What Is EBM

Question 1

What are the 4As?

Answer 1

Assess, access, appraise, apply/act

Question 2

What are the components of PICOS?

Answer 2

Population, intervention, comparator, outcome, study design

Question 3

What is the hierarchy of evidence for cause and effect?

Answer 3

SRs
RCT
Cohort 
Case control 
Case series 
Consensus/expert opinion

Question 4

What is the order of search for answer to clinical question?

Answer 4

1. Search for clinical guidelines
2. Search for evidence summaries
3. Search for systematic reviews
4. Search for primary research in bibliographic database
5. Consider asking information specialist to help with search design

Question 5

What should you do if find an answer to a clinical question regardless of type of research?

Answer 5

Appraise, adapt, adopt evidence

Question 6

Where can you search for clinical guidelines?

Answer 6

NHS Evidence

Question 7

Where can you find primary evidence?

Answer 7

Medline, embase

Question 8

What questions should you ask when appraising a paper?

Answer 8

Do I trust the results? - bias and confounding (quality of conduct)
What are the results? - direction, size, precision (relative risk/risk difference)
CASP critical appraisal checklist
AGREE tool criterial appraisal checklist for guideline quality

Question 9

What 3 elements should you look at when seeing what results are?

Answer 9

Direction, size and precision

Question 10

What is important for applying evidence you find?

Answer 10

patient’s ICE, context of evidence similarity to real-life context, doctors experience and expertise, harms of treatment, cost etc

Question 11

What are reasons for not using an RCT for cause and effect questions?

Answer 11

Ethical constraints, logistical issues (would have to recruit masses of people for rare outcome)