Evidence-Based Practice 424 EBM 2024 PDF

Evidence-Based Practice 1 Evidence-Based Practice Why is EBP/EBM important? From Wikipedia: – An evidence-based practice (EBP) is any practice that relies on scientific evidence for guidance and decision-making. Practices that are not evidencebased may rely on tradition, intuition, or other unproven...

Evidence-Based Practice 1 Evidence-Based Practice Why is EBP/EBM important? From Wikipedia: – An evidence-based practice (EBP) is any practice that relies on scientific evidence for guidance and decision-making. Practices that are not evidencebased may rely on tradition, intuition, or other unproven methods. 2 A 21st century clinician who cannot critically read a study is as unprepared as one who cannot take a blood pressure or examine the cardiovascular system – BMJ 2008;337:a1253 Evidence Based Study Design: Levels of Evidence Level Design 1a Systematic Review of RCTs 1b Individual RCT (with narrow Confidence Interval) 2a Systematic Review (with homogeneity*) of cohort studies 2b Individual cohort study (including low quality RCT; e.g., 70ml/kg/min) – Match each fit participant with a less fit participant of similar age, size, etc. – Test the urine of both groups for Viagra – See if there are more Viagra users in the fit group 34 Sample Study Designs 5 Purpose: To determine the effect of Sildenafil (Viagra) on exercise performance Method: Divide athletes into two groups randomly. Give athletes Viagra or another little blue pill for six weeks. – After 6 weeks, perform a time trial in the lab – Compare time trial time between those who had Viagra, and those who did not 36 Sample Study Designs 6 Purpose: To determine the effect of Sildenafil (Viagra) on exercise performance Method: Bring athletes to lab twice. Prior to one visit give athletes Viagra for 6 weeks, prior to the other visit give them another little blue pill for 6 weeks – Perform a time trial in the lab after each medication – Compare time trial time between Viagra and placebo Sources of Bias In groups of 3: explain each source of bias, and provide an example of each Selection Bias Measurement Bias Interviewer Bias Response Bias Referral bias Reporting Bias For the purpose of Kin 424 From KM Khan, with permission 43 Evidence Based Study Design: Levels of Evidence Level Design 1a Systematic Review of RCTs 1b Individual RCT (with narrow Confidence Interval) 2a Systematic Review (with homogeneity*) of cohort studies 2b Individual cohort study (including low quality RCT; e.g.,