Evidence Based Medicine and Epidemiology

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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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39 Terms

1
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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.

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What is another name for Evidence-Based Medicine?

Evidence-based practice.

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Which exam tests your ability to sort and rate articles by level of evidence?

The American Nurses Credentialing Center (ANCC) exam.

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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.

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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.

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How are studies rated within a systematic review?

They are ranked from grade A (best evidence) to grade D (poor evidence).

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What happens after a systematic review to synthesize data?

A meta-analysis is performed to pool acceptable studies and test the data statistically.

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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.

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What is a double-blind design?

The intervention is hidden from the patient, clinician, and/or researchers.

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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.

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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.

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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.

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What is a case series?

A series of case reports involving multiple individuals who receive similar treatment.

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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.

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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.

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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.

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What is PubMed?

A component of Medline containing more than 30 million biomedical, medical, and life sciences citations and abstracts.

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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.

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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.

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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.

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What is Absolute Risk Reduction (ARR)?

A measure of the difference between two treatments in reducing a specific outcome (e.g., MI, stroke).

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What is Relative Risk Reduction (RRR)?

A measure of how much risk is reduced in the experimental group compared with the control group.

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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).

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What is Positive Predictive Value (PPV)?

The probability that a person with a positive screening result actually has the disease.

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What is Negative Predictive Value (NPV)?

The probability that a person with a negative screening result does not have the disease.

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What is Active Immunity?

Immunity developed through vaccination or by infection.

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What is Passive Immunity?

Immunity after receiving antibodies from another host (e.g., maternal antibodies via colostrum).

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What is Herd Immunity?

Resistance to a disease in a large portion of the population, usually due to immunization programs.

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What is Health in the epidemiology sense?

A state of complete physical, mental, and social well-being.

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What is Horizontal Transmission?

Transmission of an infectious agent from one individual to another (e.g., HIV/STIs via sexual contact).

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What is Vertical Transmission?

Transmission of an infectious agent from mother to infant (congenital infections; can occur via breastfeeding in HIV).

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What does Endemic mean?

A baseline level of a disease in a population.

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What does Epidemic mean?

Rapid increase of a disease in a population involving a large number of people.

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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.

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What is Morbidity?

An illness or departure from physical and/or mental health.

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What is Mortality?

Death.

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What is Infant Mortality?

Infant deaths per 100,000 live births; leading cause in the first year is congenital malformations (including chromosomal abnormalities).

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What is Sensitivity in screening tests?

The ability of a screening test to correctly identify those with the disease.

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What is Specificity in screening tests?

The ability of a screening test to correctly identify those without the disease.