Evidence Based Medicine

Question 1

Evidence based medicine is what?

Answer 1

• Uses estimates of risk of benefit and harm
• From high quality research on samples
• Inform clinical decision making

Question 2

What are RCTs and what do they evaluate?

Answer 2

• Experimental studies
• Intervention compared to something else
• Efficacy and toxicity

Population is randomised and split into two groups 1 and 2 and then a new treatment is imposed on one and and old treatment/placebo on the other. The outcome is then assessed

Question 3

Inclusion and exclusion criteria being applied to the population being sampled can affect extent to which results can be _____

Answer 3

generalised

Question 4

Why do we randomise our sample?

Answer 4

To eliminate any confounding variables

Question 5

What is a confidence interval?

Answer 5

If repeat study 100 times, 95 of those times the point estimate would be within the confidence interval

Question 6

If p

Answer 6

Null hypothesis rejected

Question 7

If p>0.05 then what happens?

Answer 7

Null hypothesis failed to be rejected and is accepted (no difference)

Question 8

How can confounding variables be dealt with?

Answer 8

• randomisation of exposure
• stratification
• restriction
• matching
• statistical adjustment
  (multivariable regression analysis) MARCUS

Question 9

What forms are used to aid critical appraisal of literature?

Answer 9

CASP forms

Critical Appraisal Skills Programme

Question 10

What is bias?

Answer 10

Introduction of systematic error in study

• at point of study design
• cannot be eliminated at point of analysis

in terms of…

• Selection of study subjects
• Exposure classification
• Outcome classification

Question 11

List 6 different monitoring parameters…

Answer 11

1) Physiological
(bp, hr, rr, temp)

2) Biochemical
(electrolytes, urea, cr, lft, protein, cardiac enzymes, CRP)

3) Haematological
FBC, folate, INR, ESR (viscosity)

4) Serum drug conc
when narrow therapeutic index, inter patient variability

5) Microbiological
from blood, pus, sputum, aspirate, CSF - sensitivities back and fungal

6) Signs and symptoms
Stool consistency BSC, rashes, pain, consciousness (glasgow coma scale) urine output

Question 12

In relation to ADR’s what is meant by the DOTS classification?

Answer 12

Dose
Time
Susceptibility

Question 13

ADRs can be classified into 5 types… ABCDE

Answer 13

Augmented (predictable from pharmacy)

Bizarre (not predict) e.g allergy

Chronic - long term use
Delayed - carcinogenics
End of use - withdrawal