实证医学弹简介与实务.ppt

實證醫學簡介與實務 -如何改善教學技巧- 臺北醫學大學九十二學年度教師發展中心研討會 Clinical Epidemiology - 臨床流行病學 Triple “E” of EBM Search evidence 工具篇 教學資源 Oxford Centre for EBM 實施實證醫學五大步驟 EBM密碼 QSAA Q: PECOT S: PubMed A: CAT A: NNT EBM解碼 QSAA Question: PECOT Participant Exposure Comparison Outcomes Time Search: PubMed Appraisal: CAT critical appraisal of topics Apply: NNT Number need to treatment Prefiltered DATABASES Cochrane Library (HINT有) Cochrane Database of Systematic Reviews (CDSR) Cochrane Controlled Trials Register (CCTR) Database of Reviews of Effectiveness (DARE) NHS Economic Evaluation Database Health Technology Assessment Database Cochrane Library /cochrane/abstract.htm EMBASE pre-filtered EBM resource To answer focused clinical questions, the most efficient approach is to begin with a pre-filtered evidence-based medicine resource such as Best Evidence, the Cochrane Library, or Clinical Evidence National Guideline Clearinghouse Boolean Operators (AND, OR, NOT, *, (a or b) and c ) Screening for breast cancer: recommendations and rationale, 2002 filter /search/detailedsearch.aspx Search evidence Unfiltered DATABASES MEDLINE CINAHL PsycINFO ERIC (Education Resources Information Center) Searching Key Words : 搜尋策略 top down Can hyperbaric oxygenation accelerates the healing rate of nonischemic chronic diabetic foot ulcers? PECOT P: nonischemic chronic diabetic foot ulcers E: Hyperbaric oxygenation accelerates C: wound care O: the healing rate T: one month MEDLINE If a search of UpToDate, Best Evidence, and the Cochrane Library does not provide a satisfactory answer to a focused clinical question, it may be time to turn to MEDLINE. the first medical literature database something for everyone Steps Problem 1: You are trying to find a known paper 眾裡尋她 Problem 2: You want to answer a specific question 直指核心 Problem 3: You want to get general information 　　  quickly about a well defined topic 綜覽主題 Problem 4: Your search gives irrelevant articles 去蕪存菁 Pro