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knowledge management

the ability to create, acquire, analyse, maintain and disseminate knowledge for the benefit of patient care

tacit

knowledge derived from personal experience

explicit

knowledge Contained in an externally verifiable form

process

knowledge of guidelines and protocol

systematic review

Literature review focussed on a research question that tries to identify, appraise, select and synthesise high quality research evidence relevant to the question

5

elements of WHO screening test criteria 1968

bias

factors that lead to conclusions that are a systematic departure from the truth

statistically significant

the results of the test are unlikely to be due to chance

direct to consumer advertising

DTCA

conflict of interest

a set of conditions whereby professional judgement concerning a primary interest is unduly influenced by a secondary influence

primary

source: Original material that has not been altered by a third party. Represents new thoughts, discoveries or ideas

secondary

source:Information about a primary source that has been modified. It may describe, interpret, analyse or evaluate primary sources of information

tertiary

source:A collection of primary and secondary sources. Materials have been modified, collated, re-analysed etc. then compiled into a concise format such as a textbook or guide

anecdotal

evidence not based on facts

observational

Information where investigators observe the natural course of events. It is cheap, ethical and quick

experimental

Information where investigators have intervened to decide who will be exposed and who will not to a particular intervention

formulation, search, appraisal, integration

steps of evidence based clinical approach

validity

are the results correct?

reliability

can the results be reproduced?

selection bias

Allocation of subjects to groups. This can be reduced via randomisation with concealment

performance bias

Implementation of interventions. This can be reduced via double blinding or use of a placebo

attrition bias

Follow up of participants. This can be reduced via analysis of subjects as randomised.

detection bias

Evaluation of outcomes. This can be reduced via blinded outcome assessment

ARR

Difference in proportion of subjects with the outcome of interest. events in placebo group -events in treatment group.

relative risk

Probability of an event in the active treatment group divided by that of the control group

relative risk reduction

Standardised measure of absolute risk reduction

100*(x-y)/x

rrr

clinical expertise, external evidence

evidence based medicine

systematic reviews

Involve a clear question, then specific methods to identify, select and appraise relevant research and then finally the results are analysed and summarised. Aims to minimise bias and maximise confidence. For example, the Cochrane reviews

meta-analysis

The application of statistical methods for pooling and synthesising quantitative results of different studies. May be included in a systematic review

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