EBD Flashcards
What is critical appraisal
the process of assessing and interpreting evidence through the systematic consideration of its validity, relevance and results
What do the public believe about decisions being made
research funding and efforts are coordinate and prioritised
the progress of research is steady and upwards
the results of research are systematically applied to clinical practice
all clinical practice is evidenced based
What is decision making actually by
anecdote
press cutting
GOBSAT
cost minimization
What are issues to consider
are the results of the trial valid?
what are the results?
are the results relevant to your clinical practice?
How can we tell if the results of the trial are valid
by looking if they used a focussed question (PICO)
conduct of study (randomization, blinding, allocation, concealment, flow of participants)
How can we get the results?
What is the effect of the treatment
what has been measured?
what direction?
how large?
precision -CI
How can we tell if the results are relevant to your clinical practice
are they generalizable
are they clinically important outcome measures
are there adverse effects/harms?
What questions can we ask to see if the results of the review are valid
was the assignment of tx to patients randomized?
were all the patients who entered the trial 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 the NNT
1/absoltue risk difference
What are other measures of effect size
odds ratio
relative risk or risk ratio
percent risk reduction or relative risk reduction
risk difference or absolute risk reduction
number needs to treat
What are advantages of split mouth trials over parallel groups
each participants acts as own control and reduces inter individual variation
therefore fewer participants are required to obtain same study power as parallel group
every participant receives each intervention, therefore good for determining preferences
What are disadvantages of split mouth trials over parallel groups
carry across effects ‘leakage’
selection of px (need to have matching carious teeth) might limit external validity
statistical analysis more sophisticed and is usually not done
What is intention to treat
analyse data as though the switchers were still in the NEW agent group
more conservative (preferred)
pragmatic - in real life this will happen
drop outs can impute data
Whats per protocol
analyze the data according to the tx actually received
efficacy to explain the effects of the intervention itself
