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Evidence Based Practice

Evidence Based Practice. MMR Vaccine. Who Has Concerns About the Safety of This Vaccine?. MMR Vaccine. Who Would Be Able to Discuss All of the Issues of This Vaccine With Concerned Parents?. The steps. 1.    Convert the information needs into answerable questions

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Evidence Based Practice

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  1. Evidence Based Practice

  2. MMR Vaccine Who Has Concerns About the Safety of This Vaccine?

  3. MMR Vaccine Who Would Be Able to Discuss All of the Issues of This Vaccine With Concerned Parents?

  4. The steps • 1.    Convert the information needs into answerable questions • 2.    Find the best evidence • 3.    Critically appraise that evidence for its validity and usefulness • 4.     Apply the results • 5.     Evaluate the performance

  5. Where Clinical Questions Arise From: • Clinical findings • Aetiology: • Differential diagnosis: • Diagnostic tests: • Prognosis: • Therapy: • Prevention: • Self-improvement:

  6. The four elements of well built clinical questions:

  7. The four elements of well built clinical questions:

  8. The four elements of well built clinical questions:

  9. The four elements of well built clinical questions:

  10. The four elements of well built clinical questions:

  11. The four elements of well built clinical questions:

  12. The four elements of well built clinical questions:

  13. The four elements of well built clinical questions:

  14. The four elements of well built clinical questions:

  15. A mother you see is reluctant to give her child the MMR vaccine because of current concerns that it may harm her child – write three questions (at least) in pairs that this scenario presents for you.

  16. My questions • 1.      What are the benefits of giving mmr vaccine to a child at 1 year of age? • 2.      What risks of giving the vaccine have been identified? • 3.      Has an absolute risk for each scenario been published i.e. risk of harm if MMR not given versus risk of harm if MMR given? • 4.      Is there evidence of a link between MMR vaccine and autism? • How do you show that an event is causally related with another event, (What is the difference between association and causation?)

  17. Judgement of a Cause – Effect Relationship • Strength of the association • Biological credibility • Consistency with other investigations • Time sequence • Dose – response relationship

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