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EBM 2
Fichas del conjunto (28)
- 1Define EBM1. the conscientious, explicit, and judicious use of current best evidence in making clinical decisions about the care of the individual patients.
2. The practice of EBM means integrating
individual clinical experience with the best available external clinical evidence
from systematic research. - 2Aside from current evidence based. EBM incorporates two important aspects which are ---------?1. clinical experience
2. patient values - 3List factors that are part of patient values and circumstances.1. individualized preferences,
concerns, expectations
2. financial resources of the patient. - 4Key skills require to successfully practice EBM are -----?1. developing a structured clinical question
2. formulating a systematic search strategy to obtain the best available evidence
3. evaluating the literature properly
4. comprehending the study results
5. incorporating evidence into patient care. - 5patient-oriented evidence that matters (POEM) focuses include ------- ?1. “quality of life,
2. improving function
3. staying independent
4. overall mortality, and
5. cost-effectiveness - 6List the six steps of applying the evidence-based medicine (EBM) process.1. Create an answerable clinical question.
2. Find the best evidence.
3. Critically appraise the evidence.
4. Integrate evidence with clinical judgment/expertise and patient preferences.*
5. Implement intervention or apply the evidence.
6. Evaluate the effectiveness of the intervention. - 7Internal validity describes ---------?degree to which the intervention or treatment contributes to the results
- 8External validity describes --------- ?1. describes the generalizability of the results to a population (or patient) of interest
2. External validity is the extent to which the results apply to the population of interest - 9List the four components of a well-formulated question:PICO:
1. patient (or problem)
2. intervention (drug the pt is on)
3. comparison (or control) [alternative drug]
4. outcome [ effect or result expected] - 10What is PICO use for?PICO search strategy results in a well-built, searchable question that is relevant to the patient and specific for the clinical situation.
- 11Define Experimental studies/designs + Examples.1. Experimental studies contain at least two groups in which members
of one group receive active therapy and members of the other group may receive the standard of care or placebo.
2. Researchers measure effects of therapy on predetermined
outcomes.
3. Example is RCT - 12What is the major advantage of RCT designs?controls for known and unknown confounders.
- 13How is systematic error or error by chance in RCT is checked/reduced?Randomization = limits selection bias
- 14RCT designs can be affected by cofounder, define cofounder.Confounders are independent factors related to both the outcome and treatment
- 15In RCT, how do you limit cofounders?Use Inclusion and exclusion criteria.
- 16In RCT, what is the use of randomization?To limit selection bias
- 17In RCT, what is the use of blinding?To limit Hawthorne effect
- 18In RCT what is Hawthorne effect?is a type of bias in which patients respond to therapy (either control or treatment) because they are being studied
- 19In RCT, what is a placebo effect?is a type of Hawthorne effect in which patients respond favorably to placebo.
- 20In RCT, what element is assessed?Efficacy
- 21Explain observational studies1. participants may be assigned to groups, but are not assigned a treatment or therapy.
2. Researchers observe participants for the desired outcome.
3. assess drug effectiveness. - 22Identify factors that determine the internal validity of experimental and observational trials1. Confounding [inclusion and exclusion]
2. duration of therapy
3. dosage
4. primary outcome
5. surrogate outcomes - 23In RCT, what is a noninferiority study?1. a study that permits researchers to randomize patients to receive active drug or the drug considered as the gold standard.
2. Researchers design the study to show that the new treatment is not inferior to the standard treatment.
3. In doing so, a noninferiority margin is established a priori. - 24Explain observational studies1. Results from observational studies answer questions about treatment, prognosis, and harm and shed light on questions about therapy, specifically under real-world conditions and not ideal conditions, as set forth in the RCT.
2. Results from observational studies
only draw associations between therapy and outcome rather than cause and effect between treatment and disease. - 25List Xteristics of case-control1. Identify RF 1st w/ an event of disease
2. often used in studying rare diseases.
3. could have confounders (like RCT)
4. Outcome is measure in OR
5. It is only retrospective
6. watch out for selection bias and recall bias
7. Patient's outcome is known before the study. - 26In case-control, how do you minimize confounding?match cases to controls based on
patient characteristics such as age, sex, and comorbidities - 27In case-control, factors that influence internal validity includes --------?1. Selection bias
2. recall bias - 28Xteristics of cohort includes-----?1. researchers follow a group of people (a cohort), of which some have the
exposure of interest and some do not.
2. Can be retrospective or prospective