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Study Designs and Evidence Acquisition in Clinical Research

Learn to link research questions to study designs for therapy, diagnosis, prognosis, and harm evaluation. Understand utility, performance, and likelihood in RCT, cohort, and case-control studies. Explore resources for evidence-based medicine search engines. Practice guidelines, systematic reviews, and single-arm studies discussed.

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Study Designs and Evidence Acquisition in Clinical Research

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  1. TEACH 2013Track 1 Aquiring the Evidence

  2. Linking questions to study designs • Therapy • Utility • Performance • Likelihood • Diagnosis • Utility • Performance • Likelihood • Prognosis • Utility • Performance • Likelihood • Harm • Utility • Performance • Likelihood • RCT • COHORT • CROSS-SECTIONAL • CASE CONTROL

  3. Linking questions to study designs • THERAPY • Utility • Performance • Likelihood • DIAGNOSIS • Utility • Performance • Likelihood • PROGNOSIS • Utility • Performance • Likelihood • HARM • Utility • Performance • Likelihood • THERAPY • RCT • Cohort • Cohort • DIAGNOSIS • RCT • Cross-Sectional • Observational • PROGNOSIS • RCT • Cohort • Cohort/Single Arm • HARM • Cohort, Case-Control • Cohort • Cohort/Single Arm

  4. Linking study Designs to sources

  5. EBM Search engines

  6. Back to the case • QUESTION 1 • Therapy/Utility • P: Elderly patients with acute, stable AF, but no structural heart disease presenting to the ED < 48 hours of onset • I: Rapid acting pharmacological agents safely titrated to effect • C: Alternative regimens safely titrated to effect • O: Likelihood of rate control or cardioversion, hospital admission, complications of uncontrolled AF, adverse reactions to drugs Practice Guidelines, Systematic Review, RCT, Non-randomized studies

  7. Back to the case • QUESTION 2 • Prognosis/Likelihood • P: Elderly patients with acute, stable AF, but no structural heart disease presenting to the ED < 48 hours of onset • I: Observation over a 30-day period • C: N/A • O: Stroke, decompensated heart failure, MI, death Practice Guidelines, Systematic Review, Cohort, Control Arm of an RCT

  8. BACK TO THE CASE • QUESTION 3 • Harm/Likelihood • P: Elderly patients with acute, stable AF, but no structural heart disease presenting to the ED < 48 hours of onset • I: Cardioversion in ED with discharge and early follow-up • C: N/A • O: Short-term complications of cardioversion, embolic events, admission, other complications of AF Practice Guidelines, Systematic Review, Cohort, Single-Arm Study

  9. Question 1 • SUMMARY: NGC, GIN Dynamed • SYNTHESIS: DARE

  10. QUESTION 2 • SYNTHESIS: Pubmed • SINGLE STUDY: Pubmed

  11. QUESTION 3 • SUMMARY: NGC • SINGLE STUDY: Pubmed

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