HaDSoc 2.1- Evidence based practice Flashcards Preview

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Flashcards in HaDSoc 2.1- Evidence based practice Deck (16):

Who is the main figure in the history of evidence based practice?

Archie Cochrane


What did Cochrane do?

Call for a register of all RCT's


Why do we need evidence based practice?

-practice should be based on the best available evidence
-need to be sure interventions are effective and cost effective
-it's wasteful to do inappropriate/ineffective interventions
-variations in healthcare lead to inequities


How was the first analysis distributed?

Via CD-ROM for easy updating


How did people respond to the first systematic review?

at first with hostility, and suspicion.


What's the standard definition of evidence based practice?

it involves the integration of individual clinical expertise with external clinical evidence from systematic research.


What is a systematic review?

an overview of primary studies that used explicit and reproducible methods.
Brings together many different studies


What is a meta-analysis?

a quantitative synthesis of the results of 2 or more studies that addressed the same hypothesis.
Brings studies together to produce a single number


how are systematic reviews and meta-analyses linked?

a meta-analysis is a type of systematic review.


Why do we need systematic reviews?

-primary literature may be biased
-the quality of primary studies may be poor
-they can highlight gaps in research
-They increase certainty and ensure quality
-they save clinicians from having to locate and appraise studies themselves
-reduce delay between findings and implementation
-can be converted into guidelines


How do you assess the quality of evidence?

Using a critical appraisal tool, which suggests things to look for and questions to ask`


Where can you find the evidence?

Medical journals, eg BMJ, the Cochrane library


What are the 2 main groups of criticisms of EPB?

practical criticisms
philosophical criticisms


What are some practical criticisms of EPB?

-may not be possible to create and maintain reviews across all specialities
-can be difficult to disseminate
-favours biomedical outcomes, which are what are often tested
-needs good faith of pharmaceutical companies (less likely to see studies of a medication not working)


What are some philosophical criticism of EBP?

-may create rule-followers
-population outcome doesnt mean it'll benefit an individual
-lose sight of where professional responsibility/accountability takes over from evidence,


What are some problems with getting evidence into practice?

-dissemination may be ineffective so doctors dont know about evidence
-doctors may chose not to follow (tradition, habit, professional judgement)
-organisations may not be able to impliement eg not have enough staff or training for certain methods
-resources may not be available (finance, human)

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