HIEBM Flashcards
(59 cards)
What is implementation science
the study of methods to promote the integration of findings into healthcare policy and practice - research on how to get research into practice
What are the barriers to implementation?
Organisation, Peer Group, Individual, Limits to human processing
Explain the two cycle process (implementing interventions to change practice)
1) adapt knowledge to local context, asses barriers to use, implement interventions to change practice
2) monitor knowledge, evaluate outcomes, sustain knowledge use
Why is organisation a barrier to implementation of research findings?
The researchers may have to wrong skill mix, they may not have obtained the right equipment or necessary funding
How can your Peer group prevent implementation?
Members may have different standards of care and therefor believe more should be researched or things should be changed before the research is implemented.
How do individuals act as barriers to implementation?
they may not have the knowledge needed
Why should we use a wide range of interventions?
many interventions are effective under some circumstances however none are effective under all. T4 a range of interventions will “cover our bases”.
How did Hippocrates and Galenus help improve evidence based medicine?
Hippocrates - ensured doctors were professionals and good citizens (held accountable)
Galenus - used evidence/scientific discovery to aid healthcare
Who first showed the cause of scurvy?
James Lind - scurvy is dues to a lack of citrus fruits
Medicine systematic reviews can be stored where?
the Cochrane library, this is a collection of systematic reviews for all of medicine, allowing it to be scientifically assessed.
How many types of evidence are there and what are they?
3 types
Research, Clinical Practice, Patient experience.
Why is there a hierarchy of evidence?
in order to provide the best care and treatment all three types of evidence must be combined.
the hierarchy will vary depending on the case and patient.
What is the hierarchy of evidence? (bottom to top)
Bottom - background info/expert opinion
- Case controllled studies/case series
- Cohort studies
- RCTs
- Critically appraised topics & articles
Top - systematic reviews & Meta-analysis
How does the NHS decide to introduce new drugs?
how effective is the intervention vs current drugs, does it extend life && Quality of life
What are QAL years?
Quality adjusted life years - the amount of extra “good” years the drugs/treatment provides
Is evidence interpreted?
Yes, in order to ensure it doesn’t only apply in the lab.
it is frequently updated & summated globally
What is the WHO checklist?
a surgical safety checklist to be competed before surgery. research showed mortality decreased by 47%
Why did the WHO checklist fail?
it wasnt used as there was no formal process of how to use it, so the evidence(checklist) was not replicated the same way as the initial study.
What is the LHS?
Learning Health System
What are the 3 data types and how do they interact?
Routinely collected data, specific research data, Actionable data.
Both routinely collected data and specific research data feed into Actionable data.
What does the LHS allow?
movement of data between data types. data moves from research into clinical practice via DSRs (decision support roles)
What is the Learning Health System?
a system that provides the best evidence allowing the best care to be given for patients via the collection of data and sharing of knowledge.
What is EHR
Electronic health Records - the LHS is integrated into the EHR to allow automatic checks for clinical trials
What is clinical trail data used for?
It is used to complete Report forms & is stored in EHRs and research databases.