L3 - EBM

Question 1

What is EBM?

Answer 1

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

Question 2

State criticisms of EBM

Answer 2

1) Only for teaching and not in real life
2) Clinicians don’t have time to critically appraise articles
3) Translation of results to clinical practice may not be feasible
4) EBM leads to jargon which can be used inappropriately by politicians

Question 3

Does EBM replace clinical decision making?

Answer 3

No, it should only be used to help. The patient and clinicians thoughts should also be considered.

Question 4

Order evidence in best to worst

Answer 4

Systematic review + meta-analyses, RCT, cohort, case-control, ecological, descriptive/cross sectional, case-report/series

Question 5

Uses of EBM

Answer 5

Patient care, safety protocol, medical knowledge, professionalism, practice-based learning, improvement and progress, interpersonal development, communication skills, identification of aetiological agents, interpretation of symptoms, differential diagnosis, prognosis

Question 6

Describe SIDS on child mortality

Answer 6

20% child mortality in 1955

Question 7

Explain changes in SIDS advice

Answer 7

1970s - lie baby on front - this led to increased death
1980s - series of case-control studies - odds ratios performed - lying on front, over-covering, thermal insulation, head covering increases risk

Question 8

Describe changes in cot death

Answer 8

Public health campaign launched in 1991, saw deaths plummet by 75% from 1326 in 1989 to 316 in 2009