Critically Evaluating Guidelines and Recommendations About Preventive Services

Medical students, as all medical professionals, should demonstrate the skills necessary to critically evaluate and translate medical and scientific research reports to clinical practice. This includes assessing the appropriateness and correctness of a study design; methods of data collection; sources of bias and confounding factors; correct interpretation of results; standards of evidence and determination of the effectiveness of preventive interventions. The research on preventive strategies is vast. Eventually an organization or panel of experts consolidates the extensive data to produce a guideline or recommendation the medical community can follow in clinical practice. Sharon Straus and others (in “Evidence-Based Medicine”) recommend asking the following 4 questions when reviewing a study on screening to decide whether the screen is beneficial or harmful:

  1. Is there evidence based on randomized control trials that early diagnosis really leads to improved survival or quality of life or both?
  2. Are the early diagnosed patients willing partners in the treatment strategy?
  3. How do benefits and harms compare in different people and with different screening strategies?
  4. Do the frequency and severity of the target disorder warrant the degree of effort and expenditure?

There are many evidence based medicine (EBM) sites that allow you to find reliable EBM recommendations quickly:

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