314512 Final: Evidence Informed Health Practice Exam Notes
What is evidence-based practice?
Evidence based practice is explicit and consociation attempts to find the best available research evidence to
assist health professionals to make the best decision for their patients. It involves using clinical reasoning to
integrate information from 4 sources:
- Research evidence
- Information from the practice context
- Patients values
- Clinical expertise
Evidence-based practice aims to provide the most effective care possible.
Process of evidence based practice – the 5 A’s:
- Ask a question
- Access the information
- Appraise articles found
- Apply information
- Audit
Not all evidence is of sufficient quality. There are 3 main aspects of evidence that are needed to be appraised:
1. Validity
2. Impact
3. Applicability
Types of questions:
1. Descriptive – describe whats going on
2. Relational – relationship between two variable
3. Casual – determine if one or more variable cause or affect one or more outcome/variable.
Week 1: What, why and how of research
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Finding reliable evidence:
• How big is the sample size?
• Who is researching?
• When was it published?
• How recent was this research?
Levels of evidence:
1. Systematic Review – a process where by everything is reviewed and reduces the bias in the results of
the review.
2. Randomized Control Trials – participants are chosen at random; one intervention group and one
control group and they are randomly allocated into each group. Given a choice, the subjects may be
more inclined to go to one group than the other; this increases level of bias from the systematic review
because they have less of a choice.
3. Other controlled clinical trials (quasi) – Semi randomized. The random allocation decreases the bias
of the trail, can be personal preference. May also relate to the subjects ethical views and their morality.
No randomization due to ethics. PROSPECTVE
4. Observational Studies – prospective if theyre developing the trial and moving forward within a
cohort group – separating according to disclosure) and retrospective if observing a medical report and
by speaking to them. A case group that has a condition of interest as well as a similar group used as a
control in order to observe the development of the condition and how it came about; life factors and
activities (RETROSPECTIVE). The cohort has groups that are healthy at the baseline (which is bias,
choice not random). A prospective cohort study is a longitudinal cohort study that follows a group of
people over a period of time that differ.
5. Case Studies – observing one or a few patients with a specific condition and observing their condition
development as well as their treatment and recovery plan; individual data.
Cross-sectional studies – over a longer period of time; collecting data from different people over a set
time, however, only getting information from a person once.
Anecdotal – personal stories of home remedies.
1,2,3 are experimental intervention studies.
4,5 are observational studies. Have recall and attritional bias.
Systematic
review
RCT's
Other controlled
clinical trials
Observational studies (Cohort
& Case-control)
Case studies, anecdotes, correlation
and personal opinion
Bias Increases
Week 2: Levels of Evidence
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Why is baseline important for a study?
To provide an information base against which to monitor and assess and activitys progress and effectiveness
during implementation and after the activity is complete.
Range of Knowledge Sources and Evaluation of their Role in Providing Credible Information:
Probability values = p
P value < 0.05 is statistically significant and not likely due to chance.
P value > 0.05 is NOT statistically significant and likely due to chance.
Order of Importance:
r-value
Positive/Negative sign
p-value
Definitions:
Prospective → looking forwards. Has attritional bias.
Retrospective → looking backwards. Has recall bias.
Census → complete at a certain time and date
Intervention → action or process of intervening
Control → two compare two groups of results
Baseline → the time you start the study of comparisons between two groups (p-value is equal for
both). Should not be significant.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Week 1: what, why and how of research. Evidence based practice is explicit and consociation attempts to find the best available research evidence to assist health professionals to make the best decision for their patients. It involves using clinical reasoning to integrate information from 4 sources: Evidence-based practice aims to provide the most effective care possible. Process of evidence based practice the 5 a"s: There are 3 main aspects of evidence that are needed to be appraised: validity, impact, applicability. Types of questions: descriptive describe what(cid:495)s going on, relational relationship between two variable, casual determine if one or more variable cause or affect one or more outcome/variable. Prospectve control group and they are randomly allocated into each group. The random allocation decreases the bias of the trail, can be personal preference. Cross-sectional studies over a longer period of time; collecting data from different people over a set. Anecdotal personal stories of home remedies. by speaking to them.
