DAY (1)

1
DAY (1)

• Session 1
• Introduction To Evidence-based Health Care

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2
Purpose of workshop

• IMPROVE PATIENT CARE
• HOW?

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Improve patient care

• Apply principles of evidence-based health care
  (EBHC) in reproductive health (EBRHC)

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Workshop structure

• Presentations
• Group work
• Practicals
• Case studies
• Games

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Objectives of the workshop

• Formulate answerable clinical questions
• Search effectively for evidence using tools such
  as the WHO Reproductive Health Library and the
  Cochrane Library
• Critically appraise clinical evidence for its
  validity and applicability

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Objectives of this workshop

• Understand basic measures of efficacy such as
  relative risk and numbers needed to treat
• Implement available evidence in daily clinical
  practice
• Plan and facilitate an EBRHC training workshop

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Evidence-based Health Care

• What is it?
• What are its benefits to the providers and
  clients?

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Learning objective

• To get a clear understanding of the term
  evidence-based reproductive health care and all
  it implies.

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Your role (1)

• What is your role at your institution?

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Your role (2)

• How often do you ask yourself whether a specific
  intervention or procedure is appropriate under
  the given circumstances or how it contrasts to an
  alternate intervention or procedure?
• How often do you rely on clinical guidelines
  and/or attempt to find the answer in the
  published literature?

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Your role (3)

• When deciding to adopt a particular practice, do
  you
• Follow the traditional course of treatment used
  in your unit?
• Ask your colleagues for their advice?
• Get an experts opinion?
• Refer to clinical guidelines, textbooks or
  published sources of information?

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The slippery slope
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. .. . . .... .
knowledge of current best care
...
... ...
... ..
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years since graduation
CEBM web site http//cebm.jr2.ox.ac.uk/
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Why evidence-based health care?

• Health care decisions needs to be made with
  appropriate knowledge of all relevant and up- to-
  date information.
• Previous research should be carefully scrutinised
  in order to ensure that the ones with best
  practices are implemented.
• Synthesis of research findings is essential to
  make sense of all previous research.
• Lack of time for reading/consultation
• Selective reading by experts

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Application of evidence-based
health care

• Examine a patient
• Ask a question and look for best evidence
• Critically appraise the available evidence
• Utilise and apply the evidence
• Monitor the effect/change after application

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Barriers to application of
evidence-based health care

• Many practitioners have limited critical
  appraisal skills and the topic may seem
  threatening to them
• People in general like quick and easy solutions
• For many questions high-quality evidence is
  lacking
• The concept of evidence-based medicine is met
  with a lot of scepticism by many practitioners,
  faculty members and policy makers.

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Evidence-based health care

• conscientious carefully and with diligence
• explicit precisely and clearly
• judicious sensibly and with good judgement,
• use of current best evidence in making
  decisions about the care of individual patients.

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Evidence-based health care
practice means

• The integration of
• individual clinical expertise
• best available external clinical evidence from
  systematic research

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Individual clinical expertise

• skills
• judgement
• which individual health care workers acquire
  through clinical experience and clinical practice

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Best available clinical evidence

• Clinically relevant research from derived from
• basic medical sciences and
• patient - centred clinical research into the
  safety and efficacy of therapeutic interventions.

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Evidence-based health careWhat does it offer?

• offers the tools/means to appraise the research
  evidence
• offers a systematic approach to the science of
  evaluating the quality and strength of existing
  research information

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Evidence-based health care

• Due consideration must be given to factors such
  as
• the specific setting in which the patient is
  seen
• the values of the individual
• the values of the community in which that
  individual resides
• the costs involved

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Essential components

• For high quality EBHC
• 1- experience
• 2- judgement
• 3- caring
• are indispensible

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Evidence-based reproductive health care(EBRHC)

• is the application of the principles we discussed
  to reproductive health

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