POEMs and EBM glossary

Date: Oct 15, 2005

The acronym POEM stands for Patient-Oriented Evidence that Matters, and refers to a summary of valid research that is relevant to physicians and their patients. POEMs are selected from research published in more than 100 clinical journals. Each month, a team of family physicians and educators reviews these journals and identifies research results that are important and can be applied to day-to-day practice. The valid POEMs are summarized, reviewed, revised, and compiled into InfoRetriever, part of the InfoPOEMs Clinical Awareness System, copyright by InfoPOEM, Inc. POEMs have to meet three criteria: they address a question that primary care physicians face in day-to-day practice; they measure outcomes important to physicians and patients, including symptoms, morbidity, quality of life, and mortality; and they have the potential to change the way physicians practice. Studies that do not meet these criteria cannot be a POEM. For additional information about POEMs and InfoRetriever, see http://www.InfoPOEMs.com.

The level of evidence is based on criteria developed by the Evidence-Based Medicine Working Group. Level 1 is the most rigorous level, and level 5 is the least rigorous. A complete description of the Centre for Evidence-Based Medicine rating scale is available at http://www.Info POEMs.com/loe.cfm.

Glossary of Terms Used in Evidence-Based Medicine

Throughout the year, AFP provides readers with definitions of terms used to describe the quality of evidence in review articles. These definitions have been compiled by Mark H. Ebell, M.D., M.S., AFP's deputy editor for evidence-based medicine and founding member of InfoPOEM, Inc., an independent commercial entity. The complete collection of these terms is available on the Web site at http://www.aafp. org/afppoems.xml.

RELATIVE AND ABSOLUTE RISK REDUCTION

Studies often use relative risk reduction to describe results. For example, if mortality is 20 percent in the control group and 10 percent in the treatment group, there is a 50 percent relative risk reduction ([20 - 10] / 20) x 100 percent. However, if mortality is 2 percent in the control group and 1 percent in the treatment group, this also indicates a 50 percent relative risk reduction, although it is a different clinical scenario. Absolute risk reduction subtracts the event rates in the control and treatment groups. In the first example, the absolute risk reduction is 10 percent, and in the second example it is 1 percent. Reporting absolute risk reduction is a less dramatic but more clinically meaningful way to convey results.

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