Sunteți pe pagina 1din 2

Evidence Based Medicine

Use of Evidence-based Resources by Clinicians


Improves Patient Outcomes or Care
Evidence is a fact or a knowledge that is
published and is accessible
Two types of evidence:
a. Primary Author himself gathered
the data from his or her own
experiment.
e.g. Authors did a CBC on his own
class
b. Secondary Author gathered the
data from another source.
e.g. Meta analysis
Authors
gathered
hospital
record for platelet
In review of related literature there are
numbers codes:
Levels of
Definition
evidence
Ia
Evidence from Meta-analysis
of Randomized Controlled
Trials
A lot of sources
Meta analysis data from
different authors
Ib
Evidence from at least one
Randomized Controlled Trial
One source
IIa
Evidence from at least one
well designed controlled trial
which is not randomized
Case control No
intervention or
observational study in trial
IIb
Evidence from at least one
well designed experimental
trial
There is intervention or
manipulation in trial
III
Evidence
from
case,
correlation, and comparative
studies
IV
Evidence from a panel of
experts

Background information
No clinical or experimental trial
For example tawa tawa can increase
platelet, tight tourniquet can cause
hematoma
Unfiltered information
Single trials, which are not peer, reviewed
Case controlled studies or report
Not all case report are single report
For example Case report for dengue with
normal platelet
Not all case report are reliable especially on
rare diseases
For example Case report for E bola
Cohort
Follow up study
Takes years for the study to be finished
Randomized controlled trials
Filtered information
Validated trials which are peer reviewed
Critically appraised individual articles
Article synopses
Same line of experiments are done
Peer reviewed journals
Critically appraised topics
Evidence synthesis
Journals with meta analysis
Several trials have been done to prove the
validity
Systemic review
It has already took in several researches
Clinical practice guidelines
Methodological quality for selecting journals

Who performed the study


How they did the methodology
Criteria for inclusion and exclusion
Outcome measures parameter they look
into
Statistical test used
When looking for a good review of related
literature, one must consider:
PICO
Population or patient group
Intervention
Comparison or alternate intervention
Outcome or reason for using intervention
PECOT
Patient or problem
Exposure (intervention)
Comparator
Outcome
Time
Grading the quality of evidence

Level of evidence
Consistency of results across various
studies
Directness of comparisons
Precision-of-effect estimates
Level of evidence:
High:
Appropriate design for the question
Well conducted in representative
populations
Free from design-related biases.
Moderate:
Design-related biases
Low:
Wrongly designed and conducted
High likelihood that its conclusions grossly
biased and misleading.