WEEK 19 Flashcards
What is evidence based medicine
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients
Why use EBM
Leads to improved quality of care
-identifying and promoting practices which are proven to work
-eliminating practices that are ineffective or harmful
Develop critical thinking(rather than intuition or habit)
Requires that interventions and tests are scrutinized and proven
5 step EBM model
Ask
Acquire
Appraise
Apply
Assess
Expect opinion, level?
VII
Systemic review or meta analysis of all relevant RCTs (randomized controlled trial) level?
Level I
At least one RCT level?
Level II
Controlled trials without randomization (quasiexperiement) level?
Level III
Case control or cohort studies
Level IV
Descriptive ans qualitative studies
Level V
Single descriptive or qualitative study
Level VI
Evidence is further graded for quality as follows?
High quality
Good quality
Low quality or major flaws
Discuss ask in the 5 step EBM model
The question that need to be solved should be: clear
Directly focused on the clinical problem
Able to be resolved by the research evidence
A framework for this question is as follows:
Patient or Problem
Intervention
Comparison Intervention
Outcome
Discuss about Acquire evidence
Seek relevant evidence to answer the clinical question. Textbook and journals may be out of date.
Colleagues or experts may be consulted (see hierarchy or evidence)
Online electronic database-thousands of articles, large number or journals relatively quick
Learn how to search database effectively
Examples of online clinical database
Midline, Pubmedz and conchrane
Discuss Appraise the evidence
Appraise the evidence found for validity, importance and applicability to the patient/problem
Critical appraisal of research is an important skill to learn
Critical appraisal tools (checklist) commonly used to differ depending on type of study
