ebm 報告 吳晉嘉 張哲浣 何怡慧

EBM 報告吳晉嘉張哲浣何怡慧

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• 形成問題• 找出相關文獻• 評估文獻品質• 總結證據結果• 解讀文獻發現

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Free form question

• The role of albumin use in resuscitation of trauma patients

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Structured question

• Population: major trauma patients with unstable hemodynamics in intensive care units.

• Intervention: albumin use duration• Outcome: mortality rate, morbidity• comparison

Critically ill

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• 形成問題• 找出相關文獻• 評估文獻品質• 總結證據結果• 解讀文獻發現

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Literature review

• Pubmed• CINAHL Plus with Full Text• Cochrane Library• DynaMed • Ovid Medline • Wiley-Blackwell

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• 形成問題• 找出相關文獻• 評估文獻品質• 總結證據結果• 解讀文獻發現

罩門所在

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• Exclude 1980以前 study

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• 形成問題• 找出相關文獻• 評估文獻品質• 總結證據結果• 解讀文獻發現

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• Comprehensive meta-analysis

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Sensitivity test: One study removed

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Study name Statistics for each study Odds ratio and 95% CI

Odds Lower Upper ratio limit limit Z-Value p-Value

SAFE 0.996 0.887 1.118 -0.070 0.944Maitland 2011 1.017 0.788 1.312 0.130 0.897Cooper 2006 4.125 0.392 43.383 1.180 0.238Maitland 2005 0.168 0.036 0.797 -2.246 0.025Goodwin 1983 4.552 1.160 17.860 2.173 0.030Grundmann 1982 1.444 0.051 40.541 0.216 0.829Metildi 1984 1.750 0.537 5.701 0.929 0.353Rachow 1983 0.667 0.080 5.537 -0.375 0.707Tollofsrud 1995 0.302 0.011 8.332 -0.708 0.479Woittiez 1997 3.429 0.750 15.671 1.589 0.112Zetterstrom 1981a 0.312 0.012 8.285 -0.696 0.486

1.010 0.911 1.120 0.191 0.8480.01 0.1 1 10 100

Favours A Favours B

Meta Analysis

Meta Analysis

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Log odds ratio

Funnel Plot of Precision by Log odds ratio

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Log odds ratio

Funnel Plot of Standard Error by Log odds ratio

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• 形成問題• 找出相關文獻• 評估文獻品質• 總結證據結果• 解讀文獻發現

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• In general, compared with crystlloids, current albumin use has no statistical significance in treating critically ill patients.

• However, improvement of research method or subgroup analysis should be performed further.

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感恩聆聽