solutions
Evidence based medicine - ANSWER- Seeks the highest levels of published
research based on sound scientific design and ethical standards to improve
patient care and life-long learning for the physician and practitioner
Level I - ANSWER- Randomized control trial would be considered what level of
evidence?
Level II - ANSWER- Cohort studies would be considered what level of evidence
level III - ANSWER- Case controlled studies would be considered what level of
evidence
Level IV - ANSWER- Case series would be considered what level of evidence
Level V - ANSWER- Expert opinion would be considered what level of evidence
Randomized Clinical trials - ANSWER- Experimental, analytical, expensive
Cohort, case controlled, case series - ANSWER- Observational, descriptive,
dominate surgical literature, do not interfere with patient or physician choice,
easier to conduct, less costly
Literature based - ANSWER- systematic review (specific clinical questions,
comprehensive literature search, explicit selection criteria, assess
methodologies) literature review, descriptive or narrative
Expert Opinion - ANSWER- "just ask me", lack of supporting evidence, personal
opinion, biased and does not exclude lecture or other presentations
, Randomized controlled trial - ANSWER- Randomization of patients to treatment
groups, comparative study, inclusion/exclusion criteria well defined, blinding,
sample characteristics, distributions and confounding, sample size
Single blinded - ANSWER- treatment assignment is concealed from subject only
double-blinded - ANSWER- treatment assignment is concealed from both subject
and the investigator who assesses the study end point
Placebo surgery, not well designed, who wants to be randomized - ANSWER-
What are some difficulties with randomized clinical trials?
Prospective Cohort study - ANSWER- Treatments followed forward in time;
criteria decided upon in advance, sample size and sample characteristics
Design --> patients --> results
Retrospective Cohort Study - ANSWER- Treatments identified backwards in time;
criteria decided upon after intervention
sample size, and sample characteristics
Patients --> design --> results
Case controlled - ANSWER- Focuses on a specific outcome or interest, looks at
favorable vs. unfavorable outcome, retrospective
Case series - ANSWER- Patients treated one way, outcome is clinically important,
must be reproducible, primarily retrospective, may rely on medical records, target
population must be definable
Case series - ANSWER- No formal control, historical controls (literature), useful
to test new devices and procedures, where randomized controlled trials are not
possible
Case series - ANSWER- What comprises most existing literature in podiatric
medicine and orthopedics?
A)randomized control
B) Cohort study
C) case series