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Evidence-based Clinical Practice versus Research Methodology

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  • 1. Evidence-Based MedicinevsResearch Methodology
    SohailBajammal
    October 6, 2011
  • 2. Objectives
    What is EBM (EBCP)? How is it different from research?
    Why do we need to learn the skills of EBM?
    How to practice EBM?
  • 3. What got me into EBM….
    What is a double blind study?
    Two orthopaedic surgeons
    reading an ECG
  • 4. Double blind in orthopaedics?
  • 5. What is research?
    Systematic investigation towards increasing the sum of knowledge
    (Chambers 20th Century Dictionary)
  • 6. Perspectives of Research
    Basic Science
    Social
    Health Problem
    “Trauma”
    Economic
    Legal
    Clinical
    Diagnosis
    Therapy
    Prognosis
  • 7. Doing
    Research Methodology
    Research
    Evidence-Based Clinical Practice
    Using
  • 8. EBM (EBCP)
    Research Evidence
    Patients’ Preferences
    Clinical Expertise
    Clinical Circumstances
    Haynes et al. BMJ 2002;324:1350
  • 9. EBM & Critical Thinking
    “ثمنرقىفيالبحثوالمقاييسعلىالتدريجوالترتيب
    معانتقادالمقدماتوالتحفظفيالنتائج
    ونجعلغرضنافيجميعمانستقرئهونتصفحه
    استعمالالعدللااتباعالهوى
    ونتحرىفيسائرمانميزهوننتقده
    طلبالحقلاالميلمعالآراء”
    الحسنبنالهيثم
  • 10. Steps of Practicing EBCP
  • 11. How would you search for answers?
    Ask the audience
    Ask a friend
    Flip through a textbook
    Google it up!
    Search the literature
  • 12. It depends on the question!
    How do I look like in the pictures in the newspapers? Friends & Audience
    Where to download the latest song? Google
    What is the blood supply to the femur? Textbook
    What are the effects of soft drinks on fracture healing? Journals
  • 13. What’s wrong with textbooks?
    Excellent for the principles & basic knowledge
    Usually single authored chapters
    Likely biased, author’s opinion
    Not peer-reviewed
    Outdated (at least 4 years)  except the frequently updated online books (not PDF eBooks)
  • 14. What’s wrong with googling?
  • 15. What’s wrong with googling?
    Reliability & credibility of source
    Google Scholar is good
  • 16. In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13
  • 17. In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13
  • 18.
  • 19.
  • 20. Usefulness of Information
    Hurwitz SR, Slawson DA, Shaughnessy A. Orthopaedic information mastery: applying evidence-based information tools to improve patient outcome while saving orthopaedists’ time. J Bone Joint Surg Am. 2000;82:888–895.
  • 21. Satisficing
    ‘‘where busy clinicians will be satisfied with the information they can readily summon, while sacrificing quality for convenience”
    كبب وليّس ، يطلع كويس
    Carter BS, Leuthner S. Decision making in the NICU—strategies, statistics and ‘‘satisficing.’’ Bioethics Forum. 2002;18:7–15.
  • 22. Before we move on,
    What are the differences between articles & books?
    Are all articles good? Are all journals good?
    How does an article look like?
  • 23. How does an article look like?
  • 24. Read the article titles  If relevant, read the abstract
    If you read the abstract & it’s relevant  get the full text
  • 25. Journal Name, Volume, Issue, Pages
    Article Title
    Authors & Contact Info
    MeSH Terms
    Abstract
    When you search by keywords, you search in these areas
  • 26. How does a full text article look like?
    Same information as abstract, PLUS
    Introduction
    Methods
    Results
    Discussion
    References
  • 27. Where are articles stored?
    Articles are published in Journals
    Journals are published by Publishers
    Journals are indexed by Databases (e.g., MEDLINE, EMBASE)
    Instead of going to each publisher website & look for articles, you search for articles in a database
    There are many companies/websites that searches a database (e.g., Medline): PubMed, OVID
  • 28. Database (e.g. MEDLINE)
    Journal of Medicine
    Journal of Medical Research
    Engineering Journal
    Business Journal
    Article 1
    Article 1
    Article 1
    Article 1
    Article 2
    Article 2
    Article 2
    Article 2
    Article 3
    Article 3
    Article 3
    Article 3
    Article 4
    Article 4
    Article 4
    Article 4
    Article 5
    Article 5
    Article 5
    Article 5
    Article 6
    Article 6
    Article 6
    Article 6
    Multiple Browsers (e.g., PubMed, OVID)
    Publisher: Springer
    Publisher: Mosby
    Publisher: ABC
    Publisher: XYZ
  • 29. What we have talked about?
    What is EBM (EBCP)? How is it different from research?
    Why do we need to learn the skills of EBM?
    How to practice EBM?