Evidence-Based Practice in MBBS Stage 1

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Questions and Answers

What historical figure emphasized the importance of not causing harm to patients in their medical practice?

Galen

Paracelsus

Avicenna

Hippocrates (correct)

What does QALY stand for in the context of clinical evidence management?

Quality Assessment of Life Years

Quantified Annual Life Years

Quality Analyzed Life Years

Quality Adjusted Life Years (correct)

Which database is primarily focused on systematic reviews of healthcare interventions?

PubMed

Scopus

Cochrane Database of Systematic Reviews (correct)

EMBASE

What critical principle did Hippocrates advocate concerning patient confidentiality?

All patient knowledge gained during practice must be kept secret. Signup and view all the answers

What type of research design is characterized by random assignment to different treatment groups?

Randomised controlled trial Signup and view all the answers

What is the primary focus of clinical guidelines in evidence-based practice?

Providing a framework for decision making in clinical care Signup and view all the answers

Which of the following concepts is NOT a component of evidence-based practice?

Traditional healing Signup and view all the answers

What is the intended outcome when using Quality Adjusted Life Years (QALYs) in healthcare decision making?

To measure the value of health interventions by both the quality and quantity of life Signup and view all the answers

What secret is an individual in the profession expected to keep?

Confidential information encountered during practice Signup and view all the answers

Which study's findings indicate a surprising positive association with mortality?

A study on healthcare indices across 18 countries Signup and view all the answers

What was emphasized as crucial in Sir Archie Cochrane's book?

The importance of randomized control trials Signup and view all the answers

What anomaly related to doctors and mortality was reported by Cochrane?

An increase in doctors results in higher mortality in younger age groups Signup and view all the answers

What variable demonstrated a strong negative association with mortality in Cochrane’s findings?

Gross national product per head Signup and view all the answers

What criticism did Sir Archie Cochrane have for clinicians in the NHS?

They often ignore trial results that contradict their beliefs Signup and view all the answers

What was one of Sir Austin Bradford-Hill's contributions to the field?

Development of criteria for causation Signup and view all the answers

In what year did Sir Archie Cochrane publish 'Effectiveness and Efficiency'?

1972 Signup and view all the answers

What principal variable shows a strong negative association with mortality according to Sir Archie Cochrane's study?

Gross national product per head Signup and view all the answers

In Sir Archie Cochrane's findings, what unexpected relationship was noted between the prevalence of doctors and mortality?

Positively associated in younger age groups Signup and view all the answers

Who is co-founder of the Cochrane Library of Systematic Reviews?

Sir Ian Chalmers Signup and view all the answers

What aspect of health care indices was observed in Cochrane's study regarding their association with mortality?

They are positively correlated with mortality. Signup and view all the answers

In which year was the Oxford Database of Perinatal Trials established?

1986 Signup and view all the answers

What year was the report on the study of 18 countries published in the BMJ by Sir Archie Cochrane?

1978 Signup and view all the answers

How many systematic reviews does the Cochrane Library currently have?

7,500 Signup and view all the answers

What methodology is the Cochrane Library primarily associated with?

Randomized controlled trials Signup and view all the answers

What is the primary purpose of evidence-based practice?

To make decisions based on the best available evidence Signup and view all the answers

Which of the following best describes a randomized controlled trial (RCT)?

An experimental design where both treatment and control groups are randomly selected Signup and view all the answers

What is the primary function of a meta-analysis?

To integrate and analyze data from multiple studies addressing the same question Signup and view all the answers

What aspect is NOT typically considered during the critical appraisal of evidence?

Popularity of the study's conclusions Signup and view all the answers

Which of the following best reflects the hierarchy of experimental evidence?

Randomized controlled trials, cohort studies, expert opinions Signup and view all the answers

Which statement about evidence-based medicine is true?

It emphasizes critical questioning and systematic retrieval of evidence. Signup and view all the answers

What is not an essential component of evidence management?

Ignoring conflicting evidence to adhere to a hypothesis Signup and view all the answers

Which feature distinguishes systematic reviews from regular literature reviews?

They apply a rigorous and predefined methodology for study evaluation. Signup and view all the answers

What is a potential consequence of too much clinical evidence?

Statistically significant benefits may lack clinical importance. Signup and view all the answers

What is a key reason for the establishment of NICE?

To promote uniformity in clinical practices across regions. Signup and view all the answers

Which of the following is NOT a core principle of NICE?

Limited Consultation Signup and view all the answers

What does QALY stand for?

Quality Adjusted Life Years Signup and view all the answers

How does NICE ensure the quality of its guidance?

Via independent advisory committees and public involvement. Signup and view all the answers

What is one dimension assessed by QALYs?

Quality of life Signup and view all the answers

What was the initial purpose of NICE when it was first established?

To provide national guidance on clinical treatments. Signup and view all the answers

Which of the following accurately describes the importance of ongoing rationalization in clinical evidence?

It simplifies complex evidence for practical use. Signup and view all the answers

Study Notes

Overview of Evidence-Based Practice

Evidence-based practice is a systematic method of decision-making that utilizes the best available evidence for informed actions.
It translates uncertainty into answerable questions, emphasizing critical questioning and study design.

Key Concepts

Cochrane Database of Systematic Reviews: A comprehensive resource for systematic reviews of randomized controlled trials, containing over 7500 reviews.
Randomized Controlled Trials (RCTs): Experimental evaluations where participants are randomly selected from an eligible population to reduce bias and control variables.
Meta-analysis: A statistical approach that integrates data from multiple studies to derive overall conclusions and effect sizes.

Historical Figures in Evidence-Based Medicine

Hippocrates (460-370 BC): Advocated for patient welfare and ethical practice in medicine, emphasizing a non-harm principle.
Sir Austin Bradford-Hill (1897-1991): Known for establishing criteria of causation and promoting clinical trials in epidemiology.
Sir Archie Cochrane (1909-1988): Researched healthcare indices and emphasized the importance of randomized controlled trials, highlighting anomalies in doctor-related mortality data.
Sir Ian Chalmers (b. 1943): Co-founder of the Cochrane Library; instrumental in advancing systematic reviews in health research.

Role of NICE (National Institute for Health and Care Excellence)

Established in 1999 to provide national guidance on health practices and treatments; transitioned to a non-departmental body in 2013.
Aims to address variations in clinical practice, support clinicians with current evidence, evaluate cost-effectiveness of treatments, and encourage innovation.
Utilizes expert input, public consultation, and independent advisory committees to ensure a comprehensive and transparent process.

Quality Adjusted Life Years (QALYs)

A health economic measure combining the quantity and quality of life gained from healthcare interventions.
Scores range from 0 (no quality) to 1 (full quality), assessing the value of life extensions against their costs.
Provides valuable insights into the cost-effectiveness of healthcare interventions, aiding decision-making processes in public health.

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Description

Explore the essential concepts of evidence-based practice in medicine, focusing on systematic reviews, randomized controlled trials, and meta-analysis. This quiz covers the application of clinical guidelines and quality adjusted life years in the context of healthcare. Enhance your understanding of how evidence shapes medical decision-making.