MM/DD/2019

Overview of Evidence Based Medicine

4:30-6:30 Research Methods II
T
Dyann Dolour Libo-on, M.D., MBA
LDT




OUTLINE • Outcome – what are the patient-relevant consequences of the
exposure in which we are interested?
I. Evidence Based Medicine
II. Evaluation of Articles on Therapy
Type of Question Syntax Sample Question
Therapy Among P(patients Among children
EVIDENCE BASED MEDICINE with a certain with HIV (P) how
disease), how effective is
What is Evidence Based Medicine? effective is E(a isoniazid
certain treatment) prophylaxis (E) in
• Consientious, explicit, judicious and reasonable use of modern, in preventing O(an preventing
best evidence in making decisions about the care of individual adverse outcome) tuberculosis (O)?
patients Diagnosis Among P(patients Among patients
with a certain with acute chest
condition, how pain (P), how
accurate is E(a accurate is an ECG
certain test) in (E) in diagnosisng
diagnosing O(a acute MI(O)?
disease)?
Clinical Judgment Harm Among P(a certain Among healthy
group of patients), males (P), how
how much does much does
E(a potential smoking (E)
harmful exposure) contribute to the
contribute to the causation of lung
causation of O( a cancer (O)?
EBM
certain disease)
Prognosis Among P(patients Among patients
with a certain with prostatic
Patients' Values Relevant Scientific disease), by how cancer (P), by how
and Preferences Evidence much does E (a much does lumbar
prognostic factor), metastasis (E)
increase the risk of increase 5-year
O(a certain mortality (O)? or
complication)? Or Among patients
among patients with stage IV
with P how big is breast cancer (P)
• The practice of evidence-based medicine is a process of the risk of O what is the risk of
lifelong, self-directed, problem-based learning in which caring mortality in the next
for one’s own patients creates the need for clinically important 5 years (O)?
information about diagnosis, prognosis, therapy and other
clinical and health care issues 2. ACQUIRE – search for the best evidence to answer the
• Continuous researches are done to improve the evidence question
based therapy 3. APPRAISE – is the evidence valid, has impact, and
• EBM can be researched multiple times in reviewing its applicable?
relevance and applicability 4. APPLY - are the results applicable to your population?
5. ASSESS – assess the results of the intervention
Steps in Practicing EBM

1. ASK – use PICO(patient/problem, intervention, comparison,

outcome) EVALUATION OF ARTICLES ON THERAPY
• Patient/Problem – who are the relevant patients, what kind of
1. Appraising directness
problem are we trying to solve?
• How well the PIO in the study corresponds to our own
• Intervention – what is the management strategy, diagnostic
PIO(clinical question)
test or exposure (drugs, diagnostic tests, foods or surgical
procedure)? 2. Appraising validity
• Comparison of interventions – what is the control or • How fair is the comparison between patients in the treatment
alternative management strategy, test or exposure that we will and control groups
compare? 3. Appraising results

CPU College of Medicine | Magnus Animus Medicus | 2021

• Comparison of treatment and control groups
4. Assessing applicability
• Can the results be applied in our own patients?

SOURCES

• Doc’s PPT
• Recordings

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