Clinical Questions-Patterson Flashcards
T/F Physicians with more experience deliver better care.
False. Hard to keep up on new clinical info after residency.
What is the retention rate for continuing medical education of physicians?
less than 10%
What are the barriers to answering our clinical questions?
Lack of time Lack of resources Inefficiency with EBM Preference for most convenient rather than appropriate resource Poorly formulated questions
What are different types of clinical question formats?
DOE: disease oriented questions
POE: patient oriented evidence
PICO
What is a DOE question?
Which physical exam techniques detect pleural effusions?
What are the causes of bloody pleural effusion?
Involves:
Physiology
Pathophysiology
Epidemiology
Cause and effect
What is a POE question?
Accuracy of diagnosing lung cancer by thoracentesis as compared to lung biopsy? Involves: Diagnosis Prognosis Therapy Risk Harm
What are background & foreground questions?
Background: the basics a novice needs to learn
Foreground: things that an expert wonders, maybe a new area of research
What does PICO stand for?
patient/problem-consider all demographics & risk factors of patient.
intervention
comparison
outcome
A 19-year-old woman has acute maxillary sinusitis. A colleague uses a shorter 3-day course of antibiotics rather than the usual 10-14 days of prescribed treatment. It works well for his patients
You wonder whether you should try the shorter course with this patient.
P:adults w/ acute maxillary sinusitis I: 3 day course of antibiotics C: 10 day course of antibiotics O: cure of the sinusitis In adults with acute maxillary sinusitis, does a 3-day course of antibiotics yield the same cure rates as a 10-day course, with fewer adverse effects and costs?
A 69 yr-old man who smokes presents with a cough, fever , dyspnea and left chest pleurisy for 2 weeks. He has a 60 pack year history and has tried to quit smoking at least 6 times unsuccessfully. Chest x-ray demonstrates left pleural effusion. Thoracentesis reveals 1.5 liters of bloody fluid
You wonder if it is worthwhile to aggressively encourage this patient to stop smoking if he has lung cancer. What can you tell the patient to influence him to quit smoking?
P: adults with lung cancer I: smoking cessation C: continued smoking O: mortality, prognosis, QOL In adults with lung cancer does smoking cessation improve the patient’s prognosis or decrease morbidity and mortality?
