Evidence Based Medicine Searching for Evidence. Evidence Based Practice: Steps 1.A sk focused...
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Transcript of Evidence Based Medicine Searching for Evidence. Evidence Based Practice: Steps 1.A sk focused...
![Page 1: Evidence Based Medicine Searching for Evidence. Evidence Based Practice: Steps 1.A sk focused clinical question 2.S earch for the best evidence 3.A ppraise/assess.](https://reader030.fdocuments.us/reader030/viewer/2022032600/56649d9c5503460f94a846b5/html5/thumbnails/1.jpg)
Evidence Based Medicine
Searching for Evidence
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Evidence Based Practice: Steps
1. Ask focused clinical question
2. Search for the best evidence
3. Appraise/assess the evidence
4. Apply results in practice
5. Evaluate results
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What Evidence is Best?
Meta-Analyses
Systematic Reviews
Randomized Controlled Trials
Cohort Studies
Case-Control Studies
Case Series, Case Reports
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Question Types Study Types
Question Type Best Study Type
Diagnosis Prospective, blind comparison to a gold standard
Therapy RCT > cohort > case control > case series
Prognosis Cohort study > case control > case series
Harm/Etiology RCT > cohort > case control > case series
Prevention RCT > cohort study > case control > case series
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Clinical Scenario
After routine surgery, a 65 year old male presents with deep
vein thrombosis. He has no past history of DVT and no known
risk factors for recurrence. After 5 days of heparin, you
wonder how long you should treat him with warfarin:
3 months or 6 months?
![Page 6: Evidence Based Medicine Searching for Evidence. Evidence Based Practice: Steps 1.A sk focused clinical question 2.S earch for the best evidence 3.A ppraise/assess.](https://reader030.fdocuments.us/reader030/viewer/2022032600/56649d9c5503460f94a846b5/html5/thumbnails/6.jpg)
PICOT Our Question
Patient / Problem
Intervention
Comparison
Outcome
Type of question
Type of publication
Deep vein thrombosis in 65 y/o male
Heparin (5 days) 3 months of warfarin
Heparin (5 days) 3 months of warfarin
Decreased risk of bleeding and thromboembolic events
Therapy
RCT (or systematic review, meta-analysis)
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Clinical Question
In a 65 year old male with deep venous thrombosis (DVT),
after 5 days of heparin, what is the optimum duration of
warfarin therapy: 3 months or 6 months?
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EBM Website
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PubMed Clinical Queries
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Other EBM Resources
Summaries
Syntheses
Synopses
Studies RCTs, cohort studies, case-control studies, etc. e.g., PubMed
Critical Appraisals of Articles e.g., ACP Journal Club
Systematic reviews, meta-analysise.g., Cochrane Database of Systematic Reviews
Critically-appraised evidence-based topicse.g., DynaMed, UpToDate
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Questions? We’re on call….
Candace Moorer, MLISOffice: 2-5167
Emily Brennan, MLISOffice: 2-9275