台湾药师5A工作模式-索拉菲尼在肝细胞癌中的进展.ppt

* Cohort Study SUNY Downstate EBM Tutorial /EBM2/research.htm * Case Control Study SUNY Downstate EBM Tutorial /EBM2/research.htm * Case Series and Case Report SUNY Downstate EBM Tutorial /EBM2/research.htm * * Practice 實用性 (1) 這個治療是否可行？是病患可否負擔？可 這個治療對你的病人有幫助嗎？有 評估我們的患者透過該治療可能得到的好處與傷害。 估計本國此疾病的發生率（PEER, patient’s expected event rate） PEER = 16.2% 估計方法 PEER = 論文中的CER * Practice 實用性 (2) 根據疾病的發生率（PEER），計算本治療在國內的NNT、NNH。 PEER method，假設RRR，RRI不受地區影響改變。 NNT = 1/(PEER x RRR) = 1/(0.162 x 0.13) = 47.48 NNH = 1/(PEER x RRI) = 1/(0.07 x 0.142) = 100.60 根據個人經驗粗估本疾病治療好處及副作用的危險性是論文中的 f 倍 ft = 1 NNTpatient = NNTreported/ft = 47.48 fh =1 NNHpateint = NNHreported/fh = 100.60 * Practice 實用性 (3) 根據病人的期望，比較患者接受此治療的好處與壞處。 Sdisease（得到疾病的嚴重度）= 0.1 Sharm（進行治療的副作用）= 0.9 S(severity factor) = Sharm/Sdisease = 9 患者接受此治療得到的利害比（LHH, likelihood of being helped or harmed） 原始LHH = ARR: ARI = (1/NNT) : (1/NNH) = 2.12 Adjusted LHH = [(1/NNT) x ft x S] : [(1/NNH) x fh] = 19.08 * Validity (1) Definition: the best available approximation to the truth or falsity of a given proposition, inference, or conclusion. Typology of validity Conclusion Validity (statistical conclusion validity): Is there a relationship between the two variables? The confidence we have on the conclusions we reach about relationships in our data (i.e. there is a significant correlation between two variables.) It concerns only whether such a relationship exists, but not whether such a relationship is a causal one. Internal Validity: Assuming that there is a relationship in this study, is the relationship a causal one? External Validity: Assuming that there is a causal relationship between the constructs of the cause and the effect, can it be generalized to other persons, places or times. * Validity (2) Typology of Validity (~ continued) Content Validity is evaluated by showing how well the content of the test samples the class of situations or subject matter about which conclusions are to be drawn. Criterion-related Validity i