CEBD and evidence based dermatology Dou
Therapeutics of skin conditions:
Evidence-based clinical decision making
Dr Douglas Grindlay
University of Nottingham
15th Oct 2014
What I am going to cover?
• What does evidence-based dermatology mean?
• How to find relevant, high-quality evidence
• The role of the Centre of Evidence Based
Dermatology (CEBD)
• How to get involved / contribute
What is Evidence Based Dermatology?
• Linking the best quality evidence to the care of individual patients
• Involves partnership between clinician, patient (and their preferences) and available evidence
– all are important
Common misconceptions
• “I’ve always done it this way, so I know it works” Is this true?
• Evidence-based practice is a passing fancy
• It leads to “cook book” medicine, slavishly following guidelines without adaptation to particular circumstances
• It is a restriction of clinical freedom
• It is expensive and time consuming
EBM starts and ends with patients
The five steps of evidence-based dermatology • Ask an answerable question generated from a patient encounter
• Search for valid external evidence
• Critically appraise the evidence for relevance and validity
• Apply the results to the patient
• Record the information for the future
PLUS: May generate new questions
Ask an answerable question generated from a patient encounter
Providing structure
Asking the right question PICO
•
•
•
•
Patients
Intervention
Comparator
Outcome
• Can cellulitis of the leg be prevented? • “In patients with recurrent cellulitis, how effective is antibiotic prophylaxis for the prevention of repeat attacks?” Search for valid external evidence
Critically appraise the evidence for relevance and validity
Syst
ema tic Revi ews Well-conducted RCTs
Non-randomised studies (e.g. casecontrol, observational studies)
Non-interventional studies
Opinion of respected authorities (e.g. guideline writers, professional bodies) Views of colleagues / peers
Apply evidence back to patient
Providing structure
Our PICO
Evidence-based clinical decision making
Dr Douglas Grindlay
University of Nottingham
15th Oct 2014
What I am going to cover?
• What does evidence-based dermatology mean?
• How to find relevant, high-quality evidence
• The role of the Centre of Evidence Based
Dermatology (CEBD)
• How to get involved / contribute
What is Evidence Based Dermatology?
• Linking the best quality evidence to the care of individual patients
• Involves partnership between clinician, patient (and their preferences) and available evidence
– all are important
Common misconceptions
• “I’ve always done it this way, so I know it works” Is this true?
• Evidence-based practice is a passing fancy
• It leads to “cook book” medicine, slavishly following guidelines without adaptation to particular circumstances
• It is a restriction of clinical freedom
• It is expensive and time consuming
EBM starts and ends with patients
The five steps of evidence-based dermatology • Ask an answerable question generated from a patient encounter
• Search for valid external evidence
• Critically appraise the evidence for relevance and validity
• Apply the results to the patient
• Record the information for the future
PLUS: May generate new questions
Ask an answerable question generated from a patient encounter
Providing structure
Asking the right question PICO
•
•
•
•
Patients
Intervention
Comparator
Outcome
• Can cellulitis of the leg be prevented? • “In patients with recurrent cellulitis, how effective is antibiotic prophylaxis for the prevention of repeat attacks?” Search for valid external evidence
Critically appraise the evidence for relevance and validity
Syst
ema tic Revi ews Well-conducted RCTs
Non-randomised studies (e.g. casecontrol, observational studies)
Non-interventional studies
Opinion of respected authorities (e.g. guideline writers, professional bodies) Views of colleagues / peers
Apply evidence back to patient
Providing structure
Our PICO