Evidence-Based Practice MBBS Stage 1

Questions and Answers

What is the primary variable that shows a consistently strong negative association with mortality?

Gross national product per head (correct)

Age demographics

Indices of health care

Prevalence of doctors

Which association is observed between the prevalence of doctors and mortality in younger age groups?

Inversely proportional

Positive association (correct)

No correlation

Negative association

What anomaly has not been explained in relation to the prevalence of doctors?

The efficacy of doctor training programs

The impact of medical technology

The decline in childbirth mortality

The correlation between doctors and increased mortality (correct)

Who co-founded the Cochrane Library of Systematic Reviews?

Sir Ian Chalmers Signup and view all the answers

What type of trials does the Cochrane Library predominantly feature?

Randomised controlled trials Signup and view all the answers

What was a focus of the Oxford Database of Perinatal Trials created in 1986?

Effective care in pregnancy and childbirth Signup and view all the answers

What does evidence-based practice primarily rely on?

Clinical trials and empirical data Signup and view all the answers

How many systematic reviews does the Cochrane Library currently have?

More than 7,500 Signup and view all the answers

What is the primary focus of Sir Archie Cochrane's book, 'Effectiveness and Efficiency'?

The importance of clinical trials in healthcare Signup and view all the answers

What anomaly did Sir Archie Cochrane report regarding doctors and mortality in younger age groups?

A positive association between the number of doctors and mortality Signup and view all the answers

What key variable did Cochrane find to have a strong negative association with mortality?

Gross national product per head Signup and view all the answers

Which statement best reflects the recommended practices according to the BMJ review of Cochrane's findings?

Randomized control trials should be prioritized in clinical settings. Signup and view all the answers

What did Sir Austin Bradford-Hill emphasize regarding information in professional practice?

Keeping sensitive information confidential Signup and view all the answers

What conclusion did Cochrane draw regarding health care indices and mortality rates?

They are irrelevant to mortality outcomes. Signup and view all the answers

In Cochrane's view, who does he consider the 'villains' in the context of clinical trials?

Clinicians who ignore trial results Signup and view all the answers

What time period did Sir Archie Cochrane's active career span as identified in the information?

1909 - 1988 Signup and view all the answers

What was Hippocrates' main principle regarding the treatment of patients?

To prioritize the patient's well-being above all else. Signup and view all the answers

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

Hippocratic Oath Signup and view all the answers

What was Hippocrates' stance on medical procedures he was not trained for?

He advised against performing them and leaving it to specialists. Signup and view all the answers

Which of the following best describes Quality Adjusted Life Years (QALYs)?

A method to evaluate the cost-effectiveness of medical interventions. Signup and view all the answers

The Cochrane Database of Systematic Reviews is best known for:

Offering comprehensive systematic reviews on healthcare interventions. Signup and view all the answers

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

National Institute for Clinical Excellence Signup and view all the answers

The primary purpose of randomised controlled trials is to:

Generate statistical comparisons without bias. Signup and view all the answers

Which of the following best describes the significance of the Hippocratic Oath in modern medicine?

It outlines ethical principles foundational to medical practice. Signup and view all the answers

What is one of the potential drawbacks of having an overwhelming amount of clinical evidence?

Statistically significant benefits may not be clinically important. Signup and view all the answers

Which organization was established to reduce inappropriate variations in clinical practice?

NICE Signup and view all the answers

What do QALYs measure in health economics?

The added duration and quality of life gained. Signup and view all the answers

What is one of the core principles of NICE?

Independent advisory committees. Signup and view all the answers

Prior to 2013, what was NICE known as?

NHS Special Authority Signup and view all the answers

What does a QALY score of 0 represent?

No quality of life. Signup and view all the answers

Which aspect is NOT addressed by NICE?

Promoting costly treatments for all. Signup and view all the answers

Which of the following is a potential consequence of clinical evidence becoming unintelligible?

Difficulties in applying evidence to complex cases. Signup and view all the answers

What is one of the primary purposes of clinical guidelines?

To make the volume of research manageable for clinicians Signup and view all the answers

Which organization is NOT typically involved in the creation of clinical guidelines?

American Marketing Association Signup and view all the answers

What trend in systematic reviews was observed between 2000 and 2019?

The number of systematic reviews increased dramatically Signup and view all the answers

What does the existence of multiple clinical guidelines for conditions like COPD indicate?

A potential risk of duplication and confusion exists Signup and view all the answers

Who funds the development of clinical guidelines?

Special interest groups and government funding Signup and view all the answers

What role does administrative resource play in the context of clinical guidelines?

To manage the large volumes of research evidence effectively Signup and view all the answers

Study Notes

Learning Objectives

Familiarize with key resources like the Cochrane Database of Systematic Reviews.
Understand the significance of randomized controlled trials (RCTs) and meta-analyses in evidence-based practice.
Grasp the concept of Quality Adjusted Life Years (QALYs) in evaluating health interventions.
Explore the role of clinical guidelines in medical practice.

Historical Context of Evidence-Based Medicine

Hippocrates (460-370 BC) emphasized prioritizing patient well-being and ethical practice in medicine.
Sir Austin Bradford Hill contributed to the criteria of causation and was an early advocate for clinical trials.
Sir Archie Cochrane (1909-1988) promoted the importance of randomized control trials, critiquing healthcare practitioners who disregard trial outcomes.
Cochrane's influential 1978 BMJ study revealed unexpected associations between healthcare indices and mortality.

Role of the Cochrane Library

Co-founded by Ian Chalmers in 1993, the Cochrane Library oversees over 7,500 systematic reviews.
Aids clinicians by consolidating research from multiple sources to enhance decision-making in patient care.

Challenges in Evidence-Based Practice

Increasing volume of evidence makes it challenging for clinicians to manage and apply findings effectively.
Clinical guidelines aim to organize and synthesize extensive research data for practical use.
Different organizations produce independent guidelines, leading to potential duplications of recommendations.

National Institute for Health and Care Excellence (NICE)

Established in 1999; transitioned to a non-departmental public body in 2013.
Focuses on equitable access to care, supporting clinicians in navigating relevant medical evidence.
Key functions include assessing the cost-effectiveness of treatments and encouraging innovation in health care.

Quality Adjusted Life Years (QALYs)

QALYs calculate the value of medical interventions by factoring in life expectancy and the quality of life.
Scaled from 0 (no quality) to 1 (full quality), serving as a metric for evaluating healthcare programs.
Health economists use QALYs to justify healthcare costs against the benefits derived from treatments.

Sources of Clinical Guidelines

Developed by professional societies and governmental organizations, drawing on expert and public input.
Stakeholder associations and experienced bodies help ensure that guidelines reflect best practices and patient needs.

Evidence Volume Concerns

Rapid increase in systematic reviews from 4 per day in 2000 to 80 by 2019 stresses the medical community.
Need for ongoing rationalization to ensure evidence remains applicable and interpretable, especially for complex patient cases.

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Description

Explore the fundamentals of evidence-based practice in medicine through this MBBS Stage 1 quiz. Dive into concepts such as systematic reviews, randomized controlled trials, and clinical guidelines, all vital for understanding how to manage and apply experimental evidence effectively.