Lucky Guess
What is background knowledge?
Part of our ‘general’ knowledge and explains the
nature or pathophysiological mechanism of a disorder or how a treatment/test works to manage it
What is foreground knowledge?
supports directly the decision- making process when caring for a patient
This is the evidence at the heart of the EBVM practice that provides up-to-date knowledge to decide about a treatment, diagnostic or prognostic test, or current theories of causation of illness.
What is a Primary Study?
Single study
Peer-reviewed
Reporting direct & original research (i.e., data not published before)
What is a secondary study?
They are syntheses of multiple selected primary study
"Studies of studies"
What is a case report?
What is the evidence ranking?
Short narrative qualitative report (without standard article structure) about a single or few cases (usually <10) that experienced:
> a new or rare condition; or
> an unusual presentation or intervention of a common condition
May be relevant to practice when:
> revealing a new emerging condition; or
> completing a list of differential diagnoses
Evidence ranking – weak
What are the 4 clinical themes?
Aetiology
Diagnosis
Prognosis
Treatment/Intervention
What is a risk ratio?
Compares the (prevalence or incidence) Risk in the exposed group relative to the Risk in the non-exposed group
What is incident rate?
Count of new (incident) cases per unit of time when individuals were at risk during the follow-up period Δt.
What is a cohort study?
What is the evidence ranking?
Statistical comparison of the frequency of the outcome among exposed and non-exposed subjects.
Advantages - efficient when exposure of interest is rare, can investigate more than one outcome (or exposure for single cohort), can use detailed records, no risky intervention on subjects, stronger evidence (chronology certainty with exposure always before outcome)
Disadvantages - resource demanding, increased risk of loss of follow-up and follow-up biases
Can be relevant to practice when:
> Quantifying association between an exposure of interest and a clinical outcome
Evidence ranking – strong
What is a case series?
What is the evidence ranking?
Aggregate quantitative (averages) summary (using standard article structure) of a representative collection of not connected subjects sharing a same diagnosis (usually few tens) of a common condition and describing:
> patient demographics; and
> clinical presentation; and
> clinical course including outcome (Descriptive Cohort Studies if longitudinal follow-up)
Can be relevant to practice when:
> informing prognosis (with or without intervention); or
> building a working hypothesis
Evidence ranking – weaker
What are the 5 A's?
Ask
Access
Appraise
Apply
Audit
What is prediction vs causal inference aims?
Prediction - Aim – ‘Predict’ a patient’s clinical status that is impossible/difficult to observe/access by using instead one (or more) proxy that is possible/easier to measure
Causal - Aim – Establish or quantify with certainty the direct or indirect causal effect(s) of one (or more) exposure/intervention on a patient’s clinical outcome of interest.
What is Absolute Risk Increase (ARI)
Proportion of all the exposed individuals that are disease because of the exposure
What is number needed to harm?
Count of individuals that need to be exposed to cause one additional case of harm (disease)
Therapeutic vs Prophylactic treatment
Therapeutic treatment – Therapy which means "curing" or "healing“ an existing disorder
Prophylactic treatment – Prophylaxis comes from the “protection, act of guarding”. It is intended to prevent the future occurrence of a disorder
What is PICOT?
Patient/population
Intervention/Exposure
Comparison
Outcome
Timeframe
What came first?
The chicken or the egg?
The Dinosaur
OR
Evolution (acceptable)
What does using AND do in boolean terms?
Narrows the search by only retrieving articles with all terms, primarily used to link your search blocks
Prevalence vs. Incidence
Prevalence is a static measure of morbidity or mortality in the population. It is a snapshot, at a given time point, of the occurrence of a given condition in the population
Incidence is a dynamic measure (speed of changes) of morbidity or mortality in the population. During a specified follow-up period, it represents the frequency of incident cases in the population
What do I use in Boolean terms to ensure it searches for a set phase?
Quotation marks " "
What are the 3 golden rules of experimental design?
1. At least one comparison group
2. Comparable groups
3. Replication
Treatment Efficacy versus Effectiveness
Treatment efficacy - Capacity of a treatment to achieve its intended effect under strictly controlled conditions, such as in a field-based trial.
Treatment effectiveness - Capability of a treatment to achieve its intended effect under pragmatic conditions, such as in an observational study
Identify the PICOT from this Question
In dogs with snakebites does the use of antimicrobials compared to no antimicrobials reduce incidence of wound infection?
P - dogs with snakebites
I - Antimicrobials
C - No antimicrobials
O - Incidence of wound infection
T - None
If your memories and body cells change over time, in what way are you still the same person?
Yes...
I speak without a mouth and hear without ears. I have no body, but I come alive with wind. What am I?
An echo