Posted: December 20th, 2021

Evidence Based Medicine

Project
Evidence Based Medicine

Physicians are under increasing pressure to provide quality health care in a cost-effective manner. The high costs of medical care are influencing clinical decision making to adopt standardized guidelines proven to deliver satisfactory outcomes at the lowest cost.

Evidence Based Medicine (EBM) is an approach to clinical decision making that uses the scientific method to establish standards of clinical practice that lead to diagnostic and treatment guidelines.

There are five major steps involved in teaching and practicing Evidence Based Medicine (EBM):
Formation of a clear clinical question that defines a patient’s problem
Medical literature searches for current and relevant information
Expert non-commercially biased critique of selected study
Assessment of findings to formulate a plan of action
Follow-up Assessment of the efficacy of the first four steps, making improvements as necessary
EBM is optimized when data is accurate, readily available, and within standard file formats. IT deployment and integration strategies provide for the most efficient and effective EBM experience. The role of IT is to support the delivery of care including its related research and other pertinent activities.

To prepare for this Project, read the following in your course text Health Information: Management of a Strategic Resource:
Chapter 14, “Data Analysis and Use”
Also access more information on EBM as can be found at the University of North Carolina Health Science Library.
You can also watch the supplemental video, ” Health Care Information Systems Analytical Applications.”
For this Project, use the following Case Study:
Patient Description

65-year-old African American woman.
Complaint of pain in both knees, with pain more severe in the left knee.
Pain has developed over the past five years and left knee pain has worsened over the past 1 year.
Patient’s level of disability necessitates using a cane to walk.
Conservative management, including crutches and medications, failed to provide adequate relief or restore function.
No pertinent medical history or risk factors.

Objective Findings

Pain in left knee worsens with extension.
Mild discomfort in right knee at all times.
Physical exam consistent with arthritis.
Radiographs of both knees showed altered bone density, left knee with greater severity.

Preliminary Diagnosis

Bilateral arthritic changes to both knees, left worse than right.
Points of ConsiderationStaging
Key Clinical Decision: Define the stage of the disease (radiographs and magnetic resonance imaging (MRI) as needed.
Questions to Ask: What are the treatment options once a final diagnosis and staging workup has been completed Does the patient need surgery If so, to one knee or both If both, should they be done at the same time or on separate occasions

In 12 pages written in APA style:
Design an EBM protocol to explore how to best treat the patient.
What HIS Applications should be integrated
Describe the role that IT plays within the EBM protocol you designed.
Evaluate the potential costs associated with a study and the potential savings that are dependent on the findings.

Resources Overview
During Week 6, you will use a variety of resources, both required and supplemental, including selections from the course text and various Web and video resources. The Weekly Schedule (a navigation link under Week 6) outlines the resources you will need to participate in the Discussion and complete the Application and the Project.
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media players below.
________________________________________
Media
Video: Week 6 Overview
Note: The approximate length of this media piece is 20 minutes.
This video provides an introduction to the week’s resources and assignments.
Accessible player
________________________________________
Reading

Course Text: Abdelhak, M., & Hanken, M. A. (2016). Health information: Management of a strategic resource (5th ed.). St. Louis, MO: Saunders Elsevier.
Chapter 13, “Data Analytics: Reporting, Interpretation, and Use
In this chapter, you will learn about how health care data are used by different sectors in the health care system. This chapter explains about the different disease registries, as well as other health-related registries. Read about how data is analyzed and used for outcomes and decision support systems.
________________________________________
Web Resource
Agency for Healthcare Research and Quality (AHRQ)
This Web site explains what Outcomes Research is and how outcomes are measured and used for decision-making. The outcomes that matter most to patients should be measured along with the traditional biomedical measures shown here, such as mortality and physiological symptoms.
________________________________________
Web Resource
American Health Information Management Association (AHIMA)

This Web site defines a data dictionary, provides a rationale for data dictionaries, and presents guidelines for developing a data dictionary.
________________________________________
Web Resource
Australian National Health Data Dictionary

This site accesses the National Health Data Dictionary by the Australian Institute of Health and Welfare. You can download Word documents of some of the elements.
________________________________________
Web Resource
National Health Data Dictionary, Version 10, 2001

This Web site allows you to download pdf documents of the National Health Data Dictionary, including data element definitions and the National Health Information Model.
________________________________________
Web Resource
New York State Department of Health
This Web site is devoted to Disease Registries. The site explains what disease registries are and the types of disease registries maintained by the New York State Department of Health.
________________________________________
Web Resource
Sample Data Dictionaries

Here you can see two partial screen shots of a sample data dictionary and read about some of the fields and terminology used.
________________________________________
Web Resource
The Database Programmer
This blog provides an overview of how to use a data dictionary and build and upgrade databases and scripts in order to generate forms and technical documentation.
________________________________________
Web Resource
University of North Carolina Health Science Library

This tutorial takes you through Evidence Based Medicine. You can learn how to determine the validity of study results and the parts of a good clinical question.
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Web Resource
Using Clinical Pathways in Patients Undergoing Cardiac Valve Surgery

This article discusses the value of clinical pathways and how they can be used more efficiently to help patients meet expected outcomes within a prescribed length of stay. The article focuses on a clinical pathway for cardiac surgery.
________________________________________
Media
Video: Laureate Education (Producer). (2009). Healthcare information systems analytical applications [Video file]. Retrieved from https://class.waldenu.edu
Note: The approximate length of this media piece is 2 minutes.
Dr. Vincent Grasso provides real world health care IT examples of how data mining, natural language processing, and the computer science domain of artificial intelligence impact the delivery of healthcare.
Please follow the Rubric Below!
Week 6 Project: Evidence Based Medicine Assessment Rubric
(4 Points) Exceptional, complete, clear, exceeds performance indicators
(3 Points) Excellent, complete, meets performance indicators
(2 Points) Approaching performance indicators, missing some detail, not fully developed
(1 Point) Developing competence, vague, weak, needs more detail
(0 Points) Not present
Points Earned
EBM ProtocolThe submission outlines an EBM protocol for the patient.
Application IntegrationThe submission identifies the HIS Applications that should be integrated.
Costs The submission evaluates the potential costs and savings of an EBM study

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