38 Questions
What is the most important aspect for family physicians to keep up to date with?
Best available evidence
What type of evidence focuses on the disease process and physicians' knowledge?
Disease-Oriented Evidence (DOE)
What is the primary focus of Patient-oriented Evidence that Matters (POEMs)?
Improving patient outcomes such as morbidity and mortality
Why should family physicians prefer POEMs over DOE?
POEMs are more relevant to patient outcomes
What is the usefulness of information dependent on?
Relevance, validity, and work required to obtain it
What happens if the article is not relevant or not valid?
The study is useless
What is the relationship between the usefulness of information and its relevance?
Usefulness is directly related to relevance
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
What is the main goal of patient-based decision-making physicians?
To apply the best available evidence for the patient's benefit
According to traditional medicine, what is sufficient for guiding clinical practice?
Pathophysiological principles
What is the primary difference between traditional medicine and evidence-based medicine?
The use of systematic unbiased observations
Why is evidence-based medicine necessary?
Because studies showed that general physicians have many questions about patient care
What percentage of clinicians' questions were related to therapeutics?
Half
How many clinically important information needs did general physicians identify in half a day?
16
What is the rate of clinicians' questions per patient?
Two questions per three patients
What do clinicians need to evaluate new tests and treatments?
Certain rules of evidence
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
Which of the following is an agency for healthcare research and quality?
Agency for Healthcare Research and Quality (AHRQ)
What is the main purpose of the Cochrane Database of Systematic Reviews?
To provide clinical evidence for medical practice
Which of the following sources provides patient-oriented evidence that matters?
JFP Patient-Oriented Evidence that Matters (POEM)
What is the Centre for Evidence Based Medicine (CEBM)?
A centre that provides evidence-based information on healthcare interventions
Which of the following is not a source of evidence-based medicine?
Wikipedia
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
What is the first step in the process of Evidence-Based Medicine (EBM)?
Assess the patient
What is the PICO principle used for in EBM?
To formulate a clinical question
What is the 'P' in the PICO principle?
Population or Patient
What type of study is best suited to answer a question about the effectiveness of a new drug?
Randomized control trial
What is the sixth step in the process of Evidence-Based Medicine (EBM)?
Assess your performance
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
What type of study is best suited to answer a question about the cause of a disease?
Case control study
What is the major obstacle in keeping up to date with medical knowledge?
Lack of time
What is the correlation between updating knowledge and years since graduation from college of medicine?
Negative correlation
How many articles are published annually in biomedical journals?
More than 2 million
How many articles should a General Physician read daily to keep up to date?
19 articles
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
What is a limitation of textbooks as a source of information?
Little supporting evidence
What type of review provides a broad coverage of one topic?
Summary review
What is the purpose of a systematic review?
To answer a specific clinical question
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.
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.
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