Introduction to Evidence Based Medicine and its appliations

Introduction to evidence based medicine.

1. Evidence Based Medicine By: Dr. Wais Farda

2. Evidence Based Medicine What is EBM? Use the best evidence possible The most appropriate information available Make clinical decisions for individual patients EBP values, enhances, and builds on: clinical expertise knowledge of disease mechanisms, and pathophysiology .

3. Evidence Based Medicine Complex and conscientious decision-making based on: available evidence patient characteristics situations preferences

4. Evidence Based Medicine Definitions: conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients Making a conscientious effort to base clinical decisions on research that is most likely to be free from bias, and using interventions most likely to improve how long or well patients live systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patient values

5. Evidence Based Medicine

6. Evidence Based Medicine individual clinical expertise proficiency and judgment clinicians acquire through clinical experience and clinical practice Best available external clinical evidence clinically relevant research Patient values and expectations individual patients' predicaments, rights, and preferences

7. Evidence Based Medicine EBP involves five steps: formulating the question retrieval of the necessary information Assessment of the information Clinical decision Evaluation

8. Evidence Based Medicine Necessary Skills: Find the best evidence for every day practice Assess relevance Evaluate information Understand basic statistics. Computer based information and tools for clinical decision making Evaluate expert-based information Critically evaluate information from pharmaceutical representatives

9. Evidence Based Medicine Levels of Evidence IA - Meta-analysis of randomized controlled trials IB - At least one randomized controlled trial IIA – At least one controlled study without randomization IIB – At least one other type of quasi-experimental study III - Non-experimental descriptive studies, such as comparative studies, correlation studies, and case-control studies IV - Expert committee reports or opinions or clinical experience of respected authorities, or both

10. Evidence Based Medicine Grades of Recommendation A - Directly based on Level I B - Directly based on Level II, or extrapolated recommendations from Level I C - Directly based on Level III, or extrapolated recommendations from Level I or II D - Directly based on Level IV, or extrapolated recommendations from Level I, II, or III

11. Evidence Based Medicine