Duke Health - Module 1

Question 1

What is evidence based practice (EBP)?

Answer 1

• Combines clinical expertise, best research evidence, and patient values & preferences

Question 2

skipped
Why is EBP important?
(4)

Answer 2

• Medical knowledge and accepted practice change rapidly
• Volume research articles is expanding exponentially
• Integrating the evidence into your practice regularly makes it easier to find and apply the evidence during bust clinical schedules
• It allows you to blend patient’s preferences with the research, resulting in patient-centered care

Question 3

Steps in the EBP process
(5)

Answer 3

1. Assess
2. Ask
3. Acquire
4. Appraise
5. Apply
   a. EBP begins and ends with the patient

Question 4

PICO –

Answer 4

a mnemonic for the key components of a well-focused foreground question
* Patient problem
* Intervention
o Prognostic factor or exposure
* Comparison
* Outcome

Question 5

• Diagnosis
  (2)

Answer 5

o How to select and evaluate diagnostic tests
o Study designs: cross-sectional study or a prospective, blind comparison to a gold standard

Question 6

• Therapy
  (2)

Answer 6

o Is a treatment effective?
o Study designs: systematic review, RCT, or cohort study

Question 7

• Prognosis
  (2)

Answer 7

o What is the patient’s likely clinical course over time?
o Study designs: cohort study, case control, and case series

Question 8

• Harm/etiology
  (2)

Answer 8

o What caused this disease?
o Study designs: cohort, case control, or case series can answer questions of harm

Question 9

• Meta-analysis

Answer 9

o A statistical technique for quantitatively combining the results of multiple studies that measure the same outcome into a single pooled or summary estimate. A systematic review may or may not include a meta-analysis

Question 10

• Systematic reviews

Answer 10

o Systematic reviews address a focused clinical question using methods to reduce the likelihood of bias. The rigorous, standardized methodology includes identifying, selecting, appraising, and summarizing primary studies

Question 11

• Randomized controlled trials

Answer 11

o An experiment in which individuals are randomly allocated to receive or not receive an experimental diagnostic, preventive, therapeutic, or palliative procedure and then followed up to determine the effect of the intervention

Question 12

• Cohort studies

Answer 12

o This is an investigation in which a cohort of individuals who do not have evidence of an outcome of interest but who are exposed to the putative cause is compared with a concurrent cohort of individuals who are also free of the outcome but not exposed to the putative cause, Both cohorts are then followed forward in time to compare the incidence of the outcome of interest.
o Cohort studies can be conducted retrospectively in the sense that someone other than the investigator has followed patients, and the investigator obtains the database and then examines the association between exposure and outcome.

Question 13

• Case control studies

Answer 13

o A study designed to determine the association between an exposure and outcome in which patients are sampled by outcome. Those with the outcome (Cases) are compared with those without the outcome (controls) with respect to exposure to the suspected harmful agent

Question 14

• Case series/case reports

Answer 14

o A descriptive report of one patient (case report) or a collective of patients treated in a similar manner (case series) without a control group

Question 15

• Animal studies/laboratory studies

Answer 15

o A laboratory experiment using animals or biological specimens to study the development and progression of diseases. These can test how safe and effective new treatments are before they are tested in people