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evidence based class > 2nd lecture > Flashcards

2nd lecture Flashcards

1
Q

What are the 5 A’s?

A

Ask
Acquire
Appraise
Apply
Assess

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2
Q

Where can we find evidence?

A

scientific journals, magazines, government and pro websites, Grey literature

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3
Q

What is scientific journals?

A

typically peer reviewed - higher credibility

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4
Q

What is peer reviewed?

A

meaning that the stuff is scrutinized by experts before published to assure a level of quality

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5
Q

What magazines, non peer reviewed source are we talking about here?

A

provide useful summaries of info in the progression to give DIRECTION for further inquiry

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6
Q

What do we mean by Government and pro websites?

A

National Institutes of Health (NIH) website; AAPA website www.aapa.
APTA website www.apta.org

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7
Q

What do we mean by Grey literature?

A

government documents, fact sheets; provide demographic statistics,
org;
preliminary data on new intervention that is not made for publication
(unpublished data)

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8
Q

Primary vs. Secondary Sources
of Evidence

A

Primary sources are reports provided
directly by the investigator
* Examples – research articles in journals,
presentations at professional meeting,
and dissertations
Secondary sources include reviews of
studies presented by someone other
than the original author.
* Examples – review articles and
textbooks

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9
Q

What are primary sources of evidence?

A

are reports provided DIRECTLY by the investigator
examples, research articles in journals, presentations at professional meeting and dissertations

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10
Q

What do we mean by secondary sources of evidence?

A

these include reviews of studies presented by someone other than the author
examples review articles and textbooks

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11
Q

what could be a characteristic of non credible sources?

A

newspapers, non academic magazines and trade journals, if few or no references cited, self referenced, if a product is being delivered, glossy images, if the intended audience is everyone, may provide bias only one opinion, if content is in plain English - usually shorter and doesn’t have abstract or specific language

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12
Q

examples of good search engines / databases?

A

▪ MEDLINE Complete and PubMed
▪ Cochrane Library
▪ UpToDate
▪ CINAHL Complete (The Cumulative Index to Nursing and Allied Health
Literature)

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13
Q

is google a good research spot?

A

NO, not synonymous

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14
Q

When you are to ACUIRE evidence, will you be satisfied with your search on 1st try?

A

rarely, successful searches require several attempts - revising search terms/keywords to broaden or narrow down the search and using different databases

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15
Q

When do you use AND / OR during search ?

A

AND to be more specific
OR to be more broad

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16
Q

I need to decrease my results of my search?

A

get more specific - low back pain instead of back pain
include additional terms
side bar filters - date, full text, article type

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17
Q

If i need more results for my search?

A
  • On the abstract page for a citation,
    see the Similar Articles
    section for
    a pre-calculated set of additional
    PubMed citations closely related to
    that article.
  • Remove extraneous or specific
    terms from the search box.
  • Try using alternative terms (or
    synonyms) to describe the
    concepts you are searching.
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18
Q

What is research ?

A

Clinical research isa structured process of investigating facts and theories and exploring connections with the purpose of improving individual and public health (portney, 2020)

19
Q

What are the phases of research process?

A

▪ Phase 1: Identify the
Research Question
▪ Phase 2: Design the Study
▪ Phase 3: Implement the Study
▪ Phase 4: Analyze the Data
▪ Phase 5: Disseminate Findings

20
Q

ASK ______ APPRAISE APPLY ASSESS
What is missing?

A

ACQUIRE relevant literature

21
Q

ASK
ACQUIRE
APPRAISE
________
ASSESS
What is missing?

A

APPLY

22
Q

_______ ACQUIRE APPRAISE APPLY ASSESS
What is missing?

A

ASK

23
Q
  1. According to Purpose of Research
A

Descriptive Research
Exploratory Research
Explanatory Research

24
Q

FUNDAMENTALS OF RESEARCH
Category of research

A
  1. According to “Purpose of research”
    ▪ Descriptive, Exploratory, and Explanatory
  2. Based upon the Approach of Research
    ▪ Quantitative & Qualitative Research
  3. Degree of manipulation/Control of Researchers
    ▪ Experimental & Non-Experimental Research
25
Q

(according to purpose of research)
what is descriptive research?

A

To document nature and characteristics of
phenomena through systematic collection of
data

26
Q

(according to purpose of research)
What is exploratory research?

A

To investigate relationships between or among
variables
; Usually involves one group of
subjects with measurements taken of different
variables– mathematical relationship is
established among the variables

27
Q

(according to purpose of research)
What is explanatory research?

A

To compare differences in outcome measures
between/among different treatments or
conditions

28
Q

What are variables?

A

Independent variables (IV)
Dependent variables (DV)
is a variable based on how it will be used in a particular study; how an IV will be
manipulated, and/or how a DV will be measured

29
Q

Independent variable (IV)

A

Intervention(s) or treatments

30
Q

Dependent variable (DV)

A

Outcome(s) e.g., pain, dizziness, abnormal
blood pressure

31
Q

Based upon the Approach of Research
Quantitative research?

A

Research with measurement of outcomes
using numerical data under standardized
conditions; e.g.,
“What is your pain level on a scale: 0 to 10?”

32
Q

Based upon the Approach of Research
Qualitative research?

A

Research that derives data from observation,
interview or verbal interaction and focuses on
the meaning of experience of the participants;
e.g.,
“Describe the nature and type of the pain you
experience.”

33
Q

According to degree of manipulation/control of
researchers
Experimental research?

A

the design in which the investigator
manipulates the independent variable; e.g.,
➢randomly assigning subjects to groups;
➢managing dose or frequency of medication/therapy;
A cause-and-effect relationship can only be
established by an experimental design!

34
Q

According to degree of manipulation/control of
researchers
Non-experimental research

A

Researcher does not control/manipulate/alter
the independent variable or subjects, but relies
on interpretation, observation or interactions
to come to a conclusion. e.g.,
* Survey research; correlational study

35
Q

Step 3: Appraise the Literature

A

Once evidence is acquired, it must be critically
appraised to determine whether it meets quality
standards and whether the findings are meaningful
and relevant to the clinical question.
▪ There are 3 major categories of appraisal questions
(Table 5-3; Table 36-2):
1) Is the study valid?
2) Are the results meaningful?
3) Are the results relevant to my patient?

36
Q

There are 3 major categories of appraisal questions

A

1) Is the study valid?
2) Are the results meaningful?
3) Are the results relevant to my patient?

37
Q

“Anatomy” of research article

A
  • Title
  • Abstract
    Body of the text (word limits applicable)
  • Introduction
  • Methods (KEY to appraising evidence)
  • Results (Narratives and Tables and/or
    Figures)
  • Discussion & conclusion
  • References
38
Q

“Functionality” of each element of a
research article
Introduction -

A
  • Define main problems underlying the study
  • Identify the knowledge gap in the literature
  • Provide rationale for a need of the study (i.e., setting a
    stage for the need)
  • Present the research hypothesis to be tested (for
    intervention study)
  • State the specific purposes/objectives of the study
    A research “question” is not always phrased as a
    question. Authors may state the purpose/aim of the
    study or specific hypotheses! (Portney 2020, Ch 36)
39
Q

“Functionality” of each element of a
research article
Methods -

A
  • Describe the conduct/performance of the study, and sub
    divided into
    ▪ Subjects/Participants
  • Who were the subjects? Inclusion/exclusion criteria?
    ▪ Design
  • Is it appropriate for answering the research question?
  • Was bias sufficiently controlled such as use of blinding?
    ▪ Instrument/Evaluation
  • How have the authors documented the reliability and validity of the
    instruments for outcome measures?
    ▪ Procedure
  • Were data collection procedures described clearly and in sufficient
    detail to allow replication? Operationally defined?
    ▪ Data analyses
  • How were data analyzed? Analyzed appropriately?
  • What statistical tests were used? Were they appropriate to the research
    question?
    ▪Summarized as W&H questions:
  • Who
  • Where: site of performance; Institutional
    Review Board (IRB) or ethical approval
  • What: Procedures/Protocol (tests or
    treatments)
  • How: data analyses
    1) Is the study valid?
40
Q

“Functionality” of each element of a
research article
▪Results

A
  • Report the findings of the study without interpretation or
    commentary (fact only)
  • Answer questions in the order of the stated purposes in the
    text (often accompanied by tables/figures)
  • Present the outcome of statistical analyses
    2) Are the results meaningful?
  • Is the sample sufficiently representative of the target
    population so that results can be generalized?
  • Is the effect large enough to be clinically meaningful?
41
Q

“Functionality” of each element of a
research article
▪ Discussion

A
  • Present authors’ interpretation of the results
  • Compare results with previous pertinent studies (in agreement or
    in contrast)
  • Indicate limitations of the study
  • Discuss the relevance to clinical practice
  • Suggest future directions
42
Q

“Functionality” of each element of a
research article
▪ Conclusion

A
  • Restate the findings of the study with respect to the purpose or
    hypothesis outlined in the introduction
    3) Are the results relevant to my patient?
    ▪ Were the subjects in the study sufficiently similar to my
    patient?
    ▪ Is the approach feasible in my setting and will it be
    acceptable to my patient?
43
Q

“Functionality” of each element of a
research article

A

evidence based class (5 decks)

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