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EIP > Introduction into Evidence into Practice > Flashcards

Introduction into Evidence into Practice Flashcards

1
Q

Define ‘evidence based practise’

A

achieving best possible Px management by integrating:

  • best research evidence
  • clinical expertise
  • Px values
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2
Q

Is evidence based practice individualised

A

YES - about making best clinical decisions for each Px

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3
Q

What is the goal of evidence based practice?

A

achieve best management for each individual Px

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4
Q

EBP steps (6 A’s):

A
  1. Assess: question arises during Px care
  2. Ask: articulate all parts of question
  3. Acquire: find best quality evidence
  4. Appraise: evaluate evidence
  5. Apply: use clinical expertise to apply applicable evidence to Px values
  6. Audit
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5
Q

Is EBP interdisciplinary?

A

YES

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6
Q

What is step 1 of EBP and what does it involve?

A
  1. Assess:
    - assess the Px
    - prioritise questions that arise about their care
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7
Q

What is step 2 of EBP and what does it involve?

A
  1. Ask:
    - form a clinical question
    - use PICO
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8
Q

What principle can be used to formulate a clinical question?

A

PICO

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9
Q

What is PICO?

A

used to formulate a clinical question

  • P: Patient/Population
  • I: Intervention: what is the intervention/test you’re interested in?
  • C: Control/Comparison: Is there an alternative strategy to compare to?
  • O: Outcome: What are the consequences of the intervention you’re interested in?
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10
Q

Formulate a clinical question using PICO for the following scenario:
Elsie is a 68 year old female who comes to ask for your advice. Both her mother and father had macular degeneration and she is concerned about the prospect of developing the disease. Her friend has told her she should take vitamin supplements

A
  • P (patient/population): elderly female with family Hx of AMD
  • I (intervention): Vitamin supplements
  • C (control): No vitamins
  • O (outcome): decreasing risk of AMD
  • question: Does taking vitamin supplements reduce risk of elderly female with family Hx of AMD from developing AMD compared to no vitamins
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11
Q

Types of questions:

A
  • intervention
  • diagnostic accuracy
  • prognosis
  • aetiology
  • screening intervention
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12
Q

Define the following type of question - Intervention

A

What is the best treatment/therapy to deliver most benefit and cause least harm

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13
Q

Define the following type of question - Diagnostic Accuracy

A

How good is a test at differentiating b/w ppl with and without disease

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14
Q

Define the following type of question - Prognosis

A

progress of disease (gets better/worse/same?)

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15
Q

Define the following type of question - Aetiology

A

determines causal effect (cause of disease)

- factors associated with occurrence of disease?

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16
Q

Define the following type of question - Screening Intervention

A

is screening more effective than no screening or different screening?

17
Q

Types of studies related to past/current/future

A

Past: cohort, case-control

Current: survey, cross-section

Future: randomised trial
(look at diagram in lecture)

18
Q

Explain the following type of study- Randomised Control Trial

A
  • experimental
  • participants randomly divided into 2 (or more) groups
  • each group receives different intervention
  • measures effects of intervention
  • FUTURE
19
Q

Explain the following type of study- Cohort

A
  • observational/longitudinal study
  • study looking forward
  • follow participants over time and measure differences
  • participants with specific characteristics –> cohort
  • looking at: what risk factors predict disease, aetiology, prognosis, diagnosis
20
Q

Difference between cohort and case control study

A

Study looking forward –> cohort study

Study looking back –> case control study

21
Q

Explain the following type of study- Case-control

A
  • observational study
  • study looking back
  • participants with outcome already (e.g. disease) matched with participants with no outcome
  • looking back to see risk factors
  • risks, prognosis, diagnosis
22
Q

Explain the following type of study- Cross-sectional

A
  • observational study
  • sample population at particular point in time and see who has the outcome
  • how common is outcome?
  • risk factors
  • diagnosis
23
Q

What study is experimental?

A
  • randomised control trial
24
Q

Evidence Hierarchy

A 
systematic review >
randomised control trial > 
non-randomised CT >
Cohort (forward) >
Case control (backward) >
Cross section (present) >
Qualitative >
Expert opinion / Case reports
25
Q

What is the highest quality evidence?

A

Systematic reviews- looks at randomised controls trials and presents them all

26
Q

What is the lowest level of evidence?

A

Expert opinion - likely bias

27
Q

Are case reports high quality evidence?

A

NO - lowest with expert opinion

- looking at single Px

28
Q

Is hierarchy the same for all questions?

A

no- hierarchy is different for different questions

29
Q

What is critical appraisal?

A

Process of analysing research evidence to measure its quality

30
Q

What step do you integrate clinical expertise, Px values and best evidence

A

Apply

31
Q

What step requires the most skill

A

Apply

32
Q

What is the 6th step of EBP and what does it involve?

A

Audit

- evaluate your performance

33
Q

What does hierarchy of evidence mean?

A

Ranking of different types of studies in terms of most quality and risk of bias

34
Q

What step in EBP does CrowdCARE support?

A

Appraise

35
Q

A study examining the causal effect of obesity on breast cancer is an example of what type of question?

A

aetiology (b/c causal)

36
Q

A study examining use of aspirin to prevent stroke is example of what type of question?

A

intervention

37
Q

Examining link b/w diet and morbidity in Px’s with colorectal cancer is example of what type of question?

A

Prognosis

Px’s have disease and looking at how diet affects disease progression

38
Q

Examining use of leucocytes in abdominal fluid for diagnosis of appendicitis is example of what type of question?

A

Diagnostic Accuracy

39
Q

CARE in crowd care stands for:

A

Critical
Appraisal of
Research
Evidence

EIP (7 decks)

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