Module3 - Midterm

Question 1

What are three primary elements of EBM?

Answer 1

1. best scientific evidence
2. clinical experience
3. patient values

Question 2

What does evidence mean in Evidence-Based Medicine?

Answer 2

1. Totality of Evidence: best evidence is about current and TOTAL evidence, but not focusing on limited sample
2. Not all Evidence are equal
3. Evidence is necessary but not sufficient: clinical experience is needed and in addition, integrating the evidence and experience to take care of individual patient

Question 3

What are the five steps to patient care?

Answer 3

1. Ask
2. Acquire
3. Appraise (how serious is the risk of bias (validity); what are the results
4. Apply: generalize, significance of results
5. Act: shared decision making with patients

Question 4

errors will ultimately affect the ____ and ____ steps

Answer 4

appraise, apply

Question 5

What are the four clinical question types?

Answer 5

therapy, diagnosis, prognosis, etiology/harm

Question 6

Therapy

Answer 6

An evaluation of a therapeutic, or or preventative intervention

Better answered by (reduces error):
RCT > Cohort > Case Control > Case Series

Question 7

Diagnosis

Answer 7

An evaluation of a test, screening or other assessment such as history or physical exam

Better answered by(reduces error):
Prospective, blind comparison to a gold standard

Question 8

Prognosis

Answer 8

An evaluation of clinical outcomes over time

Better answered by (reduces error) :
Cohort > Case Control > Case Series

Question 9

Etiology/ Harm

Answer 9

An evaluation of a therapeutic, preventive, screening or diagnostic intervention, or a non-therapeutic exposure or behavior

Better answered by (reduces error):
RCT > Cohort > Case Control > Case Series

Question 10

Primary studies

Answer 10

hierarchy of study designs to minimize risk of bias
- not a sale or hierarchy of study design superiority

Question 11

What does EBM mean?

Answer 11

conscientiously working with patient to help them resolve or cope with problems related to their physical, mental, and social health.

Question 12

What are the three fundamental principles of EBM?

Answer 12

1. optimal clinical decision making requires awareness of the best available evidence, which ideally will come from systematic summaries of that evidence.
2. provides guidance to decide whether evidence is more or less trustworthy - how confident we can be
3. Evidence alone is never sufficient to make a clinical decision. look at patients values and preferences

Question 13

What is the hierarchy of evidence?

Answer 13

1. N-of-1 clinical trial (top)
2. Multiple-patient randomized trials
3. Observational studies: focus on outcomes important to the patient
4. Basic Research
5. Clinical Experience (bottom)

Question 14

What are the two major challenges for EBM?

Answer 14

time and ensuring that management strategies are consistent with patient’s values

Question 15

Knowledge and Skills necessary for optimal evidence based practice?

Answer 15

1. diagnostic expertise
2. In-depth background knowledge
3. Effective searching skills
4. Effective critical appraisal skills
5. more look at textbook