Introduction to Evidence Based Medicine Ppt Powerpoint Presentation slides DR.ABDULAZIZ Medical Slideshow Evidence Based Medicine

Introduction to Evidence Based Medicine

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G.KANNAN on Sep 12, 2009 Says :

simply amazing and highly informative. must read

G.KANNAN on Sep 12, 2009 Says :

Simply stupendous

Abitare on Sep 10, 2009 Says :

nice presentation

LOUIS ANTHONY on Jun 20, 2009 Says :

GOOD PRESENTATION

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Notes

Show Notes

Slide 1 :

Introduction to Evidence Based Medicine Prepared by Dr. ABDULAZIZ AL-JOHANI Consultant family physician MBBS,ABFM,SBFM 2008

Slide 2 :

2 content Introduction. Why is EBM? What is EBM? Steps of EBM. Conclusion.

Slide 3 :

3 Introduction It is known that medicine & all other health care areas are rapidly changing. No. of medical journals increased >7 times today > 20,000 biomedical journals Rate 1 new article / 26 seconds As clinicians should base our decision & action on the best possible evidence. To keep up to date in Internal Medicine, I need to read 17 articles a day, 365 days a year

Slide 4 :

Slide 5 :

5 Median minutes/week spent reading about my patients: Medical Students: 90 minutes Residents: 20 (up to 15%=none) Registrars: 45 (up to 40%=none) Sr. Registrars 30 (up to 15%=none) Consultants: Grad. Post 1975: 45 (up to 30%=none) Grad. Pre 1975: 30 (up to 40%=none)

Slide 6 :

6 Why EBM ? Our daily need for valid information about Dx, Rx, prognosis….etc. The inadequacy of traditional sources for information because they are out of date (textbook ), frequently wrong ( expert ), or too overwhelming in volume & too variable in validity ( journals ).

Slide 7 :

7 Why EBM? cont. 3. Disparity between Dx. skills & clinical judgment which increase with experience & up to date knowledge which decline.

Slide 8 :

8 What is Evidence Based Medicine ( EBM ) Is the integration of best research evidence with clinical expertise and patient values.

Slide 9 :

Best research evidence Clinical expertise Patient values EBM

Slide 10 :

10 Steps of EBM EBM comprises five steps: 1. Converting the need for information into answerable Question. 2 . Collect evidence to answer question

Slide 11 :

11 Cont. Steps of EBM 3.critically appraise that evidence for it’s validity, impact & applicability. 4. Integrating the critical appraisal with our clinical expertise & our pt. Unique biology, values & circumstances. 5. Evaluate our effectiveness & efficiency in steps 1-4 and seeking ways to improve them.

Slide 12 :

12 1- how to ask clinical question you can answer?

Slide 13 :

13 ? Ask for specific knowledge about managing patients Have four essential components: 1. Patient and/or problem 2. Intervention 3. Comparison intervention (if relevant) 4. Clinical outcomes

Slide :

Slide 15 :

15 2-searching for best evidence

Slide 16 :

16 Search resources: Text book (clinical evidence ) Medline search (Pub med ) data base ( Cochran library ,best evidence) EB journal.

Slide 17 :

Slide 18 :

18 NC Evidence-Based Medicine Education Center of Excellence:http://www.hsl.unc.edu/ahec/ebmcoe/pages/index.htm Duke University Medical Center (resource materials used in Evidence-Based Medicine course):http://www.mclibrary.duke.edu/respub/guides/ebm.html University of Illinois at Chicago, Evidence Based Medicine: Finding the Best Clinical Literature: http://www.uic.edu/depts/lib/lhsp/resources/ebm.shtml University of Rochester Medical Center, Nesbit EBM Guide: http://www.urmc.rochester.edu/hslt/miner/digital_library/evidence_based_resources.cfm SUNY Downstate Medical Center, Evidence Based Medicine Course: http://library.downstate.edu/EBM2/contents.htm

Slide 19 :

19 Michigan State University, An Introduction to Information Mastery: http://www.poems.msu.edu/infomastery/ University of Virginia Health Sciences Library, Navigating the Maze:Obtaining Evidence-Based Medical Information:http://www.healthsystem.virginia.edu/internet/library/collections/ebm/index.cfm NHS Research and Development Centre for Evidence-Based Medicine http://www.cebm.net/ Netting the Evidence - A ScHARR Introduction to Evidence Based Practice on the Internet: http://www.nettingtheevidence.org.uk/

Slide 20 :

20 Evidence-based Obstetrics & Gynecology www.harcourt-international.com/journals /ebog Evidence-Based Pediatrics www.med.umich.edu/pediatrics

Slide 21 :

21 "evidence pyramid"

Slide 22 :

22 3- Critically appraising the evidence It has 3 steps : 1. Is it valid ( close to truth) 2. Is it important 3. Is it applicable

Slide 23 :

23 There are 9 types of evidence : Diagnostic & screening test Patient prognosis Therapeutic or medical intervention. Systematic review. Quality of care Causation /harm Economic evaluation Guidelines Overview or review articles

Slide 24 :

24 4- Can you apply this valid, important evidence in caring for your patient?

Slide 25 :

25 5. Evaluate our effectiveness & efficiency in steps 1-4 and seeking ways to improve them.

Slide 26 :

26 Three solutions for keeping Clinical performance up to date: by learning how to practice evidence-based medicine ourselves. by seeking and applying evidence-based medical summaries generated by others. by applying evidence-based strategies for changing our clinical behavior.

Slide 27 :

27 What is CAT?

Slide 28 :

28 The BetsBets www.bestbets.org database is maintained by the Emergency Department of Manchester Royal Infirmary, UK. Evidence-Based OnCAll www.eboncall.org/ provides overviews and CATs on many acute care topics The TRIP database www.tripdatabase.com which includes access to questions answered by the ATTRACT service The QUEST database www.sph.uq.edu.au/cgp/red/quest/index.asp covers a range of general practice questions CAT Crawler www.bii-sg.org/research/mig/cat_search.asp is a meta-search engine for CATbanks

Slide 29 :

29 conclusion Clinical decision should be based on best available scientific evidence, informed by epidemiological and biostatical reasoning. Clinical problem should determine the evidence to be sought. Conclusion from identified and critically appraised evidence must lead to changed patient management or health care decision. Clinical performance should be constantly evaluated.

Slide 30 :

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Introduction to Evidence Based Medicine