Evidence based medicine Flashcards
Evidence base medicine definition
-conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients
Lowest ranking of research evidence
- expert or specialty group onions
- editorials
Middle ranking of research evidence
- RCT
- experiment
- cohort study
- case reports/series
Highest level of research evidence
- meta-analysis
- systematic review
Meta-analysis
-statistical method that combines data from multiple studies resulting in higher statistical power and a single conclusion
Gold standard for gathering research and evidence for EBM
meta-analysis
Systematic review
- type of literature review that identifies, selects, and analyzes multiple research articles
- specific methodlogy
- studies ranked from Grade A (best evidence) to D (poor evidence)
What happens when systematic review is completed
-acceptable studies are pooled together and statistical testing of data (meta-analysis) is performed
Randomized Controlled Trial
- assigned either control or treatment group
- some use double-blind design
- experimental studies
What is an experimental study
-random subject selection
one placebo or control group
one or more intervention groups
Cohort study is a type of what study
prospective study
Case report
-detailed report of one patient with disease, includes demographics, sign/sx, diagnosis, response to treatment, etc.
Case series
-series of case reports that involves a series of individuals who are given similar treatment
Opinions and editorials
- biased and not based on solid evidence
- weakest form of evidence
Gold standard database and resource for EBM
Cochrane review
CINAHL
worlds largest source of full-text nursing adn allied health journals
Grades of research evidence
-A best
B, C, D (poor)
What grade of research is double-blind RCT considered
Grade A
Strongest level of evidence would include words such as
meta analysis -systematic review -RCTs -Cochrane MEDLINE CINAHL database
Words that would indicate weak evidence
-expert opinion
opinion
editorial
Absolute risk reduction (ARR)
measure of difference between two different treatments in terms of their ability to reduce a particular outcome
Relative risk reduction (RRR)
measure of how much risk is reduced in the experimental group compared with the control group
Number need to treat (NNT)
-number of patients needed to treat to avoid one bad outcome
Positive predictive value (PPV)
-probability that a person with positive screening will have the disease
Negative predictive value (NPV)
-probability that a person with a negative test result does not have the disease
Herd immunity
-refers to resistance to a disease in a large number of people in the population
Health
-state of complete physical, mental and social well-being
Horizontal transmission
- transmission from one individual to another
- HIV transmission through sexual intercourse
Vertical transmission
-transmission of agent from mother to infant
Endemic
refers to baseline level of particular disease in a population
Epidemic
rapid increase of disease in a population that involves a large number of people
Pandemic
epidemic that occurs over a very large area
-involves large proportion of the global population
Morbidity
illness or any departure from physical and/or mental health
Mortality
death
Infant mortality
-infant deaths per 100,000 live births
Sensitivity
-ability of a screening test to correctly identify a person WITH disease
Specificity
ability of a screening test to correctly identify a person WITHOUT disease
What level of prevention is setting up a community youth center
primary
