PHA 335 - Evidence Based Medicine L5

What is evidence-based medicine (EBM)?

The use of published clinical evidence to guide drug information and therapeutic decisions

What is the purpose of EBM?

To provide evidence-based recommendations for patient care

Who uses EBM?

Healthcare professionals including pharmacists

Where can EBM be used?

Retail; hospital; ambulatory clinic; long-term care; managed care; pharmaceutical industry; government

Where do EBM questions come from?

Patients; physicians; healthcare professionals; P&T committees; administration; government; payers

What are the two main steps of EBM?

Summarize evidence; Interpret evidence

What does summarizing evidence mean?

Accurately and concisely summarize information from literature

What does interpreting evidence mean?

Evaluate information based on strength of evidence and patient-specific factors

What are the three types of literature in EBM?

Primary; Secondary; Tertiary

What is primary literature?

Original research studies such as RCTs and cohort studies

What is secondary literature?

Databases used to find primary and tertiary sources (e.g., PubMed)

What is tertiary literature?

Summarized and interpreted information from multiple primary sources

What are examples of tertiary literature?

Clinical practice guidelines; textbooks; drug references

Which type of literature is considered strongest for clinical decision-making?

Clinical practice guidelines and meta-analyses

What is the strength of evidence pyramid?

A hierarchy of evidence from strongest to weakest

What is at the top of the evidence pyramid?

Clinical practice guidelines; meta-analysis; systematic reviews

What is considered the gold standard study in EBM?

Randomized controlled trial (RCT)

What is at the bottom of the evidence pyramid?

Animal and laboratory studies

What are clinical practice guidelines?

Tertiary literature summarizing evidence for disease management

Why are clinical practice guidelines important?

They represent the standard of care

Who develops clinical practice guidelines?

Expert medical organizations and societies

What do clinical practice guidelines include?

Diagnosis; classification; treatment; complications; special populations

What is the goal of clinical practice guidelines?

Provide objective, evidence-based recommendations

What factors are considered when grading evidence?

Strength of recommendation; quality of evidence; benefit vs risk; study type; population

Why are RCTs considered high-quality evidence?

They minimize bias and provide strong clinical evidence

What are the components of an EBM response?

Efficacy; Safety; Health economics

What is efficacy in EBM?

How well a treatment works

What is safety in EBM?

Potential side effects or risks

What is health economics in EBM?

Cost compared to outcomes

What must be considered when interpreting EBM?

Patient-specific factors and clinical context

What is an example of an EBM question?

What is the best treatment for a specific patient condition?

What is the goal of EBM in pharmacy practice?

To improve patient outcomes using evidence-based decisions