Evidence-Based Practice Session 2
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What is the main argument for implementing evidence-based healthcare?

  • To ensure all healthcare professionals follow the same protocols.
  • To reduce costs in the healthcare system.
  • To base healthcare decisions on research findings. (correct)
  • To standardize healthcare practices across different countries.

    • What is a primary concern of evidence-based medicine regarding ineffective interventions?

  • They result in unnecessary costs and diverted resources from effective practices. (correct)
  • They lead to increased patient satisfaction but lower efficiency.
  • They are often based on outdated research and lack scientific rigor.
  • They may negatively impact the patient's health, but cost less.

    • What is one of the main reasons why systematic reviews are important for clinicians?

  • They help to ensure that research findings are implemented quickly.
  • They provide a way to easily access primary research data.
  • They offer a way to reduce the costs associated with conducting research.
  • They help to prevent biased decisions from being made. (correct)

    • What is a potential criticism of evidence-based practice?

    <p>All of the above. (D)</p> Signup and view all the answers

    Which of the following factors was NOT identified as a major influence on healthcare practices before the widespread adoption of evidence-based medicine?

    <p>Clinical research findings and evidence. (D)</p> Signup and view all the answers

    Why is it problematic for clinicians to persist in using ineffective interventions?

    <p>It prevents the adoption of proven effective interventions and wastes resources. (B)</p> Signup and view all the answers

    Which of the following databases is NOT included in the Cochrane Library?

    <p>The National Institute for Health Research (NIHR) Health Technology Assessment Programme (D)</p> Signup and view all the answers

    What is one of the main challenges associated with implementing evidence-based practice?

    <p>All of the above. (D)</p> Signup and view all the answers

    The example of MgSO4 treatment for eclamptic seizures in the UK illustrates which problem with healthcare practices?

    <p>Unwillingness to adopt new practices and evidence-based interventions. (B)</p> Signup and view all the answers

    What was the main focus of Archie Cochrane’s book "Effectiveness and efficiency: random reflections on health services"?

    <p>Criticizing the medical profession for ignoring research findings. (B)</p> Signup and view all the answers

    What is a key benefit of systematic reviews?

    <p>They provide a comprehensive and objective analysis of the available evidence. (D)</p> Signup and view all the answers

    What does the phrase "cost-effectiveness" refer to in the context of evidence-based healthcare?

    <p>Optimizing resource allocation to maximize health outcomes within budget constraints. (D)</p> Signup and view all the answers

    What was the initial impetus behind the creation of the Cochrane Collaboration?

    <p>A desire to improve the quality of medical care by systematically summarizing all relevant randomized controlled trials. (B)</p> Signup and view all the answers

    What was the focus of the first 'Cochrane Centre' established in Oxford?

    <p>Creating a register of all randomized controlled trials in obstetrics and gynecology. (A)</p> Signup and view all the answers

    The Cochrane Collaboration's logo symbolizes what?

    <p>The benefits of evidence-based practice. (C)</p> Signup and view all the answers

    What is the key distinction between a systematic review and a meta-analysis?

    <p>A systematic review may not include a meta-analysis if there is high variability in the studies being reviewed. (B)</p> Signup and view all the answers

    According to the information provided, why is it important for doctors to understand systematic reviews and meta-analyses?

    <p>To critically evaluate the evidence base for medical treatments. (C)</p> Signup and view all the answers

    The text suggests that the lack of a systematic review until 1989 had a significant impact on what?

    <p>The overall quality of healthcare. (A)</p> Signup and view all the answers

    What is the significance of the first randomized controlled trial published in 1972 regarding corticosteroid treatment for premature birth?

    <p>It provided the first evidence of the effectiveness of this treatment. (D)</p> Signup and view all the answers

    What is the primary purpose of the information provided about the corticosteroid treatment in the text?

    <p>To illustrate the importance of meta-analysis in healthcare. (D)</p> Signup and view all the answers

    What is a primary benefit of systematic reviews and meta-analyses in evidence-based medicine?

    <p>They can make evidence-based medicine more accessible to all. (C)</p> Signup and view all the answers

    Based on the text, what is the primary reason why a systematic review may not include a meta-analysis?

    <p>The studies included in the review are too different. (B)</p> Signup and view all the answers

    Flashcards

    Evidence-based Medicine

    Healthcare practice based on the best available research evidence.

    Best Evidence

    Evidence derived from rigorously conducted research regarding health effectiveness and cost-effectiveness.

    Ineffective Interventions

    Medical practices that waste resources without providing benefits to patients.

    Variations in Treatment

    Differences in treatment practices among clinicians that can lead to inequities in healthcare delivery.

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    Clinical Practice Changes

    Adjustment in medical interventions based on new effective treatments discovered through research.

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    Archie Cochrane

    A pioneer in evidence-based medicine who criticized the medical field for ignoring research.

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    MgSO4 for Eclampsia

    A treatment for eclamptic seizures that has proven effective but was underused in some regions.

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    Systematic Reviews

    Comprehensive analyses of research evidence to inform practice.

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    Cochrane Collaboration

    A major organization providing systematic reviews and health evidence databases.

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    Evidence-Based Practice (EBP)

    Integrating clinical expertise with the best available evidence.

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    Barriers to EBP

    Challenges that prevent effective implementation of research findings.

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    Quality Control in EBP

    Ensures research findings are used reliably in clinical guidelines.

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    Meta-Analysis

    A statistical method that combines results from multiple studies.

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    RCT (Randomized Controlled Trial)

    An experiment that randomly assigns participants into treatment or control groups.

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    Clinical Heterogeneity

    Variability in study populations or interventions that complicates meta-analysis.

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    First RCT Published

    The first randomized controlled trial published in 1972 showing treatment benefits.

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    Impact of Delayed Systematic Review

    Late publications can lead to unnecessary deaths and complications.

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    Importance of Critical Appraisal

    Essential for understanding and evaluating systematic reviews.

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    Study Notes

    Evidence-Based Practice Session 2

    • Evidence-based practice applies to medicine, healthcare, and practice. It's a dominant force in healthcare today.

    Components of Evidence-Based Medicine

    • Clinical Expertise: The clinician's understanding and knowledge.
    • Best Research Evidence: Information from the medical literature and rigorous studies.
    • Patient Values: The patient's preferences, needs, and expectations.

    Origins of Evidence-Based Healthcare

    • Health service delivery should be evidence-based.
    • Best evidence comes from rigorously conducted research.
    • This approach focuses on the effectiveness and cost-effectiveness of interventions.

    Factors Influencing Healthcare Practices

    • Ineffective/inappropriate interventions waste resources.
    • Variations in treatment cause inequities.
    • Historical practices, professional opinions, clinical fashions, and organizational/social cultures heavily influenced some previously practiced medicial approaches at times.

    Issues with Healthcare Practices

    • Past practices frequently relied on less effective interventions.
    • Significant variations existed across healthcare settings.

    Examples of Ineffective Practices

    • Treatment of eclamptic seizures with MgSO4 was successfully used in the USA for 60 years, but only 2% of UK clinicians used it by 1992, despite clear benefits.

    Archie Cochrane's Contribution

    • Cochrane criticized the medical profession for not using research findings in practice.
    • His work emphasizes systematic review and helped to initiate the development of evidence-based practice.
    • His 'Effectiveness and efficiency' book (1972) defined principles of evidence-based practice.

    Sources and Methods: Systematic Reviews

    • Cochrane called for registers of all randomized controlled trials (RCTs).
    • An Oxford-based group led by lain Chalmers produced a register of RCTs in obstetrics and gynaecology.
    • This led to the first Cochrane Centre.
    • Other Cochrane Centers followed.

    Cochrane Collaboration's Systematic Reviews

    • The first systematic review was published in 1989, showing that corticosteroid treatment for pregnant women at risk of premature birth helped to reduce related complications.
    • Meta-analyses of several RCTs can give highly reliable estimations of treatment effects. This often gives more accurate and reliable outcomes than individual studies alone.

    Problems with Implementing Evidence-Based Practice

    • Insufficient dissemination of evidence often leads to doctors not knowing of its existence.
    • Organizational and system-related issues, disincentives, and lack of resources cause implementation difficulties.
    • Difficulty applying the principles across multiple specialities.
    • Critiques of meta-analysis are commonplace but systematic reviews are still considered the gold standard when appropriate.

    Importance of Evidence-Based Practices Principles

    • Evidence-based practice requires combining clinical expertise, best evidence from systematic research, and patient values.
    • This is a critical feature of modern healthcare and an imperative for future healthcare practitioners.

    Critical Appraisal of Systematic Reviews

    • Doctors must be able to access, evaluate, and apply evidence from systematic reviews to guarantee quality assurance for EBP.

    Locating Evidence

    • Systematic reviews and other evidence are available in various peer-reviewed medical journals (e.g., The Lancet, BMJ, New England Journal of Medicine).
    • Cochrane Library databases, the NHS Centre for Reviews and Dissemination, and other valuable resources offer access to evidence-based practice information.

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    Related Documents

    Evidence-Based Practice Lecture Notes PDF

    Description

    This quiz covers the essential components of evidence-based practice in healthcare, including clinical expertise, best research evidence, and patient values. Explore the origins and impact of evidence-based healthcare on medical practices, and understand the factors influencing healthcare delivery today.

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