HaDSoc 2.1- Evidence based practice Flashcards Preview

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Flashcards in HaDSoc 2.1- Evidence based practice Deck (16):
1

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

Archie Cochrane

2

What did Cochrane do?

Call for a register of all RCT's

3

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

4

How was the first analysis distributed?

Via CD-ROM for easy updating

5

How did people respond to the first systematic review?

at first with hostility, and suspicion.

6

What's the standard definition of evidence based practice?

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

7

What is a systematic review?

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

8

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

9

how are systematic reviews and meta-analyses linked?

a meta-analysis is a type of systematic review.

10

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

11

How do you assess the quality of evidence?

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

12

Where can you find the evidence?

Medical journals, eg BMJ, the Cochrane library

13

What are the 2 main groups of criticisms of EPB?

practical criticisms
philosophical criticisms

14

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)

15

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,

16

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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