Evidence-Based Medicine Practice Flashcards

A comprehensive set of vocabulary flashcards based on the lecture notes regarding Evidence-Based Medicine (EBM), including its definition, practical steps, risk communication tools, and statistical metrics like NNT and NNH.

Evidence-Based Medicine (EBM)

The process of finding, appraising and using the best available external clinical evidence, in combination with individual clinical expertise and professional judgement, to make informed clinical decisions about the health and care of individual patients.

The 5 Steps of Practicing EBM

1. Formulate a clinical question. 2. Find the evidence. 3. Appraise the evidence. 4. Apply evidence to clinical practice. 5. Evaluate step 1-4, and redefine question if necessary.

Clinical Decisions

Decisions that may involve active drug treatments, surgical intervention, preventative strategies, lifestyle changes, care/support packages, and advice/reassurance.

Shared-Decision Making

A collaborative process in which patients and healthcare professionals work together to select diagnostic tests, drug treatments and support packages – based on decisions informed by EBM and patient choice.

ARR

Absolute Risk Reduction

RRR

Relative Risk Reduction

Numbers Needed to Treat (NNT)

Indicates the number of people who would need to receive an intervention to prevent one event.

Characteristics of a smaller NNT

Indicates greater effectiveness of the intervention in the study over a specific time.

Numbers Needed to Harm (NNH)

Indicates the number of people who would need to receive an intervention to cause one adverse event.

Characteristics of a larger NNH

Indicates better safety of the intervention in the study with respect to the specific adverse event over a specific time.

Patient Decision Aids (PDAs)

Tools designed to prepare patients in shared decisions with HCPs by helping them understand benefits and risks without telling them what to do or making recommendations.

Cochrane Systematic Review: PDA Outcomes

Concluded that use of PDAs leads to improved patient knowledge, improved understanding of benefits and risks, and improved prioritisation and decision-making.

Personalised Risk Information

Risk information presented based on the individual’s own risk factors (categorised as low, medium or high risk groups, or as a percentage) rather than general population estimates.

Personalised Risk Tool Examples

$\text{QRISK}$, $\text{CHA}_2\text{DS}_2\text{VASC}$, $\text{BCrisktool}$

Natural Frequencies

A combined frequency of two events (e.g. prevalence of people with uncontrolled diabetes who have developed irreversible retinopathy) that may be easier to appreciate than percentage probabilities.

Cate’s plot

A visual format used to present natural frequencies.