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EBM approach in writing essays and study proposals. Author: PhDr . Miloslav Klugar, Ph.D. Social Medicine and Medical Ethics Department of Social Medicine and Health Care Policy Office number: 5.087 Office hours: Friday 9:00 – 11: 00 Faculty of Medicine and Dentistry

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ebm approach in writing essays and study proposals

EBM approach in writing essays and study proposals


PhDr. Miloslav Klugar, Ph.D.

Social Medicine and Medical Ethics

Department of Social Medicine and Health Care Policy

Office number: 5.087

Office hours: Friday 9:00 – 11: 00

Faculty of Medicine and Dentistry

Palacky University in Olomouc

what is ebm
What is EBM
  • Good doctors and health professionals use both:
    • Individual clinical expertise
    • Best available external evidence

…neither alone is enough…

    • Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients.
    • EBM is not restricted to randomized trials and meta-analysis.
    • It involves tracking down the best external evidence with which to answer our clinical questions.
definition of evidence based medicine
Definition of Evidence Based Medicine

EBM is the “conscientious, explicit and judicious use of current best evidence in making decisions about individual patients”.

This means “integrating individual clinical expertise with the best available external clinical evidence from systematic research”

(Sackett et al., 2000, 59)


“I am determined that no matter how much I trust my treating doctors, I want to be assured that the decisions we make together are based on as much evidence as is in existence at the time. I believe that is my fundamental right, and a right of others in a similar situation.” Chris Silagy, 1960-2001

what is ebm1
What is EBM

We can summarize the EBMapproach as a five-step model:

  • Asking answerable clinical questions
  • Searching for the evidence
  • Critically appraising the evidence for its validity and relevance.
  • Making a decision, by integrating the evidence with your clinical expertise and the patients values
  • Evaluating your performance
1 asking answerable questions
1. Asking answerable questions

The four elements of a well-formed clinical question are:

Patient or problem


Comparison intervention (if appropriate)



your clinical questions
Your Clinical Questions

Write down one recent patient problem

What was the critical question?

At a recent clinic or family or your own ….

background questions
‘Background’ Questions
  • About the disorder, test, treatment, etc.

2 components:

a. Root* + Verb: “What causes …”

b. Condition: “… SARS?”

  • * Who, What, Where, When, Why, How
foreground questions
‘Foreground’ Questions
  • About patient care decisions and actions

4 (or 3) components:

Patient, problem, or population

Intervention, exposure, or maneuver

Comparison (if relevant)

Clinical Outcomes (including time horizon)

2 search for evidence track down the best evidence
2. Search for evidence Track down the best evidence
  • Formulate a focused question
  • Turn a focused question into a search
  • Search TRIP & PubMed (Scholar google)
formulate a focused question
Formulate a focused question
  • Who is your Patient group?
  • What is your Intervention/Exposure
  • Have you got a Comparator?
  • What Outcomes are you interested in?
  • What Study type would best address the question?


Clinical question:

Is donepezil effective in improving cognitive function in Alzheimer’s disease?

is donepezil effective in improving cognitive function in alzheimer s disease
Is donepezil effective in improving cognitive function in Alzheimer’s disease?

P= people with Alzheimer’s disease

I= donepezil

C= N/A

O= cognitive function,

S= systematic review

Search terms and synonyms:

P= Alzheimer*, dementia, cognitive impairment

I= donepezil, Aricept, cholinesterase inhibitors

O= cognitive function, cognition memory, quality of life…

S= systematic reviews, meta-analysis

quick search
Quick search
  • TRIPwww.tripdatabase.com
  • PubMed Clinical Querieswww.pubmed.gov
run a full search strategy why bother
Run a full search strategyWhy bother?
  • Too few results
  • Too many results
  • Irrelevant results
  • Submitting a funding proposal
  • Writing a guideline
  • Conducting a systematic review
combine terms with or
Combine terms withOR


Alzheimer ORdonepezil – either term can be present


combine terms with and
Combine terms withAND

Alzheimer ANDdonepezil– both terms must be present



how to write a research proposal
How to Write a Research Proposal

To put it bluntly, one\'s research is only as a good as one\'s proposal.

  • It should be concise and descriptive.
  • For example, the phrase, "An investigation of . . ." could be omitted.
  • Often titles are stated in terms of a functional relationship, because such titles clearly indicate the independent and dependent variables.
  • However, if possible, think of an informative but catchy title. An effective title not only pricks the reader\'s interest, but also predisposes him/her favorably towards the proposal.
abstract of maximum 200 words
Abstract – of maximum 200 words
  • It is a brief summary
  • It should include the research question (PICO), the rationale for the study
  • The hypothesis (if any)
  • The method and the main findings
  • Descriptions of the method may include the design, procedures, the sample and any instruments that will be used
introduction of maximum 400 words
Introduction – of maximum 400 words
  • The main purpose of the introduction is to provide the necessary background or context for your research problem.
  • If the research problem is framed in the context of a general, rambling literature review, then the research question may appear trivial and uninteresting.
  • However, if the same question is placed in the context of a very focused and current research area, its significance will become evident.
  • Secondly, you need to provide a brief but appropriate historical backdrop.
  • Thirdly, provide the contemporary context in which your proposed research question occupies the central stage.
  • Finally, identify "key players" and refer to the most relevant and representative publications.
  • In short, try to paint your research question in broad brushes and at the same time bring out its significance.
  • State the research problem, which is often referred to as the purpose of the study.
  • Provide the context and set the stage for your research question in such a way as to show its necessity and importance.
  • Present the rationale of your proposed study and clearly indicate why it is worth doing.
  • Briefly describe the major issues and sub-problems to be addressed by your research.
  • Identify the key independent and dependent variables of your experiment. Alternatively, specify the phenomenon you want to study.
  • State your hypothesis or theory, if any. For exploratory or phenomenological research, you may not have any hypotheses. (Please do not confuse the hypothesis with the statistical null hypothesis.)
  • Set the delimitation or boundaries of your proposed research in order to provide a clear focus.
literature review
Literature Review
  • Ensures that you are not "reinventing the wheel".
  • Gives credits to those who have laid the groundwork for your research.
  • Demonstrates your knowledge of the research problem.
  • Demonstrates your understanding of the theoretical and research issues related to your research question.
  • Shows your ability to critically evaluate relevant literature information.
  • Indicates your ability to integrate and synthesize the existing literature.
  • Provides new theoretical insights or develops a new model as the conceptual framework for your research.
  • Convinces your reader that your proposed research will make a significant and substantial contribution to the literature (i.e., resolving an important theoretical issue or filling a major gap in the literature).
literature review1
Literature Review

Most students\' literature reviews suffer from the following problems:

  • Lacking organization and structure
  • Lacking focus, unity and coherence
  • Being repetitive and verbose
  • Failing to cite influential papers
  • Failing to keep up with recent developments
  • Failing to critically evaluate cited papers
  • Citing irrelevant or trivial references
  • Depending too much on secondary sources
methods of maximum 300 words
Methods– of maximum 300 words
  • The Method section is very important because it tells how you plan to tackle your research problem. It will provide your work plan and describe the activities necessary for the completion of your project
  • You need to demonstrate your knowledge of alternative methods and make the case that your approach is the most appropriate and most valid way to address your research question
  • Design -Is it a questionnaire study or a laboratory experiment? What kind of design do you choose?
  • Subjects or participants - Who will take part in your study? What kind of sampling procedure do you use?
  • Instruments - What kind of measuring instruments or questionnaires do you use? Why do you choose them? Are they valid and reliable?
  • Procedure - How do you plan to carry out your study? What activities are involved? How long does it take?
results of maximum 200 words
Results– of maximum 200 words
  • Obviously you do not have results at the proposal stage.
  • However, you need to have some idea about
  • What kind of data you will be collecting, and
  • What statistical procedures will be used in order to answer your research question or test you hypothesis.
discussion of maximum 500 words
Discussion – of maximum 500 words
  • It is important to convince your reader of the potential impact of your proposed research.
  • You need to communicate a sense of enthusiasm and confidence without exaggerating the merits of your proposal.
  • That is why you also need to mention the limitations and weaknesses of the proposed research, which may be justified by time and financial constraints as well as by the early developmental stage of your research area.
  • Include full bibliographic citations for all reports and publications referenced in the proposal.
common mistakes in proposal writing
Common Mistakes in Proposal Writing
  • Failure to provide the proper context to frame the research question.
  • Failure to delimit the boundary conditions for your research.
  • Failure to cite landmark studies.
  • Failure to accurately present the theoretical and empirical contributions by other researchers.
  • Failure to stay focused on the research question.
  • Failure to develop a coherent and persuasive argument for the proposed research.
  • Too much detail on minor issues, but not enough detail on major issues.
  • Too much rambling -- going "all over the map" without a clear sense of direction. (The best proposals move forward with ease and grace like a seamless river.)
  • Too many citation lapses and incorrect references.
  • Too long or too short.
  • Failing to follow the citation style.
  • Slopping writing.
proposal topics
Proposal Topics
  • EMB approach in:
    • Life style
    • Healthy life style
    • Prevention of CVD
    • Determinants of health
    • Subjective health
    • Hyperbaricmedicine
  • Colman, J. E. (1968). How to Write a Proposal. Kappa Delta PiRecord, 4(3), 73-74.
  • Sahlman, W. A. (1997). How to Write a Great. Harvard business review.
  • Tornquist, E. M., & Funk, S. G. (1990). How to write a research grant proposal. JournalofNursingScholarship, 22(1), 44-51.
  • Wong, P. T. P. (2012). How to write a researchproposalRetrieved 1.9.2012, 2012