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Flashcards in Reading and Interpreting Medical Papers Deck (56):
1

Where can we find medical papers?

The library, Internet, and references in articles

2

The types of articles in paper include original research, case reports, early reports, editorials, commentary, research letters, letters to the editor, correspondence, and reviews. What are three types of reviews?

Meta-analyses, state-of-the-art reviews, and clinical updates

3

What are the contents of original research?

Abstract, introduction, methods, results, discussion, references

4

Tell readers crucial information about the article that allows them to decide whether to read the article in its entirety

Abstract

5

The abstract identifies the

Focus of the study

6

A problem in an abstract whereby the data given in the abstract is given differently than in the body

Inconsistency

7

A problem in an abstract whereby data is given in the abstract but not in the body

Omission

8

If an abstract displays inconsistency, omission, or both, the abstract is deemed

Deficient

9

What are three types of observational studies you may see in the design of analytical studies?

1.) Cross-sectional (prevalence)
2.) Case-control (retrospective)
3.) Cohort (prospective or retrospective)

10

Type of observational study where you may look at a group of diseased and non-diseased people and look into their past to see if they were exposed or not exposed to a certain factor

Case-control study

11

What are two types of clinical trials?

Preventative and therapeutic

12

Clinical trial where people WITH a disease are randomized and sorted into a treatment group and a control group and studied to see if the treatment is effective at combating the disease

Therapeutic Clinical Trial

13

Clinical trial where people WITHOUT a disease are randomized and sorted into a treatment group and a control group and studied to see if the treatment prevents the disease

Preventive Clinical Trial

14

It's main goal is to combine the results of previous studies to reach summary conclusions about a body of research

Meta-Analysis

15

Has the following steps:
1.) Identify studies with relevant data
2.) Define inclusion and exclusion criteria
3.) Abstract data
4.) Analyze abstracted data statistically

Meta-analysis

16

Becoming increasingly important in medical literature

Statistical methods

17

Gives the findings from the research

-Directed at questions posed in the introduction

Results and Discussion

18

If you wanted to know how many people in New Jersey currently had a headache, what type of study would you perform?

Cross-sectional study

19

In peer-review publication, the editor reviews the manuscript and either rejects it, or assigns it to reviewers for

External evaluation

20

The reviewers then review the manuscript and make recommendations to the

Editor

21

The editor then decides whether to

Reject the work, modify the work, or publish the work

22

What is the strongest source of evidence? What is the second strongest?

1.) Systematic review
2.) RCT

23

The 2011 OCEBM levels of evidence say that the first level for finding out how common a problem is, is a

Local and current random sample survey

24

The levels are NOT dismissive of

Systematic reviews

25

The levels are NOT intended to provide you with a definitive judgement about the quality of

Evidence

26

The levels will NOT provide you with a recommendation or tell you if you are asking the

Right question

27

Identifies the best available evidence from within a large body of research

-needed because there are too many papers and too little time

Critical Appraisal

28

How many articles a day would you need to read to keep up with the current literature?

10,000

29

Rutgers university libraries, orxford center for EBM, and enhancing the QUAlity and Transparency of health research (EQUATOR) network are all resources for

Appraisal tools

30

The oxford centre for EMB's randomized controlled trials critical appraisal sheet is an example of a

Tool for critical appraisal

31

The first question asked by the RWJMS general article review sheet is

What is the overall design of the study?

32

The second question asked by the RWJMS general article review sheet is

What is the overall question addressed by the study?

33

The third question asked by the RWJMS general article review sheet is

What is the the PICO?

34

The fourth question asked by the RWJMS general article review sheet is

Determine the validity (should I believe the results?)

35

When determining the validity, you want to look for common sources of

Error (i.e. bias or inadequate blinding)

36

If error do exist, you must ask yourself if these errors are

Fatal Flaws

37

When reading an article, you always want to determine the applicability, in other words, can you apply the results to your

Patient

38

Referral patients tend to be

Sicker

39

Volunteer patients tend to be

Less sick

40

You always want to beware of composite and surrogate (non-patient important)

Outcomes

41

When reading a paper, you always want to ask if the study used was the best study to answer the

Question

42

The question: was the assignment of patients to treatments randomized? would be answered in

Methods

43

The question: were the groups similar at the start of the trial? would be answered in the

Results

44

The question: aside from the allocated treatment, were groups treated equally? would be best answered in the

Methods and results

45

When you are determining how large the treatment effect was, you want to ask yourself

What is the measure? i.e. RR, ARR, RRR, NNT?

46

Encompasses various initiatives to alleviate the problems arising from inadequate reporting of randomized controlled trials

CONSORT

47

Measures how likely that any apparent differences in outcome between treatment and control groups are real and not due to chance.

Statistical Significance

48

Measures how large the differences in treatment effects are in clinical practice.

Clinical significance

49

Statistical significance is defined using a

P-value

50

Clinical significance is defined using

RR, ARR, and NNT

51

Important resources for obtaining evidences from scientific and clinical research to facilitate practicing evidence-based medicine

Medical Papers

52

Understanding the key study design (cross-sectional, cohort, RCT), will enable you to better distinguish the

Levels of evidence

53

What level of evidence is represented by the results of an RCT?

Level I

54

Obtained from well-designed controlled trials without randomization.

Level II-1 evidence

55

Obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

Level II-2 evidence

56

Opinions of respected authorities

Level III evidence

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