Evidence-based Medicine:
Introducing Evidence-based Resources in Practice
Dr. Fredric M. Wolf, Ph.D.
Table of Contents |
Slide #:
- Evidence-based Medicine: Introducing Evidence-based Resources
in Practice
- Session Objectives
- Session Objectives (cont'd)
- Introducing Evidence - Outline
- Antibiotics for Acute Bronchitis
- Indicate whether you would (yes) or would not (no) recommend antibiotic
treatment for your patients (1/5)
- Indicate whether you would (yes) or would not (no) recommend antibiotic
treatment for your patients (2/5)
- Indicate whether you would (yes) or would not (no) recommend antibiotic
treatment for your patients (3/5)
- Indicate whether you would (yes) or would not (no) recommend antibiotic
treatment for your patients (4/5)
- EBM: Definition (Sackett et al 1997)
- EBM is Not...
- Why Do We Need EBM?
- Half-life of "Facts"
- Why Do We Need EBM? (cont'd)
- Steps Necessary to Practice EBM
- Sources of Evidence in the "Real World" in "Real-time"
- Health Care Reform: Cost Driven? Where's the Evidence of Effectiveness?
- Problem: Information Explosion
- Cartoon (You're talking in...)
- One Possible Soulution: Decision Support Systems?
- Cartoon (On one hand,...)
- Cartoon (Random Medical News)
- What is a Systematic Review?
- What is a Systematic Review? (cont'd)
- Cochrane Library CD (& WWW)
- Graph: Pain (Antibiotic vs. Placebo) Comparison
- Indicate whether you would (yes) or would not (no) recommend antibiotic
treatment for your patients (5/5)
- Antibiotics for Acute Bronchitis - Resolution of Cough (1/5)
- Antibiotics for Acute Bronchitis - Resolution of Cough (2/5)
- Antibiotics for Acute Bronchitis - Resolution of Cough (3/5)
- Antibiotics for Acute Bronchitis - Resolution of Cough (4/5)
- Antibiotics for Acute Bronchitis - Resolution of Cough (5/5)
- Support for Tx > Prevention
- RRR>ARR, SR, NNT; RRR=OR; OR>SR; OR=ARR, SR, NNT
- RRR>all Others; OR>ARR, SR, NNT; OR
- What does it mean? Does it matter?
- Example Systematic Review/M-A
- Abstract (quote)(1/5)
- Abstract (quote)(2/5)
- Abstract (quote)(3/5)
- Abstract (quote)(4/5)
- Abstract (quote)(5/5)
- Systematic search (quote)(1/3)
- Systematic search (quote)(2/3)
- Systematic search (quote)(3/3)
- Assessment of quality & extraction of data (quote)
- Figure 1 (BMJ -- Greenhalgh 315 (7103):305)
- Assessment of quality & extraction of data (quote)(cont'd)
- Key messages (quote)
- Key messages (quote)(cont'd)
- Conclusions (quote)
- Questions?
- Figure 2 (BMJ -- Greenhalgh 316 (7135):906)
- Figure 3 (BMJ -- Greenhalgh 316 (7135):906)
- Figure 4 (BMJ -- Greenhalgh 316 (7135):906)
- "Medicine is a science of uncertainty and an art of probability"
Sir William Osler
- Cartoon (It's a Library...)
- Evaluating Reliability of Electronic Info (e.g., Web Sites)
- Evaluating Reliability of Electronic Info (e.g., Web Sites) (cont'd)
- Internet Web Sites (1/3)
- Internet Web Sites (2/3)
- Internet Web Sites (3/3)
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