Evidence-Based Medicine and Specialty Didactics

Ronald Rieder, M.D.

Course Goals and Objectives

The Evidence-Based Medicine and Specialty Didactics course spans the PGY-II year.

During this Evidence Based Medicine portion of the course, residents learn to:

• Recognize the possibility of erroneous associations in naturalistic studies
• Know the rationale and importance of controlled clinical trials
• Recognize the potential and methods for bias in pharmaceutically-sponsored clinical trials
• Know the criteria by which to appraise the quality of clinical trials
• Be familiar with systematic reviews (e.g. Cochrane Reviews)
• Be familiar with published syntheses of results of clinical trials
• Conduct literature searches that yield relevant articles that answer a specific question
• Differentiate effect size statistics from other measures of significance
• Determine how articles' results pertain to clinical care
• Understand the fundamental design issues of research studies
• Understand the fundamental issues of research ethics

During the PGY-II year, residents learn fundamental techniques to critically appraise the research quality of peer-reviewed articles. Specifically, residents focus on review articles, clinical trials, epidemiological studies, diagnostic tests, and meta-analyses. Residents learn how to understand frequently used statistical methods (e.g., Student t-tests, chi-square analyses, survival curves, sensitivity, specificity, positive predictive value, number needed to treat, number needed to harm, odds ratios) through discussions of selected literature. All sources of information - textbooks, opinion websites, scientific articles, reviews, and reports in the popular press - are discussed with regard to their veracity and usefulness in clinical decision making.

During the Specialty Didactics portion of the course, PGY 2 residents are taught the phenomenology, diagnosis, psychobiology and treatments of those disorders that are the focus of 4 specific psychiatric sub-specialties:

• Substance Abuse
• Geriatrics Psychiatry
• Child and Adolescent Psychiatry
• Neurosychiatry