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    EBCR

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    doddydr
    This document provides an overview of evidence-based medicine and evidence-based case reports. It defines key terms like evidence-based practice and describes the steps in evidence-based medicine as asking a focused clinical question, finding relevant evidence, appraising the evidence, and making a decision. For evidence-based case reports, it outlines composing the case report with a question, methods of searching literature and critically appraising evidence, and discussing the results and conclusions. The goal of evidence-based case reports is to implement evidence-based practice in managing individual patients.

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    EBCR

    Uploaded by

    doddydr
    159 views19 pages
    This document provides an overview of evidence-based medicine and evidence-based case reports. It defines key terms like evidence-based practice and describes the steps in evidence-based medicine as asking a focused clinical question, finding relevant evidence, appraising the evidence, and making a decision. For evidence-based case reports, it outlines composing the case report with a question, methods of searching literature and critically appraising evidence, and discussing the results and conclusions. The goal of evidence-based case reports is to implement evidence-based practice in managing individual patients.

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    This document provides an overview of evidence-based medicine and evidence-based case reports. It defines key terms like evidence-based practice and describes the steps in evidence-based medicine as asking a focused clinical question, finding relevant evidence, appraising the evidence, and making a decision. For evidence-based case reports, it outlines composing the case report with a question, methods of searching literature and critically appraising evidence, and discussing the results and conclusions. The goal of evidence-based case reports is to implement evidence-based practice in managing individual patients.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    159 views19 pages

    EBCR

    Uploaded by

    doddydr
    This document provides an overview of evidence-based medicine and evidence-based case reports. It defines key terms like evidence-based practice and describes the steps in evidence-based medicine as asking a focused clinical question, finding relevant evidence, appraising the evidence, and making a decision. For evidence-based case reports, it outlines composing the case report with a question, methods of searching literature and critically appraising evidence, and discussing the results and conclusions. The goal of evidence-based case reports is to implement evidence-based practice in managing individual patients.

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    © All Rights Reserved
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    Download as ppt, pdf, or txt
    of 19

    Evidence-based Case

    Report

    Kartiwa Hadi Nuryanto


    Division of Gynecology Oncology, Department of Obstetrics
    and Gynecology
    Faculty of Medicine, University of Indonesia, Dr Cipto

    "Evidence-based medicine is the


    integration of best research evidence
    with clinical expertise and patient
    values."

    What is
    idence-based Medicine
    Sackett, D. L. (2000).Evidence-based medicine: How to
    practice and teach EBM(2nd ed.). Edinburgh; New York:
    Churchill Livingstone.

    Evidence-Based Medicine (EBM)


    Evidence-Based Practice (EBP)
    Evidence-Based Clinical Practice
    (EBCP)
    Evidence-Based Health Care (EBHC)
    Evidence-Based Nursing (EBN)
    Sacketts definition refers to all of these;
    EBP and EBHC are more universally
    used.

    EBP :

    EBM :

    1.Assess the patient


    2.Ask the question
    3.Acquire the evidence
    4.Appraise the evidence
    5.Apply: talk with the
    patient

    1.Ask focused
    question
    2.Find the evidence
    3.Appraise the
    evidence
    4.Make a decision
    5.Evaluate
    performance

    (from Introduction to Evidence


    Based Practice tutorial)

    Clinical expertise: the clinicians


    cumulated experience, education, and
    clinical skills
    Patient values: The patient brings to the
    encounter his or her own personal and
    unique concerns, expectiations, and
    values.
    Best Research Evidence: usually found in
    clinically relevant research that has
    been conducted using sound
    methodology

    What is Evidence-based Case


    Report
    A form of implementation of EBP
    Used in various steps in managing
    patients
    Usefulness of information :

    Low

    Validity

    High

    High
    quality =
    valid &
    relevant
    informatio
    n

    Composition of EBCR
    Case

    Case Report

    Question
    s

    Clinical questions (PICO)

    Methods

    Searching strategies based on


    evidence-based
    Critical appraisal

    Result

    Selected articles (table?)

    Discussio
    n

    Strength and Weakness of the articles

    Conclusio
    n

    Solution for patients problems

    Case series and Case


    reports
    Collections of reports on the
    treatment of individual patients or
    a report on a single patient.
    No control groups with which to
    compare outcomes, so limited
    statistical validity.

    Forming a question
    Identify key patient problem
    Phrased to facilitate finding an
    answer
    What treatment might be
    considered
    Alternative treatments to consider
    Outcome to avoid or promote

    PICO
    P
    I

    = Patient or problem
    = Intervention, prognostic
    factor,
    or exposure
    C = Comparison
    O = Outcomes
    Depending on types of study

    Methods
    Searching strategies :
    PubMed, Medline, Ebsco, Springerlink,
    Sciencedirect, Elsevier, Cochrane
    Appropriate key word(s) And, Or, Not
    PICO
    Study design, inclusion-exclusion criterias
    Flowchart

    Critical appraisal
    Number of articles
    Abstract versus full text paper
    Table

    Database

    Search strategy

    Pubmed

    Therapy/Broad[filter] AND
    (diabetes[Title/Abstract] AND
    statin[Title/Abstract]) AND
    "cardiovascular"[Title/Abstract])
    AND prevention[Title/Abstract])

    Embase

    diabetes/exp AND statin/exp


    AND cardiovascular AND
    prevention/exp AND human/de

    Cochrane statin AND diabetes AND


    cardiovascular

    Hits

    Selection
    articles
    253
    5

    217

    Flow Chart

    Critical Appraisal
    Sample relevance
    Population, intervention, indicator,
    outcome
    Differences, similarities

    Study validity
    Bias
    Confounding

    Study Design Based On Type of


    Question
    Diagnosis

    Prognosis

    Therapy

    Etiology

    Prediction

    Presence/absenc Progression of the


    disease
    e of disease

    Result of
    intervention

    Risk factor / etiology

    Patient

    Patients
    suspected of
    having the
    disease

    Pasien (has been


    diagnosed) that at
    risk of an incident

    Pasien (has been


    diagnosed) that at
    risk of an incident

    Population at risk

    (Indicator/
    Comparison)

    As in practice

    As in practice

    Manipulation

    As in practice;
    exposure/risk

    Outcome

    The result of
    standard tests

    Mortality, morbidity, Mortality, morbidity,


    quality of life
    quality of life

    Study Design

    Cross-sectional

    Prospective

    Prospective

    Prospective
    , case-control

    Outcome
    Measurement

    Absolute risk

    Absolute risk

    Relative risk /
    Difference in risk

    Relative risk

    Mortality, morbidity,
    quality of life

    Results
    Best available evidence
    PICO
    Relevance and vailidty

    Precision
    Consistency
    Differences

    Discussion
    Interpretation of the best available
    evidence
    Recommendation for the patients
    Reason fo the recommendation

    Thank You

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