ASSESSING MEDICAL LITERATURE Flashcards
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What is the goal of evidence based medicine?
seeks the highest levels of published of research based on sound scientific design and ethical standards to improve patient care and life long learning for doctors
Grade for level I evidence or consistent findings from multiple studies of level II,III,IV
Grade A
Grade for level II,III or IV evidence and findings are generally consistent
Grade B
Grade for level II,III,or IV evidence, but findings are inconsistent
Grade C
Grade for Level V: Little or no systematic empirical evidence
Grade D
what are some methodologies that are research based?
randomized clinical trials
- experimental
- analytical
- expensive
cohort, case controlled, case studies
- observational
- descriptive
- dominate surgical literture
- no interference
- easier to conduct
- less costly
what type of literature based review is this?
review and collection of data
narrative review
what type of literature based review is this?
conducted in an area of interest with low evidence, based on quality of evidence
scoping review
what type of literature based review is this?
specific clinical question
comprehensive literature search
explicit selection criteria
assess methodologies
systematic review
what type of literature based review is this?
takes data from papers and combines them to conduct a statistical analysis and summary from a randomized control study?
meta analysis
T/F, systematic review and meta analysis are not a formal experimental study but rather a non experimental or descriptive study?
T
how is a RCT conducted?
apply inclusion and exclusion criteria
randomization consisting of doctor (experimental), blinding (placebo) , and patient (control)
that are the different types of blinding?
single, double, measurement blinding
what are the two types of observer reliability?
intra observer
inter observer
what are some difficulties with the performance of RCT?
who want to be randomized
placebo surgery, risk vs reward
not all RCT are well designed
what are the two types of validity?
internal and external validity
what is this type of validity?
the ability of a trial to come to the correct conclusion regarding the question being studied
internal validity
what is this type of validity?
the ability of trial to produced results that are generalizable to a larger population of patients with disease?
external validity
what is meant by confounding?
the effect on treatment and subsequent outcome altered as a result of preexisting risk factors
what are the alternatives to RCT?
cohort studies that consist of case controlled, case series, case report
provide date for comparison
sampling based on exposure
allow for calculation of risk
what are the two types of observational studies?
prospective and retrospective study
what are some important points about observational studies?
not randomized
cannot control for confounding factors
only establish associations that exist between predictor and outcome variables
can’t establish associations identified as cause and effect
improved by greater attention
what is this type of study?
focuses on a specific outcome or interest
looks at favorable vs unfavorable outcome
usually retrospective
case controlled study
what is this type of study?
patients treated one way outcome is important target pop must be definable reproducible retrospective relys on medical records
case series study
what are the threats to reproducible science?
publication bias failure to control for bias low statistical power poor quality control P-hacking
what is this type of method of analysis called?
use of an estimation from a sample population to a target population
statistics
what are the four types of bias?
observation bias
selection bias
literature bias
publication bias
what type of bias is this?
systematic variation between the true outcome and the outcome observed
observation bias
what type of bias is this?
a flaw in sample selection
-loss to follow up
selection bias
what type of bias is this?
English language only
literature bias
what type of bias is this?
predatory journals
publication bias
T/F, clinical significance is unrelated to statistical significance?
T
