evidence based

Question 1

what is evidence-based medicine?

Answer 1

medical practice or care that emphasizes the practical application of the findings of the best available current research

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

Question 2

why use evidence-based medicine?

Answer 2

> Leads to improved quality of care:
*Identifying and promoting practices which are proven to work
*Eliminating practices that are ineffective or harmful
Develops critical thinking (rather than intuition or habit)
Requires that interventions and tests be scrutinised and proven

Question 3

Hierarchy of evidence

Answer 3

> Different types ranked based on methodology (quality of design,
validity, applicability to patient care)
Best evidence at the top of a pyramid or at Level 1 in a table
Different grading systems exist eg. Oxford Centre for Evidence Based Medicine
Level of evidence Description
Level I

Question 4

5 steps models of evidence-based medicine

Answer 4

ask
acquire
appraise
apply
assess

Question 5

in the table how many levels of ranking evidence does it have.

Answer 5

7 levels ranked from top to less

Question 6

levels

Answer 6

level 1- meta-analysis (includes more than one study) randomized controlled trial
level 2- one randomized controlled trial
level 3- controlled study without randomization
level4- case control or cohort studies
level 5- qualitative studies or descriptive
level 6- single descriptive (single) or qualitative
level 7- expert opinion

Question 7

quality of evidence in the pyramid

Answer 7

systematic review
critically- appraised topics
critically- appraised individual articles
RCTs
cohort studies
case- controlled studies
expert opinions

Question 8

evidence is graded for quality based on:

Answer 8

high quality
good quality
low quality

Question 9

How to find evidence?

Answer 9

using 5 step EBM model
5-As

Question 10

Describe Ask:

Answer 10

Questions should be:
> clear
>directly focused on the clinical problem
>able be to be resolved by the research evidence
question must have a framework: PICO
> Patient
> intervention
> Comparison intervention
> Outcome

Question 11

Acquire evidence

Answer 11

> seek relevant evidence to answer the clinical
interview or consult collogues
access online database
learn how to search database effectively

Question 12

appraise the evidence

Answer 12

appraise the evidence found for validity
critical appraisal for research is an important skill to learn
critical appraisal tools commonly used

Question 13

apply the evidence

Answer 13

evidence based medicine does not simply apply evidence any how to every patient: some factors are always considered such as cost of treatment and availability of treatment

Question 14

Assess or evaluate

Answer 14

once EBM is incorporated
IMPLEMENTATIONS AND PATIENTS’ OUTCOMES MUST BE EVALUATED

Question 15

BASIC SEARCH PRINCIPLES

Answer 15

ASK and ACQUIRE