Ann McKibbon's CE course on evidence-based health care principles was excellent! An awful lot was fit into the 4 hours this morning, and it seemed that everyone learned something and enjoyed it despite the cold of the room. :) I think Anne's great presentation skills, along with wonderful anecdotes and random information (did you know that librarians have a higher incidence of breast cancer?), were the secret. Some highlights:
- Where to identify the question an article is answering: best place is actually in the paragraph just before the methods section. The abstract will often also have a version, but the abstract is also often advertising...Just be aware that the question often changes throughout an article!
- Other things to find/identify/evaluate in order to use EBHC literature: what's being compared, patients/participants, setting (e.g., primary care, hospital, outpatient clinic...), interventions/exposures, outcomes, statistics, culture/healthcare system, funding source, conflict of interest
- Incidence vs. prevalence (test your residents!):
- Incidence is the measure of the number of new diagnoses.
- Prevalence is how common a diagnosis is right now.
- High incidence, low prevalence disease: H1N1!
- Low incidence, high prevalence disease: chronic condition, like diabetes.
- When looking at and trying to understand statistics, be cynical! have gambling tendencies! and remember, small is beautiful!
- Definition for p-value: the measure of the probability that the difference between treatments/interventions/exposures is from chance alone. (Small is beautiful!)
- Difference between 2-tier (i.e. Canada) and 3-tier (i.e. US) health care systems: basically, 2 tier has family doctors and specialists; 3-tier includes the generalist level (our pediatricians, for example).
- Countries with socialized medicine can produce great studies with huge amount of data (for example, in Israel, everyone serves in the army and that data can be used). Under the U.S. system, great studies can be done for individual treatments (there's funding/trial structure in place).
Ann also shared a couple of great resources:
- Rod Jackson's GATE: Graphic Approach to Teaching EBP (it also stands for other names) model
- The equator network, which provides a library of reporting guidelines.