Irving slides- quiz 2

Question 1

What is EBM?

Answer 1

combination of individual clinical expertise and the most up to date research to make informed clinical decisions regarding a patient’s individual care

Question 2

Who was the founding father of EDM?

Answer 2

Archibald Cochrane

Question 3

Prior to the Cochrane database that allows for better access to literature, the literature was described as what?

Answer 3

fragmented; meaningful conversations across disciplines was difficult

Question 4

What are the 3 pieces of the EBM venn diagram?

Answer 4

individual clinical expertise, best external evidence, patient factors

Question 5

What are the 5 steps (the 5 A’s) of EBM?

Answer 5

1. ask a clinically relevant question
2. acquire the evidence
3. appraise the evidence
4. apply the evidence
5. assess your performance

Question 6

What is the ACO?

Answer 6

accountable care organization; groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients

Question 7

What goes up when we are practicing EBM?

Answer 7

quality of care

Question 8

EBM wants to reduce cost by doing what four things?

Answer 8

1. eliminating waste
2. preventing complications
3. preventing medical errors
4. reducing readmissions

Question 9

Why does EBM aim to improve prognostication?

Answer 9

if we can do a better job to anticipate disease trajectory, we can do a better job to anticipate what will happen and what we should do

Question 10

forecasting is equal to what?

Answer 10

prognosis

Question 11

Evidence comes from places like journals, clinical trials, books, etc. and is filtered through a funnel to create what?

Answer 11

evidence based guidelines that can be used to inform practice, but must be individualized to a particular patient scenario

Question 12

When considering if the evidence applies to the patient, what four things should be considered?

Answer 12

1. demographics
2. confounding factors
3. benefits
4. risks

Question 13

What are the demographics?

Answer 13

how closely does the study subjects (evidence) match the patient(s)

Question 14

what are confounding factors?

Answer 14

an extra variable that you did not account for that can affect the results of a study

Question 15

what are some examples of confounding factors?

Answer 15

1. co-morbidities
2. dietary influences
3. drug interactions
4. genetics

Question 16

What does it mean to weigh the benefits vs. the risks?

Answer 16

have to consider how the patient will benefit and if the intervention will help the patient meet their goals and if these benefits outweigh the potential harm to the patient

Question 17

Long term use of PPI’s can lead to what?

Answer 17

cognitive impairment, problems with gut microbiome, loss of bone density, increase pneumonia risks, and other nutrition problems

Question 18

Why is autism diagnosed more often in boys than girls?

Answer 18

initially only boys were studied so it was thought that only boys could have autism; girls also may have a higher social intelligence at a young age and can mimic behavior

Question 19

why did the 95 year old lady with CAD and hx of MI in the example in class keep experiencing falls?

Answer 19

from taking lovastatin which can cause musculoskeletal issues in the long term

Question 20

In the teeth brushing article in class, brushing elderly patient’s teeth at least twice a day was thought to help reduce the risk of what?

Answer 20

pneumonia by preventing aspiration of bacteria from the teeth into the lungs

Question 21

In the azithromycin article regarding COPD discussed in class, what was the main benefit observed?

Answer 21

people taking azithromycin experienced less COPD exacerbations

Question 22

what were some of the adverse events seen from taking azithromycin for COPD exacerbations?

Answer 22

• macrolide resistance

- hearing impairment

Question 23

in the example in class where the 88 year old lady taking coumadin for a fib was experiencing frequent falls, why was she switched to aspirin instead of continuing coumadin?

Answer 23

coumadin can put older patients at a higher risk for hemorrhage and the dose should be adjusted as they age; with the lady’s fall history, her risk of falling and developing a hemorrhage was greater than the risk of her having a stroke several years from now, so she was switched to aspirin to still thin her blood without the increased risk for hemorrhage