Evidence Based Practice Questions

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School
King's College London **We aren't endorsed by this school
Course
MED A100
Subject
Medicine
Date
Apr 14, 2023
Pages
2
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Evidence Based Practice Study online at https://quizlet.com/_cz1wp6 1. What is evidence based medicine?: The application of the best available research to clinical care, which requires the integration of evidence with clinical expertise and patient values 2. What aspects are involved for the internal validity of evidence?: - System- atic errors as a result of selection bias, information bias and confounding - Quantitative aspects of diagnosis and treatment - The effect size and aspects regarding its precision - Clinical importance of results - External validity or generalisability - Application of results in practice 3. How do we assess evidence for clinical decision making?: 1. Medical effec- tiveness research (context free scientific evidence) 2. Social science oriented research (context-specific scientific evidence) 3. Expertise, views, and realities of stakeholders (colloquial evidence) 4. What is hierarchy of evidence, from weakest to strongest?: 1. Expert opin- ion 2. Case report 3. Case-control studies 4. Cohort studies 5. Randomised controlled trials 6. Systematic reviews 7. Meta-analyses 5. What is meta-analysis?: An examination of data from a number of independent studies of the same subject to determine overall trends 6. What is the next step after defining what evidence is required?: May have an unmanageable volume of evidence: - Evidence needs rationalising - Evidence has to be compatible with the clinical situations in which I find myself 7. What resources are used to rationalise evidence and ensure evidence is compatible?: - Clinical Guidelines - National Institute of Health and Care Excellence - BMJ Clinical Guideline Concise 8. What are Clinical Guidelines?: - Makes the volume of research manageable for the individual clinician - Resolves clinicians' disagreement on appropriate management - Has resources to develop guidelines 1 / 2
Evidence Based Practice Study online at https://quizlet.com/_cz1wp6 - Expertise is available - specialist, generalist, the patient and public - Administrative resources included to handle large volumes of research evidence 9. What are the four main sources of guidelines?: - Specialist Societies and Associations - British Thoracic Society, European Respiratory Society - Stakeholder Associations - Asthma + Lung UK - Professional Associations - Royal College of Physicians, Royal College of Gen- eral Practitioners - National Bodies - SIGN, NICE 10. What is Quality Adjusted Life Years (QUALYs)?: They combine the outcome measure in years of quality of life gained and the cost of that gain 11. What are the two properties of QUALYs?: 1. Added duration of life 2. Quality of that life (0-1, 0 = no quality & 1 = full quality) 12. Who uses QUALYs?: Health economists 13. What is the impact of too much evidence?: - Volume of clinical guidelines becomes unmanageable - Statistically significant benefits may not be clinically important - Evidence may not apply to people with complex multi-morbidity and becomes unintelligible - There needs to be continuing rationalisation 14. Why are NICE Guidelines needed?: - Address inappropriate variations in clinical practice and "post-code" access to expensive treatments - Support clinicians to keep up to date with relevant new evidence - Assess the "value" (cost effectiveness) of new and existing treatments - Encourage innovation 15. What are the core principles of NICE Guidelines?: - Comprehensive Evi- dence Base - Expert Input - Public Patient and Carer Involvement - Independent Advisory Committees - Genuine Consultation - Regular Review - Open and Transparent Process 2 / 2
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