Evidence Based Medicine 11.10.22

Question 1

What is the evidence in EBM?

Answer 1

Evidence is information to inform clinical practice that is obtained by scientific methods

Question 2

What is EBM?

Answer 2

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

Question 3

What are the different types of evidence ?

Answer 3

-cross-sectional survey
- case-control
- cohort
- randomised controlled trial (RCT)

Question 4

What are five key elements of EBM?

Answer 4

1. Finding evidence (asking the right questions)
2. Assessing the evidence (critical appraisal)
3. Synthesising the evidence (brining it all together)
4. Making good decisions
5. Evaluating performance against the evidence

Question 5

What is the practice of EBM?

Answer 5

Means integrating individual clinical expertise with the best available external clinical evidence from systematic research

Question 6

What is the sample?

Answer 6

The people on whom the study is conducted

Question 7

What is the exposure?

Answer 7

Whether/how much the individual is exposed to the things that are hypothesised to influence the outcome

Question 8

How do we carry out cross-sectional study?

Answer 8

Take a population with one condition and see how many people have the other condition

Question 9

How do we carry out case-control?

Answer 9

Take a sample of people with one condition and a sample of matched controls. Then compare that with the prevalence of the other condition in the two groups

Question 10

How do we carry out cohort study?

Answer 10

Sample of unaffected and measure exposure to the risk factor. After a period of time, record how many people in the exposed/ unexposed group develop the outcome. Difference may still be due to other factors

Question 11

How do we carry out a randomised controlled trial?

Answer 11

Take sample of patients with condition or risk of interest. Randomisation to intervention or control greatly reduces the risk that any difference in outcome is due to unknown or unmeasured factors.

Question 12

How do we frame a question?

Answer 12

PICO
P- patient of population
I- intervention (exposure, treatment or procedure)
C- comparator (that which is compared against the intervention)
O- outcome

Question 13

How can we synthesise evidence?

Answer 13

• narrative synthesis: describing the results and telling their story
• Meta-analysis: statistical technique for combining the results of multiple studies

Question 14

What should we consider when interpreting evidence?

Answer 14

• bias
• imprecision
• inconsistency
• indirectness
• publication bias