LBM 4

CRITICAL APPRAISING AND EVIDENCE BASED MEDICINE

Step 1
1. Evidence Based Medicine :
A process of systematically reviewing appraising and using clinical
research
Technical use for decision making in the management of patient
Integration of based research evidence with clinical expertise and
patient value
2. Critical Appraisal
Assessment critically
A process of examination, appraisal and repair of research before
taking new decision for applying to the patient
Critical study for determine whether paper or article is worth
revering to be as a guidance for making clinical decision or not
3. Prognostic
Prediction of the course to desease
Outlook for the patient
4. PICO
Patient/ problem
etc)
Intervention
and

Comparison
Outcome

: Characteristic of patient (gender, age, etnic,

: Which by research methodology diagnostic test
treatment
: Comparing between therapy and medicine
: final result / expectation

5. Therapeutic
Healing
The result medical handling that suitable with what we expected
Branch of medical that is concern to treatment desease
Step 2
1. What is the definition of EBM?
2. What is the purpose of EBM?
3. How to get start EBM?
4. What are the advantages of EBM?
5. What factors will encourage EBM?
6. Why EBM needed in learning?
7. How to apply EBM in medical?
8. What is the definition of CA?
9. What are the purposes of CA?
10.What are differences between EBM and CA?

11.What are the relations between EBM and CA?

12.Why EBM and CA can make we update?
13.What is the relationship of EBM and PICO?
Step 3
1. What is the definition of EBM?
The process of systematically riviewing, appraising, and using clinical
research finding to aid the delivery of optimum clinical care to patient
Technic use for decision making to integrating three factors there are
skills and clinical expertise of physician, the interest of patient,
scientific evidence.
The best evidence of research
2. What is the purpose of EBM?
Hope will get optimal result in curing process
Help physician to make the best clinical decision
To find out whether the action of physician is right or not
Help clinicans provide better medical service
Allert clinicans to important advances in internal medicine by selecting
from medical literature
3. What are the advantages of EBM?
Clinicans can find the best research
Allows the patient acess recent clinical knowledge
Reducing the risk of medication mistake in giving to patient
Can help provider makes better use of limit resources by enabling them
to evaluate clinical effectiveness of treatments and services
Potential to improve continuity and uniformity of care through the
development of common approaches and guidelines
4. What are the steps to do EBM?
Define the problem
: formulate the clinical question (patient, intervention, comparisson,
outcome)
Tracking down the information source needed
: find out evidence which can answer the question
Crtically appraising the information
: CA to prove whether the evidence the 2nd step is valid, important,
applicabilty
Appliying information to the patient
: The thruth of evidence can apply and intergrated to the patient
Evaluation how effective it
: Improve it the activity and efficiency the steps
5. What factors will encourage EBM?
Critical thingking
Independent
Creative
6. Why EBM needed in medical practice?
7. How to apply EBM in medical?
8. What is the definition of CA?

9. What are the purposes of CA?

10.What are differences between EBM and CA?
11.What are the relations between EBM, CT, CA?
12.Why EBM and CA can make we update knowledge?
13.What is the relationship of EBM and PICO?

STEP 4

PATIENT
PROBLEM
EBM

CA

RESULT OF
CRTICAL TRIALS

APPLY

STEP 7
6. Why EBM needed in medical practice?
there is a large information gap between research and clinical
practice. Because so much research is published all the time, clinicians
understandably are unaware of most of it, or do not have the tools to
assess
its quality. Researchers, on the other hand, do not understand the
information
needs of clinicians and continue to present their work in a way that is not
easily accessible to busy practitioners.
EBM can helps practitioners to avoid information overload but, at the
same time, to find and apply the most useful information so its needed in
medical practice.
http://www.fk.unair.ac.id/pdfiles/ebook/Evidence-based%20Medicine
%20Workbook.pdf
7. How to apply EBM in medical?
Using techniques from science, engineering, and statistics, such as meta-analysis
of medical literature, risk-benefit analysis, and randomized controlled trials (RCTs)
(Mendelson and Carino, 2005)
http://www.biolmedonline.com/Articles/vol2_1_1-5.pdf

8. What is the definition of CA?

Critical appraisal is the process of carefully and systematically examining
research to judge its trustworthiness, and its value and relevance in a
particular context. (Burls 2009)
http://www.ucl.ac.uk/ich/services/library/training_material/critical-appraisal

9. What

are the purposes of CA?

Combat information overload;
Identify papers that are clinically relevant;
Continuing Professional Development (CPD) - critical appraisal
is a requirement for the evidence based medicine component of
many membership exams

http://www.ucl.ac.uk/ich/services/library/training_material/critical-appraisal

To help people develop the necessary skills to make sense of scientific

evidence, and has produced appraisal checklists covering validity, results
and relevance.
http://www.medicine.ox.ac.uk/bandolier/painres/download/whatis/what_is_
critical_appraisal.pdf
10.What are differences between EBM and CA?


Evidence-based medicine (EBM) is the process of systematically
reviewing, appraising and using clinical research findings to aid the
delivery of optimum clinical care to patients

Critical appraisal is the process of carefully and systematically

examining research to judge its trustworthiness, and its value and
relevance in a particular context. Crtical Appraisal is an important element
of evidence-based medicine.
http://www.hsmdghs-bd.org/Documents/EBM_Module_Script.pdf
http://www.ucl.ac.uk/ich/services/library/training_material/critical-appraisal

11.What are the relations between EBM, CT, CA?

12.Why EBM and CA can make we update knowledge?
13.What is the relationship of EBM and PICO?