Evidence based vs alternative therapies Flashcards
List the 4 tests of a new drug
Efficacy
Safety
Convenience
Cost
What is expected when assessing the efficacy of a new drug?
Best level of evidence of efficacy
Expected comparator
Clinical endpoints
What is looked at when assessing the safety of a new drug?
Complete safety profile - adverse effects
Safety advantages/disadvantages
What is considered when assessing the convenience of a new drug?
Formulation
Route of administration
Taste
Dose frequency
What is considered when assessing the cost of a new drug?
Number of patients
Cost implications for patients
Cost implications for organisations
Cost effectiveness analysis
Define evidence based medicine
The use of mathematical estimates of the risk of benefit and harm, derived from high quality research on population samples, to inform clinical decision making in the diagnosis, investigations and management of individual patients
What is the evidence based medicine principle?
Treat where there is benefit and do not treat where there is no benefit or risk of harm
Risk benefit balance
Describe PICO-M
Patient/problem Intervention Comparison/control Outcome/effect Methodology
What acronym is used for clinical interpretation?
PICO-M
What questions should you ask when interpreting a clinical study?
Are the results clinically important?
Are the study results relevant to practice?
Are the methods valid?
What questions are asked to assess the validity of methods?
Randomised assignment of patients?
Follow up time long enough?
Analysis of groups allocated?
How can you tell if a study has clinical importance?
Hard endpoints? Size of the treatment effect? Statistical significance? Adequate power? Conclusions based on questions posed and results obtained?
How can you assess whether the study has clinical relevance?
Population similar to your patients?
Intervention feasible in your clinical setting?
Risks and benefits to your patients?
Alternative treatments?
Are there alternatives to evidence based medicine?
Eminence based medicine Vehemence based medicine Eloquence based medicine Providence based medicine Nervousness based medicine Diffidence based medicine Confidence based medicine
Give some examples of evidence based medicine and complementary alternative medicine combinations
Alexander technique for parkinson’s
Ginger and acupressure for morning sickness
Acupuncture and manual therapy for low back pain
