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Introduction to Evidence-Based Medicine

Learning Objectives. Define EBMUnderstand how to structure a clinical questionImprove awareness of evidence-based resourcesImprove awareness of study types. EBM Defined. Integration of Best Research EvidenceClinical ExpertisePatient's Values and Circumstancesto improve clinical decisionsIn

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Introduction to Evidence-Based Medicine

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    1. Introduction to Evidence-Based Medicine Sandhya Wahi-Gururaj, MD, MPH University of Nevada School of Medicine

    2. Learning Objectives Define EBM Understand how to structure a clinical question Improve awareness of evidence-based resources Improve awareness of study types

    3. EBM Defined Integration of Best Research Evidence Clinical Expertise Patients Values and Circumstances to improve clinical decisions Informs but does NOT dictate decisions Not cookbook medicine

    4. Why Use EBM? Daily need for valid information Studies have shown ~5 questions/inpt, 2/3 outpts Inadequacy of traditional resources With time diagnostic skills and clinical judgment increases but updated knowledge may decline Lack of time

    5. Steps to Practice EBM Step 1: Create answerable question Step 2: Track down best evidence Step 3: Critically appraise the evidence Validity, impact, applicability Step 4: Integrate with clinical expertise and patient values/circumstances Step 5: Evaluate effectiveness and efficiency in executing steps 1-4

    6. Step 1 Create an answerable question

    7. Types of Clinical Questions: Background Question Asking about general knowledge Two components: Question root and verb Disorder, test, treatment, etc. E.G.: What precipitates hospital admissions for congestive heart failure?

    8. Types of Clinical Questions: Foreground Question Ask for specific knowledge to inform decisions Four Essential Components (PICO): Patient/Problem Intervention (exposure, test, treatment, etc.) Comparison Outcome E.G. Among patients presenting with an acute CHF exacerbation, what is the frequency of identifying myocardial ischemia as the underlying cause in patients referred for noninvasive stress testing?

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