Modalities Ch. 3 Flashcards Preview

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Flashcards in Modalities Ch. 3 Deck (31)
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1
Q

difference between EBM and EBP

A

EBP applies EBM

2
Q

overarching goal of EBP

A

use best evidence possible to improve patient care

3
Q

Evidence-Based vs. Patient-Centered Medicine

A

Powerful, different, somewhat contradictory philosophies

4
Q

EBM

A

approaches patient care from a biomedical perspective
based solely on scientific facts
is a doctor-oriented, disease-centered model
aims to improve quality by standardizing medical, through clinical guidelines of best practice
patients treated as a group
_____

5
Q

best practices

A

philosophy of action
specific techniques, methods, activities, or processes
good guidelines apply to only 80% of patients
a given best practice only applies to a specific condition or circumstance
-may be modified or adapted for similar circumstances

6
Q

protocols

A

a plan or set of specific steps to be followed
a strict process for monitoring and caring for specific conditions
often provides a practical, step-by-step framework for implementing guidelines

7
Q

patient-centered medicine

A

a humanistic, biophychosocial approach
focus on patient participation in clinical decision making, using in-depth patient communication to understand patients’ complaints, unique needs, and who they are
moves care from clinician control to_______
patients are experts in the experience of their symptoms
patients differ, even with same S/S

8
Q

benefits of EBP and PCM

A
EBP
-increased quality of care
-proven to work
PCM
-patient-specific (not cookie cuter)
-empowers the patient
9
Q

detriments of EBP and PCM

A

EBP
-less personal
-might not work for everybody
-doesn’t account for patient differences
PCM
-giving patients too much control/power without knowledge
-can negate the expertise of the clinician

10
Q

who one is best?

A

not either-or, but both
both are needed and must be integrated
-external clinical evidence can inform, but can never replace, individual clinical expertise

11
Q

components of EBP

A
defining a clinically relevant question
searching for the best evidence
appraising the quality of the evidence
applying the evidence to clinical practice
evaluating the process
12
Q

clinically relevant questions

A

what’s the best course of action?

13
Q

components of clinical questions

A

patient population
intervention/treatment
outcome of interest

14
Q

searching for the best evidence

A

technology is a blessing

15
Q

what is evidence

A

anything used to establish a fact, or give a reason to believe something
seek “facts”

16
Q

sources of medical evidence

A

tradition
experience
research
theory

17
Q

types of research

A

laboratory
observational
clinical trials

18
Q

laboratory

A

controlled
looks at
-physiological processes
-tissue response to intervention

19
Q

laboratory pros and cons

A

pros
-easy to control
cons
-limited by tissue type (healthy, animals)

20
Q

observational

A

observations in a natural environment

prospective or retrospective (before/after data collection)

21
Q

observation pros and cons

A

pros
-natural
cons
-uncontrolled

22
Q

clinical trials

A

observation + lab

23
Q

clinical trials pros and cons

A

pros

  • well controlled
  • natural setting
24
Q

narrowing the focus of your search

A

patient group
intervention
outcome
use studies within last 5-10 years

25
Q

quality of evidence

A

there is a direct correlation between the quality of evidence and the quality of healthcare

26
Q

levels of evidence

A
  1. systematic reviews or meta-analyses or randomized controlled trials and high-quality, single, randomized controlled trials
  2. well-designed cohort studies (observation)
  3. case-control studies
    - comparison of two patients
  4. case series and poor-quality cohort and case-control studies
  5. expert opinion, based not on critical appraisal, but on reasoning from physiology, bench research, or underlying principles
27
Q

quality of evidence

A

relates to the credibility, clinical significance, and applicability of evidence

  • how confident are you that it represents the “truth”
  • can you trust the results?
28
Q

things to consider when applying the intervention

A

what are the goals?
evidence
patient preference

29
Q

clinical outcomes

A

end results of specific health care practices and interventions

30
Q

examples of clinical outcome measures

A
objective measurements (ROM, strength)
patient-based assessments (questionnaires, pain scales)
31
Q

how to integrate EBP and PCM

A
adjust evidence-based intervention based on the patient
-determined by
--patient progress
--outcome measures
communication
-what?
-why?