Evidence Based Practice In Clinical Decision Making Flashcards
What are the Evidence Based Practice steps?
- Answerable clinical question
- Systematic literature review
- Research analyzed
- Integrate w/ expertise and patient needs
- Evaluate
OR -> Question > Lit > Analysis > Integrate > Evaluate (QLAIE)
How do you write a PICO question?
Pt/population
Intervention
Comparison
Outcome
-write an example!
What is the best research evidence for better diagnosis and why?
Cross-sectional studies to rule out poor tests.
What is the best research evidence to better prognosis?
Longitudinal studies.
What is the best research evidence to better intervention?
Experimental studies (RCT)
What is a guideline? And what should it do?
A peer-reviewed document written by a panel of experts that makes recommendations for treatment.
- be based on systematic reviews
- include ratings of evidence
What is the difference between a systematic review and a meta-analysis?
A meta-analysis pools data from multiple studies to estimate the “overall” effect of an intervention.
What is the “effect” in a meta-analysis? What are the two types?
The magnitude of the difference found in the study.
Absolute effects: in units of the outcome measure (i.e. meters, sec, etc.)
Standardized effects: unit less and useful for comparing studies using different outcome measures
What is the relationship between an SEM and CI in a forest plot?
In the forest plot the SEM is the amount of error you can consider as measurement error (the “standard error of measurement”). The best studies have a smaller SEM and therefore a smaller CI.
What is an MDC?
An MDC is a measurement of the Minimal Detectable Change which is the minimum amount of change in a patient’s score that ensures the change was not the result of measurement error.
What is the MCID?
The Minimal Clinically Important Difference, a measurement of that smallest change that would be clinically relevant in an outcome measure.
What is the difference between reliability and validity?
Reliability means a tool is the right tool all the time. Validity means the tool is the relevant tool.
What is the difference between an absolute effect within the group vs. between groups?
An absolute effect within the group is the change the treatment has on a the group tested receiving the treatment. The absolute effect between the group is the differentiation between tested group results and control group results.
How do you interpret absolute effect?
Your experience, MCID
How do you interpret standardized effect?
- 2 - not likely meaningful
- 5 - maybe meaningful
- 8 - large, likely meaningful
