Session 2 Flashcards
(31 cards)
What is the origin of evidence based health care?
It is ethical practice for a doctor to do what they believe will work for their patients. Therefore their treatment must have evidence to support it.
Ineffective treatments waste valuable resources
Variation in treatment causes inequity
Why are Systematic reviews very useful in treatments?
They allow the researcher to see the bigger picture made by lots of smaller studies put together
Can prevent unnecessary deaths/trials
Collates information for clinicians to read more easily
Shortens the time that it takes for the research to reach practice
What is Evidence based practice?
Involves the integration of individual clinical expertise with the best available external clinical evidence from systematic research
What must be included in a systematic review to try and address bias?
The inclusion and exclusion criteria needs to be stated
What are some of the advantages of Systematic reviews?
They can help prevent bias management decisions being made
Relatively easy to convert into guidelines for better care
What is a negative of Systematic reviews?
They need to be appraised by the clinician to ensure they are happy with the quality of evidence
Where can you find Systematic reviews?
Medical journals
Cochrane collection/library
NHS centre for reviews and dissemination
What are some of the Practical criticisms of Evidence based practice?
Hard to create and maintain systematic reviews across all specialties
Challenging and expensive to implement findings
RCTs may not always be feasible or desirable/necessary
Outcomes are often very biomedical which may limit interventions trialed and therefore bias the NICE guidelines
What are some of the Philosophical criticisms of Evidence based practice?
Does not align with most doctors modes of reasoning
Population level outcomes may not be the same for individual
Creates unreflective rule followers instead of professionals
May be seen as legitimising rationing of treatments
May conflict with professional responsibility/autonomy as it works on probabilities not individuals (May loose patient centred practice)
What are some of the issues with getting evidence into practice?
Doctors may not be up to date
Professional judgement
Organisations cannot support the innovation
Commissioning reflects different priorities
Resources not available to implement the change
How is evidence started to be placed into practice?
Establishment of the Care Quality Commission
Legally, the NHS organisation has to follow NICE guidelines within 3 months of the issue
What are the 2 main groups of methods used in social research?
Quantitative
Qualitative
What is Quantitative research?
Collection of numerical data
Has Hypothesis
Conclusion drawn
What is the strength of Quantitative research?
Reliable Reputable Good at describing/measuring Relatively cheap Allow comparisons
What are some of the Quantitative research designs?
Experimental study design Cohort studies Case-Control studies Questionnaires Secondary analysis of data from other sources
What can Questionnaires be used to measure?
Exposure to risk factors Effect of lifestyle & dietary factors Knowledge Attitudes Satisfaction with health serivces
What should a Questionnaire always be?
Valid
Reliable
What is Validity (with regards to a Questionnaire)?
Measure what they’re supposed to measure
This can be increased by clear questions
What is Reliability (with regards to a Questionnaire)?
If it was repeated, the same result would be given. So it can measure things consistently and differences come from differences in participants not from inconsistencies in understanding
What are some of the negatives of Quantitative methods?
May force people into inappropriate categories
Don’t allow people to express in the way they want
May not access all important information
May not be effective at establishing causality
What are some examples of research methods that gain Qualitative data?
Observation & Ethnography
Interviews
Focus groups
Documents & Media Analysis
Define Ethnography
Studying human behaviour in its natural context
What are the 2 forms of Ethnography?
Participant observation (Usually covert) Non participant observation (Overt)
What are the issues with Covert and Overt observation?
Covert = Many ethical issues Overt = The participants may react differently as they know they are being observed
