EBM

Question 1

Hierarchy of study design

Answer 1

Systematic reviews & meta-analyses 
Randomised Controlled Trials
Cohort studies 
Case-control studies
Ecological studies
Descriptive/cross-sectional studies
Case report/series

Question 2

Evidence Based Medicine

Answer 2

conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.

Question 3

Role of EBM in clinical medicine

Answer 3

Clinical findings
Aetiology
Clinical manifestations of disease
Differential diagnosis
Diagnostic tests
Prognosis
Therapy
Prevention

Question 4

Criticism of EBM

Answer 4

Time consuming

Jargon is used inappropriately

Question 5

Why EBM matters to clinicians

Answer 5

Better service for patients
Patient care + safety
Medical knowledge
Revalidation
Professionalism

Question 6

Systemic reviews + meta analysis

Answer 6

Aims to answer defined research question by collecting & summarising empirical evidence that fits pre-specified eligibility criteria.

Question 7

Advantages to systemic approach

Answer 7

Transparent inclusion of studies
MA increases power of study
May identify lack of adequate evidence

Question 8

Randomised Control Trial

Answer 8

Selection for people you want to experiment on.

GOLD STANDARD for clinical trials & surgical interventions.

Question 9

RCT disadvantages

Answer 9

–With some treatment, effect might be weak so trials may need to be very large to demonstrate an effect.
–Expensive!

Question 10

Cohort

Answer 10

Individuals selected on basis of exposure status &
followed over time to allow frequency of occurrence of outcome of interest in exposed & non-exposed groups to be compared.

Question 11

Time period of cohort

Answer 11

Prospective

Question 12

What can be calculated from cohort studies

Answer 12

Relative risk
Incidence
Which came 1st incidence or risk factor

Question 13

Advantages of cohort studies

Answer 13

looks at multiple outcomes
follows natural history of disease
minimise bias in estimating exposure as prospective

Question 14

Disadvantages of cohort studies

Answer 14

Inefficient for rare diseases
Expensive
Time consuming
Loss of follow-up =Bias

Question 15

Case control studies

Answer 15

Selection based on whether or not they have outcome of interest
Exposure (risk factor) status explored to establish whether exposure is more common in the case or control group

Question 16

Case control studies determine

Answer 16

whether an exposure is associated with an outcome

Question 17

What can be calculated from a case control study

Answer 17

Odds ratio

Question 18

Advantages of case control study

Answer 18

Quick
Cheap
Good for outbreaks of infectious/ rare disease
Can investigate many exposures simultaneously

Question 19

Disadvantages of case control study

Answer 19

Problems of selection of controls
Subject to recall bias
Uncertainty of exposure-disease time relationship
Poor for rare exposures
Can't calculate incidence directly

Question 20

Case control study time period

Answer 20

Retrospective

Question 21

Ecological studies

Answer 21

Type of descriptive study

Uses correlations between different populations, using different exposures

Question 22

Descriptive/ cross-sectional studies

Answer 22

Based on routinely collected data. Difficult to show causal relationship

Question 23

Descriptive/ cross-sectional study example

Answer 23

Survey

Census

Question 24

Case report/ series

Answer 24

–Description of single case/ series of cases.

–NOT evidence used to support practice BUT sometimes useful in picking out new syndromes or conditions.

Question 25

Reporting guidelines for RCT

Answer 25

CONSORT

Question 26

Reporting guidelines for observational studies

Answer 26

STROBE

Question 27

Reporting guidelines for systematic reviews

Answer 27

PRISMA/MOOSE