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Evidence Based Medicine (EBM) : Tim Fome
Evidence Based Medicine (EBM) : Tim Fome
Evidence Based Medicine (EBM) : Tim Fome
Medicine (EBM)
Tim FOME
Fakultas Kedokteran Universitas Andalas
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Introductory Lecture: Objectives
1. What
What is evidence-based medicine?
What does it look like in practice?
2. How
Formulate Clinical Questions
1. Search for Evidence
2. Appraisal of research
3. Apply to clinical problem
What is evidence-based medicine?
Patient
Concerns
EBM
Best research Clinical
evidence Expertise
What is EBM NOT?
What we have always done
Cookbook medicine
Only a cost-cutting trick
Only randomized trials
Meta-Analysis
Randomized Controlled Trial
Uncontrolled Trial
Case Series
Anecdote
Meta-Analysis
Randomized Controlled Trial
Uncontrolled Trial
Case Series
Anecdote
Apply Clinical
Evidence Question
Critical Literature
Appraisal Search
The EBM Cycle
1. Assess the patient: A clinical question arises from caring for a
patient.
2. Ask the question: Construct a well-built foreground question derived
from the case.
3. Acquire the evidence: Find the answer from the evidence presented
in the medical literature and identify the best resource from among
the many.
4. Appraise the evidence: Appraisal includes validity (closeness to
truth) and applicability (usefulness in clinical practice).
5. Apply: Communicate the evidence to your patient and integrate the
evidence with clinical expertise, patient preference and apply.
6. Self-evaluation: Evaluate the process and outcome.
Clinical Questions
Ask the question: Construct a well-built
foreground question derived from the
case.
Two Types of Questions are
Generated in the EBM Cycle
Background Questions ask about general knowledge
relating to a condition, diagnostic test or treatment.
They typically start with who, what, where, when, how, or why.
Richardson WS, Wilson MC, Nishikawa J, Hayward RS. The well-built clinical question: a key to evidence-based decisions. ACP J Club. 1995 Nov-
Dec;123(3):A12-3.
Formulating the Foreground Question
A. Read an evidence-based
abstraction journal
(and cancel other journals)