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Lecture Evidence based medicine: Effectiveness of therapy

This lecture includes these contents: Effectiveness of therapy, critically appraising a therapy paper, efficacy versus effectiveness, observation versus experimental studies,. Invite you to consult this lecture. | EVIDENCE BASED MEDICINE Effectiveness of therapy Ross Lawrenson Critically appraising a therapy paper Critical Appraisal of a therapy paper - methodology When critically appraising a paper ask yourself three questions: Are the results valid? What are the results? Will the results help me in caring for my patients? Go to the therapy worksheet for the complete list of questions I. Are the results valid? In other words was this a well designed study in a relevant population. The best study design to answer a therapy question is a randomised controlled trial. Go through the worksheet questions 1- 6 to help you decide whether you are likely to believe the results of the paper you are considering. 1. Did the study address a clearly focused question? Can you define The population they studied The intervention The comparison group The outcomes 2. Was the assignment of patients randomised? Efficacy versus effectiveness Efficacy versus effectiveness Efficacy - does receiving treatment work under ideal conditions? Efficacy versus effectiveness Efficacy - does receiving treatment work under ideal conditions? Effectiveness - does offering treatment help under ordinary circumstances? Observation versus experimental studies. Observation versus experimental studies A study population of 2000 patients with acute coronary heart disease of whom half receive a certain intervention and the other half do not. Of the 2000 patients, 700 have arrhythmia "X" and 1300 do not. Observation versus experimental studies A study population of 2000 patients with acute coronaries of whom half receive a certain intervention and the other half do not. Of the 2000 patients, 700 have arrhythmia "X" and 1300 do not. X(+) = Patients with arrhythmia "X" have a mortality of 50% X(-) = Patients without arrhythmia have a mortality of 10%. Observational study Intervention No intervention X(-) 800 X(+) 200 X(-) 500 X(+) 500 Deaths 180 300 Relative risk = 0.6 . | EVIDENCE BASED MEDICINE Effectiveness of therapy Ross Lawrenson Critically appraising a therapy paper Critical Appraisal of a therapy paper - methodology When critically appraising a paper ask yourself three questions: Are the results valid? What are the results? Will the results help me in caring for my patients? Go to the therapy worksheet for the complete list of questions I. Are the results valid? In other words was this a well designed study in a relevant population. The best study design to answer a therapy question is a randomised controlled trial. Go through the worksheet questions 1- 6 to help you decide whether you are likely to believe the results of the paper you are considering. 1. Did the study address a clearly focused question? Can you define The population they studied The intervention The comparison group The outcomes 2. Was the assignment of patients randomised? Efficacy versus effectiveness Efficacy versus effectiveness Efficacy - does .