Reading and Interpreting Medical Papers

Question 1

Where can we find medical papers?

Answer 1

The library, Internet, and references in articles

Question 2

The types of articles in paper include original research, case reports, early reports, editorials, commentary, research letters, letters to the editor, correspondence, and reviews. What are three types of reviews?

Answer 2

Meta-analyses, state-of-the-art reviews, and clinical updates

Question 3

What are the contents of original research?

Answer 3

Abstract, introduction, methods, results, discussion, references

Question 4

Tell readers crucial information about the article that allows them to decide whether to read the article in its entirety

Answer 4

Abstract

Question 5

The abstract identifies the

Answer 5

Focus of the study

Question 6

A problem in an abstract whereby the data given in the abstract is given differently than in the body

Answer 6

Inconsistency

Question 7

A problem in an abstract whereby data is given in the abstract but not in the body

Answer 7

Omission

Question 8

If an abstract displays inconsistency, omission, or both, the abstract is deemed

Answer 8

Deficient

Question 9

What are three types of observational studies you may see in the design of analytical studies?

Answer 9

1. ) Cross-sectional (prevalence)
2. ) Case-control (retrospective)
3. ) Cohort (prospective or retrospective)

Question 10

Type of observational study where you may look at a group of diseased and non-diseased people and look into their past to see if they were exposed or not exposed to a certain factor

Answer 10

Case-control study

Question 11

What are two types of clinical trials?

Answer 11

Preventative and therapeutic

Question 12

Clinical trial where people WITH a disease are randomized and sorted into a treatment group and a control group and studied to see if the treatment is effective at combating the disease

Answer 12

Therapeutic Clinical Trial

Question 13

Clinical trial where people WITHOUT a disease are randomized and sorted into a treatment group and a control group and studied to see if the treatment prevents the disease

Answer 13

Preventive Clinical Trial

Question 14

It’s main goal is to combine the results of previous studies to reach summary conclusions about a body of research

Answer 14

Meta-Analysis

Question 15

Has the following steps:

1. ) Identify studies with relevant data
2. ) Define inclusion and exclusion criteria
3. ) Abstract data
4. ) Analyze abstracted data statistically

Answer 15

Meta-analysis

Question 16

Becoming increasingly important in medical literature

Answer 16

Statistical methods

Question 17

Gives the findings from the research

-Directed at questions posed in the introduction

Answer 17

Results and Discussion

Question 18

If you wanted to know how many people in New Jersey currently had a headache, what type of study would you perform?

Answer 18

Cross-sectional study

Question 19

In peer-review publication, the editor reviews the manuscript and either rejects it, or assigns it to reviewers for

Answer 19

External evaluation

Question 20

The reviewers then review the manuscript and make recommendations to the

Answer 20

Editor

Question 21

The editor then decides whether to

Answer 21

Reject the work, modify the work, or publish the work

Question 22

What is the strongest source of evidence? What is the second strongest?

Answer 22

1. ) Systematic review

2. ) RCT

Question 23

The 2011 OCEBM levels of evidence say that the first level for finding out how common a problem is, is a

Answer 23

Local and current random sample survey

Question 24

The levels are NOT dismissive of

Answer 24

Systematic reviews

Question 25

The levels are NOT intended to provide you with a definitive judgement about the quality of

Answer 25

Evidence

Question 26

The levels will NOT provide you with a recommendation or tell you if you are asking the

Answer 26

Right question

Question 27

Identifies the best available evidence from within a large body of research -needed because there are too many papers and too little time

Answer 27

Critical Appraisal

Question 28

How many articles a day would you need to read to keep up with the current literature?

Answer 28

10,000

Question 29

Rutgers university libraries, orxford center for EBM, and enhancing the QUAlity and Transparency of health research (EQUATOR) network are all resources for

Answer 29

Appraisal tools

Question 30

The oxford centre for EMB's randomized controlled trials critical appraisal sheet is an example of a

Answer 30

Tool for critical appraisal

Question 31

The first question asked by the RWJMS general article review sheet is

Answer 31

What is the overall design of the study?

Question 32

The second question asked by the RWJMS general article review sheet is

Answer 32

What is the overall question addressed by the study?

Question 33

The third question asked by the RWJMS general article review sheet is

Answer 33

What is the the PICO?

Question 34

The fourth question asked by the RWJMS general article review sheet is

Answer 34

Determine the validity (should I believe the results?)

Question 35

When determining the validity, you want to look for common sources of

Answer 35

Error (i.e. bias or inadequate blinding)

Question 36

If error do exist, you must ask yourself if these errors are

Answer 36

Fatal Flaws

Question 37

When reading an article, you always want to determine the applicability, in other words, can you apply the results to your

Answer 37

Patient

Question 38

Referral patients tend to be

Answer 38

Sicker

Question 39

Volunteer patients tend to be

Answer 39

Less sick

Question 40

You always want to beware of composite and surrogate (non-patient important)

Answer 40

Outcomes

Question 41

When reading a paper, you always want to ask if the study used was the best study to answer the

Answer 41

Question

Question 42

The question: was the assignment of patients to treatments randomized? would be answered in

Answer 42

Methods

Question 43

The question: were the groups similar at the start of the trial? would be answered in the

Answer 43

Results

Question 44

The question: aside from the allocated treatment, were groups treated equally? would be best answered in the

Answer 44

Methods and results

Question 45

When you are determining how large the treatment effect was, you want to ask yourself

Answer 45

What is the measure? i.e. RR, ARR, RRR, NNT?

Question 46

Encompasses various initiatives to alleviate the problems arising from inadequate reporting of randomized controlled trials

Answer 46

CONSORT

Question 47

Measures how likely that any apparent differences in outcome between treatment and control groups are real and not due to chance.

Answer 47

Statistical Significance

Question 48

Measures how large the differences in treatment effects are in clinical practice.

Answer 48

Clinical significance

Question 49

Statistical significance is defined using a

Answer 49

P-value

Question 50

Clinical significance is defined using

Answer 50

RR, ARR, and NNT

Question 51

Important resources for obtaining evidences from scientific and clinical research to facilitate practicing evidence-based medicine

Answer 51

Medical Papers

Question 52

Understanding the key study design (cross-sectional, cohort, RCT), will enable you to better distinguish the

Answer 52

Levels of evidence

Question 53

What level of evidence is represented by the results of an RCT?

Answer 53

Level I

Question 54

Obtained from well-designed controlled trials without randomization.

Answer 54

Level II-1 evidence

Question 55

Obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

Answer 55

Level II-2 evidence

Question 56

Opinions of respected authorities

Answer 56

Level III evidence