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Flashcards covering Evidence-Based Medicine definitions, study designs, evidence grades, key databases, statistical terms, and core epidemiology concepts from the provided notes.
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What is Evidence-Based Medicine (EBM)?
The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
What is another name for Evidence-Based Medicine?
Evidence-based practice.
Which exam tests your ability to sort and rate articles by level of evidence?
The American Nurses Credentialing Center (ANCC) exam.
What is meta-analysis?
A statistical method that combines data from multiple studies (systematic review) to increase statistical power and provide a single conclusion; gold standard in EBM.
What is a systematic review?
A literature review that identifies, selects, and analyzes multiple research articles on a health topic, following explicit methodology and criteria.
How are studies rated within a systematic review?
They are ranked from grade A (best evidence) to grade D (poor evidence).
What happens after a systematic review to synthesize data?
A meta-analysis is performed to pool acceptable studies and test the data statistically.
What is a randomized controlled trial (RCT)?
An experimental study where subjects are randomly assigned to a control or treatment group; the intervention may be a drug, procedure, or device; some RCTs are double-blind.
What is a double-blind design?
The intervention is hidden from the patient, clinician, and/or researchers.
What is an experimental study?
A study with random subject selection, one placebo or control group, and one or more intervention groups; an RCT is a type of experimental study.
What is a cohort study?
A study that investigates risk factors for diseases by observing subjects over a long period with no intervention; aims to identify risk factors and associations (not causation); example: Nurses’ Health Study.
What is a case report?
A detailed report of one patient with a disease or unusual condition, including demographics, signs/symptoms, diagnosis, and response to treatment.
What is a case series?
A series of case reports involving multiple individuals who receive similar treatment.
What are opinions and editorials in the evidence hierarchy?
The weakest form of evidence; they can be biased and may not be based on solid evidence.
What are Cochrane Reviews?
Gold standard database for EBM; systematic reviews (Cochrane Database of Systematic Reviews); funded without commercial/conflicted sources; also known as the Cochrane Collaboration.
What is Medline?
The U.S. National Library of Medicine’s premier bibliographic database with over 26 million life-sc sciences articles; includes journals from around the world.
What is PubMed?
A component of Medline containing more than 30 million biomedical, medical, and life sciences citations and abstracts.
What is CINAHL?
The world’s largest source of full-text nursing and allied health journals (>1,300 journals) with indexing of over 4,000 journals.
What are the Grades of Research Evidence?
A, B, C, and D; well-designed controlled experimental trials (double-blind RCTs) are grade A (level 1) evidence.
What is a Confidence Interval (CI)?
A measure of certainty in a sampling method; e.g., a 95% CI means you are 95% certain the true population mean lies within the interval.
What is Absolute Risk Reduction (ARR)?
A measure of the difference between two treatments in reducing a specific outcome (e.g., MI, stroke).
What is Relative Risk Reduction (RRR)?
A measure of how much risk is reduced in the experimental group compared with the control group.
What is Number Needed to Treat (NNT)?
The number of patients you must treat to avoid one bad outcome (e.g., an NNT of 7 means 7 patients need treatment to prevent one event).
What is Positive Predictive Value (PPV)?
The probability that a person with a positive screening result actually has the disease.
What is Negative Predictive Value (NPV)?
The probability that a person with a negative screening result does not have the disease.
What is Active Immunity?
Immunity developed through vaccination or by infection.
What is Passive Immunity?
Immunity after receiving antibodies from another host (e.g., maternal antibodies via colostrum).
What is Herd Immunity?
Resistance to a disease in a large portion of the population, usually due to immunization programs.
What is Health in the epidemiology sense?
A state of complete physical, mental, and social well-being.
What is Horizontal Transmission?
Transmission of an infectious agent from one individual to another (e.g., HIV/STIs via sexual contact).
What is Vertical Transmission?
Transmission of an infectious agent from mother to infant (congenital infections; can occur via breastfeeding in HIV).
What does Endemic mean?
A baseline level of a disease in a population.
What does Epidemic mean?
Rapid increase of a disease in a population involving a large number of people.
What does Pandemic mean?
An epidemic that occurs over a very large area (several countries/continents) and involves a large portion of the global population.
What is Morbidity?
An illness or departure from physical and/or mental health.
What is Mortality?
Death.
What is Infant Mortality?
Infant deaths per 100,000 live births; leading cause in the first year is congenital malformations (including chromosomal abnormalities).
What is Sensitivity in screening tests?
The ability of a screening test to correctly identify those with the disease.
What is Specificity in screening tests?
The ability of a screening test to correctly identify those without the disease.