EBM (Evidence Based Medicine) PDF

WE MAKE DOCTORS EBM (Evidence Based Medicine) Cabrera Salaiza 1.. EVIDENCE- BASED MEDICINE a. Define evidence-based clinical practice. b. Assess the diagnostic accuracy of physical findings. c. Contrast sensitivity vs specificity. d. Analyze the different levels of scientific evidence. e. Revise c...

WE MAKE DOCTORS EBM (Evidence Based Medicine) Cabrera Salaiza 1.. EVIDENCE- BASED MEDICINE a. Define evidence-based clinical practice. b. Assess the diagnostic accuracy of physical findings. c. Contrast sensitivity vs specificity. d. Analyze the different levels of scientific evidence. e. Revise clinical practice guidelines. Bibliography: McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey 2  EVIDENCE BASED CLINICAL PRACTICE To diagnose is to categorize illness, based on the clinical problems. Overcoming disease implies understanding it. The methodology of making patient care decisions using the best available evidence. McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey Al-Ghimlas F. The philosophy of evidence-based clinical practice: Is evidence enough? Ann Thorac Med. 2013 Jul;8(3):131-2. doi: 10.4103/1817-1737.114282. PMID: 23922606; PMCID: PMC3731853.  What is the diagnostic value of the traditional physical examination? Is it outdated and best discarded? Is it completely accurate and underutilized? Is the truth somewhere between these two extremes? There are still abundant diagnosis depending on clinical examination itself. A technologic test provides findings, which could increase or decrease probability of disease. McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey  Evaluating Diagnostic Accuracy of Physical Findings The diagnostic accuracy of physical findings is assessed by comparing the test results to the patient's true disease status. Positive and negative findings, shift probability of disease. Starting point: pre-test probability. Higher discriminatory power of physical signs comes from sensitivity and specificity. McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey Scholar Rx McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey Scholar Rx McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey Scholar Rx McGee Steven. Evidence-Based Physical Diagnosis, 5th ed Elsevier; 2022. Chapter 1. Available at ClinicalKey Scholar Rx Oliveira, M.C., Scharan, K.O., Thomés, B.I. et al. Diagnostic accuracy of a set of clinical and radiological criteria for screening of COVID-19 using RT-PCR as the reference standard. BMC Pulm Med 23, 81 (2023). https://doi.org/10.1186/s12890-023-02369-9  Levels of Scientific Evidence Promoting evidence-based practice in the care of patients requires clinicians to understand the hierarchy of evidence in the medical literature and the potential biases and limitations inherent in certain study designs. The steps in evidence-based practice begin with asking a clinical question (diagnosis, treatment) and acquiring the evidence. When performing a literature search, one can align articles found with their original clinical question to deem whether the article may provide useful evidence. Wallace SS, Barak G, Truong G, Parker MW. Hierarchy of Evidence Within the Medical Literature. Hosp Pediatr. 2022 Aug 1;12(8):745-750. doi: 10.1542/hpeds.2022- 006690. PMID: 35909178.  From: Hierarchy of Evidence Within the Medical Literature Hosp Pediatr. 2022;12(8):745-750. doi:10.1542/hpeds.2022-006690 Rigurous, answer a question based on the preexisting evidence from multiple distinct studies. Evaluate effectiveness of interventions vs placebo or gold standard. Follow a population over time to determine if an exposure is associated with a disease. Evaluate Population data are collected at specific point in time, simultaneous measurement of exposure and outcome. current practices. 2 existing groups with or without disease are compared to identify risk factors. Describe a clinical event: Dx or Tx Figure Legend: Strength of evidence pyramid. Date of Download: 1/14/2025 Copyright © 2025 American Academy of Pediatrics. All rights reserved. Revision of Clinical Practice Guidelines Let’s do some research! Search engine. Analysis of information. Thank you so much for being here! 14  WE MAKE DOCTORS EBM (Evidence Based Medicine) Cabrera-Salaiza