210 likes | 606 Vues
Evidence-Based Medicine Presentation. [Insert your name here] [Insert your designation here] [Insert your institutional affiliation here]. Department of Obstetrics & Gynecology Greenville Hospital System University Medical Center Greenville, South Carolina. Patient Presentation.
E N D
Evidence-Based Medicine Presentation [Insert your name here] [Insert your designation here] [Insert your institutional affiliation here] Department of Obstetrics & Gynecology Greenville Hospital System University Medical Center Greenville, South Carolina
Patient Presentation • Details of patient presentation that prompted the clinical question
Clinical Question • State the clinical question
Background • What general knowledge about the clinical topic and or disease is needed PRIOR to searching for evidence to answer your specific clinical question? • Limit background slides to 2 slides at most
Search Strategy • List the data sources you utilized • If you conducted a search of an electronic database, summarize your search strategy
Search Results • For each data source, list the types of information that you identified • RCT • Case-control studies • Cohort studies • Case series • Guidelines, expert opinions, review articles
Evidence Appraisal • List which of the identified sources were appropriate to your specific clinical question • Summarize how you determined which of the identified studies were appropriate to use in answering your specific clinical question • Remember, you are not trying to present ALL of the evidence, just the BEST evidence
Evidence Appraisal • For each BEST evidence source, perform a critical appraisal, to include some or all of the subsequent slide content • You must critically evaluate EACH evidence source that you believe helps to answer your clinical question.
Hypothesis • If an analytic study, what is the hypothesis that is being tested?
Objectives • What are the primary and secondary objectives of the study?
Methods: Design • What type of study was done? • Primary research (experiment, randomized controlled trial, other controlled clinical trial, cohort study, case control study, cross sectional survey, longitudinal survey, case report, or case series)? • Secondary research (simple overview, systematic review, meta-analysis, decision analysis, guideline development, economic analysis)? • If a “randomized trial” was randomization truly random?
Methods: Setting • What is the setting in which the subjects were studied (e.g. inpatient, outpatient, community hospital, teaching hospital, university)? • If a clinical investigation, was the study conducted in “real life” circumstances?
Methods: Subjects • Who is the study about? • How were subjects recruited? • Who was included in and who was excluded from the study?
Methods: Interventions • What intervention or other maneuver was being considered?
Methods: Outcomes • What outcome(s) were measured and how? • Was assessment of outcome (or, in a case-control study, allocation of cases) “blind”? • Was follow-up complete?
Methods: Statistics • What sort of data do the authors have? • What types of statistical tests were used and were they appropriate to the data type? • Have the data been analyzed according to the original study protocol?
Results • Were the groups similar at the start of the trial? • Aside from the experimental intervention, were the groups treated equally? • What are the key results?
Conclusions • Do the results support the original study hypothesis?
Commentary • Does the evidence you found help to answer your original clinical question? • Can the results be applied to my patient case? • Will the results lead directly to selecting or avoiding therapy? • Are the results useful for reassuring or counseling patients?
Recommendation • State what specific recommendation that you can make (if any) in regards to your clinical question and list the level of evidence for each recommendation: • Level I: Evidence obtained from at least one properly designed RCT • Level II-1: Evidence obtained from well-designed controlled trials without randomization • Level II-2: Evidence obtained from well-designed cohort or case-control studies analytic studies • Level II-3: Evidence obtained from multiple time series, with or without the intervention • Level III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees