Using an expert / being an expert
Expert is anything or anyone you go to for an answer to a question.
Person as an expert
Type 1: Content expert
Type 2: Clinical scientist
Don't have to be content experts
Good at evaluating evidence
separation of therapeutics
YODA: Your Own Data Analyzer
Relies on POEMs first, even if this information conflicts with DOEs or clinical experience
When POEMs not available, YODAs use the best DOE
Demonstrate appropriate validity assessments
YUCK - Your Unsubstantiated Clinical Know-it-all.
POEM isn't a POEM if it's not Patient oriented. A valid DOE is NOT a POEM.
EBM - absence of proof is not proof of absence
Are CME's beneficial. Traditional lecure format (passive) - no. Hands on (active) learning - Maybe.
Validity - depends on speaker
Relevancy - depends on POEM:DOE ration
Type 3: Review articles
McMasters - worksheet to evaluate review articles
The expertise of the author vaires inversely with the quality of the review - Oxman / Guyatt
Cochrane - Excellent source for hunting and foraging. Top of the EBM pyramid.
Our (medical librarians') job - how to tell quality from the PERCEPTION of quality.
Be careful of the term Evidence-based Guidelines. What is important is how the evidence is USED.
Better - Evidence-Linked Guidelines
-Brief summary statement
-Detailed discussion of the evidence
-long reference section point to original research
-Methods section showing how evidence was obtained and evaluated.
SORT (Strength of Recommendation Taxonomy) classification - only system that takes Validity AND Relevance into consideration.
A = Consistent and good quality POE
- Standard LOEs for validity, POE for revelance
B = Inconsistent or limited-quality POE
C = Consensus, usual care, opinion, DOE, case series
No hunting tool uses SORT.
PDR - compendium of drug advertising without peer review. hmmm, I'm looking at PDR differently now.