This document provides information about a workshop on evidence-based medicine (EBM) for residents. The workshop objectives are to present clinical EBM summaries to peers and critically reflect on applying clinical studies to practice. The document reviews the EBM process and provides worksheets and resources for critically appraising different study designs, including randomized controlled trials, cohort and case-control studies, and systematic reviews. Key points of the critical appraisal worksheets are summarized for each study design. Logistical details are provided for the next workshop.
This is the handout version of a lecture I give to medical residents and fellows on the basics of clinical research designs and the inherent issues that go along with each one. I give this lecture as part of a multi-module lecture series on research design and statistical analysis.
This is the handout version of a lecture I give to medical residents and fellows on the basics of clinical research designs and the inherent issues that go along with each one. I give this lecture as part of a multi-module lecture series on research design and statistical analysis.
Lecture given to Unit 8 (INDS 208) -- Pathobiology Treatment and Prevention of Disease -- in the undergraduate medical curriculum at McGill University on September 10, 2012.
Evaluating a pratice guideline is essential given the rapid proliferation of them in the recent times. Here some general principles of evaluation of the guidelines are described with a guideline for panic disorder used in Australia, as an example.
A very vital article that briefly and nicely describes how shpuld evidence be handled in order to evaluate it and make use of the information provided.
Jan Hrabal: Evaluation of medical information quality #bcs2015KISK FF MU
Talk given at the BOBCATSSS 2015 conference - http://www.bobcatsss2015.com/.
The paper deals with the concept of quality of health-related information in the internet environment. It brings definitions of indicators of medical information quality, which are set into the methodics for evaluation of medical information quality on Czech websites. The methodics is divided in two parts: one for non-expert sources in common online environment designed for laymen and one extended version designed for experts, which includes also criteria for evaluation of research papers and reviews.
Similar to Resident Presentations - Evidence-Based Medicine for Haematology (20)
Tweet Your Pubs: How Altmetrics are Changing the Way We Measure Research ImpactRobin Featherstone
Presentation given to the Northern Alberta Health Libraries Association (NAHLA) Trends Mini Conference in Edmonton at the University of Alberta on May 2, 2014
Workshop given at the Medical Library Association Conference in Seattle WA, May 24th, 2012. This course is part of the Medical Library Association's Disaster Information Specialization Program.
Workshop - Disaster Health Information Sources: The BasicsRobin Featherstone
Continuing Education workshop given at the Midcontinental Medical Library Association (MLA) Chapter Meeting in St Louis Missouri on September 21, 2011. Disaster Health Information Sources: The Basics is the foundational class in MLA's Disaster Information Specialization. For more info, see: http://www.mlanet.org/education/dis/
Webinar - Disaster Health Information Sources: The BasicsRobin Featherstone
Webinar workshop given on September 14th and 15th to members of the Medical Library Association (MLA). Disaster Health Information Sources: The Basics is the foundational course in MLA's Disaster Information Specialization. For more info see: http://www.mlanet.org/education/dis/
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Resident Presentations - Evidence-Based Medicine for Haematology
1. Jewish General Hospital
LIFE SCIENCES LIBRARY Library
Workshop 4: Resident
Presentations
Chantal Cassis, MD
Robin Featherstone, MLIS
Francesca Frati, MLIS
Summer/Fall 2012 Roland Grad, MDCM, MSc, FCFP
2. Workshop 4 - Objectives
By the end of the workshop, you will be able to:
1. Present clinical EBM summaries to your peers
2. Critically reflect on the practical application of a
clinical study
3. Workshops
July 25 - Introduction to EBM for Haematology
Aug 8 - Hands-on Searching Workshops
Aug 22 - Critical Appraisal
Sept 5 - Resident Presentations
Sept 19 - Review
4. EBM Process
Formulating
Workshop Evaluating the clinical
the Process Workshop
5 question
1
Your patient for whom
you are uncertain about
therapy, diagnosis, or Searching
Incorporating prognosis the Evidence
evidence into
Workshop
decision-making
2
Workshop
Workshop 3
4
Appraising
the Evidence
5. Worksheets & Resources
Critical Appraisal Worksheets from JAMA Evidence:
http://jamaevidence.com/
Critical Appraisal Worksheets from Dartmouth
(include calculations for odds ratio, relative risk,
absolute risk, etc.):
http://www.dartmouth.edu/~library/biomed/guides
/research/ebm-teach.html
6. Therapy (RCTs)1
1. Are the results valid?
A. Did intervention and control groups start with the same prognosis?
Were patients randomized?
Was group allocation concealed?
Were patients in the study groups similar with respect to known prognostic
variables?
B. Was prognostic balance maintained as the study progressed?
To what extent was the study blinded?
C. Were the groups prognostically balanced as the study progressed?
Was follow-up complete?
Were patients analyzed in the groups to which they were first allocated?
Was the trial stopped early?
1. http://jamaevidence.com/criticalAppraisalWorksheet/27
7. Therapy (RCTs), cont.
2. What are the results?
A. How large was the treatment effect?
What was the relative risk reduction?
What was the absolute risk reduction?
B. How precise was the estimate of the treatment effect?
What were the confidence intervals?
8. Therapy (RCTs), cont.
3. How can I apply the results to patient care?
A. Were the study patients similar to my population of interest?
Does your population match the study inclusion criteria ?
If not, are there compelling reasons why the results should not apply to your
population?
B. Were all clinically important outcomes considered?
What were the primary and secondary endpoints studied?
Were surrogate endpoints used?
C. Are the likely treatment benefits worth the potential harm
and costs?
What is the number needed to treat (NNT) to prevent 1 adverse outcome or
produce 1 positive outcome?
Is the retention of clinical endpoints worth the increase of cost and risk of harm?
9. Harm (Cohort Studies, Case-Control Studies)2
1. Are the results valid?
Cohort Studies: Aside from the exposure of interest, did the exposed and
control groups start and finish with the same risk for the outcome?
Were patients similar for prognostic factors known to be associated with the
outcome (or was statistical adjustment done)?
Were the circumstances and methods for detecting the outcome similar?
Was the follow-up sufficiently complete?
Case-Control Studies: Did the cases and control group have the same
rise (chance) for being exposed in the past?
Were cases and controls similar with respect to the indication or circumstances
that would lead to exposure?
Were the circumstances and methods for determining exposure similar for cases
and controls?
2. http://jamaevidence.com/criticalAppraisalWorksheet/23
10. Harm (Cohort Studies, Case-Control Studies), cont.
2. What are the results?
A. How strong is the association between exposure and outcome?
What is the risk or odds ratio?
Is there a dose-response relationship between exposure and outcome?
B. How precise was the estimate of the risk?
What is the confidence interval for the relative risk or odds ratio?
11. Harm (Cohort Studies, Case-Control Studies), cont.
3. How can I apply the results to patient care?
A. Were the study subjects similar to your patients or population?
Is your patient so different from those included in the study that the results may
not apply?
B. Was the follow-up sufficiently long?
Were study participants followed-up long enough for important harmful effects to
be detected?
C. Is the exposure similar to what might occur in your patient?
Are there important differences in exposures (dose, duration, etc.) for your
patients?
D. What is the magnitude of the risk?
What level of baseline risk for the harm is amplified by the exposure studied?
E. Are there any benefits known to be associated with the exposure?
What is the balance between benefits and harms for patients like yours?
12. Summarizing the Evidence (Systematic Reviews)3
1. Are the results valid?
A. Did the review explicitly address a sensible clinical question?
Is the underlying biology or sociology such that, across the range of interventions
and outcomes included, the effect should be similar?
Did the review include explicit and appropriate eligibility criteria?
B. Was the search for relevant studies detailed and exhaustive?
Were sources of evidence and search strategies specified in sufficient detail for
replication
Was the likelihood and direction of publication bias considered?
C. Were the primary studies of high methodologic quality?
Were clear methodological selection criteria specified?
Were all included studies accessed by these criteria?
D. Were selection and assessments of studies reproducible?
Was an explicit approach used to select and extract data from all included
studies?
Was study selection and assessment validated by a blinded second observer?
3. http://jamaevidence.com/criticalAppraisalWorksheet/26
13. Summarizing the Evidence (Systematic
Reviews), cont.
2. What are the results?
A. Were the results similar from study to study?
How similar were the point estimates?
Do confidence intervals overlap between studies?
B. What are the overall results of the review?
Were results weighted both quantitatively and qualitatively in summary
estimates?
C. How precise were the results?
What is the confidence interval for the summary or cumulative effect size?
14. Summarizing the Evidence (Systematic Reviews),
cont.
3. How can I apply the results to patient care?
A. Were all patient-important outcomes considered?
Did the review omit outcomes that could change decisions?
B. Are any postulated subgroup effects credible?
Were subgroup differences postulated before data analysis?
Were subgroup differences consistent across studies?
C. What is the overall quality of the evidence?
Were prevailing study design, size, and conduct reflected in a summary of the
quality of evidence?
D. Are the benefits worth the costs and potential risks
Does the cumulative effect size cross a test or therapeutic threshold?
15. Next Workshop
10:30 am to 12:30 pm
Rm 519 (Dean’s conference room), McIntyre Medical
Building, McGill
Slides available: http://www.slideshare.net/featherr
Editor's Notes
Process can also be described as: Ask, Acquire, Appraise, Apply and Assess