Intro to evidence based Flashcards
What does it mean for a disease to be self-limiting?
Patient may recover from a disease, and just because you gave them treatment does not mean that the diagnosis/treatment were correct
What are the main factors that are used by an MD to make a decision?
- **Physicians year of graduation from med school
- Level of blood pressure
- Patients age
- Amount of target-organ damage
What things happen after you graduate from vet school?
1.Memory of what you learned will lose its freshness
- New discoveries will be found that they never taught you
**need to ensure you keep learning and know about these new things
What is evidence based medicine?
Make decisions by:
Applying the best and most relevant scientific evidence, integrating with clinical expertise, and taking into account owner’s individual circumstance
Importance of evidence based medicine
-provide you with the skills to identify and appraise research evidence so that you can provide the best possible care for your clients and patients throughout your career
What does EBVM suggest?
- personal experience can be misleading
- Randomised studies are required for validation
- Predictions based on physiological principles are often wrong
- Reading the literature requires more than common sense to evaluate evidence
Why practice EBVM?
-Research is very accessible with journals and pubmed
- Clients also have access to information/research
-We need information (both known and not known)
Barriers to EBVM
- Information/research is spread out over many different sources
- Not enough time to look at all the research
- Hard to evaluate the value of information, especially when there is bias from commercial organisations
- Evidence based in some areas of vet med are lacking (fewer clinical trials; lack of large scale slinical studies; clinical research not focused on practice needs)
Limitations of evidence based VET medicine
- literature base is very small
- Have to use poorer sources of evidence
- lots of clinical questions have poor evidence available
- Question: do owners prefer truth and don’t mind uncertainty?
Just in time information OR keeping up to date?
There are some cases that we see so rarely that it is not efficient to keep up to date on their latest therapies.
**that information will need to be looked at “just in time”= Searching mode
Cases we see all the time, we will want to keep up to date on= Appraising mode
What are the two keys of evidence based medicine?
- Ability to efficiently and accurately search for best available evidence
- Basic understanding of criteria for determining strength of evidence
Evidence based pyramid
-includes both filtered (top) and unfiltered (bottom) resources
-textbooks, experience/opinion, background info at the bottom
-places evidence in a period from best choice of information to worst
Filtered resources
-summarize, examine, and appraise the evidence of multiple individual unfiltered studied
**only as good as the individual unfiltered studies that are examined
Examples of filtered resources
1.Meta-analysis
2.Systemic reviews
3. Critically appraised topics
Unfiltered resources
- original research studies (usually published peer reviewed journal articles) providing information on a specific topic
**must appraise resources to ensure they are valid and reliable
