Evidence Based Obstetric Medicine. Robert Hopkins, MD, FACP, FAAP UAMS Associate Professor of Medicine and Pediatrics. Outline. EBM Overview What is EBM Why is EBM important Basics of E-B medical practice Evidence Based Obstetrics 2005 Selected examples. Overcoming inertia….
Robert Hopkins, MD, FACP, FAAP
UAMS Associate Professor of Medicine and Pediatrics
Work (required to find data)”
Medical knowledge continues to grow
We do NOT read enough:
Freemantle N., et.al. Cochrane Database of Systematic Reviews 2000;2.
Ultimate goal is …to apply evidence-centered strategies to answer questions in our practice-- leading to refinement of our clinical behavior.
Studies estimate at least:
1989 Georgia [One man’s opinion]
[Other than Diazoxide [more symptomatic hypotension], there are no clear differences in studied agents including Labetalol, Hydralazine, Nifedipine ER,…]
Database: Pub Med, Ovid and others
Search engines are highly sensitive…but they are not specific
(Specificity left to the questioner/searcher)
MeSH: Structured medical subject headings- freely available from NLM (topic map) allow targeting of search to topic
‘Related articles’ is useful if narrow topic evaluated
Limits: Clinical Trial OR Systematic Reviews
Some ‘pre-assessed’ sources for your use:
JAMA Guide: EBM Working Group
Data Source Access Quality
Experience Longitudinal Rapid Variable
Colleague Variable Variable Variable
Patients Rapid Rapid ???
Guidelines Variable Variable Variable
Texts Rapid Slow Good?
Research Slow Slow Good?
Journals Buried Variable Good
[And I hope Never…]
To NOT have to wade through 100+ papers
To NOT have to go through Medline
TO have evidence indexed by strength
TO have a brief (1 word ?) answer…
TO see questions that are already answered
i.e. ALL applicable knowledge in 15 seconds
13043 “Pregnancy + HTN” articles
15852 “Preeclampsia” articles in 2005 [Pubmed 1/13/05]