updated September 1, 2009
updated September 1, 2009
Therapeutic Decision Making
This is a site for clinicians who are dedicated to advancing their knowledge and skills related to EVIDENCE-BASED PHARMACOTHERAPEUTIC DECISION-MAKING.
The resources here are intended for self-directed, objective-based learning.
When all of the objectives are met, learners should be capable of making defensible therapeutic decisions within an evidence-based practice framework, whether in the context of individual patients or pharmaceutical policy development.
The SKILL/KNOWLEDGE objective for each item is "can accurately EXPLAIN and/or independently PERFORM/USE"
Dead link? Got another article/link? email Peter.Loewen@vch.ca
Objective
Know when/why/how to search primary literature databases
Subdomains
Medline, Embase, CINAHL via Ovid, Pubmed; including Boolean operations, wildcards; Google Scholar
Fundamentals
Objective
Know when/why/how to search Cochrane & specialized sites/databases databases
Subdomains
CDSR, CCCTR
Objective
Finding unpublished results
Subdomains
Finding trials in progress, conference proceedings, discussions
Resources
Stroke Trials [similar directories exist for many diseases... search Google]
Objective
Finding other peoples’ critiques/evaluations
Subdomains
NICE, CEDAC/CADTH, journalwatch, ACP Journal Club, EBM, Bandolier, TherInit
Objective
Guidelines: sources, databases
Subdomains
Objective
Formulating an answerable Focused Clinical Question
Subdomains
PICO format
Objective
Retrieving fulltext online
Subdomains
Ovid, UBC RSVPN, ILL, CISTI
Objective
Building an eDocs collection / organizing literature
Subdomains
Resources
Objective
Common statistical representations (descriptive and inferential)
Subdomains
what's a p-value? what's an OR, RR, ARR, RRR, HR, NNT/H? power, clinical vs. statistical significance, confidence intervals, kaplan meier plots, forest plots
Resources
Biostatistics for the Clinician PSAP-4th Ed.pdf
Toward Evidence-Based Medical Statistics-1- The P Value Fallacy-AIM.pdf
To P or Not to P- Why Use a P Value Anyway-MS.pdf
ACP Primer on 95% confidence intervals.pdf
Survival probabilities (the Kaplan-Meier method)-BMJ.pdf
Objective
Critical Appraisal/Design of: Guidelines
Subdomains
Resources
Guidance for Guidelines-NEJM.pdf
Practice guidelines developed by specialty societies- the need for a critical appraisal.pdf
Practice
AHA-ASA 2007 Guidelines for the Early Management of Adults With Ischemic Stroke.pdf
Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease-ACP 2007 Guidelines.pdf
CHEP 2007 Clinical Summary.pdf
Guidelines for anticoagulant use in acute coronary syndromes-critique-Lancet.pdf
QuickSearch in Pubmed for more Guidelines
Objective
Critical Appraisal/Design of: simple RCTs
Subdomains
CONSORT, ITT analysis, understanding/evaluating composite endpoints
Resources
How to Use an Article About Therapy or Prevention-JAMA
How to read a paper-Papers that report drug trials-BMJ.pdf
Intention-to-treat principle-CMAJ.pdf
What is meant by intention to treat analysis-Survey of published RCTs-BMJ.pdf
Validity of composite end points in clinical trials-BMJ.pdf
Composite Clinical Endpoints: Proceed With Caution
Cautionary tales in the clinical Interpretation of therapeutic trial reports-IMJ.pdf
Practice
WHS-RCT of Low-Dose Aspirin in the Primary Prevention of CV disease in Women-NEJM.pdf
RCT Comparing tinzaparin and dalteparin for the Outpatient Treatment of DVT-PE-ArchIM.pdf
QuickSearch in Pubmed for more RCTs
Objective
Application of clinical trial (RCT) quality scoring systems
Subdomains
Jadad
Objective
Criteria for how/when to apply study results to my patient/practice/decision
Subdomains
Objective
Principles of Evidence-Based Practice
Subdomains
Objective
Know the functions of and resources available at health policy / analysis organizations
Subdomains
NPDUIS, IMS, CADTH
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