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Evidence-Based Medicine(EBM) 1. QUESTION 2.SEARCH 3.APPRAISE 4.PRACTICE 5.AUDIT
Where is the Evidence?Cohort StudyMulti-center StudyClinical Research and/or Studies in Medline:Clinical TrialsClinical Trials Phase IClinical Trials Phase IIClinical Trials Phase IIIClinical Trials Phase IVRandomized Controlled Trials
Animal researchIn vitro(Test tube) researchCase ReportsIdeas, Editorials, OpinionsCase Control StudiesCohort studiesRandomized Controlled Double Blind Studies Meta - analysisRandomized Controlled Studies
- 1 randomized controlled trials 2systematic review
-
-
Grade of recommendation
Level of evidence
Interventions
A
1a
Systematic review of randomized controlled trials
1b
Individual randomized controlled trial
B
2a
Systematic review of cohort studies
2b
Individual cohort study
3a
Systematic review of case-control studies
3b
Individual case-control study
C
4
Case series
D
5
Expert opinion without explicit critical appraisal or based on physiology or bench research
-
Sheet1
LevelTherapy
1aSystematic review()
1b
1cAll or none
2aSystematic review()
2bCohort study
2c"Outcome" Research; Ecological studies
3aSystematic review(-)
3b- Case-control syudy
4-
5
Sheet2
Sheet3
(Case Reports )
-Case Reports(halothane)?
Recurrent hepatitis attributable to halothane sensitization in an anesthetist. N Engl J Med 1969; 280:515-522.
,(Case Series, Case Analysis )(10)p
-Case Series laryngeal cancer19817199161061556%615179246271182425824503582%73%73%67%64%54%35100%91%95%85%88%82%72%61%3594%93%86%71%52%42%25%0%10,, 1994; 295: 376-383
(Case-control study)
Retrospective, ,
- Case-control study
(Cohort study)
ProspectiveretrospectiveBoth are longitudinal!
- Cohort study
(Intervention study)
(Clinical Trial)
(Clinical Trial)Inclusion criteria ()Exclusion criteria () randomized assignSingle blind () Double blind () Triple blind ( )
- Randomized Controlled Clinical Trial()()
(Meta-Analysis):
-1(all studies)?() (P)
-2(cohort studies)
-3(randomized trials)()
-4 (case-control studies)
-5 (Meta-analysis)()()()
CoChrane Collaboration1972Archie Cochrane(Randomized controlled trials;RCT)1992Archie Cochrane1993Cochrane Collaboration http://www.cochrane.org
Archie CochraneIt is surely a great criticism of our profession that we have not organised a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomised controlled trials.
THE COCHRANECOLLABORATION
Cochrane Organization- Collaborative Review Groups Methods Groups Field/Networks Consumer Network Centers Steering Group
EBM- ReviewArticle Review-Database of Abstract of Review Effectiveness
Topic Review-Cochrance Database of Systematic Review
What is Article Review????
Article ReviewBest Evidence
ObjectiveDesignSettingPatientsInterventionMain OutcomeMain ResultsConclusion
Article Review ProcessMonthly Reviewof Top ClinicalJournalsQualityScreeningArticle Review :Enhanced Abstract
Core Journals for Article ReviewAmerican Journal of MedicineAnnals of Internal MedicineArchives of Internal MedicineJournal of Internal MedicineNew England Journal of MedicineDiabetes CareCirculation, JAMA, Lancet
Outline of a Article ReviewAbstract:QuestionDesignSettingPatientsInterventionMain Outcome MeasureMain ResultsConclusions
Commentary:
Reference
Footnotes
What is Systematic Reviews????Topic Review?(CDSR)
Topic ReviewRCTCochrnae Database of Systematic Reviews(CDSR)
Systematic Review ProcessComprehensiveTopic SearchQualityScreeningMeta AnalysisTopic Review
Review Groups HIV/AIDSHypertensionIncontinence Infectious diseasesInflammatory bowel diseaseInjuriesLung cancerMenstrual disorders and subfertilityMetabolic and endocrine disordersMovement disordersMultiple sclerosisMuskuloskeletal Musculoskeletal injuriesNeonatalNeuromuscular diseaseOral healthPain, palliative and supportive carePeripheral vascular diseasesPregnancy and childbirthProstatic diseases and urologic cancersRenalSchizophrenia
200450Review Groups
Cochrane LibraryUpToDateClinical EvidencePubMed-Clinical QueriesMedline-Publication Types
Cochrane Library Cochrane Reviews Cochrane Database of Systematic Reviews DARE Database of Abstracts of Reviews of Effects CENTRAL Cochrane Central Register of Controlled Trials Methodology Reviews CMR--The Cochrane Methodology Register HTA The Health Technology Assessment Database NHS EED The NHS Economic Evaluation Database About Topics
Cochrane Reviews-- Cochrane Database of Systematic Reviews Systematic Reviews of Topic Areas CDSR 49 RCT
DAREDatabase of Abstracts of Review of Effects -4100-Nathonal Health Service Centre for Reviews and Dissemination (NHS CRD)- Systematic reviews- CDSR.
CENTRALCochrane Central Register of Controlled Trials - 40 / - Cochrane - MedlineCinahl -
Cochrane Database of Methodology Reviews (Methodology Reviews)- - - .- Cochrane Methodology Register (CMR) - - - - MEDLINE - systematic review
Health Technology AssessmentDatabase (HTA) - ()NHS Economic Evaluation Database (NHS EED) - - -
AboutThe Cochrane Collaboration and the Cochrane Collaborative Review Groups - /Topics - Cochrane review groups
Search
Search The cochrane library:
EX: Cochrane Reviews
Search The cochrane libraryTopies-- Groups
Search The cochrane libraryTopies
Search The cochrane library:
Search The cochrane library
Search The cochrane library
Search The cochrane libraryAdvanced Search
Search The cochrane libraryMeSH Search/
Search The cochrane libraryMeSH Search
Search The cochrane libraryMeSH Search
Results
Results- The cochrane library
Results- The cochrane libraryReviews / Protocols
Results- The cochrane library
Results- The cochrane library A full Review A Protocol (Review) /(Review) (Review/Protocal)
Results- The cochrane libraryExporting Citations
Results- The cochrane libraryExporting Citations
Results- The cochrane librarySave SearchEdit Search
Registration
Search History
Saved Searches
Alert
Registration
Registration
Registration
Registration-Log inPersonal Navigation Bar
Registration-Cochrane Library
Search History
Search History
Save Search
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Saved Searches
Saved Searches / Alert AlertAlert
UPToDate
American Academy of Family PhysiciansTopic Review6,0003000
narrow search
Clinical Evidence
Topic Review
PubMed-Clinical Queries
Haynes RB(Therapy)(Diagnosis)(Etiology)(Prognosis)(sensitivity)(specificity)
Medline-Publication Types LimitPublication types hierarchy systematic reviewrandomized controlled trials(RCT)controlled trialsMedlineLimitpublication typesmeta-analysisrandomized controlled trials(Ctrl+Enter)
Publication Types
-
National Guideline Clearinghouse (NGC)PDA
http://www.guideline.gov
1994OxfordRAM and HJM1995
http://www.jr2.ox.ac.uk/bandolier/ Bandolier
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