Lecture 33 - Evidence - based practice

Question 1

What is evidence based practice

Answer 1

EBP integrates the best available research evidence, clinical expertise and patient values to guide medical decisions and practices

Question 2

Three pillars of evidence based practice

Answer 2

1. Best available evidence
2. Clinical expertise
3. Patient values and choices

Question 3

Why is it important to evaluate research in EBP

Answer 3

Evidence is constantly evolving and healthcare professionals need to critically appraise studies to ensure their relevance, validity and applicability to patient care.

Question 4

What is conservative treatment

Answer 4

Doing nothing is non-inferior ( e.g. no treatment is treatment)

Question 5

What is the hierarchy of evidence

Answer 5

The hierarchy of evidence ranks study design based on their ability to minimise bias, from systematic reviews and RCTs at the top to expert opinion. and Anecdotal at the bottom

Question 6

Why is good evidence important for interventions

Answer 6

Without good evidence, ineffective treatments may be used, harmful treatments may be administered and effective interventions may be overlooked

Question 7

What was the impact of the incorrect recommendation for infant sleeping position

Answer 7

Thousands of infant deaths from sudden infant death syndrome (SIDS) could have been prevented if evidence supporting the back-sleeping position had been systematically reviewed earlier

Question 8

What did the MMR vaccine autism debacle illustrate about EBP

Answer 8

It showed how poor-quality research can lead to harmful myths, like the false link between MMR vaccines and autism, resulting in decreased vaccination rates and increased measles cases

Question 9

Good evidence is vital, otherwise;

Answer 9

• Ineffective treatment are used (e.g. hydroxychloroquine for covid)
• Give treatments for which the harms outweigh the benefits (e.g. chest drain pneumothorax)
• Fail to provide effective intervention (e.g. MMR vaccine)
• New expensive treatments may be no better than older cheaper ones

Question 10

It can be difficult to communicate the evidence:

Answer 10

• Adverts backed by dubious scientific claims
• Endorsements by prominent people (e.g. trump covid 19)
• Scares and conspiracy theories
• The values that people on individual stories may lead people to ignore objective evidence