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Flashcards in Information: Quality Not Quantity Deck (13):
1

What is evidence based medicine (EBM)?

Using the best evidence in scientific literature to provide the best care for an individual patient

2

What are the 3 principles of evidence based medicine?

1. High quality health care rests on objective and clinically relevant information

2. There is a hierarchy of evidence where some types are stronger than others

3. Scientific data alone is not sufficient basis for making clinical decisions

3

What is the number needed to treat?

+ The number of patients who need to be treated in order for one person to benefit

+ Ideally NNT is 1 i.e everyone who is treated benefits

+ The larger the NNT the less the benefit

4

What is a systematic review (detailed)?

+ An attempt to identify, appraise and synthesize ALL THE EMPIRICAL EVIDENCE that meets PRE-SPECIFIED ELIGIBILITY CRITERIA to answer a given research question

+ Researchers condcuting systematic reviews use explicit methods aimed at MINIMIZING BIAS in order to produce more RELIABLE FINDINGS that can be used to inform decision making

5

List potential sources of bias in medical research:

+ Selection bias
+ Performance bias
+ Attrition bias
+ Detecting bias
+ Reporting bias
+ Publication bias
+ Time-lag bias
+ Language bias
+ funding bias
+ Citation bias
+ Developed country bias
+ Multiple publication bias

6

What is a systematic review (simple) ?

+ Comprehensive literature search that identifies all similar and relevant studies that satisfy pre-defined:
- inclusion criteria
- exclusion criteria

+ Objective analysis of all qualifying primary research studies

7

What is meta-analysis (detailed)?

+ When results of the INDIVIDUAL STUDIES ARE COMBINED TO PRODUCE AN OVERALL STATISTIC

+ Data collected from more than once clinical trial; combined to generate average result

+ This aims to provide a more PRECISE ESTIMATE OF THE EFFECTS OF AN INTERVENTION and to reduce uncertainty

8

What us the confidence interval?

+ Describes the UNCERTAINTY OF THIS ESTIMATE

+ It describes a RANGE OF VALUES within which we can be REASONABLE SURE THAT THE TRUE EFFECT ACTUALLY LIES

9

What does the width of the confident interval tell you about the measurement?

+ Narrow = HIGHER level of confidence in results

+ Wide = LOWER level of confidence in results

10

What is NICE?

National Institute for Health and Care Excellence

11

What is the purpose of NICE?

+ Appraisal of new and implemental pharmaceutical interventions

+ Development and implementation of evidence-based guidelines for appropriate clinical practice

12

Rules when trying to asnwer a clinical question:

1. Systematic reviews/meta-analysis

2. NICE and SIGN guidelines

3. Medline, PubMed, Ovid etc.

13

What is a meta-analysis (simple)?

Integrated analysis of the numerical data from all qualifying studies