question: Why is it so difficult to come a consensus about medical information?
comment: Exactly because of what you said, everybody is different. Theres no exact amount of sleep we can say is the right amount because its up to the brain. It knows when it needs to wake, it uses sleep to preform maintenance, it could take a little more or less each day. Because there are so many different variations of genes in our current human gene pool, and we still dont fully understand the use of each gene or all the little subprocesses preformed by it, the best we have is subjective data collected from a sample group. Each research finding may show slightly different data, creating a slight deviance between studies
passages: The Evidence-based Medicine Working Group decided to build on the popular series in the "Canadian Medical Association Journal" by creating a more practical approach to applying the medical literature to clinical practice. Championed by Dr. Drummond Rennie, an editor of the "Journal of the American Medical Association", the result was the "Users' Guides". The guides originally consisted of 25 topics, covered in a series of 32 articles published in the "Journal of the American Medical Association" between 1993 and 2000, describing approaches to different types of medical questions and the study designs that may answer them.
   The books teach a systematic approach to reading and applying the medical literature to individual patient care. It focuses on three questions: 1. Whether new information is likely to be valid, 2. What the information says about patient care, and 3. How the information can be used. To demonstrate the clinical relevance of the suggested approach, each section begins with a practical clinical scenario. The chapter is then structured around identifying the best available evidence and applying the three key questions to the evidence, in the context of the clinical scenario. Each chapter concludes with a resolution of the scenario.
   Each witness seminar is transcribed and published by HoMBRG. Recent volumes have been edited by E M Jones, C Overy and E M Tansey. there are 62 Volumes. Titles include "The Development of Brain Banks", "Narrative Medicine"; "Migraine"; "The National Survey of Sexual Attitudes and Lifestyles"; and "The Avon Longitudinal Study of Parents and Children (ALSPAC)" The publication of these works are often referred to by specialists in their fields of medical practice.
   After consensus has been reached, it is incorporated in textbooks. There are textbooks on every medical specialty and they contain comprehensive discussion on all diseases and their diagnosis, therapy and prognosis. The first textbook to utilize experts to write specific chapters within the book was the Cecil Textbook of Medicine edited by Russell Cecil, MD in 1927. The book was an immediate international success because of the idea that single or double author medical books was outmoded, "since the scope of medical knowledge was far surpassing the capacity of any single individual to encompass". Since that time, this has been the standard. Examples are:
   Users' Guides to the Medical Literature
  
  The Users’ Guides to the Medical Literature is a series of articles originally published in the "Journal of the American Medical Association", later rewritten and compiled in a textbook, now in its third edition. The guides provide practical, clinician-friendly advice on all aspects of evidence-based medicine.
  
  Section::::As articles.
  
  During the late 1970s a group of clinical epidemiologists at McMaster University including Dr. David Sackett prepared a series of articles to assist clinicians interpreting clinical research. These articles, introducing the term "critical appraisal", appeared in the "Canadian Medical Association Journal" beginning in 1981.
   Consensus statements differ from medical guidelines, another form of state-of-the-science public statements. According to the NIH, "Consensus statements synthesize new information, largely from recent or ongoing medical research, that has implications for reevaluation of routine medical practices. They do not give specific algorithms or guidelines for practice."
  
  Section::::History.
   Most of the book chapters are based on specific types of clinical questions, including questions of therapy, harm, diagnosis, and prognosis. Other chapters deal with general skills that are important for all clinical questions, such as “Finding the Evidence”, “Summarizing the Evidence”, and “Moving From Evidence to Action”.
  
  The "Users' Guides" come in two book versions: the "Essentials" introduces the concepts of evidence-based medicine (EBM), with which every practicing clinician should be familiar, while the "Manual" provides a more comprehensive, in-depth exploration of EBM concepts for clinicians seeking a deeper understanding, or for those who wish to teach EBM.
  
  Section::::Website.
   Since 1879, the National Library of Medicine has published the Index Medicus, a monthly guide to articles, in nearly five thousand selected journals. The last issue of Index Medicus was printed in December 2004, but this information is offered in the freely accessible PubMed, among the more than fifteen million MEDLINE journal article references and abstracts going back to the 1960s and 1.5 million references going back to the 1950s.
   The first two volumes were reviewed in "Journal of the Royal Society of Medicine" in 1999, with the comment, "Few books are so intellectually stimulating or uplifting." Reviewing the series in the "British Medical Journal" in 2002, medical historian Irvine Loudon wrote, "This is oral history at its best...all the volumes make compulsive reading...they are, primarily, important historical records
   BULLET::::3. Use the minimum necessary patient-identifiable informationbrWhere use of patient identifiable information is considered to be essential, the inclusion of each individual item of information should be considered and justified so that the minimum amount of identifiable information is transferred or accessible as is necessary for a given function to be carried out.
   One of the most important advanced for BAPM was the publication of the report, called the Körner report in 1984. led by the National Health Service (NHS) Reformer Edith Körner. The most important recommendations from BAPM's perspective from the report, was that in future all infants should be recognised at birth as a patient, as well as defining a data set for the baby as well as the mother, in part to move the NHS into the digital age.
  
  Section::::Dunn Perinatal Library.
   Section::::History.
  
  "Index Medicus" was begun by John Shaw Billings, head of the Library of the Surgeon General's Office, United States Army. This library later evolved into the United States National Library of Medicine (NLM). For such a major publication over many years the history naturally involved many changes as people died and sources of funding changed. 
  
  Section::::History.:Years of paper publication.
   Nevertheless, it is more feasible for a business to do this centrally, even if incompletely, than for each individual doctor to try to keep up with all the research being published.
  
  In addition to being laborious, integration of new data can sometimes be difficult to quantify or incorporate into the existing decision support schema, particularly in instances where different clinical papers may appear conflicting. Properly resolving these sorts of discrepancies is often the subject of clinical papers itself (see meta-analysis), which often take months to complete.
  
  Section::::Challenges to adoption.:Evaluation.
   HON Foundation issued a code of conduct (HONcode) for medical and health websites to address reliability and usefulness of medical information on the Internet. The principles of the HONcode are:
  
  BULLET::::1. Authority – information and advice given only by medical professionals with credentials of author/s, or a clear statement if this is not the case
  
  BULLET::::2. Complementarity – information and help are to support, not replace, patient-healthcare professional relationships which is the desired means of contact
  
  BULLET::::3. Confidentiality – how the site treats personal and non-personal information of readers
   From 1977 to 2013, the National Institutes of Health (United States) promoted about five to six consensus panels per year, and organized this knowledge by means of a special Consensus Development Program, managed by the NIH's Office of Disease Prevention (ODP). It was retired in 2013 in deference to other agencies and organizations that had picked up the lead, such as the U.S. Preventive Services Task Force, the Community Preventive Services Task Force, Institute of Medicine, and Cochrane. Its archive is available in printed form as well as for downloading from the Internet.
  
  Section::::See also.
  
  BULLET::::- Medical decision making
   In beginning of 2008, with most of the elements of the plan now shaping up, the group began to discuss how to make the plan public. It was felt by most of the members that it should attempt to involve the medical community, and so it should be handled as other medical information- through a prominent medical journal. A writing group was assembled that covered expertise in a spectrum of issues including preventative medicine, public health, medical informatics and business administration.
  
  Section::::Publication of the EMBRACE healthcare system reform plan.
   BULLET::::- Burnham, John C. "What Is Medical History?" (2005) 163pp. excerpt
  
  BULLET::::- Chaplin, Simon. "Why Creating a Digital Library for the History of Medicine is Harder than You’d Think!." "Medical history" 60#1 (2016): 126-129. online
  
  BULLET::::- Litoff, Judy Barrett. "Midwives and History." In Rima D. Apple, ed., "The History of Women, Health, and Medicine in America: An Encyclopedic Handbook" (Garland Publishing, 1990)
  
  BULLET::::- Numbers, Ronald L. "The History of American Medicine: A Field in Ferment" "Reviews in American History" 10#4 (1982) 245-263 in JSTOR
   BULLET::::- Dixon-Woods studied patient information leaflets and found they privileged the biomedical model's explanations for illness and disease. Other models providing information and knowledge about health are therefore ignored. By failing to provide alternatives to the biomedical, model patients are forced to comply with the biomedical model. This means they may not be empowered insomuch as they are not as free to choose between a number of models on health as a result of being unaware of these alternatives. For example, alternative therapies may not be recognized as valuable. This explains how when people do use alternative therapies, they often use them alongside more traditional forms of medicine. Traditional forms of medicine based on the biomedical model are trusted more. Nevertheless, there has been an increase in the use of alternative medicine, so the biomedical model may not be as strong as it once was.
   The MLA Exchange was one of the founders’ earliest and most important projects, helping build medical libraries in the United States and many other countries by exchanging duplicate publications. The organization has subsequently developed a variety of programs to serve the needs of health information specialists.
  
  The National Library of Medicine holds a collection of the organization's archival material that ranges from 1898 to 2002.
  
  Section::::Membership.
   BULLET::::- As modern multimedia and the information age have evolved, they have had an ever-increasing effect on the collection, verification, summation, and presentation of information of all kinds. Medical encyclopedias such as Medline Plus, WebMD, and the Merck Manual are examples of new forms of the medical encyclopedias as information retrieval becomes simpler. Some online encyclopedias are medical wikis, which use wiki software to write the information collaboratively.
  
  Section::::Listing of Medical Encyclopedias.
  
  Section::::Listing of Medical Encyclopedias.:A.D.A.M. Medical Encyclopedia (MedlinePlus).
   The written record of medical consensus is stored in scientific journals. Since the advent of electronic publishing there has been academic journal publishing reform which had a range of effects, including more researchers and physicians having greater access to professional information in medical journals through the Internet.
  
  Section::::Types.:Patients' personal health information.
  
  Through various sources both publicly and privately available, datasets containing health information about large numbers of patients are available on the Internet to an extent which was impossible to manage before the Internet.
  
  Section::::Quality.
   One disadvantage of current (2012) medical history systems is that they cannot detect non-verbal communication, which may be useful for elucidating anxieties and treatment plans. Another disadvantage is that people may feel less comfortable communicating with a computer as opposed to a human. In a sexual history-taking setting in Australia using a computer-assisted self-interview, 51% of people were very comfortable with it, 35% were comfortable with it, and 14% were either uncomfortable or very uncomfortable with it.
   The complete text of the second edition of the "Users’ Guides Manual" is available online by subscription. The JAMAevidence website also includes a large number of calculators, worksheets and additional aids for the practice of EBM, including the updated and edited collection of another long-running JAMA article series, "The Rational Clinical Examination: Evidence-based Clinical Diagnosis".
   Following Vesalius, William Harvey, Ignaz Semmelweis, Louis Pasteur, and others, the medical community have changed the way it conducts research. After incorporating the scientific method, medical literature has introduced peer review, and is currently divided into journals and textbooks.
  
  Section::::Medical journal.
  
  These are publications in which the medical community shares information. The common articles are original articles, reviews and case reports.
   The National Library of Medicine has long provided programs and services for professional medical scientists and health care providers, including MEDLINE and the various services that access it, such as PubMed and Entrez. By the 1990s, more members of the general public were using these services as Internet access became widespread. But nonprofessional users could benefit from reliable health information in a layperson-accessible format. The National Library of Medicine introduced MedlinePlus in October 1998, to provide a non-commercial online service similar, for example, to the commercial WebMD. In 2010 another NCBI service, PubMed Health, complemented MedlinePlus in offering curated consumer health information; PubMed Health focuses especially on finding information about clinical effectiveness of treatments.
  