Ambulatory Care Course (MS3)

Prerequisite

Information Mastery component of the Clinical Foundations (INTD 3030) course

Research conduted in this course

Information sheet about research data collected.

Goals by the end of MS3 year

1. Learn how to use 3° resources such as UpToDate and MicroMedex
2. Learn how to find individual article when you know part of their citation (eg Smith in NEJM) (taught in Clinical Foundations)

3. Learn how to assess articles
   • More specifically
     • Be able to assess the quality of an article using the framework of Levels of Evidence, followed by PICO
     • Be able to extract the strength of the effect (diagnostic or thereapeutic) reported in an article
   • Rationale - even with the emergence of excellent 3° resources such as UpToDate, doctors still need to be able to assess emerging research. Recently published research will not have had time to be vetted by 3° resources such as UpToDate or PIER and 2° resources such as Cochrane, InfoPoems, ACPJournalClub, or JournalWatch

Schedule

• Week 1 (see details in handout)
  • Assessing articles
    • Session 1 - slides
    • Critical appraisal care (PDF)
• Week 2 (see details in handout)
• Using probablistic thinking in medicine - not everything is black and white
  • Diagnosis
    • Using Bayes theorem to group diagnostic tests into categories without having to crunch numbers
    • Prediction rules
  • Treatment - use absolute numbers: absolute risk reduction and NNT
  • Significance testing - don't worry too much about the exact p-value
  • Calculators
    • Online calculators:
      • Generic epi Calculator (UTHSCSA)
      • Center for Evidence-based medicine (click 'EBM tool box')
      • Dx calculator
      • Dx nomogram
    • Palm OS application available at either:
      • Clinical.UTHSCSA.edu/PDA
        • UHS - VA phone book
      • Centre for Evidence-based Medicine - Toronto
    • Pocket PC Versions:
      • Clinical.UTHSCSA.edu/PDA - (requires StyleTap)
        • UHS - VA phone book
      • Centre for Evidence-based Medicine - Toronto
• Evidence table assignment
  • What is the well-formulated question for your question?
  • Sample evidence table with PICO question and conclusion.
    
  • Bibliography
  • Requirements and Grading - see handout
• Week 3
  • Discussion of your evidence table (for pass-fail grade)
    • Sample evidence table (from handout)
    • Requirements and Grading - see handout