The system of search of medical information

[ ] Yes

[ ] No

[ ] Do not know

2. Whether all clinically important outcomes were taken into account?

Are the replacement of end points?

[ ] Yes

[ ] No

[ ] Do not know

3. Overlap if the supposed benefits of such treatment possible harm and costs?

NNT for different outcomes?

[ ] Yes

[ ] No

[ ] Do not know

SPECIFICATION SHEET FOR ENTRIES FOR THE ASSESSMENT OF DIAGNOSTIC TESTS

Bibliographic details:

-------------------------------------------------------------------------------------

Guide

Comments

Are the results of research important?

1. Has there been an independent, "blind" comparison with the reference standard?

- Is the chosen reference standard?

- Has applied reference standard and test all patients?

[ ] Yes

[ ] No

[ ] Do not know

2. Consistent whether the band structure of the patient real patient population for whom this diagnostic test should be used in clinical conditions?

[ ] Yes

[ ] No

[ ] Do not know

3. Did the results of the test evaluated the decision to implement the control standard?

"Verification" or "bringing"?

[ ] Yes

[ ] No

[ ] Do not know

4. Is there sufficient detail the method of test so that it can be played?

- Preparation of the patient?

- Carrying out the test?

- Analysis and interpretation of results?

[ ] Yes

[ ] No

[ ] Do not know

5. In general - are the results of the study significant?

[ ] Yes

[ ] No

[ ] Do not know

6. What are the results obtained? How large or small likelihood ratio?

The value of the likelihood ratio

0.1 or 10

0,1-0,2 or 5-10

0,2-0,5 or 5.2

0,5-1, 1-2

The load on the probability of pre-and post-test

- Large or significant,

- Average,

- Small, but sometimes visible,

small, rarely conspicuous

[ ] Yes

[ ] No

[ ] Do not know

7. Can these results help me in treating my patients?

A) Will provide satisfactory reproducibility and interpretation of test results in terms of my work?

[ ] Yes

[ ] No

[ ] Do not know

B) Are these results to my patient?

- Similar distribution of disease severity?

- A similar distribution of comorbidity?

- Objective reasons for which these results apply not?

[ ] Yes

[ ] No

[ ] Do not know

C) Affect whether the results of my work?

Test and clinical thresholds?

High or low values of the likelihood ratio?

[ ] Yes

[ ] No

[ ] Do not know

D) Will the patient better as a result of the test?

- Is it dangerous to the underlying disease, if it remains undiagnosed?

- Does accept a risk with this test?

- Is there an effective treatment?

- Will the information obtained during testing, to changes in medical practice?

[ ] Yes

[ ] No

[ ] Do not know

Specification sheet for the article on forecast

Bibliographic data

----------------------------------------------------------------------------------------

Guide

Comments

Are the results of research important?

1. Can I assume that the group was representative and clearly defined and that the patients in it are on the same same stage of the disease?

- Inclusion and exclusion criteria?

- Bias of selection?

- Stage of disease?

[ ] Yes

[ ] No

[ ] Do not know

2. Was follow up sufficiently long and complete?

- Reasons for follow-up was incomplete?

- Have similar prognostic factors for patients past and have not undergone follow-up?

[ ] Yes

[ ] No

[ ] Do not know

3. Were the evaluation criteria objective and unbiased?

- Outcomes defined at the beginning of the study?

- Prognostic factors were concealed from investigators?

[ ] Yes

[ ] No

[ ] Do not know

4. Has there been an adjustment for important prognostic factors??

[ ] Yes

[ ] No

[ ] Do not know

5. In general - are the results of the study

significant?

[ ] Yes

[ ] No

[ ] Do not know

What are the results?

1. What is the probability of certain outcomes over time?

- Survival curves?

2. How accurate are estimates of the probability?

- Confidence intervals?

Will the results of my experiment in treating my patients?

1. Similar whether the patients studied on my patients?

- Are similar whether patients on demographics, disease severity, comorbidities and other prognostic factors?

- Identify the objective reasons for excluding the possibility of applying these results?

[ ] Yes

[ ] No

[ ] Do not know

2. Whether these results directly to the selection any treatment or denial of any treatment?

[ ] Yes

[ ] No

[ ] Do not know

3. Whether these results are useful for the encouragement of patients or

issuance of recommendations?

[ ] Yes

[ ] No

[ ] Do not know

Naturally, the use of these questionnaires leaflets reading each article is not needed. They need only one - two times to remember the process of critical evaluation.

In conclusion, it must be emphasized that the modern sources of information do not contain so many articles both interesting and quality content. So, start reading, you should make sure that the time is not spent in vain.

yes

no

Figure 2. The general algorithm for estimating the article.

Case studies

Task 1. Look for evidence-based information to answer the questions presented below, do the following:

* Determine the type of question presented;

* Analyse the question by the formula PICO;

* Identify the most suitable design of epidemiological studies, allowing to get an answer to this question;

* Find a MEDLINE database a set of 3 articles that give an answer to this question;

* Conduct a similar search in the Cochrane Library, giving preference to systematic reviews.

Structured clinical questions:

1. Whether to use antidepressants for the prevention of depression in the postpartum period?

2. Does abortion affect the risk of breast cancer?

3. Efficiently and safely whether intravenous immunoglobulin for the treatment of Kawasaki disease in children?

4. Due to a high incidence of coronary heart disease in ethnic groups in Asia, differences in levels of insulin?

5. What factors are associated with risk of obesity in children?

6. Whether to apply a PCR test for chlamydia screening among young people, sexually active?

7. Effectively whether the use of BCG vaccine for immunotherapy of tuberculosis?

8. Effectively whether the use of placebo for treating patients with mental disorders?

9. How accurately identifies computed tomography brain aneurysm?

10. Whether to use hyperbaric oxygen therapy in the treatment of ischemic stroke?

11. Reduces whether the appointment of Vitamin E death risk of prematurity?

12. Whether to prescribe nystatin as a prophylactic and therapeutic tool for treating patients with severe immune deficiencies?

13. How does the probability of death from all causes for smoking cessation in patients with coronary heart disease.

14. How accurately you can tell the premature onset of labor based on the results of cervicovaginal test fibrino-ektin?

15. What is the accuracy of hysteroscopy for diagnosing endometrial hyperplasia and cancer?

Task 2. Using the possibility of a sensitive search filters Clinical Queries, posted on the site www.pubmed.com, locate at least four articles devoted to the study:

* risk factors;

* the effectiveness of preventive interventions and drugs in the following nosologic forms: prostate cancer, esophageal cancer, chronic fatigue syndrome, alopecia, aneurysm of the left ventricle of the heart, Kawasaki disease, Meniere's disease.

The final control of knowledge

Complete the tasks and answer the questions

1. Perform the following steps.

a) formulate a question on any topic that interests you (or may become subject to a systematic review of standard practice);

b) break it down to the maximum (out of 4 possible) the number PVSI (R1SO) components;

c) Determine the type of your question;

d) Determine the type of epidemiological study which will find the answer to this question.

2. Name the 5 foreign or domestic periodicals, publishing primary medical information.

3. Name the 5 sources of medical information, publishing secondary materials (summary trials and systematic reviews, systematic reviews)

4. Enter the dignity and the following sources of non-medical information:

a) logs of the primary information;

b) magazines secondary information;

a) lists;

d) The Cochrane Library;

g) MEDLINE;

e) World Wide Web.

5. List the major search capabilities?

6. Indicate the principles of the search of scientific articles in the Clinical Queries site PubMed MEDLINE?

7. Undertake a critical evaluation of any article from PubMed?

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