1,2 – Evidence-based Medicine Flashcards
1
Q
Many diseases are self-limiting
A
- “the fact that your patient gets well does NOT prove that your diagnosis (or treatment) was correct”
2
Q
In the years after you graduate
A
- Memory of what you learned will be less
- New treatments, etc. will be found
o If a good vet, you will NEED to stay up to date of new developments
3
Q
What is evidence-based medicine?
A
- Applying the best and most relevant scientific evidence, integrated with clinical expertise
- While taking in account each patient and owner’s circumstances
4
Q
EBVM suggest
A
- Personal experience may be misleading
- Randomised studies are required to validate results
- Predictions based on physiological principles are often WRONG
- Reading literature requires more than common sense to evaluate
5
Q
Barriers to the process
A
- Don’t always have the time and resources
- Difficult to evaluate VALUE of info
- May be lacking in some areas
- Lack of rigorous, large-scale clinical studies in vet med
6
Q
Limitations of EBVM
A
- Literature base is smaller than human med
- Need to put emphasis on poorer sources
- Lack of evidence!
7
Q
‘just in time’ info: searching mode
A
- Diseases/conditions that we see rarely
- Refer or find info to deal with them
8
Q
Keeping up to date: appraising mode
A
- See regularly and want to stay up to date
o Know how to deal with them on a regular basis
9
Q
Filtered resources
A
- Summarize, examine and appraise the evidence of MULTIPLE individual studies
- Only as good as the individual studies (un-filtered resources) examined and the RIGOR at which the review was conducted
10
Q
Unfiltered resources
A
- Original research studies
- Need to take extra care to appraise the resources to ensure VALID and RELIABLE
11
Q
5 Developments that have made EBM possible
A
- Develop of strategies for efficiently tracking down and appraising evidence (Ex. PubMed)
- Creation of systematic reviews and concise summaries
- Creation of EB journals of secondary publication
o Vet Evidence
o Best Bets for Vets - *clinician still needs to decided it the evidence applies to the individual patient
12
Q
Steps of EBVM
A
- Convert info needs to answerable questions
- Track down best evidence
- Critically appraise
- Apply results
- Evaluate performance
13
Q
5 A’s of EBVM
A
- Ask – defining a clinical question
- Acquire – find best available evidence
- Appraise – assess quality of evidence
- Apply – implementing evidence where appropriate
- Assess – evaluate impact and changes
14
Q
3 basic strategies for cases
A
- Appraising mode
- Searching mode
- Replicating mode
15
Q
- Appraising mode
A
o Conditions we commonly encounter
o Need to be ‘up to the minute’
o Invest time into step 2 and 3
