如何提出问题.pptVIP

At least 1-year duration Sudden death 2 grams/day 2 grams/day RCT Overall mortality Sunflower seed oil EPA+DHA Recent myocardial infarction Study Design Outcomes Control Intervention Population Specify Review Criteria Approach to (de)constructing research question Question of interest is often over-archingg Need to break it down into answerable subunits Final answers (recommendations) require syntheses of answers from multiple questions, and typically involve additional information, balancing the benefits and harms, feasibility, costs, etc Analytic framework for omega--3 FA intake and CVD Target Populations Healthy Adults Adults with known CVD Adults with elevated risk for CVD Diabetes, Hypertension, Hyperlipidemia Adverse Events Omega-3 Fatty Acid Consumption Source, Dosage, Duration Tissue / Plasma Levels Modifiers RBC Phospholipid FAs WBC ghost Phosphlipid FAs Plasma Phospholipid FAs Platelet Phospholipid FAs Drug Interactions Other Others Intermediate Outcomes / Biological Effects Blood Pressure Diabetes Markers Heart Rate Variability Cholesterol Lipoprotein (a) C Reactive Protein Carotid Intima Media Thickness Coronary Arteriography Markers Others Fibrinogen Clinical Outcomes Death Myocardial Infarction Stroke Unstable Angina Ventricular Arrhythmia Others 表. 构造临床问题 Outcome Patient or Problem Intervention or Exposure Comparison 你遇到一位55岁的每年例行体检的绝经后妇女。她患 有高血压，平时很少运动，为静坐的生活方式，且长 期重度吸烟。为了预防骨质疏松和缺血性心脏病，她 可以进行联合激素替代治疗。但是她75岁的母亲最近 被诊断为乳腺癌。她母亲的肿瘤科大夫告诉她因为有 家族史，所以她（我们的病人）发生乳腺癌的危险性 也会增加，所以建议她不要进行激素替代治疗，因为 这样会进一步增加她发生乳腺癌的危险性。现在这位 妇女来征求你的意见。 与短期进行或不进行 HRT 进行比较… Comparison 可 以预 防缺血 性心脏 病 和股骨骨折，同时这一收 益 超过 了可能 会发生 乳 腺癌的危害？ 进行长 期的联合激素替 代 治疗（HRT ）... 一绝经后妇女：骨质疏 松及心脏病的危险性增 加，其母亲 75 岁时被诊 断为乳腺癌… OutcomeOu co e Interventione ve o oro Exposureposu e Patiente oro Problemob e 与治疗有关的问题 你的病人是一个健康的35岁男性，发生咽喉炎2天。不 发烧，不咳嗽，检查发现颈前淋巴结增大，扁桃腺或 咽后无分泌物。你最近在内科学年报上读到一篇文章， 提到快速的链球菌抗原检验在检测A族β溶血性链球菌 时有较低的灵敏度和较高的特异度。你开始犹豫是否 有必要放弃快速的链球菌抗原检验，而改为咽培养。 与诊断有关的问题 Pat