EBM – therapy Dr. Tina Dewi J , dr., SpOG

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Presentation transcript:

EBM – therapy Dr. Tina Dewi J , dr., SpOG Dept Epidemiology and Biostatistics Padjdjaran University School of medicine

Therapeutic or Intervention Worksheets General Overview Diagnostic test Therapeutic or Intervention S.R. & others prognosis cost-effective Harm

Worksheet Is the result VALID? How large was the treatment effect? Randomized assignment? Was follow-up complete? Patients are analyzed in the assigned group Double-blind Groups similar at the start of the trial? Aside from the experimental intervention, were the groups treated equally? How large was the treatment effect?

Therapeutic (Rx) Worksheet Can We Apply it to our Pts? Will the results help me in caring for my patients? Can the results be applied to my patients? Rx/intervention AVAILABLE in our setting. Were all clinically relevant outcomes considered? Are the benefits worth the harm and cost?

Tools Used in Rx Worksheet Relative Risk (RR) ARR RRR RR 150-100 =50 Kg 150-100/150 =33 % 100%/150% =66% Patient was 150 kg weight He lost 50 Kg form his weight. If we say that 1 kg = 1 risk

Tools Used in Rx Worksheet Relative Risk (RR) For the relative risk (RR), the same applied RR is calculated the rate of exposed or treated divided by those not exposed or treated CI is used to calculate the magnitude of the treatment / intervention effect.

Tools Used in Rx Worksheet Relative Risk (RR) Hypertension No CHD CHD drug 97 3 Rx + 90 10 Rx - Tools Used in Rx Worksheet Relative Risk (RR) Control event rate (CER) = 10 / 100 =10% Experimental event rate (EER) = 3 / 100 =3% RR = EER/CER =3% / 10% =33 % RRR = CER – EER / CER =10% - 3% / 10% = 70 % ARR = CER – EER = 10% - 3% = 7 % NNT = 1/ARR =1 / 7 x100 =15

Tools Used in Rx Worksheet Confidence interval Is the result of the study true for the whole population? It specifies how far above or below a sample-based value the population value lies. The smaller the size of the study = the wider confidence interval.

Read the discussion Did they make good reasoning for the findings Any other trial that support the study results. Any other study that contradict the result.

Read the conclusions Are the objectives met? Is there any recommendations? Any mention about limitations of the study?