques ... [more ▼]

L’objectif de cet atelier est de familiariser les orthophonistes avec l’Evidence-Based Practice (EBP). Chaque clinicien est de façon régulière confronté à des incertitudes quant aux choix thérapeutiques ou aux décisions cliniques à prendre pour un patient particulier. L’EBP est une approche méthodologique qui permet de réduire cette incertitude. Elle préconise d’associer les résultats cliniquement pertinents issus de la recherche scientifique à la compétence clinique du praticien et à la situation d’un patient correctement et complètement informé (Sackett et al., 1996). L’EBP est une démarche complexe qui nécessite de maîtriser les outils de recherche d’informations, de pouvoir accéder à la littérature, d’avoir une approche critique des données disponibles et de les confronter aux caractéristiques d’un patient cible. Nous partirons de situations cliniques concrètes liées aux troubles développementaux du langage pour illustrer la démarche et aider le participant à se l’approprier. [less ▲]

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See detailEvidence-based practice: fondements et réflexions sur l’apport en clinique.
Maillart, Christelle ULg; Durieux, Nancy ULg

in Langage et Pratiques (2014), 53

L’evidence-based practice ou pratique basée sur les preuves est une approche de plus en plus encouragée en logopédie au niveau international. Cet article présente les principaux composants en détaillant ... [more ▼]

L’evidence-based practice ou pratique basée sur les preuves est une approche de plus en plus encouragée en logopédie au niveau international. Cet article présente les principaux composants en détaillant la nature des preuves liées aux trois piliers de l’EBP (preuves externes, preuves internes ou préférences du patient). La démarche de l’EBP est brièvement discutée ainsi que les freins et les bénéfices attendus en clinique. [less ▲]

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See detailEvidence-based semiquantitative methodology for prioritization of foodborne zoonoses.
Cardoen, Sabine; Van Huffel, Xavier; Berkvens, Dirk et al

in Foodborne Pathogens and Disease (2009), 6(9), 1083-96

OBJECTIVES: To prioritize an extended list of food- and water-borne zoonoses to allow food safety authorities to focus on the most relevant hazards in the food chain. METHODS: An evidence-based ... [more ▼]

OBJECTIVES: To prioritize an extended list of food- and water-borne zoonoses to allow food safety authorities to focus on the most relevant hazards in the food chain. METHODS: An evidence-based semiquantitative methodology was developed. Scores were given by 35 scientific experts in the field of animal and public health, food, and clinical microbiology and epidemiology to 51 zoonotic agents according to five criteria related to public health (severity and occurrence in humans), animal health (severity of disease coupled with economic consequences and occurrence in animals), and food (occurrence in food). The scoring procedure was standardized and evidence-based as experts were provided, for each zoonotic agent, a same set of up-to-date help information data related to the five criteria. Independently, the relative importance of the five criteria was weighted by seven food chain risk managers. The zoonotic agents were ranked based on overall weighted scores and were grouped in four statistically different levels of importance. RESULTS: The following foodborne zoonotic pathogens were classified as "most important": Salmonella spp., Campylobacter spp., Listeria monocytogenes, and verocytotoxigenic Escherichia coli. A second group of "significant importance" included Toxoplasma gondii, the agent of bovine spongiform encephalopathy, Clostridium botulinum, Staphylococcus aureus, Cryptosporidium parvum, Mycobacterium bovis, Echinococcus granulosus, Streptococcus spp., Echinococcus multilocularis, Yersinia enterocolitica, Mycobacterium avium, Fasciola hepatica, Giardia intestinalis, and Rotavirus. CONCLUSIONS: This methodology allowed to rank 51 zoonotic agents with objectivity and taking account of a combined input from risk assessors and risk managers. Applications: These results support food safety policy makers to establish the multiannual monitoring program of foodborne zoonoses. They also enable to identify knowledge gaps on specific zoonotic agents and to formulate key research questions. Principally, this method of prioritization is of general interest as it can be applied for any other ranking exercise and in any country. [less ▲]

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See detailEvidence-Based Veterinary Medicine
Pasleau, Françoise ULg; Vandenput, Sandrina ULg; Fairon, Nicolas ULg et al

Conference (2004, September 24)

At the University of Liege, the medical library recently merged with several entities including the libraries of Zoology, Botany, Psychology and Veterinary Medicine. Everywhere, the librarians are ... [more ▼]

At the University of Liege, the medical library recently merged with several entities including the libraries of Zoology, Botany, Psychology and Veterinary Medicine. Everywhere, the librarians are involved in teaching activities and users training programs are rather well developped in every field. But the comparison of the curriculum contents points to a few amazing differences. The most surprising one is the approach of Evidence-Based Medicine (EBM). The concept is well introduced in the medical community and it is a legal obligation for the medical students to be thaught in and to practice EBM. Surprisingly, the veterinarians don't seem very interested. Besides its impact on clinical practice, EBM is a good opportunity to create new habits that are valuable for continuing education and to develop critical appraisal skills. Thus, we wish to analyze the reasons that might explain why EBM seems to be left aside at the Faculty of Veterinary Medicine. Two approaches are envisionned. First, we plan to ask the Faculty itself about its position regarding the concept. Surveys and interviews will be conducted, distinguishing between the general practitionners, the researchers and the teaching staff. On the other hand, an in depth analysis will be conducted regarding the media available at the veterinary library. Are they suited to the practice of EBM? If not, which additional tools should be purchased ? At the end of the process, we expect to be able to adapt the content of the training sessions we offer to library users and possibly to improve the collaboration with the veterinary teaching staff. [less ▲]

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