EBVM Week 1: Introduction to EBVM and patient record system Flashcards
Define EBVM
the use of current best evidence in making clinical decisions. A rational approach to clinical decision making. The integration of best research evidence, clinical experience, patient’s unique values and circumstances.
What is RCVS Knowledge
The Trust division of the RCVS (drives EBVM forward)
Outline the steps involved in undertaking EBVM
Identify an answerable question
Search for the best evidence
Critically appraise the evidence
Integrate the evidence with clinical experience and patient needs
Evaluate own effectiveness at practising EBVM
Define PICO
The main elements of a good 'answerable question': P = patient or problem I = Intervention C = Comparison O = Outcome
List common categories of clinical questions - 4
Prognosis
Aetiology
Therapy
Diagnostic test
What is CEBM?
Centre for Evidence Based Medicine
What types of knowledge are involved in finding the best evidence? 2
Background knowledge
Foreground knowledge
What is meant by Systems, Synopses and Syntheses?
Origin in human EBM, now translating into EBVM:
Systems - clinical information system, integrated to patient
Synopses - summaries of individual studies and reviews
Syntheses - systematic reviews
Differentiate narrative and systematic review papers.
Narrative - a review of papers from a clinical perspective, usually lack a systematic search protocol or explicit criteria for searching and selecting evidence
Systematic - more objective than a narrative review, focuses on a research question and tries to identify, appraise, select and synthesise this information
Define IVIS
International Veterinary Information Services
How can evidence be appraised?
Validity - strength of study design and individual studies mertis
Importance of results - clinically relevant improvements? precision of results, relevance to the clinical problem/patient
Outline the hierachy of evidence strength
HIGH: Systematic reviews/meta-analyses Randomised control trial Cohort study Case-control study Cross-sectional study Case series Single case reports Editorials Opinion LOW
What is an analytic study?
Examples?
explicit comparison between groups
build on descriptive studies
test hypotheses/identify risk factors
TYPES:
Observational - cross sectional, case-control, cohort
Intervention
What are descriptive studies?
describe events
generate hypotheses for further evaluation
valuable for conditions where little is known
TYPES:
case reports
case series
surveys
True/False: in case reports you evaluate the association between exposure and outcome
False
