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Information Mastery 2. Approaches, tools, techniques and skills. Information Mastery requires two different approaches to managing information: Foraging - a method of being alerted to new information when it is published Hunting - a method of finding information when it is needed

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information mastery 2

Information Mastery 2

Approaches, tools, techniques and skills

slide2
Information Mastery requires two different approaches to managing information:
    • Foraging - a method of being alerted to new information when it is published
    • Hunting - a method of finding information when it is needed
  • Without both:
    • clinicians won’t know when new important information becomes available
    • clinicians won’t be able to find it easily, even when they remember reading it
usefulness relevance x validity work
Usefulness = Relevance x ValidityWork

What are the criteria used when looking for the best answer or important evidence?

Slawson DC and Shaughnessy AF. J Am Board Fam Pract 1999; 12: 444-9

so filtering for relevance
So, filtering for relevance
  • Feasible (intervention)
  • Outcomes (patient-orientated)
  • Common (condition)
  • Change in practice required
slide5

Validity - A hierarchy of evidence

  • (Well conducted MA of several, similar, large, well designed RCTs)
  • Large well designed RCT
  • Meta analysis of smaller RCTs
  • Case control and cohort studies
  • (Case reports and case series)
  • Consensus from expert panels
  • I think
some terms used
Some terms used
  • Relative risk:
    • “What is the chance of the endpoint occurring in the treatment group compared with the control group?”
    • Stays constant in different populations
  • Relative risk reduction:
    • “By how much did treatment reduce the chance of the endpoint occurring in the treatment group compared with the control group?”
    • Stays constant in different populations
  • Absolute risk reduction:
    • “How many fewer patients experienced the endpoint in the treatment group than in the control group?”
    • Decreases the lower the baseline risk
  • Number needed to treat:
    • “How many people, on average, need to be treated for one to gain a benefit?”
    • Increases the lower the baseline risk
filtering for validity
Filtering for validity
  • P values and confidence intervals tell us if the result was likely to have occurred by chance
  • Confidence intervals tells us the range in which the “true” result probably lies
  • BUT we still need to determine the clinical significance of the result even if statistically significant
  • Look for the POOs
  • Power - watch out for short term studies, and studies / subgroups with few people
  • Watch out for the comparator
  • Beware of publication bias
  • Look to see if the allocation was concealed