Lecture 14 - EBM

Question 1

PrISM

Answer 1

Prescription information services of Manitoba

Question 2

List examples of an EBM source and a drug info source

Answer 2

EBM resource = RxFiles or PubMed

Drug Info resource = Lexicomp

Question 3

How many hours per day would it take to read all of literature relevant to primary care ?

Answer 3

21 hours per day

*obvs not possible

Question 4

Explain the usefulness “Equation”

Answer 4

U = R x V / W

Usefulness = Relevance x Validity / Work

Relevance - very easy to tell, ex if you’re a diabetes educator and you read a diabetic article then it’s relevant to you

Validity - amorphous information

Question 5

What is the goal?

Answer 5

to find the most trusted and relevant information in the shortest time

Question 6

We should continually ask which questions?

Answer 6

• What is your process for obtaining evidence?
• How good is your process?
• Am I spending too much/too little time ?

Question 7

What are 2 reasons to why we do research?

Answer 7

• “Just in time” information

- “Keeping up” information

Question 8

What are 4 broad ways that we gather information ?

Answer 8

• Search the primary literature directly and synthesize your own interpretation
• Utilize a resource that pre-searches the literature for what is “important”
• Utilize resources that searches and interprets and synthesizes a complete narrative

Question 9

Where do you go to find out what trials are currently being run?

Answer 9

ClinicalTrials.gov

*all clinical trials are registered here

Question 10

What is Evidence Updates from BMJ ?

Answer 10

it looks at the 130 top powered journals in the world and is literally just getting the abstracts of those and the fact that it is there and it has relevance to certain areas

you can pick which abstracts you want sent to you

Question 11

What is an ACP journal club?

Answer 11

a quick way to gain information on the study

Question 12

Describe the hierarchy of research evidence

Answer 12

Top to Bottom:

• Systemic Reviews
• Critically-Appraised Topics [Evidence Syntheses and Guidelines]
• Critically-Appraised Individuals articles [article synapses]
• RCTs
• Cohort studies
• case controlled studies (case series/reports)
• background info/expert opinion

Question 13

What does Common Drug Review (CDR) do?

Answer 13

Tells provincial payers if they should pay

• Literature evaluation of new drugs for listing on provincial formularies
• Answers, “why is drug X not paid for”?

Question 14

Describe therapeutic initiative

Answer 14

funny but brutal reviews

Question 15

What is a Decision Box ?

Answer 15

You put all your factors into it and it will tell you how a medication will change your health status ??

**same idea as Mayo Clinic for osteoporosis or Framingham for CVD risk

Question 16

What are the Do’s ?

Answer 16

-Whenever possible, do the clique yourself first (for RCTs)
-Then, look at critiques/commentaries from reliable sources
-This will help you to do 2 things:
1-Pick up on things you missed
2-Get better at doing this by seeing how others do it

• Explore many resources (remember the usefulness equation) and identify the most useful for your practise scenario
• Bookmark your top resources (“Just in time” or “Keeping up”)_

Question 17

What are the Don’ts ?

Answer 17

• Reinvent the wheel or conduct a complete analysis when someone you trust has created something already
• Use just one resource