Keck Year 2 Evidence Based Medicine - Observational Studies and Trials

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Keck Year 2 Evidence Based Medicine - Observational Studies and Trials

  1. 1. Locating Observational Studies and Trials Lynn Kysh, MLIS kysh@usc.edu Information Services Librarian Norris Medical Library
  2. 2. Evidence Pyramid – Publication Types Evidence-Based Guidelines Systematic Review & Metaanalysis Higher Quality of Information Fewer Articles Randomized Controlled Trials Cohort Studies Case Control Studies Lower Quality of Information More Articles Case Series, Case Reports
  3. 3. Agenda 1. Define and locate: a. b. c. d. Case reports & case series Case control studies Cohort studies Randomized controlled trials 2. Build PubMed search skills 3. Introduce ClinicalTrials.gov Allie Brosh - Hyperbole and a Half http://hyperboleandahalf.blogspot.com/
  4. 4. ALL STUDIES Descriptive Case Report Case Series Analytic Qualitative Studies Adapted from Derrick Bennett and John Emberson Centre for Evidence Based Medicine www.cebm.net
  5. 5. Case Report Case Series A report on an individual patient with an outcome of interest A report on a series of patients with an outcome of interest. • Helpful for rare or new diseases/disorders • No control group • Little statistical validity
  6. 6. • U.S. National Library of Medicine & National Institutes of Health • MEDLINE, life science journals, online books • Over 23 million citations • USC will connect you to full text options
  7. 7. Finding case reports and case series: Use “Article Type” filter
  8. 8. ALL STUDIES Descriptive Case Report Case Series Analytic Qualitative Studies Observational Case-Control Study Adapted from Derrick Bennett and John Emberson Centre for Evidence Based Medicine www.cebm.net Cohort Study
  9. 9. Case Control Study Compare patients with a specific condition to people without the condition Cohort Study Identify a group of patients under treatment or an exposure, follow them forward over time, and then compare their outcomes with a similar unaffected (control) group • Ethically safer, easier and cheaper than RCTs • No blinding or randomization • Hidden confounders
  10. 10. Finding case control studies and cohort studies: Use MeSH Terms
  11. 11. ALL STUDIES Descriptive Case Report Case Series Analytic Qualitative Studies Experimental Trials Adapted from Derrick Bennett and John Emberson Centre for Evidence Based Medicine www.cebm.net Randomized Control Trial Observational Case-Control Study Cohort Study
  12. 12. Randomized Control Trials Participants are randomly allocated into an experimental or control group and followed over time for the variables/outcomes of interest • Randomization • Blinding • Processes counteract bias • Statistical analysis possible
  13. 13. Finding randomized control trials: Use “Article Type” filter
  14. 14. Are all trials published? NO.
  15. 15. •2007 FDA Amendment Act • Drug and Device trials MUST post to clinicaltrials.gov • Abbreviated summary tables • Within 1 year of completion
  16. 16. •It is not perfect... • Only starts with trials in 2008 • Label use only • Study from 2012 shows only 1 in 5 trials are compliant Prayle, A P 01/03/2012). "Compliance with mandatory reporting of clinical trial results on ClinicalTrials.gov: cross sectional study". BMJ. British medical journal (Clinical research ed.) (0959-8138), 344, p. d7373.
  17. 17. Cannot rely on information being accurate solely because it was published in a peer reviewed journal
  18. 18. vs. EBM 1. Ask 2. Acquire 3. Appraise 4. Apply 5. Assess + Advocate Publication Bias • Unreported results • Incomplete data • Poorly designed trials • Ghost writing
  19. 19. Agenda 1. Define and locate: a. b. c. d. Case reports & case series Case control studies Cohort studies Randomized controlled trials 2. Build PubMed search skills 3. Introduce ClinicalTrials.gov Allie Brosh - Hyperbole and a Half http://hyperboleandahalf.blogspot.com/
  20. 20. Thanks! Lynn Kysh, MLIS Information Services Librarian kysh@usc.edu (323) 442-1124 Laney Griner http://www.flickr.com/photos/sammyjammy/

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