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ODP exam 1 questions and answers
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ODP exam 1 questions and answersEDBM and information
-applying the best available research results (evidence) when making decisions about health
care
-health care professionals who perform evidence-based practice use research evidence along
with clinical expertise and patient preferences
-over 700 dental journals
-study has showed that you would have to read 6 articles per week to keep up
-consumers are reading too
-education requirements are changing
>traditional curricula put an emphasis on memorization of facts and a dependence on faculty
>higher level thinking and problem solving skills are necessary for EBDM
*for example, a health care provider recommends acetaminophen to treat arthritis pain in a
patient who has recently had stomach bleeding; the health care provider makes this
recommendation because research shows that acetaminophen is associated with less risk for
stomach bleeds than other common pain relievers; the health care provider's recommendation
is an example of evidence-based practice
Evidence pyramid
-the least evidence-based are those that are "test tube or animal" studies, then of course
opinions-you can get those anywhere
-then reports of case studies; the best ones are what we call RCT that are double blind with
control groups, not so common because they are expensive to run
-you will probably skip over the systemic reviews or meta studies because they are all about
statistics, but they are the most credible
,Systematic reviews
-a summary of the clinical literature; a systemic review is a critical assessment and evaluation of
all research studies that address a particular clinical issue; the researches use an organized
method of locating, assembling, and evaluating a body of literature on a particular topic using a
set of specific criteria
-a systemic review typically includes a description of the findings of the collection of research
studies, the systematic review may also include a quantitative pooling of data, called meta-
analysis
-example: scientist collected all the published studies that compared types of treatment for
prostate cancer that had not spread beyond the prostate gland; they compiled the results of
these studies in a comparative effectiveness review, which is a type of systematic review
>>>it will give an average of the data and achieve a higher statistical
Meta analysis
-a way of combining data from many different research studies; is a statistical process that
combines the findings from individual studies
-for example: researches wanted to know about the risk of stomach bleeding in people taking
aspirin; they did a meta-analysis of data from 24 clinical trials with nearly 66,000 participants
and found that the risk of stomach bleeding was 2.47% with aspirin compared to 1.42% with
placebo
Clinical trials
-a carefully conducted research study that compares the effects of drugs, treatment,
or diagnostic tests
,-for example: in a randomized controlled clinical trial to understand whether calcium tablets
work to prevent broken bones in women with low bone density, women with low bone density
in another group are randomly assigned to the control group and receive a placebo; the
number of women who suffer fractures in each group are compared to find out whether
calcium works
Rating system for the hierarchy of evidence
level I:
evidence from a systematic review of all relevant randomized controlled trials, or evidence-
based clinical practice guidelines based on systematic reviews of RCT
level II:
evidence obtained from at least one well-designed randomized controlled trial (RCT)
level III:
evidence obtained from well-designed controlled trials without randomization, quasi-
experimental
*cochrane library, pubmed, ADA
level IV:
evidence from well-designed case-control and cohort studies
level V:
evidence from systematic reviews of descriptive and qualitative studies
level VI:
evidence from a single descriptive or qualitative study
level VII:
evidence from the opinion of authorities and/or reports of expert committees
*pubmed, medline, journals
EBDM 5-steps
-convert information needs/problems into clinical question so they can be answered
, -conduct a computerized search with maximum efficiency
-critically appraise the evidence for validity and usefulness
-apply the results in clinical practice
-evaluate the process and your performance
PICO asking good questions
-forces clinician to focus on what the patient believes is the most important issue/outcome
-facilitates the next steps in the process-key terms for computer search
-forces a clear ID of the problem and results related to specific care and helps determine the
type of evidence required to solve the problem
PICO:
p= patient problem
i= intervention
c= comparison
o=outcome
Patient problem
-describe the patient's problem to a colleague
-what is the primary problem, main concern, chief complaint, disease, or condition?
-age, race, sex, medications?
-should any of these be considered as you search for evidence?
*in a patient with...
Intervention
-what you plan to do for the patient
-diagnostic tests, treatments, adjunctive therapies, medications, recommendations
*in a patient with... will
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