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Module 4 Finding the Evidence: Individual Trials

Module 4 Finding the Evidence: Individual Trials. EBM Literature: Reviews. Individual Studies: Experimental. Individual Studies: Observational. Evidence hierarchy. Search ordr. Level of evidence. Meta analyses Systematic reviews Randomized control trials (RCTs)

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Module 4 Finding the Evidence: Individual Trials

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  1. Module 4Finding the Evidence:Individual Trials

  2. EBM Literature: Reviews Individual Studies:Experimental Individual Studies:Observational Evidence hierarchy Search ordr Level of evidence Meta analyses Systematic reviews Randomized control trials (RCTs) Controlled trials w/o randomization Cohort studies Case control studies/retrospective cohort Case studies/qualitative studies

  3. Resources for Trials

  4. Resources for Trials

  5. CENTRAL

  6. Resources for Trials

  7. TRIP Database

  8. TRIP Database

  9. Resources for Trials

  10. RecruitmentWho did the subjects represent? Allocation Was the assignment to treatments randomized? Were the groups similar at the trial’s start? MaintenanceWere the groups treated equally?Were outcomes ascertained & analyzed for most patients? MeasurementsWere patients and clinicians “blinded” to treatment? ORWere measurements objective & standardized? Appraisal - RAMMbo

  11. Be careful • 102 trial protocols (3736 outcomes)  122 published journal articles • 62% of trials  discrepancy in outcomes • 92% of trials  incomplete reporting of efficacy outcomes • 86% of authors  denied existence of unreported outcomes despite evidence • Statistically significant outcomes had a higher odds of being fully reported Chan JW, et al. 2004. Empirical evidence for selective reporting of outcomes in randomized trials: comparison of protocols to published articles. JAMA 291(20):2457

  12. Module 4Finding the Evidence:Individual Trials

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