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Information Resources for Evidence-Based Medicine. A Review 3 rd Year Family Medicine Clerkship - EBM. What is Evidence Based Medicine?. Evidence Based Medicine =. An integration of… The best research evidence Clinical expertise Patient values.

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information resources for evidence based medicine

Information Resources for Evidence-Based Medicine

A Review

3rd Year Family Medicine Clerkship - EBM

what is evidence based medicine
What is

Evidence Based Medicine?

evidence based medicine
Evidence Based Medicine =
  • An integration of…
    • The best research evidence
    • Clinical expertise
    • Patient values

Sacket DL, et. al. Evidence-based medicine: how to Teach and Practice EBM. 2nd ed. Edinburgh: Churchill Livingston, 2000

evidence based medicine1

Evidence Based Medicine

Sackett: Integrating individual expertise with the best available clinical evidence from systematic research.

Domino: Basing the care of patients on clinical research whose outcomes are our main priority.

clinical trial

Clinical Trial

An intervention is given to half of a study population, and half receive a placebo

Outcomes are compared to look for a difference

Produces an Absolute Risk for Intervention and Placebo

cohort study
Cohort Study
  • Prospective analysis of a population believed to be free of a disease, but who vary in exposure
  • This population is followed over time to determine the Incidence in the Exposed group and the Incidence in the Unexposed group
  • Produces a Relative Risk
    • Incidence of the disease state in the Exposed population divided by the Incidence in the Unexposed population.
case control study
Case Control Study
  • Patients are identified, matched to Controls (people with similar demographics but without the disorder), in hopes of finding exposures that may have increased the risk of developing the disease.
review articles
Review Articles
  • Summaries of the literature on a certain topic
  • Problems
    • Many do not include all of the relevant evidence
    • They may mix the opinions and biases of the authors with the evidence.
systematic review
Systematic Review
  • A study of studies.
  • Explicit criteria for selecting which studies to review is included (results in less bias)
  • Has a structured format for consistent presentation of information
slide12

Typical Systematic Review “Skeleton”

AbstractBackgroundObjectivesCriteria for considering studies for this reviewTypes of participantsTypes of interventionTypes of outcome measuresTypes of studiesSearch strategy for identification of studiesMethods of the reviewDescription of the studiesMethodological qualities of included studiesResultsDiscussionConclusionsImplications for practiceImplications for researchInternal sources of support to the reviewExternal sources of support to the reviewPotential conflict of interestAcknowledgementsContribution of Reviewer(s)SynopsisCharacteristics of included studiesTable 01 resultsReferences to studies included in this reviewAdditional references

meta analysis
Meta-Analysis
  • A subclass of systematic reviews
  • Meta-Analyses combine and statistically summarize the results of individual studies
slide14

Evidence Pyramid

MOST evidence

Only a small amount of the medical literature contains best evidence!

LEAST evidence

From SUNY Downstate Medical Research Library http://servers.medlib.hscbklyn.edu/ebm/2100.htm

questions
Questions?
  • Bring them to your 3rd year Family Medicine Clerkship EBM session in the Lamar Soutter Library OR
  • Contact:
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