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   Are the results of this prognosis study valid?

Was a defined, representative sample of patients assembled at a common (usually early) point in the course of their disease?

 

Was patient follow-up sufficiently long and complete?

 

Were objective outcome criteria applied in a “blind” fashion?

 

If subgroups with different prognoses are identified, was there adjustment for important prognostic factors?

 

Was there validation in an independent group (“test set”) of patients?

 



   Are the valid results of this prognosis study important?

How likely are the outcomes over time?

 

 

How precise are the prognostic estimates?

 

 

If you want to calculate a confidence interval around the measure of prognosis:

Clinical Measure

Standard Error (SE)

Typical Calculation of CI

Proportion (as in the rate of some prognostic event, etc.) where:

 

the number of patients = n

 

the proportion of these patients who experience the event = p

 

 

 

 

where p is proportion and n is number of patients

If p = 24/60 = 0.4 (or 40%) and n = 60

 

SE =

      = 0.063 (or 6.3%)

 

95% CI is 40% ± 1.96 × 6.3%

or 27.6% to 52.4%

n from your evidence: ___

p from your evidence: ___

Your calculation:

SE: ____________

95% CI: ________

 

Can you apply this valid, important evidence about prognosis in caring for your patient?

Were the study patients similar to your own?

 

Will this evidence make a clinically important impact on your conclusions about what to offer or tell your patient?

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