Session 4 Flashcards
What is evidence based medicine?
The use of mathematical estimates of the risk of benefit and harm, derived from high-quality research on population samples, to inform clinical decision making in diagnosis, investigation or management of patients.
What are the 5 steps of evidence based medicine?
1) Formulate the question.
2) Find the best evidence.
3) Critically appraise the evidence.
4) Implement the results into clinical practice.
5) Evaluate our performance.
How can you formulate a question for evidence based medicine?
Think of a clinical question based on a patient, treatment decision, from colleagues, etc.
Use the PICO structure:
- Patient.
- Intervention.
- Comparison/ control.
- Outcome.
What questions should you ask when finding the best evidence?
Is the article relevant to my interest?
Is there a clear research question?
When was it published?
Has it been peer reviewed?
Do I want to proceed?
What is peer reviewing?
The evaluation of work done by one or more people with similar competencies as the producer of the work.
The research is trying to add new knowledge to the field so the reviewers should be experts in the field.
What errors may lead to a study being rejected via the peer review process?
The study didn’t address the important scientific issue.
The study was not original.
The study didn’t test the hypothesis.
A different type of study should have been done.
The sample size was too small.
The protocol of the original study was compromised.
The study was uncontrolled or inadequately controlled.
The statistical analysis was incorrect or inappropriate.
There is a significant conflict of interest.
The paper was written poorly to the point it was incomprehensible.
What is critical appraisal?
The process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context.
How can search terms be developed?
If there are very few results then widen the search.
If there are many results then narrow the search.
What is confirmation bias?
How people evaluate evidence differently if it supports our preconceptions compared to evidence that challenges our ideas.
People may accept evidence if it agrees with prior preconceptions but challenge it if it disagrees.
What is the structure of a paper?
What are the weaknesses for the methods of conduction of a study?
Selection bias.
Data collection methods.
Confounding.
What is selection bias?
A systematic difference between those that have participated in the study and those that have not.
How can data collection methods impact a study’s findings?
It can rely on recall - recall bias.
The method in which people were recruited.
People who started the study but dropped out.
Response rate of those that saw the study.
How can confounding affect a study?
Confounding is another variable that affects the outcome of a study.
These may not be acknowledged or adjusted for.
What are the aims of the presentation of results?
The question has been answered.
It can be applied to other groups or populations - it can be generalised.
The findings easily understood so conclusions can be drawn about it, by the author and the people reading it.
