Fellowship - research methods Flashcards
Data regarding the conduct and outcomes of anaesthesia are now widely collected (eg NACOR).Outline the benefits and the potential errors that can occur when using this data for research
“In a large clinical trial, patients were randomised into two groups to study the impact of bispectral index (BISTM) monitoring on the incidence of awareness.
The table below shows the results.
Groups Sample size,
n Cases of awareness,
n BIS-guided 1250
2 Routine care 1250 11
Data analysis found that the statistical difference in the incidence of awareness had a p value of 0.022.
The study reported that BIS-guided anaesthesia reduced the risk of awareness by 82% (95% confidence interval 17-98%) with an odds ratio of 0.2 and a number needed to treat of 140. Define the following terms and explain their meaning in relation to this study: p value risk reduction confidence interval odds ratio number needed to treat”
Describe the principles that are important in making clinical research ethical.
Evaluate the merits of large multicentre randomised controlled trials compared with the merits of single-centre observational studies in guiding clinical practice.
Describe how you would determine the usefulness of a published paper for your own practice.
You wish to investigate the effects of a new anaesthesia technique on postoperative patient outcomes. Describe the stages of study design that are important to consider when planning this trial.
You are planning a trial to evaluate the efficacy of a new drug on reducing post-laparotomy pain. Describe potential sources of bias and indicate how these can be minimised.
a. What is evidence based medicine. (30%) b. Describe the features of a systematic review, indicating how it may influence your practice of anaesthesia. (70%)
The Mallampati test is a commonly used bedside screening tool to assess the probability of a difficult intubation. Explain the terms sensitivity, specificity, positive predictive value, and negative predictive value when applied to this test.
A new randomised controlled trial suggests therapy A is better than therapy B in the treatment of condition X.How would you evaluate this trial before changing your clinical practice?
How would you critically appraise a paper published in a journal?
What are the key objectives of ethical review of a research project?
A clinical trial is planned to evaluate a new analgesic. Discuss the ethical considerations in having a placebo group in the trial.
