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EBM Exam 1

  1. What is EBM?
    • systematic approach
    • integrating best scientific evidence with clinical judgement/experience
    • providing best clinical decisions
  2. Why do we need EBM?
    • sources of knowlege for decision making
    • reference tradition
    • reference authority
    • trial and error
    • logical reasoning
    • scientific method
  3. comparative trials
    • head to head
    • similar control
    • dissimilar control
  4. head to head trials
    strong recommendations can be made
  5. similar control trials
    recommendations can be made with caveats
  6. dissimilar control tirals
    comparissons can be discussed
  7. observational trials
    • cohort
    • case control
  8. cohort trials
    no cause-effect relationship can be drawn
  9. case control trials
    no cause-effect relationship can be drawn
  10. trials that provide observations only with some speculation
    • case study
    • case series
    • case report
  11. trials for best clinical evidence
    randomized control trials
  12. why not just use clinical experience/judgement
    we tend to overestimate efficacy and underestimate safety risks
  13. 5 step process
    • define clinical question
    • retrieve literature
    • evaluate critical literature
    • categorize quality of evidence
    • develope conclusion and recommendation
  14. Tools to evaluate literature
    • 33 item check list
    • ten major considerations
  15. 10 majors
    • power set/met?
    • dosage/treatment regimen appropriate?
    • length of study appropriate to show effect?
    • inclusion criteria adequate?
    • exclusion criteria adequate?
    • blinding present?
    • randomization resulted in similar groups?
    • biostat tests appropriate for type of data analyzed?
    • measurement standard/validated/accepted practice?
    • author's conclusions supported by results?
  16. Level 1 confidence
    • interventional study
    • randomized control group
    • power met
  17. Level II confidence
    • Interventional study
    • control group randomized
    • power not met
  18. level 3 confidence
    • observational study
    • prospective cohort
    • not randomized
  19. level IV confidence
    • observational study
    • retrospective
    • not randomized
  20. level V confidence
    • interventional/observational
    • no control group
    • not randomized
  21. Recommendations are based on
    • efficacy
    • safety
    • cost
    • other considerations
Author
Rx2013
ID
130304
Card Set
EBM Exam 1
Description
application of the 5 step process
Updated

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