HaDSoc 2.1- Evidence based practice Flashcards Preview

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

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

A

Archie Cochrane

2
Q

What did Cochrane do?

A

Call for a register of all RCT’s

3
Q

Why do we need evidence based practice?

A
  • 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
Q

How was the first analysis distributed?

A

Via CD-ROM for easy updating

5
Q

How did people respond to the first systematic review?

A

at first with hostility, and suspicion.

6
Q

What’s the standard definition of evidence based practice?

A

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

7
Q

What is a systematic review?

A

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

8
Q

What is a meta-analysis?

A

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
Q

how are systematic reviews and meta-analyses linked?

A

a meta-analysis is a type of systematic review.

10
Q

Why do we need systematic reviews?

A
  • 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
Q

How do you assess the quality of evidence?

A

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

12
Q

Where can you find the evidence?

A

Medical journals, eg BMJ, the Cochrane library

13
Q

What are the 2 main groups of criticisms of EPB?

A

practical criticisms

philosophical criticisms

14
Q

What are some practical criticisms of EPB?

A
  • 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
Q

What are some philosophical criticism of EBP?

A
  • 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
Q

What are some problems with getting evidence into practice?

A
  • 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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