From west to east; experience with adapting a curriculum in evidence-based medicine

Introduction to evidence-based medicine

Lecture

EBM

How to make an evidence-based case report

Lecture

EBM

Making an answerable clinical question

Lecture

EBM

Frequency and association measures

Lecture

CE

Diagnosis

Lecture

CE

Prognosis

Lecture

CE

Formulation of the clinical question; search and comparison of study-book knowledge, study of EBCR design

Group work

EBM

Intervention

Lecture

CE

Aetiology

Lecture

CE

Critical appraisals

Lecture

EBM

Internet literature search

Practical lecture

EBM

Computer exercise on prognosis and diagnosis

Practical lecture

CE

Exercise critical appraisal on therapy

Group work

EBM

Establishing the search query, literature search and selection, critical appraisal of the selected papers regarding their relevance and methods, description of methods and (provisional) results

Group work

EBM

Levels of evidence

Lecture

EBM

Computer exercise on aetiology and intervention

Practical lecture

CE

Exercise critical appraisal on prognosis and diagnosis

Group work

EBM

Sorting and structurally summarize the search and appraisal; description of methods and (provisional) results

Group work

EBM

Exercise critical appraisal on aetiology

Group work

EBM

Report of EBCR both orally and in writing according to the requirements for form, structure and content; formulation of a recommendation for patient care and further research

Group work

EBM

Lectures

30

22

20

20

Computer practical

6

8

10

3

Tutorial working group

18

14

5

8

Collaborative and individual learning^a

45

0

110

55

Plenary presentation

4 × 3

2 × 3

4 × 3

4 × 3

Total hours

111

50

157

98

Module duration

4 week

3 months

6 weeks

5 weeks

Pre-test scores

  N

389

196

160

  Mean (SD)

62.20 (9.21)

54.69 (10.51)

46.23 (8.69)

  Minimum

9.38

31.58

28.12

  Maximum

87.50

92.11

68.75

 Mean difference (95 % CI)

7.52 (5.85–9.18)

15.97 (14.30–17.64)

 p value

<0.001*

<0.001*

Post-test scores

  N

377

196

200

  Mean (SD)

74.75 (9.66)

73.54 (10.13)

61.39 (10.39)

  Minimum

31.25

34.21

18.75

  Maximum

100

89.48

81.25

 Mean difference (95 % CI)

1.32 (0.40–3.04)

13.36 (11.66–15.06)

 p value

0.484†

<0.001†

Difference in scores

 N

350

196

159

 Post-test minus pre-test

12.54 (11.44)

18.85 (12.81)

17.51 (9.49)

 Mean difference (95 % CI)

6.32 (4.22–8.41)

4.98 (2.93–7.02)

 p value

<0.001*

<0.001*

EBCR

  N

71

40

40

  Median

8.0

8.4

7.8

  Minimum

5

7.5

7

  Maximum

10

9.0

8.6

 p value

0.001‡

0.44‡

University of Indonesia

 Is artemether–lumefantrine (AL) as effective as artesunate–amodiaquine (ASAD; standard treatment of malaria therapy in Indonesia) for treating uncomplicated childhood malaria?

Therapy

 Mortality after balloon aortic valvuloplasty in male with severe aortic stenosis

Prognosis

 Is the nitrite test accurate as diagnostic tool in pregnant women?

Diagnosis

 In hospitalised elderly patients, is depression related to higher mortality?

Prognosis

 Could calcium supplementation prevent osteoporotic fracture in post-menopausal women?

Therapy

 Diagnostic value of abdominal radiography to diagnose acute appendicitis in children

Diagnosis

 The effectiveness of normal saline solution vs Ringer’s lactate solution to overcome dengue shock syndrome in children

Therapy

 Is acupuncture effective to decrease pain in patient with chronic back pain?

Therapy

University of Malaya

 Is exercise stress echocardiography superior in diagnosing patients presenting with chest pain compared with exercise stress electrocardiography?

Diagnosis

 Can Parkinson’s disease be treated more effectively by using dopamine agonists compared with levodopa in Parkinson patients above 50 years?

Therapy

 Do colorectal cancer patients with high levels of tumour markers CEA and CA19-9 have a low 3-year survival rate?

Prognosis

 Does the Revised Trauma Score (RTS) make a good prognostic tool in trauma patients?

Prognosis

 Do children with past history of sexual abuse have increased risk of psychiatric problems in adulthood?

Prognosis

University Medical Center Utrecht

 The prognostic value of a history of shoulder pain on predicting the duration of pain in patients presenting with a new episode of shoulder pain

Prognosis

 The influence of physiotherapy on pain in patients with shoulder impingement

Therapy

 Diagnostic ultrasound in a patient suspected of a partial rotator cuff rupture

Diagnosis

 Does treatment with heparin in adults diagnosed with cerebral venous thrombosis reduce mortality within 3-months?

Therapy

 CT venography: the new reference test for diagnosing cerebral venous thrombosis?

Diagnosis

 Glasgow Coma Scale as a prognostic factor in sinus thrombosis

Prognosis

 Prognostic value of current smoking for exacerbations in COPD

Prognosis

 For patients with COPD in the primary care setting: what is the predictive value of CRP for community-acquired pneumonia?

Prognosis

 Diagnostic value of BNP for determining chronic heart failure in patients with COPD

Diagnosis

The objective of the course is achieved

89

N.A.

48.7

The course increased my competence (knowledge and skills)

85

95

N.A.

The course is useful for my professionalism

N.A.

60

56