Using EBM to Answer Clinical Queries

Using EBM to Answer Clinical Queries Robin Featherstone Clinical Medicine Librarian [email_address] http://www.slideshare.net/featherr

Agenda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Two Broad Question Categories ,[object Object],[object Object],[object Object],[object Object],[object Object]

Sources for Background Questions Resource Example Textbook Robbins basic pathology Handbook Adolescent medicine: a handbook for primary care Manual The Washington manual of surgery Encyclopaedia Encyclopedia of respiratory medicine Dictionaries Dorland’s pocket medical dictionary

Refine Foreground Questions using PICO ,[object Object],[object Object],[object Object],[object Object]

Determine your Question Type 1,2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006. 2 Glover, Jan, and Lei Wang. Find it Fast: The Clinical Question : www.med.yale.edu/library/education/guides/screencasts/finditfast/finditfast_2/

Studies to Answer Each Type 1,2 1 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006. 2 Glover, Jan, and Lei Wang. Find it Fast: The Clinical Question : www.med.yale.edu/library/education/guides/screencasts/finditfast/finditfast_2/ Type of Question Type of Evidence Aetiology ,[object Object],[object Object],[object Object],Diagnosis ,[object Object],[object Object],Prognosis ,[object Object],[object Object],[object Object],Therapy ,[object Object],[object Object],Prevention ,[object Object],[object Object],[object Object],Cost-effectiveness ,[object Object],Quality of life ,[object Object]

Level of Evidence Pyramid Qualitative Studies

CASE STUDIES AND SEARCHING EXERCISES

Case study 1 ,[object Object],Your patient travels regularly on business and suffers frequently from the effects of jet lag. They’ve tried tomato juice and exercise but neither seems to help. They ask if there is anything else they can do?

Create an answerable question ,[object Object],P atient, Problem, or Population Jet lag I ntervention C omparison O utcome(s) Reduced symptoms

Identify your question type 1 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006. 2 Glover, Jan, and Lei Wang. Find it Fast: The Clinical Question : www.med.yale.edu/library/education/guides/screencasts/finditfast/finditfast_2/ Type of Question Type of Evidence Aetiology ,[object Object],[object Object],[object Object],Diagnosis ,[object Object],[object Object],Prognosis ,[object Object],[object Object],[object Object],Therapy ,[object Object],[object Object],Prevention ,[object Object],[object Object],[object Object],Cost-effectiveness ,[object Object],Quality of life ,[object Object]

Select a resource Qualitative Studies

Exercise ,[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusions ,[object Object],Source Hits Cochrane Library 2 ACP’s PIER 43 PubMed 561 (56 if using MeSH with prevention subheading) Google Scholar About 78,300

Discussion ,[object Object],[object Object]

Case Study 2 ,[object Object],What step should we take first to answer this question?

Create an answerable question What is the quality of life of patients following mastectomy? P atient, Problem, or Population Patients following mastectomy I ntervention C omparison O utcome(s) Quality of life

Exercise ,[object Object],[object Object],[object Object],[object Object]

Conclusions ,[object Object],Source Hits PsycINFO 10 CINAHL 92 Google Scholar about 21,900

Create an answerable question P atient, Problem, or Population I ntervention C omparison O utcome(s)

Create an answerable question In cataract surgery patients, does topical anaesthetic alone reduce pain perception when compared to topical anaesthetic supplemented by intracameral lidocaine? P atient, Problem, or Population Patients undergoing cataract surgery I ntervention Topic anaesthesia alone C omparison Topical anaesthesia with intracameral lidocaine O utcome(s) Reduction of pain perception

What kind of question is this?

1 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006. 2 Glover, Jan, and Lei Wang. Find it Fast: The Clinical Question : www.med.yale.edu/library/education/guides/screencasts/finditfast/finditfast_2/ Type of Question Type of Evidence Aetiology ,[object Object],[object Object],[object Object],Diagnosis ,[object Object],[object Object],Prognosis ,[object Object],[object Object],[object Object],Therapy ,[object Object],[object Object],Prevention ,[object Object],[object Object],[object Object],Cost-effectiveness ,[object Object],Quality of life ,[object Object]

Exercise ,[object Object],[object Object]

Results ,[object Object],[object Object]

Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]

Using EBM to Answer Clinical Queries

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Using EBM to Answer Clinical Queries

Similar to Using EBM to Answer Clinical Queries (20)

More from Robin Featherstone

More from Robin Featherstone (20)

Recently uploaded

Recently uploaded (20)

Using EBM to Answer Clinical Queries