EBP Flashcards
Define clinical expertise
A combination of clinical skills, medical knowledge, and professional experience that is accumulated by practitioners over the course of their career
What three types of information guide decisions about patience care
1.Best research evidence.
2.Clinical expertise.
3. Patient values and circumstances.
Define best research evidence
Is evidence that is up-to-date and authoritative scientific research into various aspects of patient care diagnosis, treatment, or prevention of disease.
Define patient, values and circumstances
Patient values in circumstances relate to the unique preferences, concerns, expectations, beliefs, hopes, strength, limitations, and stresses that each patient brings to a clinical encounter.
What is the importance of clinical expertise?
Clinical expertise is important because research evidence on its own is not enough to inform practice. It needs to be contextualise to local environments and specific patients.
What is the importance of best research evidence?
Actively searching for research evidence is it is important because gaps between research and clinical practice can lead to save suboptimal quality of care. These gaps maybe due to variations in practices between different geographical location, or due to the rapid advances in medical knowledge.
What is the importance of patient, values and circumstances
Considering the individual patient values and circumstances is important because the ideal treatment may not always be appropriate, and you may need to find an alternative course of action. For example patients may not consent to a particular treatment due to religious or cultural reasons or may have a medical condition which prevents them from undertaking certain treatments.
What are the five key steps in evidence based practice process?
1.Ask
2. Acquire.
3. Appraise.
4.apply.
5.assess
What is required in step 1, ask ?
Convert your problem into a structured and answerable clinical question
What is step 2 acquire?
Locate the best research evidence to answer your question
Step 3 appraise?
Critically appraise the evidence for it’s validity and applicability to your patient
Step 4 apply?
Apply the evidence to your case, using your clinical expertise and consider the patients circumstances determines the course of action
Step 5 assess?
Reflect on the process and assess effectiveness and efficiency, looking for ways to improve and optimise your clinical practice
What is primary research?
Original research carried out in a clinical or lavatory setting examples include observational studies, and randomise control trials
What is Secondary research?
The analysis of primary research often to pull data or review the body of evidence on specific conditions. Examples include systematic reviews and guidelines.
The hierarchy of evidence pyramid
1.systematic review.
2.RCT.
3.cohort studies.
4.case control.
5.case report.
6.expert opinion.
What is systematic review?
High quality pieces of evidence, that identify all relevant evidence and assessed quality of each study found before synthesising the results and presenting a summary of the findings
What are Randomise control trial (RCT)
These include methodologies that reduce the risk of bias, so I placed above other types of primary research
What are cohort studies?
Cohort studies are observational studies that follow a defined group for people over a specific period of time, the outcomes of people in subset of this cohort, I can paired to examine people who were exposed or not exposed to a particular intervention or other factor of interest
What are case-control studies?
Case-control studies are retrospective, observational studies, they help to identify if an outcome or disease is associated with a particular risk factor. Two groups have studied one group with the outcome or disease and the other group without the outcome disease (control group). Significant differences in rates of exposure can suggest association between the risk factor and the disease.
What are case reports in case series?
A case study provides evidence from just one individual with no comparison to other groups. This type of study has little statistical availability and is low down in the pyramid.
What is expert opinion?
Expert opinion can be useful information, but also subject Tobias often not backed by research studies. Sometimes this is the only evidence available on a topic though.
Guidelines
The use of evidence drawn from systematic reviews for the best available primary studies and are an integration of the best available evidence. Guidelines provide recommendations on treatment or care of a condition.
