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2021/2022

Evidence-based Medicine

Code: 102875 ECTS Credits: 3
Degree Type Year Semester
2502442 Medicine OT 3 0
2502442 Medicine OT 4 0
2502442 Medicine OT 5 0
2502442 Medicine OT 6 0
The proposed teaching and assessment methodology that appear in the guide may be subject to changes as a result of the restrictions to face-to-face class attendance imposed by the health authorities.

Contact

Name:
Xavier Bonfill Cosp
Email:
Xavier.Bonfill@uab.cat

Use of Languages

Principal working language:
catalan (cat)
Some groups entirely in English:
No
Some groups entirely in Catalan:
No
Some groups entirely in Spanish:
Yes

Teachers

Gerard Urrutia Cuchi

Prerequisites

There are no prerequisites, but English reading skills (scientific literature) and internet access are necessary.

 

 

Objectives and Contextualisation

Evidence-based medicine (EBM) aims at accelerating and improving the clinical use of the best available scientific evidence from relevant clinical research (ideally patient‑focused high-quality studies). EBM therefore requires the ability to integrate individual clinical experience with the best external scientific evidence available, in order to offer high-quality patient care by suggesting the most effective treatment based on the resources and means available in our setting.


For many years —and still nowadays in some areas—, Medicine —as well as other healthcare disciplines— has used theories about the mechanisms of action of many of the interventions without duly contrasting the hypotheses on which these theories are based by means of appropriate studies; assuming that the explanations offered by the theory are as scientific as the evidence of its effectiveness. Conversely, EBM considers that the rationality or biological efficacy of an intervention does not constitute enough evidence of its clinical efficacy. This efficacy must instead be measured by rigorous studies evaluating clinical outcomes directly on patients.


For EBM practice, medical professionals need to acquire skills to detect the problem presented by their patient, transform uncertainties into well-structured clinical questions, locate the best scientific evidence available that will allow them to solve this problem, assess its importance and validity, and to know how to apply the research results into clinical practice, considering the specificities of each case or situation.


The objective of this course is to present the principles and tools of EBM, training medical students in the basic skills to find and critically apply scientific evidence warranting their action, in order to achieve the best possible clinical outcomes for each patient.

Competences

    Medicine
  • Communicate clearly, orally and in writing, with other professionals and the media.
  • Critically assess and use clinical and biomedical information sources to obtain, organise, interpret and present information on science and health.
  • Demonstrate a sufficient command of English, both oral and written, for effective scientific and professional communication.
  • Demonstrate understanding of basic statistical methodologies used in biomedical and clinical studies and use the analytic tools of modern computational technology.
  • Demonstrate understanding of the importance and the limitations of scientific thought to the study, prevention and management of diseases.
  • Demonstrate, in professional activity, a perspective that is critical, creative and research-oriented.
  • Formulate hypotheses and compile and critically assess information for problem-solving, using the scientific method.
  • Maintain and sharpen one's professional competence, in particular by independently learning new material and techniques and by focusing on quality.
  • Obtain and use epidemiological data and assess trends and risks for decision-making on health.
  • Recognise the role of complexity, uncertainty and probability in decision-making in medical practice.
  • Use information and communication technologies in professional practice.

Learning Outcomes

  1. Choose and interpret statistical techniques and results in accordance with the epidemiological hypotheses and designs used.
  2. Choose the experimental or observational technique to develop a working hypotheses.
  3. Choose the most suitable type of study to respond to the hypotheses formulated.
  4. Communicate clearly, orally and in writing, with other professionals and the media.
  5. Correctly apply statistical techniques to obtain reference values and compare them to the results of analytic tests on patients.
  6. Critically evaluate the main sections of a clinical research project.
  7. Critically interpret medical literature.
  8. Critique original or review scientific papers.
  9. Critique scientific papers on bioinformatics.
  10. Demonstrate a sufficient command of English, both oral and written, for effective scientific and professional communication.
  11. Demonstrate, in professional activity, a perspective that is critical, creative and research-oriented.
  12. Describe the main biomedical bibliographic databases and filter the information provided.
  13. Design and draw up a basic research protocol.
  14. Design and understand basic epidemiological research studies in public health.
  15. Establish a research question, a working hypotheses and objectives.
  16. Evaluate the appropriate scientific methodology for a biomedical paper.
  17. Formulate hypotheses and compile and critically assess information for problem-solving, using the scientific method.
  18. Identify good scientific practice and scientific fraud.
  19. Identify sources of information on analytic tests for patients and professionals and critically evaluate their content.
  20. Identify the bioethical aspects of research in humans and the Helsinki Declaration.
  21. Maintain and sharpen one's professional competence, in particular by independently learning new material and techniques and by focusing on quality.
  22. Manage the principles of medicine based on (the best) evidence.
  23. Present research results.
  24. Use information and communication technologies in professional practice.

Content

Introductory session (Virtual)

  • What is Evidence-Based Medicine?

  • Why is EBM necessary?

  • Barriers and limitations

  • Information needs and study design

  • The process of EBM

  • Useful resources for EBM practice

     

Electronic modules

(To be developed within 8 weeks)

  • Module 1: Introduction

  • Module 2: What is EBM?

  • Module 3: What is not EBM?

  • Module 4: Formulating clinical questions

  • Module 5: Searching the best evidence

  • Module 6: Critically assessing the evidence

  • Module 7: Applying scientific information

  • Module 8: Saving and finding the information

  • Module 9: Epilogue

     

Final session

 

Student presentation of the final essay.

 

Comments on different materials, including the book Testing treatments.

 

The competences that will be developed are:

 

CE1 Recognizing the essential elements of the medical profession as a result of an evolving, scientific and sociocultural process, including ethical principles, legal responsibilities, and patient-focused professional practice.


CE36. Obtaining and developing a medical record containing all relevant, structured and patient-focused information.

 CE40. Preparing diagnosis and establishing a reasoned strategy of action, assessing the results of the anamnesis and the physical exam, as well as the subsequent results of the required complementary tests.

CE43 Indicating the most appropriate therapeutic intervention of the most prevalent acute and chronic processes, as well as for those patients at the end-of-life stage.

Methodology

GUIDED SESSIONS:

The course includes an introductory online session. The objective of the first session besides presenting an overview of the course and its functioning– is to discuss with the students about the scientific and philosophical basis of EBM, the need for it and its main limitations or barriers. We will also share available resources and tools, potentially useful to develop and make the most of the course. The final evaluation of the course is done through the presentation and resolution of a 'clinical case', where students will have applied the theory and practice learnt throughout the course. The aim of the exercise is that it constitutes a learning experience that strengthens and enriches the knowledge acquired from discussing the practical cases.

SELF-LEARINING SESSIONS:

The course includes an electronic course consisting of 8 modules, to teach the theory contents. Each module includes a single clinical scenario that evolves throughout the course, introducing the concepts that will be developed in depth in the theoretical body of themodule. Some of the modules also include additional activities as well as an automatically assessed test, which must be passed to be able to move on to the next module. Students are expected to do at least one module per week to complete them within eight weeks.

 

In addition, the book "Els tractaments, a prova" is distributed free of charge, and analytical comments have to be made based both on the book and the reference website "Testing Treatments".

 

Annotation: Within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.

Activities

Title Hours ECTS Learning Outcomes
Type: Directed      
Contents communicated as oral lectures (Theory) VIRTUAL 2 0.08
Type: Supervised      
Virtual lessons (VIRT) 10 0.4
Type: Autonomous      
Developing essays 20 0.8
Studying 35 1.4

Assessment

The competences of this course will be assessed with the automatically marked tests at the end of each module (25%). These tests will be virtually conducted and each module will have to be correctly answered to move onto the next.

The presentation of the final essay of the course represents 80% of the final mark. It consists of presenting a 'clinical case', and students will have to apply theory and practice acquired throughout the course.

Those students who do not present the final essay will be considered "Unassessable".

 A second exam will be scheduled for those students who do not pass the assessment

Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Attendance and active participation in class and in seminars 5% 2 0.08 14, 22
Conducting the electronic course 25% 2 0.08 5, 6, 16, 4, 8, 10, 11, 3, 15, 17, 21, 23, 1, 2, 22
Submitting reports 50% 2 0.08 6, 16, 4, 8, 10, 11, 12, 14, 3, 15, 17, 20, 18, 19, 7, 21, 23, 1, 22, 24
Submitting reports and specific essays 20% 2 0.08 5, 6, 16, 4, 8, 9, 10, 11, 12, 14, 13, 3, 15, 17, 20, 18, 19, 7, 21, 23, 1, 2, 22, 24

Bibliography

1. Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Medicina basada en la evidencia.

Cómo practicar y enseñar la MBE. 2ª edición. Madrid: Ediciones Harcourt; 2001.

2. Straus SE, Richardson WS, Paul Glasziou, et al. Evidence-based Medicine: How to Practice and Teach

EBM. Third Edition. Churchill Livingstone: Edinburgh, 2005.

3. The Evidence-Based Working Group. Guías para usuarios de literatura médica. Manual para la práctica

clínica basada en la evidencia. Barcelona: Ars Medica, 2004.

4. Bonfill X. La medicina basada en la evidencia y la práctica clínica. En: Medicina Interna (ed. Rodés,

Guàrdia), voI. 2a. ed. Ediciones Masson, pàg 13-16, 2004.

5. Bonfill X. Asistencia Sanitaria Basada en la Evidencia. Barcelona: Sanidad y Ediciones (SANED); 2000.

6. Sackett D, Rosenberg WM, Gray JA Muir, Haynes RB, Richardson WS. Evidence based medicine: what it is

and what it isn't. BMJ 1996; 312:71.

7. Cabello J. Lectura crítica de la evidencia clínica. Barcelona: Elsevier, 2015.

8. Evans I, Thornton H, Chalmers I, Glasciou P. Els tractaments, a prova. F. INPECS, 2016.

9. Els tractaments, a prova. INPECS: Barcelona,2017.

Software

Microsoft Teams