Evidence Based Medicine on Harm

CASE SCENARIO #1:

Efren, 56 year-old, smoker since high school, consulted in your clinic

because of difficulty of breathing and shortness of breath. You advise him
to quit on smoking to improve his condition. He asked you what will
happen if he continued smoking? Will he develop also lung cancer like his
other friends? Can he change to another form of smoking like vape?

1. Identify the P-I-C-O in the case?

 Population/Problem: Chronic middle-aged male smokers
complaining of DOB and SOB
 Intervention: Cessation of smoking
 Comparison: Non-smokers, smokers who stopped smoking, and
smokers who changed form of smoking (vape)
 Outcome: Decreased risk of developing esophageal cancer and
improvement of patient’s condition

2. Formulate your own clinical question?

 Will smoking cessation or switching to vape among chronic
middle-aged male smokers who started smoking since high
school, reduce the risk of development of esophageal cancer and
improve symptoms such as DOB and SOB?
Evidence Based Medicine on Harm

CASE SCENARIO #2:

Elvira, a 21 year old clerks, has just been diagnosed with a deleterious
mutation of the breast cancer susceptibility gene ( BRCA 1 ). She has
recently started taking oral contraceptives. She ask you if taking oral
contraceptives will increase her risk of early onset breast cancer and
whether she should change to another form of contraception.

1. Identify the P-I-C-O in the above clinical question.

 Population/Problem: Women ages 20-25 taking oral
contraceptives
 Intervention: Using OCP as a form of contraception
 Comparison: Using other form of contraception
 Outcome: Increased risk for developing early onset breast cancer

2. Formulate your own clinical question?

 Are women ages 20-25 who just recently started taking oral
contraceptives at greater risk for developing early onset breast
cancer compared to women ages 20-25 who use another form of
contraception?