文献有效性分析.ppt

研究效果的衡量 （1）治疗效果的大小 （2）治疗效果的价值 （3）试验结果对病人作用的大小 （4）试验结果能否指导医疗实践 （5）该项治疗的效益、风险和成本 （Exp: 动机——作者vs 赞助者） 偏倚 ——是指各种可以导致研究结果失真的系统性误差。 选择偏倚（Selection bias) 志愿者偏倚（Volunteer bias）,也称无应答偏倚（Non-respondent bias） 检出偏倚（Unmasked bias） 幸存者偏倚（Survivor bias） 会员制偏倚（Membership bias） 测量偏倚（Measurement bias） 观察者偏倚（Observer bias） 回忆偏倚（Recall bias） 干预偏倚（Intervention bias） 随访偏倚（Follow-up bias） 分析偏倚（Analysis bias） 如何有效应用医学文献 参见临床问题与资源的一般矩阵 证据资源倒金字塔 医学文献的有效应用 Prepare students to make independent, balanced clinical decisions that contribute to optimal patient outcomes. Clinical Reasoning 的纵向目标: Clinical Reasoning 的纵向目标 By end of Year 2, students should be able to: Understand patient-centered outcomes and shared medical decision-making Systematically analyze any clinical problem Make independent judgments on tests and treatments, based on published evidence Habitually seek and apply new knowledge from reliable sources Core Competencies Heath Professions Education: A Bridge to Quality Institute of Medicine 2003 Provide patient-centered care Work in interdisciplinary teams Employ evidence-based practice Apply quality improvement Utilize informatics Scientific Foundations for future Physicians  AAMC-HHMI 2009 “science competency” (learner performance), rather than academic courses. Competency M8 Apply quantitative knowledge and reasoning—including integration of data, modeling, computation, and analysis—and informatics tools to diagnostic and therapeutic clinical decision making. 本次课的目标 理解从文献样例中获得的两个关键概念： 关注结果 从病人角度考虑医学, （6 “requests” ） 理解医学文献及其有效性的评价标准 What is it? What’s in it? Who creates it, how and why? What is clinical “evidence”? What are the criteria for validity of medical literature? Where to find the medical literature. Matching information sources to question types: what should an MS1 read? What are the best sources for PBL? PBL Learning issue sourcing matrix: how