This document discusses evidence-based medicine and searching PubMed for evidence to answer clinical questions. It provides an example of a focused clinical question about treating strep throat in children with amoxicillin versus penicillin. The best study design to answer a therapy question would be a randomized controlled trial. The document also outlines strategies for searching PubMed, including using Boolean operators, MeSH terms, and Clinical Queries filters.

1. Using PubMed to search for Evidence-Based Medicine Reference Section Conrado F. Asenjo Library UPR-MSC

3. Evidence-Based Medicine Judicious incorporation of the best available evidence, in conjunction with the values and preferences of those involved and with the circumstances of care in clinical decision-making. Evidence along is not enough.

5. Clinical Encounter- Carlitos Carlitos is an active 5 year old boy. His mother brought him in for a check-up because Carlitos has had a fever and a sore throat for several days. You suspect Strep and take a throat culture. The standard treatment for Streptococcal Pharyngitis is oral Penicillin three times a day. However, for Carlitos and his mother, you are concerned about compliance and the expense of this medication. You recall that a drug representative recently told you that a daily dose of amoxicillin is just as good as penicillin, but costs less. You want to review the literature before you decide on amoxicillin for Carlitos and possibly changing your standard practice.

7. Focused Clinical Question In pediatric patients with strep throat, is amoxicillin as effective as penicillin for relief of symptoms? relief of symptoms Outcome penicillin Comparison amoxicillin Intervention, Prognostic factor, Exposure pediatric patients with strep throat Patient or problem

9. Type of Study Meta-Analysis Systematic Reviews Randomized Controlled Trials Cohort Studies Cross Sectional Studies Case Control Studies Case Series/ Case Reports Animal Research In vitro (‘test tube’) research

10. Case Series and Case Reports

11. Case Control Studies

12. Cohort Studies

13. Randomized Controlled Trials

14. Systematic Reviews and Meta-Analysis

15. Preferred Study Designs RCT>cohort study > case control > case series Prevention RCT>cohort>case-control>case series Etiology Longitudinal cohort study>case control>case series Prognosis RCT>cohort>case control>case series Therapy Cross-sectional study (compared with a gold standard) Diagnosis