HaDSoc S2 - Evidence-Based Healthcare Flashcards
Why is evidence based medicine important?
Studies show that clinicians often persist using healthcare interventions which have been proven ineffective and often fail to uptake other interventions which
What are the arguments for evidence-based healthcare?
Healthcare should be based upon the best available evidence for both effectiveness AND cost-effectiveness
Ineffective/inappropriate interventions waste resources which could be used more effectively
Variations in treatment create inequality
Define evidence based practice
The integration of individual clinical expertise with the best available external clinical evidence from systematic research
Why are systematic reviews needed?
Traditional literature reviews may be biased
Methodology of study selections for literature reviews isn’t always clear
Variable quality of studies selected
Systematic reviews can identify gaps in research and address clinical uncertainty
How are systematic reviews useful to clinicians?
They offer quality control and increased certainty
Up to date
Save clinicians from having to find and appraise studies themselves
They may reduce the delay between research discoveries and their implementation
What are some practical criticisms of the evidence based practice movement?
May be an impossible task to maintain systematic reviews across all specialties
May be challenging and expensive to disseminate and implement findings
RCTs are seen as the gold standard but in some cases aren’t necessary, feasible or even desirable
Requires good faith on the part of pharmaceutical companies
What are some philosophical criticisms of the evidence based practice movement?
Does not align with most doctors modes of reasoning
Population level outcomes may not be applicable to individuals
Potential to create unreflective rule followers
Encroaches on professional responsibility and autonomy
What are some problems with getting evidence into practice?
Evidence exists but doctors don’t know about it
Doctors know the evidence exists but don’t use it
Organisational systems cannot support innovation
Commissioning decisions reflect different priorities
The resources to implement change are unavailable
What are the types of social research?
Qualitative
Quantitative
Describe quantitative social research
Collection of numerical data
Begins with idea/hypothesis
By deduction allows conclusions to be drawn
Strengths are reliability and repeatability
How are quantitative social research studies designed?
RCTs
Cohort studies
Case control studies
Cross sectional surveys
Often questionnaires are used
How should questionnaires be designed?
To be valid and reliable
Define validity in the context of questionnaires
Measures what it’s supposed to measure
Define reliability in the context of questionnaires
Measures things consistently
Differences in results come from differences between participants rather than inconsistencies in understanding of questions asked or responses given
How can reliability and validity be ensured?
Use a published questionnaire - the reliability and validity have already been proven
