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Flashcards covering key concepts from levels of evidence, bias, NHMRC, and clinical practice guidelines.
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What is the central goal of evidence-based practice in healthcare as described in the notes?
To answer major clinical questions using research evidence; acknowledges that not all research is equally strong and bias can affect validity.
How are levels of evidence related to risk of bias?
Higher levels of evidence correspond to a lower risk of bias; lower levels have a higher risk of bias.
Name the typical research designs listed from strongest to weakest in the Levels of Evidence framework.
Systematic Reviews, Randomized Controlled Trials, Cohort Studies, Case-Control Studies, Case Series/Case Reports, Editorials/Expert Opinion.
What are the five common bias types that can affect intervention studies?
Allocation bias, Detection bias, Performance bias, Attrition bias, Measurement bias.
What databases are recommended for accessing high-quality healthcare evidence?
CINAHL, MEDLINE, Cochrane Library, PsycINFO.
What questions should you ask to determine if evidence is current and high quality?
Is it current? Is it informed by research? How well was it conducted? Is it bias-free? Is it peer-reviewed? How relevant is it to your population and setting?
What is the NHMRC and what does it do?
The National Health and Medical Research Council; it funds high-quality health research and guides clinicians to evaluate quality and relevance; defines levels of evidence and grades for recommendations.
What are the two aspects of research considered by NHMRC?
Clinical question (clearly defined to determine the evidence needed) and Level of evidence (well-designed research minimises bias).
What study design answers the question 'How effective is this treatment for this health condition?'
Intervention study, such as a randomized controlled trial.
What study design answers 'How accurate is this assessment or diagnostic procedure?'
Diagnostic accuracy study.
What study design answers 'What genetic, lifestyle or environmental hazards cause this health condition or make it more likely?'
Aetiological (epidemiological) study.
What study design answers 'How does this health condition progress if untreated?'
Prognostic study.
What study design answers 'Will community-wide screening for this health condition help or harm?'
Screening intervention study.
What is Level I NHMRC evidence?
Systematic reviews of Level II studies or Randomized Controlled Trials.
What characterizes Level IV NHMRC evidence?
Case series with a single arm; no control group; pre-post testing; cannot definitively attribute outcomes to the treatment.
What is a bias in research?
A systematic error in results or conclusions that threatens validity and trustworthiness.
What is the purpose of a clinical practice guideline?
A document providing evidence-based recommendations for managing a specific condition to aid clinical decision making.
What system does NHMRC use to rate quality of evidence and strength of recommendations?
The GRADE system, which classifies quality of evidence and strength of recommendations as strong, weak, conditional, or discretionary.
What is publication bias in systematic reviews?
The tendency for studies with positive or significant results to be published more often than negative results, skewing review conclusions.
What is the difference between primary and secondary evidence in the hierarchy of evidence?
Primary evidence comes from original studies (Levels II–IV); secondary evidence comes from systematic reviews (Level I) and reviews of Level II studies.