Chapter 5

Question 1

research evidence with clinical expertise, patient values, and clinical circumstances, to inform clinical decisions.

Answer 1

Evidence-based practice

Question 2

Five A’s of EBP

Answer 2

•Ask
•Acquire
•Appraise
•Apply
•Assess

Question 3

Step 1: Ask a Clinical Question

Answer 3

Background questions: Who, what, where, when, how, or why

Foreground questions: PICO format
‒Population or Problem
‒Intervention (Exposure or test)
‒Comparison (if relevant)
‒Outcome

Question 4

Sources of Clinical Questions

Answer 4

●Diagnosis and measurement
●Prognosis
●Intervention
●Patient experiences

Question 5

Are measures of peripheral sensation valid for assessing peripheral neuropathies in patients with type 2 diabetes?

Is an example of

Answer 5

Diagnosis

Question 6

In patients with type 2 diabetes who have peripheral neuropathy, which measure of balance will provide the best assessment to predict falls?

Is an example of

Answer 6

Measurement

Question 7

In patients with type 2 diabetes, how does an HbA1C of 7.5 influence disease progression?

Is an example of

Answer 7

Prognosis

Question 8

In patients with type 2 diabetes who experience a frozen shoulder, will a corticosteroid injection be effective to improve shoulder function?

Is an example of

Answer 8

Intervention

Question 9

In patients with type 2 diabetes, what factors contribute to a lack of adherence to a medication regimen and exercise?

Is an example of

Answer 9

Patient experiences

Question 10

Step 2: Acquire Relevant Literature

Answer 10

●Types of studies depend on the clinical question

●Synthesized evidence: Systematic reviews, Meta-analyses, Clinical practice guidelines, Scoping review

Question 11

How many levels of evidence are there

Answer 11

5

Question 12

Levels of evidence are based on

Answer 12

Clinical question

Question 13

Relative hierarchy of levels of evidence can be

Answer 13

graded up or down based on study quality

Question 14

Level 1 example of evidence

Answer 14

Systematic reviews

Question 15

Level 2 example of evidence

Answer 15

RCTs, observational studies with strong designs

Question 16

Level 3 example of evidence

Answer 16

Study designs with poor control of bias, such as retrospective cohorts

Question 17

Level 4 example of evidence

Answer 17

Descriptive studies such as case series

Question 18

Level 5 example of evidence

Answer 18

Mechanistic reasoning

Question 19

Step 3 in process of EBP

Answer 19

Appraise the Literature

Question 20

Appraise the Literature has 3 primary questions

Answer 20

Three primary questions:
●Is the study valid?
●Are the results meaningful?
●Are the results relevant to my patient?

Question 21

Step 4 in EBP

Answer 21

Apply the evidence

Question 22

Applying the evidence involves

Answer 22

●Putting it all together to inform a clinical decision
•Evidence
•Clinical expertise
•Patient values
•Clinical circumstances
●How well does the evidence fit your patient?

Question 23

Step 5 in EBP

Answer 23

Assess Effectiveness of Evidence

Question 24

Assess Effectiveness of Evidence involves questions such as

Answer 24

●Did the patient improve?
●Is additional evidence needed?
●Do additional questions need to be answered?

Question 25

Barriers to Implementation

Answer 25

●Lack of critical appraisal skills
●Access to the literature
●Lack of time
●Lack of resources
●Strategies to address barriers

Question 26

involves the adaptation of quality research into relevant priorities

Answer 26

Knowledge Translation

Question 27

Relates to the long-standing problem of underutilization of evidence.

Answer 27

Knowledge translation

Question 28

Knowledge-to-Action Framework involves what 3 things

Answer 28

●Inquiry
●Synthesis
●Development of Tools