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@ubc.ca

  Intermediate

Objective

Qualitative Systematic Review Methodology (Cochrane) and appraisal

Subdomains

Objective

Types and sources of bias in clinical studies

Subdomains

Objective

Quantitative Systematic Review (Meta-analysis) methodology (Cochrane) and appraisal

Subdomains

binary endpoints, continuous variables; Statistical heterogeneity (i2); clinical heterogeneity; publication bias; robustness (file drawer problem); patient-level meta-analysis

Resources

Cochrane Handbook For Systematic Reviews of Interventions

Assessing heterogeneity of primary studies in systematic reviews and whether to combine their results-CMAJ.pdf

Measuring inconsistency in meta-analyses-BMJ.pdf

The file drawer phenomenon-suppressing clinical evidence-CMAJ.pdf

Comparison of Two Methods to Detect Publication Bias in Meta-analysis-JAMA.pdf

Numbers needed to treat derived from meta-analysis-BMJ.PDF

Forest plots-trying to see the wood and the trees-BMJ.pdf

MOOSE-Meta-analysis of observational studies-guidelines for reporting-JAMA.pdf

Patient-Level (Individual Patient) Meta-Analysis
Meta-analysis of continuous outcomes combining individual patient data and aggregate data-StatMed.pdf
Meta-analysis of individual patient data versus aggregate data from longitudinal clinical trials-ClinTrial.pdf


Practice

Effects of Early Treatment With Statins on Short-term Clinical Outcomes in ACS-metaanal-JAMA.pdf

Meta-Analysis of Proton Pump Inhibitors in Treatment of Bleeding Peptic Ulcers-APT.pdf

Derry and Loke-Risk of gastrointestinal haemorrhage with long term use of aspirin meta-analysis-BMJ.pdf

ATTC 2009-ASA in primary and secondary prevention of vascular disease metaanalysis-Lancet.pdf
Cardiovascular Risk of Celecoxib in 6 RCTs-The Cross Trial Safety Analysis-Circn.pdf

Pooled Analysis of Individual Patient-Level Data From All RCTs of Darbepoetin Alfa in the Treatment of Patients With Chemotherapy-Induced Anemia-JCO.pdf

QuickSearch in Pubmed for more quantitative systematic reviews

 

Objective

Calculating 95%CIs around ARR, OR, RR, RRR, NNT/H from any clinical trial (with binary endpoints)

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Objective

Interconverting between ARR, OR, RR, RRR, NNT/H from any clinical trial (binary endpoints), calculating same from any 2x2 table (ABCD)

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Objective

Critical Appraisal/Design of: Epidemiologic studies (Cohort, Case control)

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fundamentals of regression analysis


propensity scoring


immortal time bias

Objective

Critical Appraisal/Design of: RCT factorial, crossover, N-of-1 designs

Subdomains

Objective

Subgroup Analysis

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assessing appropriateness, interpreting statistics, when to generalize

Objective

Budget Impact Analysis

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scenarios, confidence intervals, critiquing manufacturer-generated ones

Objective

Know when/why/how to use bibliographic database tools

Subdomains

collaborating with colleagues using

Objective

Assessing/understanding/incorporating patients' VALUES in the evidence-based practice process

Subdomains

evidence-based patient choice, shared decision making

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