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How to appraise Medical Journal (Therapy). นพ.บริบูรณ์ เชนธนากิจ หน่วยเวชศาสตร์ฉุกเฉิน ภาควิชาเวชศาสตร์ครอบครัว คณะแพทยศาสตร์มหาวิทยาลัยเชียงใหม่. Patient Concerns. EBM. Clinical Expertise. Best research evidence. What is EBM?. Critical appraisal . Are the result valid?
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How to appraiseMedical Journal(Therapy) นพ.บริบูรณ์ เชนธนากิจ หน่วยเวชศาสตร์ฉุกเฉิน ภาควิชาเวชศาสตร์ครอบครัว คณะแพทยศาสตร์มหาวิทยาลัยเชียงใหม่
Patient Concerns EBM Clinical Expertise Best research evidence What is EBM?
Critical appraisal • Are the result valid? • What are the results? • How can I apply the result to patient care?
Are the result valid? • ประเด็นที่ต้องประเมินว่า RCT นั้นน่าจะมี BIAS หรือไม่ • Did Intervention & Control groups start with same prognosis? • Was prognostic balanced maintained as the study progressed? • Were the groups prognostically balanced at the study’s complettion?
Are the result valid? • Did Intervention & Control groups start with same prognosis? • Were patients randomized? • Was randomization concealed? • were patients similar in respect to known prognostic factor • Was prognostic balanced maintained as the study progressed? • Were the groups prognostically balanced at the study’s completion?
Are the result valid? • Did Intervention & Control groups start with same prognosis? • Was prognostic balanced maintained as the study progressed? • To what extent was the study blinded? • Were the groups prognostically balanced at the study’s completion?
Are the result valid? • Did Intervention & Control groups start with same prognosis? • Was prognostic balanced maintained as the study progressed? • Were the groups prognostically balanced at the study’s completion? • Was follow up complete? • Were patients analyzed in the group to which they were randomized?
Critical appraisal • Are the result valid? • What are the results? • How can I apply the result to patient care?
What are the result? • How large was the treatment effect? • How precise was the estimate of treatment effect?
Critical appraisal • Are the result valid? • What are the results? • How can I apply the result to patient care?
Apply to patient care? • Were the study patients similar to my patient? • Were all clinically important outcomes considered? • Are the likely treatment benefits worth the potential harm and costs?