Introduction to evidence-based practice

Question 1

Define evidence based medicine

Answer 1

The conscientious explicit and judicious use of best evidence in making decisions about care of individual patients

Question 2

What is evidence based medicine the integration of?

Answer 2

is the integration of best research evidence with clinical expertise and patient values

Question 3

What is the need for evidence based medicine?

Answer 3

1. Change in disease levels
2. Advancement of technology
3. Different treatment philosophies
4. Increased patient expectations
5. Ethical and legal implication s
6. Emphasis on cost effectiveness
7. Resource constraints

Question 4

What does evidence based dentistry integrate?

Answer 4

1. The systemic assessments of clinical relevant scientific evidence relating to the patients oral and medical condition and history
2. The dentists clinical expertise
3. The patients treatment needs and preferences

Question 5

What os evidence based dentistry?

Answer 5

The process of making decisions based on known evidence

Question 6

What are the benefits of evidence based dentistry?

Answer 6

1. Improves the effective use of research in clinical practice
2. Uses resources more effective
3. Relies on evidence rather than authority for clinical decision making
4. Enables practitioner to monitor and develop performance

Question 7

Go through the 5 step mode;

Answer 7

1. ASK answerable questions
2. FIND the best evidence
3. APPRAISE the evidence for validity and clinical performance
4. ACT on the evidence
5. EVALUATE your performance

Question 8

Where do you find the evidence?

Answer 8

1. Medline/pubmed
2. The Cochrane library
3. Database of abstracts of reviews of effectiveness
4. Clinical trial s

Question 9

What do you check the you are appraising evidence?

Answer 9

1. Validity
2. Clinical importance
3. Clinical relevance

Question 10

What is validity?

Answer 10

It is the degree to which the results of the study are likely to be true, believable and free

Question 11

What is bias?

Answer 11

Bias is any facto that could change the study results in a non random way

Question 12

Name the 2 different types of validity

Answer 12

1. Internal validity

2. External validity

Question 13

What is internal validity

Answer 13

The extent to which the findings can sustain the conclusion

Question 14

What is external validity?

Answer 14

The extent to which the conclusion can be generalised to a wider population

Question 15

Name some biases that threaten internal validity

Answer 15

1. Information/ observational bias
2. Detection bias
3. Observer bias
4. Measuremtn bias
5. Interview bias
6. Recall bias
7. Reporting bias
8. bias due to confounding factors

Question 16

Name some biases that threaten external validity

Answer 16

1. Selection bias
2. Sampling bias
3. Non response bias

Question 17

How do we grade the quality of evidence?

Answer 17

On a scale:

I, II1, II2, II3, III

Question 18

What does it mean if the quality of evidence has been given a I

Answer 18

evidence is from at least one properly randomised controlled trials

Question 19

What does it mean if the quality of evidence has been given a II1

Answer 19

Evidence is from well-designed controlled trials without randomisation

Question 20

What does it mean if the quality of evidence has been given a II2

Answer 20

Evidence from well-designed cohort or case-controlled analytic studies, preferably from more than one centre or research group

Question 21

What does it mean if the quality of evidence has been given a II3

Answer 21

Evidence from comparisons between times or places with or without the intervention. Dramatic results in uncontrolled experiments.

Question 22

What does it mean if the quality of evidence has been given a III

Answer 22

The evidence is based on the opinion of respected authorities based on clinical experience, descriptive studies or reports of expert committee

Question 23

How do we grade the type and strength of evidence?

Answer 23

It is graded on a scale of 1-5

Question 24

What does it mean if the type and strength of evidence is given a grade of 1?

Answer 24

Theres string evidence from at least one published systematic review of
multiple well-designed randomised controlled trials

Question 25

What does it mean if the type and strength of evidence is given a grade of 2?

Answer 25

Theres strong evidence from a t least one published properly designed randomised controlled trial of appropriate size and in an appropriate clinical setting

Question 26

What does it mean if the type and strength of evidence is given a grade of 3?

Answer 26

Theres evidence from published wwell-designed trials without randomisation, single group pre, post, cohort, time series or matched case-controlled studies

Question 27

What does it mean if the type and strength of evidence is given a grade of 4?

Answer 27

Theres evidence from well researched experimental studies from more than one centre or research group

Question 28

What does it mean if the type and strength of evidence is given a grade of 1?

Answer 28

Theres Evidence of respected authorities, based on clinical experience, descriptive studies or reports of expert committee

Question 29

What is the gold standard for clinical trials?

Answer 29

Doing a randomised controlled trial

Question 30

What are randomised controlled trails the best at assessing?

Answer 30

The cause and effect relationship between treatment and outcomes