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Terry

That looks like a pretty comprehensive list of topics, particularly from the statistical side. Some other content areas to cover I think would include 1) communication of evidence to patients (eg, how to REALLY explain in lay terms that, "no, you DON'T need an annual PSA and DRE" ), 2) exploration of the issues raised more recently regarding the problems with the evidence base itself (your topic list is good, but would seem to presume the evidence base is trustworthy - Carl Heneghan's blog (http://blogs.bmj.com/bmj/2014/12/04/carl-heneghan-evidence-based-medicine-on-trial/) is a good reminder of when and why it may not be.

As for teaching methods, I like Brian's experiential idea - going beyond lectures to small-group work or working with real-life cases (both real patient cases, and real cases of evidence in the literature) would make for a much better learning experience.

BC

Bill Cayley, Jr, MD MDiv
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On Monday, December 15, 2014 3:20 PM, Brian Alper MD <[log in to unmask]> wrote:


I have had med students join me for an advanced EBM elective.  One of the most impactful experiences I believe has been to have them do the detective work for statements promoted in the literature and keep tracing it back to discover that It was never supported in the first place, but the chain of citations and interpretations leads to “false knowledge” being perpetuated.   I don’t have “canned examples” because I always targeted it to whatever content I was working with at the time, but it seemed like finding such an experience was consistent and eye-opening.
 
Brian S. Alper, MD, MSPH, FAAFP
Founder of DynaMed
Vice President of EBM Research and Development, Quality & Standards
dynamed.ebscohost.com
 
DynaMed_100x25 
 
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Shaneyfelt, Terry
Sent: Monday, December 15, 2014 4:14 PM
To: [log in to unmask]
Subject: ideas for advanced EBM elective
 
I am starting a new advanced EBM elective for 3rd and 4th yr medical students. I wanted to get opinions on topics to cover. There will be 11  1.5 hr sessions. It is assumed students have understanding of basic EBM principles (all will have taken intro class)
 
These are the topics I have thought of for now.
·         Stats: interaction/subgroup analysis
·         Cohort study: propensity scores
·         Case control: matching/conditional logistic regression
·         RCT(1): survival analysis, patient specific NNT/NNH, composite endpoints
·         RCT(2): noninferiority
·         Systematic review: heterogeneity, publication bias
·         Diagnostic testing: LRs, diagnostic OR, ROC curves, clinical prediction rules
·         Screening: analyze conflicting recommendations from different societies
·         Maybe CEA
 
What other topics should I consider?
 
Do any of you offer an advanced EBM elective?