Evidenced based practice

Question 1

What does numbers needed to treat mean?

Answer 1

The number to treat to achieve 1 successful outcome not possible absence of treatment.

Question 2

What 3 features should we use to assess whether the evidence is good or not?

Answer 2

Number of studies,
Quality - reliability
Consensus - Similar theories/conclusions about it’s effectiveness.

Question 3

What are some of the hierarchies of evidence?

Answer 3

Systematic review/meta-analysis
Critically appraised/peer reviewed topics (Evidence synthesis)
Critically appraised/peer reviewed individual paper.
Randomised control trials

Question 4

What are some of the reasons for publication bias?

What are the implications of this?

Answer 4

Publication bias leads to over-estimation of ‘true’ effect in CBT for depression - Cuijpers et al. 2010)
Uncorrected: ES = 0.67
Adjusted for pub bias: ES = 0.42

Question 5

What are some of the negative consequences of bad therapy?

Answer 5

financial costs
waiting lists (if you have such things…)
learned helplessness for the patient
learned helplessness for the therapist
patient attributes failure to the self
less likely to seek help in the future
- 1patient acculturated to therapy being ineffective
so why would they think differently next time?