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Spring '14-148 (Exam 1) > 2/4/14 Ch. 8-Lecture 2 > Flashcards

2/4/14 Ch. 8-Lecture 2 Flashcards

1
Q

What is EBP?

A

Evidence-based Practice

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2
Q

What is the symbol that we typically use to depict EBP?

A

Triangle

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3
Q

Name and describe the components of the EBP triangle.

A
  • External scientific evidence
  • Clinical expertise/experience
  • Client/Patient/Caregiver Perspectives
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4
Q

Which side of the triangle is this scenario on: An 85 year old client with aphasia refuses to work on CROSSWORD PUZZLES for his home exercise program

A

client/patient/caregiver perspectives

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5
Q

Which side of the triangle is this scenario on: A study that includes a control group and random assignment with an n=50 demonstrates the efficacy of a fluency program

A

Research expertise

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6
Q

Which side of the triangle is this scenario on: An aphasiologist with 25 years of experience modifies a therapy approach for a specific client on his caseload

A

Clinical expertise

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7
Q

T/F: EBP is highly contextual and addresses the individual in need of services?

A

True

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8
Q

Is EBP highly individualized?

A

Yes

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9
Q

T/F: EBP is not prescribed?

A

True

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10
Q

T/F: EBP is endorsed by an authority, institution, or organization?

A

False, it is NOT

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11
Q

What is a systematic process that is NOT dictated in a handbook or manual?

A

EBP

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12
Q

Who determines the quality of our field’s evidence?

A

In making clinical practice, evidence based practice AuD & SLPs determine the quality of our fields evidence

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13
Q

What does PICO stand for?

A 
P = population
I = intervention 
C = comparison
O = outcome
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14
Q

When using systematic reviews, what are the two questions to guide your evaluation that you want to ask?

A
  1. What are some variables to consider?

2. Why does this matter?

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15
Q

What are systematic reviews?

A
  • They form the basis for evidence-based clinical practice guidelines.
  • They are formal assessments of the body of scientific evidence related to a clinical question, and describe the extent to which various diagnostic or treatment approaches are supported by the evidence, but stop short of making specific recommendations for clinical practice.
  • They are useful in helping clinicians make treatment decisions in that, when done properly, they have pulled together and in a systematic way characterized the available evidence on a clinical question.
  • These reviews can be an important and time-saving resource for clinicians wishing to incorporate evidence into their clinical decision-making.
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16
Q

What are the individual studies?

A

When clinical practice guidelines or systematic reviews are not available, not current, not trustworthy, and/or not relevant, one can turn to individual studies to seek evidence to help make treatment decisions.

  • The first place to find individual studies would be an online bibliographic database.
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17
Q

Looking at the Adapted from theScottish Intercollegiate Guidelines Network (and recommended for use in our field by ASHA) what is level Ia?

A

Well-designedmeta-analysisof >1randomized controlled trial

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18
Q

Looking at the Adapted from theScottish Intercollegiate Guidelines Network (and recommended for use in our field by ASHA) what is level Ib?

A

Well-designed randomized controlled study

19
Q

Looking at the Adapted from theScottish Intercollegiate Guidelines Network (and recommended for use in our field by ASHA) what is level IIa?

A

Well-designed controlled study without randomization

20
Q

Looking at the Adapted from theScottish Intercollegiate Guidelines Network (and recommended for use in our field by ASHA) what is level IIb?

A

Well-designed quasi-experimental study

21
Q

Looking at the Adapted from theScottish Intercollegiate Guidelines Network (and recommended for use in our field by ASHA) what is level III?

A

Well-designed non-experimental studies, i.e., correlational andcase studies

22
Q

Looking at the Adapted from theScottish Intercollegiate Guidelines Network (and recommended for use in our field by ASHA) what is level IV?

A

Expert committee report, consensus conference, clinical experience ofrespected authorities

23
Q

Given this scenario: Convenience sample of four participants with aphasia and four research assistants with seven days of intervention and pre-/post- assessments…. What is the level?

A

IIb or III

24
Q

Given this scenario: Community-based program for individuals with aphasia with a comparison group. Participants self-selected treatment group versus comparison group…. What is the level?

A

IIa

25
Q

Given the scenario: Sample size was 250 (consecutive enrollment of stroke survivors in a large medical center) with random assignment into Treatment A, Treatment B, or a control group…. What is the level?

A

Ib

26
Q

What is Treatment efficiency?

A

Tied to many factors and is assessed via a cost-benefit analysis.

27
Q

What is treatment outcomes research?

A

Therefore, “identifies treatment benefits” with the intent of establishing a relationship between treatment and functional improvement.

28
Q

What is treatment efficacy?

A

When it is established, the improvement in client performance can be shown to be …

(1) derived from the treatment rather than other extraneous factors,
(2) real and reproducible, and
(3) clinically important.

That is, treatment efficacy studies must demonstrate internal validity, statistical significance, as well as practical significance

29
Q

What is randomization?

A

Selecting random samples of people, settings, and times to be included in the study is a key procedure researchers use to enhance the external validity of results.

30
Q

What is simple random sampling?

A

often discussed only with respect to subjects in a study but can also be considered for settings, values of the independent variable, times or measurement, stimulus materials, measurement procedures, and so on.

31
Q

What is stratified random sampling?

A

an accessible populations for study is first divided into categorized subgroups, or strata, from which subjects are drawn randomly.

32
Q

What is cluster sampling?

A

all subjects are members of a group that was selected at random.

33
Q

What is multistage sampling?

A

a school district might be chosen at random initially, and then a school from within that district would be randomly selected.

34
Q

What is a sample size?

A

Generalization can also be improves by increasing sample size; in general, a larger sample more closely approximates that characteristics of a population.

35
Q

What are the 4 key steps in the EBP process?

A
  1. Framing the clinical question
  2. Finding the evidence
  3. Assessing the evidence
  4. Making the decision
36
Q

What are the advantages of a group research design?

A
  • Nontreatment group provides independent reference
  • Subjects can be randomly assigned to treatment groups
  • Can generalize from representative sample by inductive inference
  • Can calculate effect size with meta-analysis
  • Attrition has less effect on overall results
37
Q

What are the disadvantages of a group research design?

A
  • Not as flexible as single-subject design
  • Intrasubject variation not measured or controlled
  • Random sampling or close matching of subjects needed for inference
  • Does not reveal extended temporal measures of dependent variable
  • Needs larger number of subjects
38
Q

What are the advantages of a single subject research design?

A

Smaller number of subjects who act as their own controls

  • Avoids subject-matching problems
  • Examines behavior at level of individual subject over time
  • Flexible design can be modified during experiment
  • Intrasubject variation can be measured and controlled.
39
Q

What are the disadvantages of a single subject research design?

A
  • Less generalizable than group designs
  • Greater need for direct or systematic replications
  • Intersubject variability not well accounted for
  • Needs more time and effort per subject to collect measurements
  • Attrition has more effect on overall results.
40
Q

What is treatment effectiveness?

A

Results in “clinically significant improvement in a client’s communication skills”

41
Q

What is therapeutic effect?

A

“The manifestation of altered physiology (through the application of treatment) as beneficial change.”

42
Q

What is treatment outcomes research?

A

Identifies treatment benefits with the intent of establishing a relationship between treatment and functional improvement

43
Q

What does Clinical efficiency research seek to prove?

A

Treatment benefits

Spring '14-148 (Exam 1) (4 decks)

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