Intro To EBM

Question 1

How is EBM defined?

Answer 1

Evidence Based Medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients….

… EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research’’

Question 2

According to the Folk Model, the patient comes to a doctor seeking answers to 8 question:

Answer 2

What has happened?
Why has it happened?
Why to me?
Why now?
What would happen if nothing were done about it?
What should I do about it or whom should I consult for further help?
What can you do about it?
How can I stop it happening again?

Question 3

Define Data

Answer 3

Datais factual information such as numbers, percentages, and statistics.Data is just information and has no intrinsic meaning on its own. Data just is.

Question 4

Define Evidence

Answer 4

Evidence has to be evidence for or of something: an argument, an opinion, a viewpoint or a hypothesis. Evidenceisdata that is relevant and furnishesproofthat supports a conclusion.
The evidence you use depends on your argument.
As we get more evidence or different types of evidence our argument might change.

Question 5

Define epidemiology

Answer 5

The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.

Question 6

Purpose of epidemiology

Answer 6

allows the distribution of health and ill-health in a population to be described, and possible causal factors to be identified.

It enables public health professionals to understand health problems and take appropriate action (policies, measures, interventions)

Question 7

What are primary sources?

Answer 7

Primary sources - contain the original data and analysis from research studies. Refers to data that has come direct from the direct results of experiments or original research.
No outside evaluation or interpretation is provided. An example of a primary literature source is a peer-reviewed research article. Other primary sources include preprints, theses, reports and conference proceedings.

Question 8

What are secondary sources?

Answer 8

Secondary sources - provide acommentary on and discussion of evidence. An analysis, synthesis, interpretation and evaluation of primary works: systematic reviews, meta-analyses, clinical practice guidelines summaries, synopsis etc.

Question 9

The levels of evidence pyramid provides a way to visualise both the_______ of evidence and the _____ of evidence available.

Answer 9

quality

amount

Question 10

Systemic review is a type or primary or secondary source?

Answer 10

Secondary

A systematic review is a synthesis and appraisalof primary research papers using a rigorous and clearly documented methodology in boththe search strategyandthe selection of studies.This minimises bias inthe results. The clear documentation of the process and the decisions made allow the review to be reproduced and updated.
Systematic Reviews are vital for practicing clinicians as they provide an objective summation of the most up-to-date EVIDENCE on a given condition/ treatment/ pathway etc

Question 11

A Systematic Review (with or without meta-analysis) is a subjective selection of papers chosen to support the reviewer’s hypothesis or a narrative piece, describing some of the recent or historical research developments in the field.

True or false?

Answer 11

False

Question 12

Definiton for clinical practice guidelines (CPG)

Answer 12

CPG are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.

Question 13

What is evidence best practice (EBP)?

Answer 13

EBP is a process that allows health professionals to assess research and guidelines on clinical procedures from highly trusted findings and then to apply them in their daily practice.

Question 14

EBP is based on two principles:

Answer 14

Understanding that scientific evidence alone is insufficient to guide decision-making

Within all the available sources of evidence, hierarchies exists - some types of evidence are seen as more valid or carry more weight than others

Question 15

The 5 A’s of Evidence based practice (EBP)

Answer 15

Asking a critical question
Acquiring the evidence
Appraising and assessing the evidence
Applying the best evidence to make an action plan and take action
Assessing the outcomes of the action taken

Question 16

What is generalisability?

Answer 16

how applicable are the findings to a wide range of scenarios or do these finding only really relate to a very specific set of circumstances or conditions?

Question 17

What is reliability?

Answer 17

how stable and consistent the results of a study are over time? If we do the study again, are we going to get the same results?

Question 18

What is replicability?

Answer 18

can the study be repeated and retested? If not, how can we make any claims of reliability?

Question 19

What is validity?

Answer 19

do the methods and design of the study measure or describe what the study is purporting to show?

Question 20

What is internal validity?

Answer 20

do the methods and instruments used actually measure or describe what we think they are or are they measuring or describing something else?

Question 21

What is external validity?

Answer 21

This refers to whether the study in question is applicable to the situation you want to apply it to.

Question 22

What is authority?

Answer 22

has the study come from a well known and respected academic/university or a consultancy selling a product or service for example?

Question 23

What is the term ‘peer-reviewed’?

Answer 23

has the study or paper been through a process of checking and critique by fellow researchers or is it self-published?