ch5: evidence based health care

Question 1

what is evidence based practice

Answer 1

• research
• clinical expertise
• pt values

Question 2

pt-oriented evidence tha matters

Answer 2

POEM
provide info on areas about which pt would most be concerned
more holistic view of a pt health statusdi

Question 3

disease-oriented evidence

Answer 3

physiological info such as bp, jnt ROM, symptoms.
trad gathered by clinician
also called clinician-oriented evidence

Question 4

pt-oriented outcome measures

Answer 4

self-reported questionaires pt complete throughout tx

Question 5

5 steps to follow EBHC

Answer 5

1- dev a clinical question
2- search for the best evidence
3- eval the evidence for validity, impact, and applicability
4- integrate the evidence into cllinical decision
5- eval the efficiency and effectiveness of steps 1-4

Question 6

PICO/T

Answer 6

used to dev question
P: pt/problem
I: intervention/ variable of interest
C: comparison
O: outcome
T: time

Question 7

filtered information

Answer 7

other cllinicians/researchers have already searched the existing evidence, evaluated it, and synthesized a clinical rec

ex: clinical practice guidelines, meta-analysis, systemic reviews

Question 8

unfiltered info

Answer 8

include indv research, expert opinions

Question 9

boolean terms

Answer 9

and, or , not

Question 10

effect size

Answer 10

measures the dif in outcmes btw tx and nontx groups

Question 11

scales of evidence

Answer 11

• strength of rec taxonomy SORT
• oxford center for evidence based medicine CEBM
• grading of recommendation assessment, dev and eval GRADE

Question 12

reliability

Answer 12

how reproductable the resualts are

Question 13

Intra-rater reliability

Answer 13

det the consistency of the measure made by a single researcher or instrument

Question 14

interrater reliability

Answer 14

reliability of measurement made btw several researchers/instruments

Question 15

validity

Answer 15

measurment represents what we think they represent

Question 16

sensitivity

Answer 16

ability of test to detect injury

high sensitivity = good to rule out injury

snout

Question 17

specificity

Answer 17

ability of test to detect health

good to rule in injury

spin

Question 18

exp event rate EER

Answer 18

numb of adverse outcome or unsuccessful tx

Question 19

control event rate CER

Answer 19

failed outcome in control group (placebo)

Question 20

relative risk reduction

Answer 20

reduction in unsuccesful tx compared to control group

no idea of how large the tx effect is

Question 21

absolute risk reduction

Answer 21

actual dif in risk btw tx and control group

Question 22

number neede to treat NNT

Answer 22

indicates how many pt need to receive therapy to prevent one adverse outcome
ex 1/4 so every 4 pt one has a good outcome