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    Introduction To Evidence Based Medicine: Maisuri T. Chalid

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    Muhammad Isya Ansyari
    This document provides an introduction to evidence-based medicine (EBM). It discusses how EBM aims to use current best evidence from scientific research to guide treatment decisions for individual patients. The EBM process involves asking a clear clinical question, searching relevant literature, critically evaluating the evidence, and applying the results to patient care. Key steps include forming a well-structured question using the PICO framework, searching appropriate databases and journals, assessing the validity and results of studies, and determining if the evidence will help with a specific patient. EBM requires lifelong learning as it integrates research findings into daily clinical practice.

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    Introduction To Evidence Based Medicine: Maisuri T. Chalid

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    Muhammad Isya Ansyari
    48 views29 pages
    This document provides an introduction to evidence-based medicine (EBM). It discusses how EBM aims to use current best evidence from scientific research to guide treatment decisions for individual patients. The EBM process involves asking a clear clinical question, searching relevant literature, critically evaluating the evidence, and applying the results to patient care. Key steps include forming a well-structured question using the PICO framework, searching appropriate databases and journals, assessing the validity and results of studies, and determining if the evidence will help with a specific patient. EBM requires lifelong learning as it integrates research findings into daily clinical practice.

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    Introduction to Ebm

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    This document provides an introduction to evidence-based medicine (EBM). It discusses how EBM aims to use current best evidence from scientific research to guide treatment decisions for individual patients. The EBM process involves asking a clear clinical question, searching relevant literature, critically evaluating the evidence, and applying the results to patient care. Key steps include forming a well-structured question using the PICO framework, searching appropriate databases and journals, assessing the validity and results of studies, and determining if the evidence will help with a specific patient. EBM requires lifelong learning as it integrates research findings into daily clinical practice.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    48 views29 pages

    Introduction To Evidence Based Medicine: Maisuri T. Chalid

    Uploaded by

    Muhammad Isya Ansyari
    This document provides an introduction to evidence-based medicine (EBM). It discusses how EBM aims to use current best evidence from scientific research to guide treatment decisions for individual patients. The EBM process involves asking a clear clinical question, searching relevant literature, critically evaluating the evidence, and applying the results to patient care. Key steps include forming a well-structured question using the PICO framework, searching appropriate databases and journals, assessing the validity and results of studies, and determining if the evidence will help with a specific patient. EBM requires lifelong learning as it integrates research findings into daily clinical practice.

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    INTRODUCTION TO EVIDENCE BASED MEDICINE

    Maisuri T. Chalid

    In an Ideal World
    The most effective care for every condition would be known Every clinician would know the most effective care for every patient Every clinician would practice the most effective care that she/he knows

    In the Real World


    Much of what should be known is not known Much that is known, is not known by most clinicians Clinicians often fail to practice what they know to be the most effective form of care

    Evidence-based medicine is the systematic, scientific and explicit use of current best evidence in making decisions about the care of individual patients.
    EBM : KEDOKTERAN BERBASIS BUKTI

    Evidence-based medicine
    creates the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues.

    Evidence-based medicine
    Requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. A process of lifelong learning, selfdirected learning, problem-based learning in which caring for one's own patients is now considered to be an integral component of undergraduate medical curricula, postgraduate training and clinical practice.

    Why is EBM important?


    The textbook collections too old Lack of knowledge appropriate resources Lack of time to find the needed information. Has confirmed the management decision
    lead to a new therapy Changed medication & diagnostic test corrected a previous plan.

    The EBM Process

    The Steps in the EBM Process


    EBM always begins and ends with the patient. To begin this process, consider the following clinical scenario:

    Anatomy of a good clinical question (PICO)


    Patient or problem (P)
    What are the most important characteristics of the the patient? (the primary problem, disease, co-existing conditions, sex, age, which relevant to diagnosis & treatment)

    Intervention, prognostic factor, or exposure ( I )


    Which main intervention, prognostic factor, or exposure are you considering? dose/intensity/timing?

    Anatomy of a good clinical question (PICO) Comparison ( C )


    What is the main alternative to compare with the intervention? between two drugs, a drug and no medication or placebo, or diagnostic tests?

    Outcomes Measures(O)
    What can you hope to accomplish, measure, improve or affect? What are you trying to do for the patient? Relieve or eliminate the symptoms/ the number of adverse events? Improve function or test scores?

    The Literature Search

    Raw material ~ 115 journal titles

    Top Yielding Journals


    N England Journal of Medicine JAMA BMJ Lancet Cochrane Database Systematic Reviews

    Select the resoursces

    MEDLINE will give you access to the primary literature. Secondary resources such as ACP Journal Club, POEMS, Clinical Inquiries, Clinical Evidence, will provide you with an assessment of the original study. Cochrane Library provides access to systematic reviews which help summary results from a number of studies.

    Detailed list of resources for practicing EBM

    For this question, we have chosen MEDLINE as our resource. MEDLINE is comprehensive resource for health-related literature searches and is acces everyone through PubMed.
    Formulate the strategy

    Step 1: Search each important concept separately.


    Enter the term for Pauline's condition: congestive heart failure. PubMed => map your term to an appropriate Medical Subject Heading (MeSH). Click on DETAILS to see what terms PubMed used in its search. To be sure it found the appropriate MeSH Terms and Text Words.

    Next, Clear the search box and enter the term for the intervention, digoxin. Click on Details to see what terms PubMed used in its search.

    Next, Clear the search box and enter the term for the outcome, hospitalization. Click on Details to see what terms PubMed used in its search.

    Step 2: Combine the separate sets of articles.


    Click on History to view the 3 separate sets of articles you retrieved. Combine them to identify those articles that contain all 3 terms. In PubMed use the "#".

    Step 3: Limit the results to the appropriate publication type, language, human.

    Review the results


    Review the titles and abstracts to identify potentially relevant articles

    EVALUATING THE EVIDENCE 3 basics questions


    Are the results of the study valid? What are the results? Will the results help in caring for my patient?

    Are the results of this therapy study valid? Randomization Follow up (80% or better) Blinding (the more blinding the better) Baseline similarities (established at the start of the trial)

    Take a moment to reflect on how well you were able to conduct the step of EBM Process. Did you ask a relevant, well focused question? Do you have fast and reaccess to the necessary resources? Do you know how to use them efficiently? Did you find a pre-appraised article? If not, was it difficult to critically evaluate the article?

    THANK YOU

    World Health Organization (WHO), Geneva,Switzerland

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