Critcal apprisal Flashcards
What is evidence based dentistry
An approach to oral health care that requires the judicious integration of:
Systematic assessments of clinically relevant scientific evidence, relating to the patient’s oral and medical conditions and history, together with
Dentist’s clinical expertise and
The patient’s treatment needs and preferences
What is critical appraisal
The process of assessing and interpreting evidence through the systematic consideration of its validity, relevance and results
What are the studies strengths and weaknesses and can it be used to inform your practice?
Why do you need to critically apraise
Making clinical decisions based on good quality evidence
Theres so many research papers now a days so it helps you descide what treatments do you use for your patients
What are the issues to consider when appraising a paper
Are the results of the trial valid?
-Focussed question (PICO)
-Conduct of study (randomization, blinding, allocation concealment, flow of participants)
What are the results?
-Effect of treatment – what has been measured? what direction? How large?
-Precision - CIs
Are the results relevant to your clinical practice?
-Generalizable
-Clinically important outcome measures
-Adverse effects/ harms?
When deciding are the results of the trial valid what is the first question you ask
did the trial address a cleary focused issue
What do you use to find out whether the the study is addressing a clearly focused issue or not
PICO
Whtat does PICO stand for
Population
Intervention
Comparison
Outcome
How do you use PICO
You look in the methods and compare it to the PICO,
P- What population is it being applied to? Who is it? (e.g. the population who have caries in there prim. molars)
I- Whats the new thing being done, whats being tested here?
C- The group the intervention group is being comapred to (e.g. a placebo of somesort)
O- the outcome measured to see if the intervention was succsessful or not
What other qusetions could you ask to see if the results of the review were valid
Was the assignment of treatments to patients randomized?
Were all of the patients who entered the trail accounted for at its conclusion?
Were patients, health workers and study personnel “blind” to treatment?
Were the groups similar at the start of the trial?
Aside from the experimental intervention, were the groups treated equally?
What is a randomised control trial
A randomized controlled trial (RCT) is an experimental form of impact evaluation in which the population receiving the programme or policy intervention is chosen at random from the eligible population, and a control group is also chosen at random from the same eligible population.
Sometimes referred to as a Clinical Trial
RCTs considered the gold standard study design
For effectiveness and efficacy
Particularly useful for clinical studies
Provides strongest evidence on effectiveness of treatments
What is meant by, were all of the patients who entered the trail accounted for at its conclusion
and what type of dropout are you looking for
In the end of the study did everyone involved get a outcome or were they excluded, if they were there must be a reason given for that
Systematic dropout
What is meant by, Were patients, health workers and study personnel “blind” to treatment?
Were they all blind to which patients were in what group to prevent bias
What is meant by, Were the groups similar at the start of the trial?
What to make sure the control and intervention group is balanced and that theres no drasdtic changes during the study in the groups
What is (absolute) risk difference
Difference in risk between groups
What is numbers needed to treat
The number of patients you would need to treat to prevent one patient from developing the disease/ condition/ outcome
