Scenario: Consider the following abstract as an example – NEJM 2003, 349: 949 – 58 “Treatment of opiate addiction with sublingual buprenorphine and naloxone has been proposed, but its efficacy and safety have not been studied.
Methods – we conducted a multi-centre, randomised, placebo-controlled trial involving 326 opiate- addicted persons who were assigned to sublingual buprenorphine and naloxone, buprenorphine alone or placebo…….
Results – The trial was terminated early because both active treatments were found to have a greater efficacy than placebo…….
Conclusions – Buprenorphine/naloxone and buprenorphine are safe and efficacious in reducing opiate craving…….”
Introductory question: What do you understand by the term “evidence-based medicine”?
Nineteen out of twenty-three candidates passed this section.
Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.