Why EBM?

Question 1

Why is evidence based medicine important?

Answer 1

• to treat patients
• patient safety
• medical knowledge
• re validation
• professionalism
• practice- based learning
• communication

Question 2

What are some of the problems with evidence based medicine?

Answer 2

• not relevant in clinical practice?
• takes too much time
• confusing for patients (statistics)

Question 3

What things is evidence used for in clinical practice?

Answer 3

• Clinical findings and how to attain the right info and interpret it properly
• Aetiology identification
• Differential diagnosis
• Diagnostic test - picking and confirming
• Prognosis
• Therapy selection
• Prevention

Question 4

What is the order of the hierarchy of studies (lowest to highest)?

Answer 4

Animal/lab studies, case report, cross sectional study, ecological study, case control, cohort, randomised control, systematic review/meta analysis

Question 5

What are systematic reviews/meta analyses?

Answer 5

Analysing data from other trials - pooling of results

Question 6

What is a randomised controlled trial?

Answer 6

Used to trial, manipulation of independent variable

Question 7

What is an advantage and a disadvantage of RCT?

Answer 7

Large size needed to get good effect, expensive, missing trials can make results bias, inappropriate controls, cause and effect established

Question 8

What is a cohort study?

Answer 8

Using a group of people before they get an illness and look retrospectively at the exposure/risk factors. Follow through to see how develops condition.

Question 9

What is an advantage and a disadvantage of cohort studies?

Answer 9

Less prone to bias, good for common conditions, very time consuming

Question 10

What is a case control study?

Answer 10

Those with a condition and those without are compared to look for risk factors etc. ALWAYS RETROSPECTIVE

Question 11

State an advantage and disadvantage of case control studies

Answer 11

cheap, quick, good for rarer conditions, but retrospective so reliable?

Question 12

What is an ecological study?

Answer 12

It is a descriptive study. Uses correlations between populations using exposures

Question 13

What is a cross sectional/descriptive study and what is a disadvantage of it?

Answer 13

Surveys or analysis

Cannot establish cause and effect

Question 14

What is a case report?

Answer 14

Describing one case - not used in EBM alone

- can be useful in rarer conditions

Question 15

What is homeopathy?

Answer 15

uses principle - like causes like
diluted medicines etc.
NHS spends $4 million a year

Question 16

How many times is the MMR vaccine given and at which ages?

Answer 16

2
Ages 12-15 months
Ages 3-5 years

Question 17

When was the MMR vaccine introduced?

Answer 17

1988

Question 18

What does the MMR vaccine do?

Answer 18

Protects against measles, mumps (highest cause of viral meningitis in kids) and rubella

Question 19

Why was the MMR vaccine discontinued and the brought back?

Answer 19

people thought they caused autism, GI problems and behavioral problems

Number of cases increased and there was no causal relationship