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Practical Public Health Experience in Evidence-based Medicine and Cochrane Austria
Austria (AMSA) - Danube University Krems Medical Faculty, Krems
Department of Evidence-based Medicine and Clinical Epidemiology and Cochrane Austria, Danube University Krems, Austria
Type of Research Project
- Basic science
What is the background of the project?
In recent years, doctors from various medical specialties (e.g., internists and emergency physicians) have increasingly used Point of Care Ultrasound (POCUS) to improve diagnostic timeliness, safety and accuracy in acute patient care. The technical improvements and miniaturization of ultrasound devices has led to the possibility of examining patients in a non-invasive way at the point of care wherever the patient is located (e.g.in a medical facility, at the patient’s bedside, or in an emergency room). Most commonly, POCUS is used: • To augment clinical examination (i.e., history taking and physical examination) in patients with particular symptoms or signs; • To guide invasive procedures such as central line placement, paracentesis, thoracentesis, or other invasive medical interventions to increase success rates and decrease complications; • For screening (e.g. for cardiovascular and gynecologic diseases) and for compact ultrasonography screening as part of mobile screening labs); (1) • For patients in resource-limited settings. To better understand the feasibility and accuracy of POCUS, two key questions were formulated to guide our systematic review process: KQ 1a: In patients with acute dyspnea, what is the diagnostic accuracy of POCUS plus clinical examination compared to clinical examination alone to detect congestive heart failure, pleural effusion, pneumonia, pneumothorax, or pulmonary embolism as the underlying cause of acute dyspnea? KQ 1b: What are the beneficial and harmful health effects of POCUS as an add-on diagnostic test for patients with acute dyspnea? * Please note that depending on the application date, the project may be different than stated above. We aim to update the project details as much as possible. Nevertheless, any project will undoubtedly have a focus on evidence-based medicine and students will gain immense knowledge of the systematic review and methodology process.
What is the aim of the project?
To conduct a systematic review on the diagnostic accuracy of using POCUS in clinical care for the American College of Physicians. The systematic methodological steps will introduce the student to the methods of evidence-based medicine and their application in real world practice.
What techniques and methods are used?
A comprehensive literature search will uncover literature needing to be dually abstract and full text screened. Data extraction and risk of bias assessment will also be done dually. Data will be analyzed and Evidence-to-Decision tables will be produced using the GradePRO software. The first version of the report is due next year.
What is the role of the student?
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
Depending on when the student comes into our department, various stages of the project will be underway. They will likely assist in the updated literature search with abstract and full text screening, and then data extraction and risk of bias for any additional papers that are found. Alongside this, the department is always conducting systematic reviews at a local, national, or international level and help is always needed at any stage of the review. The student will get an overview on the basics of reviews and analysis and will then be expected to contribute to study screening, data extraction, and data analysis. The student may be asked to help with writing the background and perhaps other sections of a paper. The possibility for the student to take part in additional training sessions may also be present.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Scientific papers, mentioned below; some further learning materials will be provided (e.g. book on evidence-based medical practices). If the student comes during a period in which we teach lectures, they are welcome to sit in on the lectures.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a presentation - The student will prepare a scientific report - The student’s name will be mentioned in a future publication
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Basic knowledge on the components of evidence-based medicine and an understanding of the importance of evidence-based medicine in clinical practice. Knowledge on the systematic review process not obligatory, but advantageous.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months) - Pre-Medical students from the American-British system - Students in biomedical fields - Dental medicine students (IADS members)
- Khan; Khalid S; et al. “Five Steps to Conducting a Systematic Review.” Journal of the Royal Society of Medicine. 2003;96:3 (118–121); doi:10.1177/014107680309600304.
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