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Evidence-Based Health Care: A Tutorial   ,[object Object],[object Object]
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You will learn: ,[object Object],[object Object],[object Object],[object Object],[object Object]
  The clinical question may require general background knowledge involving the who, what, when, where or why about a disease or disease process. Background questions are simple two-part questions about the basic facts of a disease. Look for answers to  background questions  in current, regularly updated electronic or print texts. Examples would be UpToDate, Clinical Evidence and ACP   Medicine.
More often you will need information about: ,[object Object],[object Object],[object Object]
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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[object Object],[object Object],[object Object],[object Object],[object Object]
What Type of Question Do You Want to Ask? Clinical Map Checklist Differential Diagnosis Education Quality of Life Harm/Risk Diagnostic Tests Therapy Clinical Findings Manifestations of Disease Prevention Prognosis Cause/Etiology Cost-effectiveness
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[object Object],[object Object]
Evidence Pyramid From:  Medical   Research Library of Brooklyn
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[object Object]
[object Object]
[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object]
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Evidence (Study Design) Appropriate for  Question Types Matched to EBM Search Filters   MEDLINE Search Filter Terms   Study Design   Type of Question   Cohort Studies  Follow-up Studies Prognosis  Time Factors Morbidity  Mortality  Placebos  Survival Analysis  Disease Progression Recurrence  Natural History Clinical Course Progression  Observational Studies: Cohort Studies Case Control Studies Case Series  Prognosis  Sensitivity and Specificity Predictive Value of Tests Likelihood Functions Reproducibility of Results  Cross-sectional Study: Consecutive sample design  Diagnosis  Double-blind Method  Meta-analysis  Random Allocation  Clincial Trial  Randomized Controlled Trial  Placebo  Random  Systematic Reviews and Meta-Analyses Randomized Controlled Studies Therapy
MEDLINE Search Filter Terms   Study Design   Type of Question   Randomized Controlled Trial Prevention and Control Mass Screening Sensitivity and Specificity Likelihood Functions Randomized Controlled Trials  Screening  Randomized Controlled Trial Prevention and Control Treatment Outcomes Clinical Trial Random  Randomized Controlled Trials  Prevention  Case-control Studies Cohort Studies Cross-sectional Studies Risk Odds Ratio Causation Etiology or Aetiology Cohort Studies Case Control Studies Case Series Etiology/Harm
MEDLINE Search Filter Terms   Study Design   Type of Question   McKinnell, I. and Elliott, J. (1997) The Cochrane Electronic Library: Self training guide and notes. R&D Directorate, NHS Executive Anglia and Oxford.   Costs and Cost Analysis Cost-benefit Analysis Cost Control Cost Savings Cost of Illness Health Care Costs Drug Costs Hospital Costs Health Expenditures Quality Adjusted Life Year  Randomized Controlled Trials Systematic Reviews Decision Analysis Model  Economic  Randomized Controlled Trial Practice Guidelines Outcomes Assessment (health care)  Randomized Controlled Trials  Quality Improvement
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Evidence-Based Health Care: A Tutorial Part 1

  • 1.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. The clinical question may require general background knowledge involving the who, what, when, where or why about a disease or disease process. Background questions are simple two-part questions about the basic facts of a disease. Look for answers to background questions in current, regularly updated electronic or print texts. Examples would be UpToDate, Clinical Evidence and ACP Medicine.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. What Type of Question Do You Want to Ask? Clinical Map Checklist Differential Diagnosis Education Quality of Life Harm/Risk Diagnostic Tests Therapy Clinical Findings Manifestations of Disease Prevention Prognosis Cause/Etiology Cost-effectiveness
  • 15.
  • 16.
  • 17. Evidence Pyramid From: Medical Research Library of Brooklyn
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26. Evidence (Study Design) Appropriate for  Question Types Matched to EBM Search Filters MEDLINE Search Filter Terms Study Design Type of Question Cohort Studies Follow-up Studies Prognosis Time Factors Morbidity Mortality Placebos Survival Analysis Disease Progression Recurrence Natural History Clinical Course Progression Observational Studies: Cohort Studies Case Control Studies Case Series Prognosis Sensitivity and Specificity Predictive Value of Tests Likelihood Functions Reproducibility of Results Cross-sectional Study: Consecutive sample design Diagnosis Double-blind Method Meta-analysis Random Allocation Clincial Trial Randomized Controlled Trial Placebo Random Systematic Reviews and Meta-Analyses Randomized Controlled Studies Therapy
  • 27. MEDLINE Search Filter Terms Study Design Type of Question Randomized Controlled Trial Prevention and Control Mass Screening Sensitivity and Specificity Likelihood Functions Randomized Controlled Trials Screening Randomized Controlled Trial Prevention and Control Treatment Outcomes Clinical Trial Random Randomized Controlled Trials Prevention Case-control Studies Cohort Studies Cross-sectional Studies Risk Odds Ratio Causation Etiology or Aetiology Cohort Studies Case Control Studies Case Series Etiology/Harm
  • 28. MEDLINE Search Filter Terms Study Design Type of Question McKinnell, I. and Elliott, J. (1997) The Cochrane Electronic Library: Self training guide and notes. R&D Directorate, NHS Executive Anglia and Oxford. Costs and Cost Analysis Cost-benefit Analysis Cost Control Cost Savings Cost of Illness Health Care Costs Drug Costs Hospital Costs Health Expenditures Quality Adjusted Life Year Randomized Controlled Trials Systematic Reviews Decision Analysis Model Economic Randomized Controlled Trial Practice Guidelines Outcomes Assessment (health care) Randomized Controlled Trials Quality Improvement
  • 29.