Evidence Based Interventions
Lecture 1: Introduction & finding evidence
18-24 oktober groep presentatie
Learning goals course (today):
- Can search literature for evidence based treatments when confronted with a clinical
case
Learning objectives for today:
- Learning how to search for scientific evidence
o Learning how to formulate a clinical question
- Learning how to appraise the quality of scientific evidence and methods for improving
quality
- Knowing about possible biases in published evidence
Spring article: figure 1
Clinical expertise: you shouldn’t just follow the manual
Copernicus or Bacon scientific revolution: kind of skipped it
- Describe characteristic
- Classify charachteric (X) into:
o When is X present
o When is X absent
, o When is X present in varying degrees
o Reject what is not connected to X
Another example of improvement: Vesalius, because of his autopsies
The medical profession was based on galen: bloodletting, not on the vesalius
Harvey found that the heart pumped blood in and out
But what about the scientific method with psychological problems:
Sackett: evidence based medicine: ‘integrating individual clinical expertise with the best
available external clinical evidence from systematic research’.
Another type of therapy: Mesmer’s says exorcism works because of an electrical energy, so
the person treats you can realign the energy. Mesmer was really popular. Most often the
patients were woman and they would yell and scream and they were cured.
There is still healing ceremony (for example cristianity) that still looks and feels the same.
Mesmer said that normal medical science isn’t needed. So people were angry so the King
set up a commision that researched it with experiments and found that it helped some
people. But when they did other experiments for example randomization blind to condition
they found no effect.
But if you now set it up you can find an effect size if you have large groups.
Learning objectives Today: Learning how to search for scientific evidence
Randomized controlled trail = gold standard
,Searching for scientific evidence:
- Scientific journals
o Quality: look at the reputation and impact factor
o Research perspective
▪ Fundamental
▪ Applied
- Specific evidence based mental health..
PICO (TT) framework: = developed for therapy questions
- Systematic search protocol
- To formulate a well-focused clinical questions
- To retrieve a higher % of relevant citations
Patient/population: Who or what?
Intervention: Could include diagnostic test, treatment, prognostic factor
Comparison: What is the main alternative?
Outcome: What are you trying to accomplish?
Type of question: therapy diagnosis
Type of study: The design that is best for the question
Learning objectives for today: Learning how to appraise the quality of scientific
evidence and methods for improving quality.
, Article David and Montgomery: is an addition to lets find out what works. But if you don’t
know about the theory it isn’t useful. Het table: docent finds it useful, but there is a lot of
potential to get a good study?
Double blind is difficult
He likes the study of Wechsler. Subjective is really interesting, because the patients feels the
same.
Quality of control group influences outcome: so control group really important.
Lecture 1: Introduction & finding evidence
18-24 oktober groep presentatie
Learning goals course (today):
- Can search literature for evidence based treatments when confronted with a clinical
case
Learning objectives for today:
- Learning how to search for scientific evidence
o Learning how to formulate a clinical question
- Learning how to appraise the quality of scientific evidence and methods for improving
quality
- Knowing about possible biases in published evidence
Spring article: figure 1
Clinical expertise: you shouldn’t just follow the manual
Copernicus or Bacon scientific revolution: kind of skipped it
- Describe characteristic
- Classify charachteric (X) into:
o When is X present
o When is X absent
, o When is X present in varying degrees
o Reject what is not connected to X
Another example of improvement: Vesalius, because of his autopsies
The medical profession was based on galen: bloodletting, not on the vesalius
Harvey found that the heart pumped blood in and out
But what about the scientific method with psychological problems:
Sackett: evidence based medicine: ‘integrating individual clinical expertise with the best
available external clinical evidence from systematic research’.
Another type of therapy: Mesmer’s says exorcism works because of an electrical energy, so
the person treats you can realign the energy. Mesmer was really popular. Most often the
patients were woman and they would yell and scream and they were cured.
There is still healing ceremony (for example cristianity) that still looks and feels the same.
Mesmer said that normal medical science isn’t needed. So people were angry so the King
set up a commision that researched it with experiments and found that it helped some
people. But when they did other experiments for example randomization blind to condition
they found no effect.
But if you now set it up you can find an effect size if you have large groups.
Learning objectives Today: Learning how to search for scientific evidence
Randomized controlled trail = gold standard
,Searching for scientific evidence:
- Scientific journals
o Quality: look at the reputation and impact factor
o Research perspective
▪ Fundamental
▪ Applied
- Specific evidence based mental health..
PICO (TT) framework: = developed for therapy questions
- Systematic search protocol
- To formulate a well-focused clinical questions
- To retrieve a higher % of relevant citations
Patient/population: Who or what?
Intervention: Could include diagnostic test, treatment, prognostic factor
Comparison: What is the main alternative?
Outcome: What are you trying to accomplish?
Type of question: therapy diagnosis
Type of study: The design that is best for the question
Learning objectives for today: Learning how to appraise the quality of scientific
evidence and methods for improving quality.
, Article David and Montgomery: is an addition to lets find out what works. But if you don’t
know about the theory it isn’t useful. Het table: docent finds it useful, but there is a lot of
potential to get a good study?
Double blind is difficult
He likes the study of Wechsler. Subjective is really interesting, because the patients feels the
same.
Quality of control group influences outcome: so control group really important.
