Y tế cộng đồng - Xây dựng câu hỏi lâm sàng pico

Nội dung text: Y tế cộng đồng - Xây dựng câu hỏi lâm sàng pico

1. Xây dựng câu hỏi lâm sàng PICO Sheila Snow-Croft NN/LM SE/A Taken in part from the tutorial developed by Connie Schardt, Duke University Medical Center Library and Jill Mayer, University of North Carolina at Chapel Hill Health Sciences Library, at
2. "Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values." Sackett, D. L. (2000). Evidence-based medicine: How to practice and teach EBM(2nd ed.). Edinburgh; New York: Churchill Livingstone.
3.  Evidence-Based Medicine (EBM)  Evidence-Based Practice (EBP)  Evidence-Based Clinical Practice (EBCP)  Evidence-Based Health Care (EBHC)  Evidence-Based Nursing (EBN) Sackett’s definition refers to all of these; EBP and EBHC are more universally used.
4. EBP: 1. Assess the patient 2. Ask the question 3. Acquire the evidence 4. Appraise the evidence EBM: 5. Apply: talk with the 1. Ask focused question patient 2. Find the evidence (from Introduction to Evidence Based 3. Appraise the evidence Practice tutorial) 4. Make a decision 5. Evaluate performance (from Centre for Evidence Based Medicine www.cebm.net)
5.  Clinical expertise: the clinician’s cumulated experience, education, and clinical skills  Patient values: The patient brings to the encounter his or her own personal and unique concerns, expectiations, and values.  Best Research Evidence: usually found in clinically relevant research that has been conducted using sound methodology
6. Forming a question  Identify key patient problem  Phrased to facilitate finding an answer  What treatment might be considered  Alternative treatments to consider  Outcome to avoid or promote
7. PICO P= Patient or problem I = Intervention, prognostic factor, or exposure C=Comparison O=Outcomes (T)=Type of Study
8. Exercises: PICO scenarios
9. Types of Studies Case series and Case Reports Case control studies Cohort studies Randomized, controlled clinical trials Systematic Reviews Meta-analysis
10. Case series and Case reports  Collections of reports on the treatment of individual patients or a report on a single patient.  No control groups with which to compare outcomes, so limited statistical validity.