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Some Evidence Based Cases
Some Evidence Based Cases
In this section we will discuss several case studies that show how EBP can help in a range of clinical situations. You can then think of a clinical question of your own and we will try to answer it.
Reference:
!las?iou P .:@@82. Evidence "ased case report6 ,wenty year cough in a non s#oker. British Medical Journal =:46:44+5:44:
Reference:
&u##ings P .:@@A2. Anti"iotics to prevent infection in patients with dog "ite wounds6 a #etaanalysis of rando#i?ed trials. Annals of Emergency Medicine *=65=555A+.
E#pirical questions$ on the other hand$ ask a"out outco#es F in this case$ whether conventional investigation leads to "etter health outco#es. 8ere$ the evidence .surprisingly2 showed that such investigation provides no "enefi t$ "ecause #icroscopic hae#aturia see#s to "e no #ore prevalent a#ong those who later develop urological cancer than those who do not. Dnce again$ "eing e#pirical and quantitative allows patients to participate #uch #ore fully in clinical decisions.
Study 1
:+$+++ #en were screened. A"out *5+ .*.5;2 had hae#aturia. ,h ese #en were asked to visit their !P and a"out :5+ .4+;2 did so. Df those$ only three had a serious pro"le#. Df these6 7 * had "ladder cancer 7 : had refl u9 nephropathy. ,h is shows that there is a"out a : in 5+ chance of having a serious disease.
Study 2
As part of a personal health appraisal$ *+$+++ #en were given a urine test. Gollow up studies of the #en who were positive for hae#aturia found three cancers per year$ or :.5 cancers per :+++ person years. 8owever$ the people who did not have hae#aturia were also followed up and the rate of cancer for these people was e9actly the sa#e as for the people with hae#aturia.
Reference:
/el -ar & .*+++2. Asy#pto#atic hae#aturia H in the doctor. British Medical Journal =*+6:455:44.