Evidence-Based Medicine (EBM) for Family Physicians

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Questions and Answers

What is the most important aspect for family physicians to keep up to date with?

Best available evidence (correct)

Individual clinical experience

Patient values

Basic and clinical subjects

What type of evidence focuses on the disease process and physicians' knowledge?

Individual clinical experience

Patient-oriented Evidence that Matters (POEMs)

Disease-Oriented Evidence (DOE) (correct)

Basic and clinical subjects

What is the primary focus of Patient-oriented Evidence that Matters (POEMs)?

Physicians' knowledge in basic and clinical subjects

Decreasing serum lipid levels

Improving patient outcomes such as morbidity and mortality (correct)

Disease process and treatment

Why should family physicians prefer POEMs over DOE?

POEMs are more relevant to patient outcomes Signup and view all the answers

What is the usefulness of information dependent on?

Relevance, validity, and work required to obtain it Signup and view all the answers

What happens if the article is not relevant or not valid?

The study is useless Signup and view all the answers

What is the relationship between the usefulness of information and its relevance?

Usefulness is directly related to relevance Signup and view all the answers

What is the relationship between the usefulness of information and the work required to obtain it?

Usefulness is inversely related to the work required to obtain it Signup and view all the answers

What is the main goal of patient-based decision-making physicians?

To apply the best available evidence for the patient's benefit Signup and view all the answers

According to traditional medicine, what is sufficient for guiding clinical practice?

Pathophysiological principles Signup and view all the answers

What is the primary difference between traditional medicine and evidence-based medicine?

The use of systematic unbiased observations Signup and view all the answers

Why is evidence-based medicine necessary?

Because studies showed that general physicians have many questions about patient care Signup and view all the answers

What percentage of clinicians' questions were related to therapeutics?

Half Signup and view all the answers

How many clinically important information needs did general physicians identify in half a day?

16 Signup and view all the answers

What is the rate of clinicians' questions per patient?

Two questions per three patients Signup and view all the answers

What do clinicians need to evaluate new tests and treatments?

Certain rules of evidence Signup and view all the answers

What is metanalysis in the context of evidence-based medicine?

A type of systematic review in which the results of several scientific trials are pooled Signup and view all the answers

Which of the following is an agency for healthcare research and quality?

Agency for Healthcare Research and Quality (AHRQ) Signup and view all the answers

What is the main purpose of the Cochrane Database of Systematic Reviews?

To provide clinical evidence for medical practice Signup and view all the answers

Which of the following sources provides patient-oriented evidence that matters?

JFP Patient-Oriented Evidence that Matters (POEM) Signup and view all the answers

What is the Centre for Evidence Based Medicine (CEBM)?

A centre that provides evidence-based information on healthcare interventions Signup and view all the answers

Which of the following is not a source of evidence-based medicine?

Wikipedia Signup and view all the answers

What happens when a study is valid and relevant to the practice but the work needed to obtain the information is huge?

The study is useless Signup and view all the answers

What is the first step in the process of Evidence-Based Medicine (EBM)?

Assess the patient Signup and view all the answers

What is the PICO principle used for in EBM?

To formulate a clinical question Signup and view all the answers

What is the 'P' in the PICO principle?

Population or Patient Signup and view all the answers

What type of study is best suited to answer a question about the effectiveness of a new drug?

Randomized control trial Signup and view all the answers

What is the sixth step in the process of Evidence-Based Medicine (EBM)?

Assess your performance Signup and view all the answers

What type of question is being asked in the example 'In mild to moderate adult asthmatics, does the regular use of salbutamol compared to as needed use result in worse asthma control?'

Therapy Signup and view all the answers

What type of study is best suited to answer a question about the cause of a disease?

Case control study Signup and view all the answers

What is the major obstacle in keeping up to date with medical knowledge?

Lack of time Signup and view all the answers

What is the correlation between updating knowledge and years since graduation from college of medicine?

Negative correlation Signup and view all the answers

How many articles are published annually in biomedical journals?

More than 2 million Signup and view all the answers

How many articles should a General Physician read daily to keep up to date?

19 articles Signup and view all the answers

What is the primary goal of becoming competent in modern medical practice?

To have a logical, systematic quick approach to get an answer to clinical problems Signup and view all the answers

What is a limitation of textbooks as a source of information?

Little supporting evidence Signup and view all the answers

What type of review provides a broad coverage of one topic?

Summary review Signup and view all the answers

What is the purpose of a systematic review?

To answer a specific clinical question Signup and view all the answers

Study Notes

Importance of Evidence-Based Medicine (EBM)

EBM is crucial for family physicians to keep up-to-date and reinforce previously known concepts
It helps translate medical recommendations to patients and answer their questions
EBM combines best available evidence, individual clinical experience, and patient values

Disease-Oriented Evidence (DOE) vs. Patient-Oriented Evidence that Matters (POEMs)

DOE focuses on disease processes and physician knowledge, e.g., using drug X decreases serum lipid levels
POEMs focus on patient outcomes, e.g., using drug X reduces mortality and morbidity
Family physicians should prioritize POEMs over DOE when making decisions

Usefulness Equation

Usefulness of information is directly related to relevance and validity, and inversely related to work required to obtain it
Relevance is the importance of information in the clinical setting
Validity is the level of correctness of the information
Work is the amount of effort needed to acquire new information

Differences between Traditional Medicine and EBM

Traditional medicine relies on unsystematic observation and pathophysiological principles
EBM emphasizes systematic unbiased observations, critical appraisal of literature, and evidence-based guidelines

Need for EBM

Studies show that clinicians have many unanswered questions, and the current system is inefficient
The number of biomedical journals and articles is overwhelming, making it difficult for clinicians to keep up-to-date
Traditional continuing medical education is ineffective in improving patient outcomes

Sources of Information

Academic reviews, including textbooks and scientific journals
Agency for Healthcare Research and Quality (AHRQ)
American College of Physicians Journal Club (ACPJC)
Bandolier
Centre for Evidence Based Medicine (CEBM)

Steps of EBM

Assess the patient
Ask a clinical question using the PICO principle
Acquire the best evidence
Appraise the evidence
Apply the best evidence
Assess your performance

PICO Principle

Population or Patient
Intervention or Indicator
Comparator or Control
Outcome

Examples of PICO Questions

In mild to moderate adult asthmatics, does regular use of salbutamol compared to as-needed use result in worse asthma control?
In pediatric age group with otitis media, using Amoxicillin compared to no treatment will lead to early recovery.

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Description

Assess your understanding of evidence-based medicine principles and applications in family practice. Learn how to stay updated, manage patients, and answer their questions effectively.