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8 Cards in this Set
- Front
- Back
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General model for deliverting scientifically grounded medical care
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Generalizable scientific knowledge + particular pt leads to a measurable outcome
Explore a method for summarizing evidence is what you do to attain generalizable scientific knowledge To integrate the knowledge and pt you must hear stories about applying this information in clinical care. |
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Quality of evidence hierarchy
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Lowest to highest
At least one RCT Controlled trials without randomization Cohort of case-control studies Multiple time series or dramatic results Agreement among respected authorities. |
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Quality of evidence grades
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A - Found good evidence that the service improves health - benefits outweight harms
B - Fair evidence... C - Balance of benefits and harms are too close to tell D - Service is ineffective and harms outweight benefits I - Service is bad. |
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What EBM is NOT
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Common practice
impossible to practice culinary medicine a cost cutting strategy restricted to randomized clinical trials and meta-analyses. |
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How to practice evidence based medicine
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Formulate a clinical question
Find the best evidence Eval and summ that evidence Apply to clinical care Evaluate performance. |
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Categories of clinical questions
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Dx test - test accuracy
Px - Risk Tx - effectiveness |
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Framing an answerable question
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Define the pt or clinical problem
What is the test or intervention? Who is the comparison group? Define diagnosis or outcome |
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The things that make up a treatment question:
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Patient or clinical problem
“In this postmenopausal woman with possible early osteoporosis” Intervention “is the addition of alendronate” Comparison “compared to current treatment with estrogen, calcium and Vitamin D” Diagnosis or Outcome “associated with a stabilization of her bone density?” |
