RESEARCH University of Pittsburgh的研究匹兹堡大学.pptVIP

EVIDENCE BASED MEDICINEfor Beginners Maria Fidelis Manalo, MD, Msc Epidemiology Department of Community Family Medicine FEU-NRMF Medical Center Philippines Evidence-Based Medicine Definition “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient” David Sackett EBMHistorical Evolution Has roots going back to 19th c.? Recently broadened interest due to information explosion that increased dramatically in the last decade. Has become more formalized that have enabled practitioners to approach medical problems and evaluate medical literature with greater consistency and to deal with massive amounts of medical information via a qualitative approach. Misapprehensions Misinterpretations about EBM 1) Evidence-based medicine ignores clinical experience and clinical intuition. 2) Understanding of basic investigation and pathophysiology plays no part in evidence-based medicine. 3) Evidence-based medicine ignores standard aspects of clinical training such as the physical examination. Types of Questions Asked for general knowledge about a disorder? Has two essentials components: a question root ( who, what, where, how, why) with a verb a disorder Background Questions Textbooks answer background questions, they contain collected synthesized wisdom for topics that do not change often.? Not all topics are covered, easy to use, relatively inexpensive and can be opinion-based rather than evidence-based, written by experts in their fields. Basis of Evidence-based care involves the integration of the best research evidence with clinical expertise and patient values.???????????? EBM Principles  1.? Construct a well-built clinical question and classify it into one category (therapy, diagnosis, etiology or prognosis) 2.? Find the evidence in health care literature 3.? Critically appraise or formally evaluate for validity and