Introduction To Evidence Based Medicine

Question 1

Evidence based medicine includes what?

Answer 1

1) best research evidence
2) patient values
3) clinical expertise

Question 2

When was evidence based medicine introduced

Answer 2

1980s in Canada and UK

• wasn’t officially coined until 1991
• grew out of epidemiology and biostatistics

Question 3

What percentage of interventions are evidence based?

Answer 3

33%

33% are insufficient evidence and 33% have been shown to cause harm

Question 4

5 steps of evidence based EBM

Answer 4

Apply evidence

Assess your patient

Ask clinical questions

Acquire the best evidence

Appraise the evidence

Question 5

What is the average amount of questions per patient encounter?

Answer 5

1-3

Question 6

what does PICO stand for?

Answer 6

Patient/population

Intervention

Control

Outcome

(Also includes TIME)

Question 7

Quality of evidence ranked best to least strong

Answer 7

• TOP is meta analyses*
  1) systematic reviews
  2) critically appraised topics (syntheses)

3) critically appraised individual articles (synopses)
* 1-3 are critical appraisal*

4) randomized controlled trials

5) non randomized controlled trials
* 4-5 are experimental studies

6) cohort studies
7) case-controlled studies and reports

8) individual case reports
* 6-8 are observational studies*

9) background info and expert opinions