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