16/04 Flashcards
Forrest Plot
- blue dot shows results (Risk ratio)
- line means confidence interval
- if overlap the line, then its no use, no significant evidence
- Pool at risk ratio - overall effect (big Diamond)- favours antibiotic, but there is no sufificient evidence
Heterogenity
- huge difference among studies
- Types: Clinical, Methodological, Statistical
Clinical - variation in participants, intervention, outcomes, and study design
Methological - variation in methods used in studies (quality of how they locate the people)
Statistical - excessive variation in results of studies
P value
- I^2 larger than 50% there is significant heterogenity, no chance
Odds and Risk ratio
RR
event of interest/ total
- 60/70
- normally in %
Absolute risk difference ARD
- between intervention and control
- bigger value - smaller value
Odds ratio
- event of interest/ event of no interest
- decimals
Number needed to treat NNT
- 1/ ARD
- 1/ in decimal
- 10 people will get pain relief from paracetamol to get 1 without pain relief
RR Value of no difference- 1
OR Value of no difference- 1
ARD - 0
PICO
Population
Intervention
Comparison
Outcome
Systemic review
Confidence interval
- cannot overlap 1
- RI 4.21 CI (4-5) - it’s sufficient evidence
- ARD 2 (CI 0.1- 3) - sufficient evidence
4 Randomised Controlled trial
- blinding/ masking
- controlled/ comparison group
- inclusion/ exclusion criteria
- randomisation
- allocation concealment
5 types of Study methods
- randomised controlled trial
- case report/ case series
- cross- sectional study
- case control
- cohort study
Case report
- report on a single patient/ series of pts with an outcome of interest; no controlled group involved
CSS
- observation of a defined population at a single point of time
- larger size group
Case control/ Retrospective study
- retrospective study
- study of people with or without the disease
- looks back in time and exposure to a particular RF of both groups
Cohort study
- prospective study
- establish a group of individuals in apopulation
- measure exposure and follow up for a period of time
2 study of critical appraisal
- to critically appraise a study
- CASP tool- critical appraisal skills programme
- CONSORT- identify flaws in RCT
Systematic review and Metaanalysis
GRADE
- metaanalysis
Cochrane uses GRADE
- Grading of
- Recommendations assessment
- Development and
- Evaluation
Section 47
Adult with Capacity
- decision and action
Access incapacity
Principle of AWI Act
- benefit pt
- acc for pt wishes
- least restrictive option; minimal intervention
- encourage adult to exercise residual capacity
- consult relevant others
Legal definition
- cannot enter legally binding contract
- decision no legal effect
AMCUR
Acting
Making a decision
Communicating decision
Understanding decision
Retaining the memory of decision
Adults at Risk
- someone unable to safeguard their wellbeing, property and rights because they are at risk of harm
- due to mental health disorder, disability, illnesses
Types of Toothwear
- Attrition
- Erosion
- Abrasion
- Abfraction
