Evidence based healthcare

Question 1

When is a causal link likely?

Answer 1

If a biological plausible mechanism is demonstrated (if it makes sense biologically)

Question 2

How is biological plausible mechanism limited?

Answer 2

By current knowledge - may know something helps but not HOW

Doesn’t guarantee association

Question 3

Evidence based medicine

Answer 3

Conscientious (search)
Explicit (appraised)
Judicious (appropriate)
Using clinical expertise

to make decisions about healthcare

Question 4

What is evidence based medicine now?

Answer 4

Cookbook medicine - clinical expertise must decide if this external evidence applies to individual

Question 5

Evidence based medicine (3)

Answer 5

Clinical judgement
Relevant scientific Evidence
Patients values and preferences

Question 6

Hierarchy of evidence

Answer 6

Systematic reviews (highest)
Critically appraised

Randomised control trials
Cohort studies
Case-control
Expert opinion (lowest)

Question 7

What does scientifically proven to work mean?

Answer 7

It is better than other treatment
OR
You are more likely to benefit than not

Question 8

Calculating relative risk

Answer 8

Deaths / total people in each case (placebo vs drug) = risk

placebo risk / drug risk

Question 9

Calculating risk difference

Answer 9

Deaths / total people (calculates risk)

placebo risk - drug risk

Question 10

Number needed to harm

Answer 10

100 / risk calculated

deaths/ total people in each case = risk