Evidence Based Practice

Pregunta	Respuesta
What makes up EBM intersection?	Intersection of individual clinical expertise, best external evidence, and patient value and expectations.
Waht is EBM ?	Set of tools and disciplined approach to informing clinical decision making by applying best evidence available
what is the hieararchy of evidence?	studies--> synopses--> synthesis reviews--> synopses of syntheses--> summaries--> system actionable knowledge
what are the 4 tier sources of evidence?	studies -> synthesis-->synopses-> systems
where sources are in the evidence category "studies"	journal articles
What is in the syntheses category of evidence hieararchy?	systematic reviews?
what are in the synopses category of evidence hierarchy?	Textbooks, compenium, guidelines
what are in system category of evidence hierarchy?	Rules, order sets, guidelines
what is the process of applying EBM?	phrase a clinical question that is pertinent and answerable, identify the evidence to answer the question, critically appraise the evidence to determine if applies to a patient
what is the process of applying EBM?	phrase a clinical question that is pertinent and answerable, identify the evidence to answer the question, critically appraise the evidence to determine if applies to a patient
what is a background question?	ask for general knowledge about a disorder , usually answered in review articles or textbooks
What is a foreground question?	ask for knowledge about managing patients with disorder, using EBM techniques
What are the 4 essential components of a foreground question	PICO patient/problem Intervention Comparison of intervention Outcomes
What are the 4 essential components of a foreground question	PICO patient/problem Intervention Comparison of intervention Outcomes
List four categories of Foreground questions	Intervention Diagnosis Harm Prognosis
what is the treatment effecT?	difference btw an intervention on a population on a population of interest vs. control population
What is the control Event Rate?	Risk of even from control intervention = CER = had event/had event+no event in the control population
what is the experimental Event Rate?	risk of event from experimental intervention - EER - Had Event / had event + didn't have event in the experimental population
what is the relative risk of experimental intervention?	Experimental event rate/control event rate = RR = EER/CER
what is the Hazard ratio ?	used in treatment context to indicate survival over time
what is the relative risk Reduction from an experimental intervention?	Relative risk reduction (RRR ) = 1-RR
what is the absolute risk reduction?	ARR = control event rate - Experiemental Event rate
WHat is the number to treat ?	NNT = 1/ARR 1 over Absolute Risk Reduction
What is ACP PIER rating scheme?	In guidelines, it is a rating of quality of the evidence
what are the limitations of Guidelines?	may not apply in complex patients, may be incomplete or inaccurate, difficult to implement in EHRs due to need for precise coding of logic and worfklow integration, and there may be significant COI associated with authors.

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	Creado por Michael Riben hace alrededor de 11 años