MedEdPORTAL (Jul 2013)
The Making Evidence-Based Medicine Simple Series — Diagnostic Testing Module
Abstract
Abstract Introduction The Making Evidence Based Medicine Simple Series is an evidence-based clinical practice curriculum. It consists of six modules that review the articles types addressing the most common clinical questions (i.e., diagnosis, therapy, harm, prognosis, meta-analysis, and clinical decision rules). Each module reviews an article from the medical literature using the Users Guide to Medical Literature criteria for validity, results, and applicability. Each modules includes a PowerPoint presentation with a script, a video of the presentation with narration, a quiz with answers, tips for teaching the module, a blank review form, and a completed critical article review for the article reviewed in the module. Methods The Diagnostic Testing Module reviews the appraisal of the validity, results, and applicability of a cross-sectional study of adults with suspected appendicitis. The study addresses the following clinical question: In patients with suspected appendicitis, what are the test characteristics of a non-contrast CT of the abdomen and pelvis when compared to operative findings or clinical follow-up? In addition, this module reviews the following critical appraisal skills: (1) understanding the concepts of testing and treatment thresholds in diagnostic decision making, (2) defining and calculating the test characteristics of a diagnostic test from a 2 × 2 table, (3) utilizing a likelihood ratio nomogram to calculate posttest probability of disease, and (4) understanding the study parameters used for “ruling in” and “ruling out” disease. Results Evaluations by course participants have been extremely positive. Participants often comment that they have finally grasped important content that they have previously struggled with. The materials have been particularly useful to those who are leading a teaching session. Feedback from a 2013 course for pediatric emergency medicine fellows indicated that 92% of participants felt the Diagnostic Testing Module was “extremely helpful.” In addition, 100% of participants agreed or strongly agreed that the modules improved their ability to appraise an article, and their ability to conduct evidence-based clinical practice. One-hundred percent also agreed or strongly agreed that the precourse materials were useful. Discussion The Making Evidence Based Medicine Simple Series is a well-received evidence based clinical practice curriculum and the Diagnostic Testing Module is an effective component of the series that can be used independently or with the other modules.
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