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Centre for Evidence-
Based Medicine

Completed Therapy Worksheet for Evidence-Based Physiotherapy Practice

Citation

Fagevik Olsen M, Hahn I, Nordgren S, Lonroth H, Lundholm K. Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery. British Journal of Surgery 1997;84:1535-1538.

Are the results of this single preventive or therapeutic trial valid?

  1. Was the assignment of patients to treatments randomised?
    And was the randomisation list concealed?
    Yes
    No
  2. Were all patients who entered the trial accounted for at its conclusion?
    And were they analysed in the groups to which they were randomised?
    Yes (control 192/194; experimental 172/174)
    No
  3. Were patients and clinicians kept "blind" to which treatment was being received?
    Not possible to blind patients. Outcome assessors were not blind.
  4. Aside from the experimental treatment, were the groups treated equally?
    Yes
  5. Were the groups similar at the start of the trial?
    Yes

Are the valid results of this randomised trial important?

Post-operative Pulmonary Complications (all patients) Relative Risk Reduction
RRR		 Absolute Risk Reduction
ARR		 Number Needed to Treat
NNT
CER EER (CER-EER)/CER CER-EER 1/ARR
0.27 0.06 79%
52% to 100% 		21%
14% to 29% 		5
(4-8)

Your Calculations

Post-operative Pulmonary Complications (high risk patients) Relative Risk Reduction
RRR		 Absolute Risk Reduction
ARR		 Number Needed to Treat
NNT
CER EER (CER-EER)/CER CER-EER 1/ARR
0.51 0.15 71%
33% to 100% 		36%
17% to 56% 		3
(2-6)

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

Do these results apply to your patient?

  1. Is your patient so different from those in the trial that its results can't help you?
    Similar
  2. How great would the potential benefit of therapy actually be for your individual patient?
    Similar
  3. Method I: f
    Risk of the outcome (school absence) in your patient, relative to patients in the trial. expressed as a decimal: 1

    NNT/f = 5/1 = 5
    (NNT for patients like yours)
  4. Method II: 1 / (PEER x RRR)
    Your patient's expected event rate if they received the control treatment: PEER:______

    1 / (PEER x RRR)
    = 1/________
    = _______
    (NNT for patients like yours)

Are your patient's values and preferences satisfied by the regimen and its consequences?

  1. Do your patient and you have a clear assessment of their values and preferences?
    Needs to be addressed in each patient
  2. Are they met by this regimen and its consequences?
    Needs to be addressed in each patient

Additional Notes

Need to know the post-operative pulmonary complication rate for my unit.

Continue to CAT

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