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TEACH 2013 Track 1. Aquiring the Evidence. Linking questions to study designs. Therapy Utility Performance Likelihood Diagnosis Utility Performance Likelihood Prognosis Utility Performance Likelihood Harm Utility Performance Likelihood. RCT COHORT CROSS-SECTIONAL
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TEACH 2013Track 1 Aquiring the Evidence
Linking questions to study designs • Therapy • Utility • Performance • Likelihood • Diagnosis • Utility • Performance • Likelihood • Prognosis • Utility • Performance • Likelihood • Harm • Utility • Performance • Likelihood • RCT • COHORT • CROSS-SECTIONAL • CASE CONTROL
Linking questions to study designs • THERAPY • Utility • Performance • Likelihood • DIAGNOSIS • Utility • Performance • Likelihood • PROGNOSIS • Utility • Performance • Likelihood • HARM • Utility • Performance • Likelihood • THERAPY • RCT • Cohort • Cohort • DIAGNOSIS • RCT • Cross-Sectional • Observational • PROGNOSIS • RCT • Cohort • Cohort/Single Arm • HARM • Cohort, Case-Control • Cohort • Cohort/Single Arm
Back to the case • QUESTION 1 • Therapy/Utility • P: Elderly patients with acute, stable AF, but no structural heart disease presenting to the ED < 48 hours of onset • I: Rapid acting pharmacological agents safely titrated to effect • C: Alternative regimens safely titrated to effect • O: Likelihood of rate control or cardioversion, hospital admission, complications of uncontrolled AF, adverse reactions to drugs Practice Guidelines, Systematic Review, RCT, Non-randomized studies
Back to the case • QUESTION 2 • Prognosis/Likelihood • P: Elderly patients with acute, stable AF, but no structural heart disease presenting to the ED < 48 hours of onset • I: Observation over a 30-day period • C: N/A • O: Stroke, decompensated heart failure, MI, death Practice Guidelines, Systematic Review, Cohort, Control Arm of an RCT
BACK TO THE CASE • QUESTION 3 • Harm/Likelihood • P: Elderly patients with acute, stable AF, but no structural heart disease presenting to the ED < 48 hours of onset • I: Cardioversion in ED with discharge and early follow-up • C: N/A • O: Short-term complications of cardioversion, embolic events, admission, other complications of AF Practice Guidelines, Systematic Review, Cohort, Single-Arm Study
Question 1 • SUMMARY: NGC, GIN Dynamed • SYNTHESIS: DARE
QUESTION 2 • SYNTHESIS: Pubmed • SINGLE STUDY: Pubmed
QUESTION 3 • SUMMARY: NGC • SINGLE STUDY: Pubmed