Making Sense of Evidence-based Medicine

Dr Morris Gordon is Consultant Paediatrician, Blackpool Victoria HospitalHead of Professionalism, transition and careers and theme lead for evidence informed practice of medicine, School of Medicine and Dentistry,Director, Best Evidence Medical Education (BEME) International collaborating centre, Blackpool/UCLAN

Evidence in Medicine. The evidence pyramid. Randomised controlled trials. Cohort studies. Case control studies. Case series and case reports. Consensus guidance. Social science research in medicine. Application and translation to practice. Self-assessment questions. Gathering Evidence in Practice. Considering clinical scenarios. Constructing a clinical question – PICO. Search strategy. Appraising the evidence. Constructing non-clinical questions – eg. Medical Education. Case studies. Self-assessment questions. Systematic Review and Evidence Synthesis. Definitions. Contrasting systematic and traditional reviews. Building a question for a systematic review. Methodological choices – quantitative vs qualitative synthesis. Defining inclusion criteria. Considering risk of bias and quality assessment. Heterogeneity. Synthesising results. Case studies. Forming conclusions based on the data. Implications for practice / future research. Appraising systematic reviews. Summary and step by step guide to your own review project. Evidence to Inform Policy and Practice. Evidence versus opinions – the role of evidence in guidance. Case study 1 – evidence to change national guidance. Case study 2 – Cochrane reviews impacting on practice. Limitations of evidence based medicine.