module 4 finding the evidence: individual trials
DESCRIPTION
Module 4 Finding the Evidence: Individual Trials. EBM Literature: Reviews. Individual Studies: Experimental. Individual Studies: Observational. Evidence hierarchy. Search ordr. Level of evidence. Meta analyses Systematic reviews Randomized control trials (RCTs) - PowerPoint PPT PresentationTRANSCRIPT
Module 4Module 4Finding the Evidence:Finding the Evidence:Individual TrialsIndividual Trials
Meta analysesSystematic reviews
Randomized control trials (RCTs)Controlled trials w/o randomization
Cohort studiesCase control studies/retrospective cohortCase studies/qualitative studies
EBM Literature: Reviews
Individual Studies:Experimental
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Individual Studies:Observational
Evidence hierarchy
Resources for Trials
Resources for Trials
CENTRAL
Resources for Trials
TRIP Database
TRIP Database
Resources for Trials
1. RecruitmentWho did the subjects represent?
2. Allocation Was the assignment to treatments randomized? Were the groups similar at the trial’s start?
3. MaintenanceWere the groups treated equally?Were outcomes ascertained & analyzed for most patients?
4. MeasurementsWere patients and clinicians “blinded” to treatment? ORWere measurements objective & standardized?
Appraisal - RAMMbo
Chan JW, et al. 2004. Empirical evidence for selective reporting of outcomes in randomized trials: comparison of protocols to published articles. JAMA 291(20):2457
102 trial protocols (3736 outcomes) 122 published journal articles
62% of trials discrepancy in outcomes 92% of trials incomplete reporting of efficacy
outcomes 86% of authors denied existence of
unreported outcomes despite evidence
Statistically significant outcomes had a higher odds of being fully reported
Be careful
Module 4Module 4Finding the Evidence:Finding the Evidence:Individual TrialsIndividual Trials