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Evidence Based Medicine > Exam #1: Understanding Clinical Literature > Flashcards

Exam #1: Understanding Clinical Literature Flashcards

1
Q

Outline the standard structure of a research paper.

A
  • Abstract
  • Introduction
  • Methods
  • Results
  • Discussion

*IMRAD mnemonic– leaves out abstract

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2
Q

What are the preliminary questions that you should ask when reading a research paper?

A

1) Why was the study done?
2) What is the hypothesis?
3) What type of study was done?
4) Was the study design appropriate?

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3
Q

What are the two broad categories of studies?

A

Primary i.e.

  • Experiments
  • Observations
  • Clinical trials
  • Surveys

Secondary

  • Reviews
  • Economic analyses
  • Decision analyses
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4
Q

What is the difference between a systematic review and a non-systematic review?

A

Non-systematic= something is guaranteed to be left out

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5
Q

What are the traditional study designs?

A
  • RCT
  • Cohort studies
  • Case-control studies
  • Cross-sectional surveys
  • Case reports
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6
Q

What is the purpose of systematic reviews and meta-analyses?

A

To evaluate groups of studies

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7
Q

What is the best study design for a therapy/ intervention question?

A

RCT

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8
Q

What is the best study design for a harm/risk/etiology question?

A

RCT

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9
Q

What is the best study design to assess harmful outcomes?

A

Cohort-study OR
Case-control

*****Note that it is NOT ethical to assess harmful outcomes with RCTs

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10
Q

What is the best study design for a diagnosis question?

A

Diagnostic validation study

*****This is an independent, blinded comparison with the “gold” –also called reference– standard.

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11
Q

What is the best study design for a prognosis question?

A

Cohort study

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12
Q

Describe the methodology of a RCT.

A
  • Participant randomly assigned to one intervention group or another
  • Both analyzed for a specific defined outcome
  • Randomization should produce demographically similar groups
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13
Q

What type of bias does randomization decrease? What is the caveat to this?

A
  • Randomization reduces “selection bias”

*****Requires “concealed allocation” i.e. a third party assigns groups

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14
Q

What is the difference between concealed allocation and blinding?

A

Blinding= keeping participants unaware of their group assignment

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15
Q

What is the difference between single and double blinding?

A

Single= only subjects blinded

Double= patients and investigators blinded

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16
Q

What are the advantages of RCTs?

A
  • In dept analysis of one variable
  • Prospective
  • Seek to CONFIRM null hypothesis
  • Allow for meta-analysis
  • Minimize bias
17
Q

What are the disadvantages of RCTs?

A
  • Expensive
  • Long-term
  • Can introduce hidden bias
  • Randomization can be impractical or unethical
18
Q

When is randomization inappropriate?

A
  • If the study involves PROGNOSIS
  • Studying the VALIDITY of a test
  • Investigating a quality of care issue
19
Q

Describe the methodology of a cohort study.

A
  • OBSERVATIONAL

- 2+ subject groups are selected based on exposure

20
Q

What is the disadvantage of a cohort study?

A

Can be biased

21
Q

Describe the methodology of a case-control study.

A
  • OBSERVATIONAL
  • Not randomized
  • Patients w/ condition matched to a control
  • Retrospective

*****Generally concerned with harm or etiology

22
Q

What is the disadvantage of case-control studies?

A

V. prone to bias, even more than cohort studies

23
Q

Describe the methodology of a cross-sectional study.

A

Sample is interviewed, examined, or evaluated for a specific question

24
Q

What is a systematic review?

A

A review that includes ALL original articles, GLOBALLY, even if UNPUBLISHED

*****All individual reports are then critically evaluated for strict quality criteria

25
Q

What are the advantages of a systematic review?

A
  • Information assimilated quickly
  • Limit bias
  • New hypotheses can be formulated
  • B/c of #, conclusions more reliable
26
Q

What is a meta-analysis?

A

A synthesis of numerical results of several studies which all addressed the same question

Evidence Based Medicine (14 decks)

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