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Evidence based Practice- Dr. A review
Terms in this set (22)
How to formulate a clinical question using PICO /PICO-T ?
- how would you describe a group of patients similiar to yours?
what are most important characteristics of the patient?
*** THIS MAY include the primary problem, disease, or co-existing condition.
Sometimes the age, sex, or race of patient might be relative to the diagnosis or treatment
What do you want to do for the patient?
• Prescribe a drug?
• Order a test?
• Order surgery?
• What factor may influence the prognosis of the patient?
• Co-existing problems?
• What was the patient exposed to ?
• Cigerette smoke?
Intervention, prognostic factor, or exposure
Relevant most often when looking at therapy questions
____ intervention or diagnostic test
not always a requirement
What you can hope to accomplish, measure, improve or affect?
What are you trying to do for the patient
Relieve or eliminate the symptoms
Reduce the number of adverse events
Improve functions or test scores
questions are of two types?
___- broken down into ___ & ____
background and foreground
____- The question root (who, what, when, where, why) with a verb a disorder, or an aspect of a disorder
is sought when a learner has general clinical questions regarding a topic such as what is the disorder; what causes it; how does it present; what are some treatment options. These questions can be answered by using "_____" resources such as textbooks (both in print and electronic) and narrative reviews in journals which give a general overview of the topic
answers specific questions a clinician has regarding a specific patient.
____- can be divided into ____ such as original research articles published in journals; and ____such as systematic reviews of the topic, and synopses and reviews of individual studies.
____ consists of 4 components
The Patient or problem being addressed
The Intervention or exposure being considered
The Comparison intervention or exposure, when relevant
The clinical Outcomes of interest.
How to properly gather and interpret findings from the history and physical examination
When considering the possible causes of our patient's clinical problem, how to select those that are likely, serious, and responsive to treatment
How to identify causes for disease (including iatrogenic).
Knowing how often and when a disease causes its clinical manifestations and how to use this knowledge in classifying our patient's illness.
Clinical Epidemiology of Disease
How to select and interpret diagnostic tests in order to confirm or exclude a diagnosis based on considering their precision, accuracy, acceptability, expense and safety
How to empathize with our patient's situations, appreciate the meaning they find in the experience and understand how this meaning influences their healing
experience and meaning
How to keep up to date, improve our clinical and other skills and run a better, more efficient clinical practice
The hardest conviction to get into the mind of a beginner is that the education upon which he is engaged is not ... a medical course, but a life course, for which the work of a few years under teachers is but a preparation.
Sir William Osler (1849-1919), from: The Student of Medicine
How to select treatments to offer our patients that do more good than harm and that are worth the efforts and costs of using them
How to estimate our patients' likely clinical course over time and anticipate likely complications of the disorder and our treatments.
How to reduce the chance of disease by identifying and modifying risk factors and how to diagnose disease early in screening.
prevention and education
1) Is Tamiflu more effective than bed rest and Tylenol for the flu?
2) In healthy adults, does Tamiflu reduce the severity of acute influenza?
3) How much does Tamiflu cost?
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