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DPT: Critical Inquiry > CI Test 1 > Flashcards

CI Test 1 Flashcards

1
Q

Evidence Based Practice

A

includes standardized outcomes, standardized terminology, personalized care, and constantly evolving practice

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2
Q

International Classification of Function

A

A model of health and disability; labels health conditions based on its effects on body sxs/fxns, activities, participation, environmental factors, and personal factors

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3
Q

Body Structures/Functions (ICF)

A

Addresses where the impairment is; includes things such as pain, limited ROM, weakness,

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4
Q

Activities (ICF level)

A

Actual activity effected by the impairment; could include walking, climbing stairs, bed mobility, balance

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5
Q

Participation (ICF level)

A

How the limited activity actually effects daily life; things such as cannot deliver mail because they can’t walk, cannot be an usher at church, cannot wash the dishes; could include mobility activities, community activities

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6
Q

Environmental Factors (ICF)

A

things that could effect the individual’s function/limitations that are in the environment; weather, climate, roads, disability access

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7
Q

Personal Factors (ICF)

A

Factors within the individual that could effect an individual’s outcome in recovery; depression, motivation

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8
Q

Evidence Based Practic

A

the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients; requires clinical expertise, research evidence (valid/relevant), and patient values

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9
Q

Steps of Evidence Based Medicine

A
  1. Determine need
  2. Create Question
  3. Search Database
  4. Triage
  5. Critical Appraisal
  6. Integration
  7. Application

(DCST CIA)

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10
Q

Determine Need (EBM)

A

Step 1

The patient creates need for clinically important information

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11
Q

Create Question (EBM)

A

Second step

Information needs to be converted into an answerable question

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12
Q

Search Database (EBM)

A

3rd step in EBM

Search for answer to clinical question using relevant sources

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13
Q

Triage (EBM)

A

Fourth step in EBM

Determine best evidence source for the solution to the problem

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14
Q

Critical Appraisal (EBM)

A

Step five

Evidence is appraised for validities and applicability

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15
Q

Integration (EBM)

A

Step 6

Integrate the evidence, experience and patient values to develop a plan of care

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16
Q

Application (EBM)

A

Step 7

Evidence is applied and clinical outcomes are evaluated

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17
Q

How do we prevent PTs from not maintaining EBP after they graduate?

A

Encourage use of standardized outcome tools, keep track of outcomes, and assess performances

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18
Q

Autonomy

A

The ability to make one’s own decisions and to act on them; “self-determination”

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19
Q

Beneficence

A

The obligation to attend to the well-being of participants;

The need to maximize benefits and minimize harm

The need to critically evaluate the risk/benefit relationship

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20
Q

Justice

A

Fairness in a study; equitable distribution of benefits and burdens

There is an equal chance of being assigned to intervention groups

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21
Q

Control Groups in Clinical Research (maintaining ethical action)

A

The best way to determine the effect of an intervention is to compare to a control group;

To make it ethical, offer a treatment option to the control group

There might not be any treatments that have been shown to be effective, so in this case it may be justified in comparing no treatment to a new treatment

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22
Q

Nuremberg Code

A

First formalized guidelines for research; evolved from Nazi war crimes trials;

Every individual must give informed consent for participation

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23
Q

Declaration of Helsinki

A

Independent review of research protocols by an impartial committee; research findings obtained without this review should NOT be published

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24
Q

Institutional Review Board

A

Reviews research protocols to ensure rights of participants are protected; must consist of at least 5 members of a diverse make up from different social, cultural, and occupational backgrounds

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25
Q

IRB Reviews Research Proposals Based on:

A 
Scientific merit
Competence of investigators
Risk to participants
Feasibility based on resources available
Risk-benefit ratio
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26
Q

Full IRB Review

A

For experimental procedures that have never been performed; with more than minimal risk; also for vulnerable populations;

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27
Q

Expedited Review

A

for very minimal risk experiments that uses standardized protocols frequently used in the past; reliability studies of the common clinical examination tools fall under this

Only a partial board convenes

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28
Q

Exempt REview

A

Surveys, interviews, as long as the information remains anonymous/ cannot be identified;

Studies of existing records

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29
Q

Elements of Informed Consent

A

Invitation to participate; Information, consent, and authorization Elements

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30
Q

Information Elements of Informed Consent

A

Disclosure of information; what is going to happen during the study to the subject;

What risks are there? What steps minimize these risks? What would happen in the case of harm? What are the benefits? How are they ensuring confidentiality? How long are they keeping info? Where can a participant go if they have questions?

Form written in lay language

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31
Q

Consent Elements

A

The assurance that participation is voluntary and the subject must be able to provide consent for themselves, otherwise they need a responsible party to sign

Is there compensation?

The subject is free to withdraw at any time

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32
Q

Authorization Elements

A

Consent to use data and other materials for publication and dissemination

33
Q

Who gets authorship in a research study?

A

Made Substantial contributions to conception and design OR acquisition of data OR analysis and interpretation of data
AND
Drafted the article or revised it critically for important intellectual content
AND
Contributed to final approval of the version to be published

34
Q

Population (N)

A

The larger group to which you want to generalize your findings

35
Q

Sample (n)

A

A smaller, hopefully representative, subgroup from the population used to determine truths about the population

36
Q

Process of Sampling

A

Define target population (clearly define the criteria for the group), identify accessible population (identify the portion of the target pop that has an equal chance of being selected), obtain sample

37
Q

Inclusion Criteria

A

Characteristics that you decide must be present; primary trains of your target population that should be relevant to the research question; more of these strengthens INTERNAL validity but creates more restrictions so there is a lower EXTERNAL validity

38
Q

Homogenous Sample

A

Makes generalization difficult; could be easier to study, however may be difficult to apply to a large group

39
Q

Exclusion Criteria

A

Factors that would disqualify individuals from participating in your study; confounding factors that may interfere with interpretation should be considered; closely related to inclusion criteria

40
Q

Probabilistic Sampling

A

Ideal scenario; uses a randomly selected sample from the accessible population

41
Q

Non-Probabilistic Sampling

A

Used when it is not possible to obtain a true random sample; non-probabilistic

42
Q

Random Selectin

A

Probabilistic; every individual in the accessible population has an equal chance of being included in the study;

Every individual has an equal chance of having some of the characteristics in the target population

Should help prevent “sampling bias”

43
Q

Sampling Bias

A

Individuals either over-represent or under-represent characteristics of the population;

44
Q

Sampling Error

A

Difference between sample statistics and population parameters is due to chance;

Probabilistic: can estimate this error
Non-probabilistic: cannot estimate sampling error

45
Q

Simple Random Sampling

A

Accessible population often defined by membership, directories, or lists

Each member has an equal chance of being selected

Random number generator, throw dice, names in hat, etc.

46
Q

Systematic Sampling

A

Systematically select individuals on an interval basis (every other, every third, etc.)

Sample Interval= number in the accessible population divided by the desired number for the sample (N/n)

47
Q

Stratified Random Sampling

A

Identify relevant population characteristics; partition the population into homogenous, non-overlapping strata based on characteristics; draw random or systematic samples from each strata

48
Q

Disproportional Sampling

A

When stratified sampling is being used, but the strata have very different representation in the population; results in insufficient sample sizes in some groups

Select random samples of adequate size from each category; must weight the scores for data analysis to correctly represent the sub strata

49
Q

Weighting Data

A

Score is multiplied by the weighting factor in the analysis; makes the scores from the more highly represented individuals count for more in the analysis

50
Q

Cluster/Multistage Sampling

A

Strategy to link members of the accessible population to an already established grouping; successive random sampling of a series of groups in the population

Ex: if we already have geographical groupings; in large multi enter trials; during every step of reducing groups we randomly select; (regions of the US)

51
Q

Convenience Sampling

A

Recruiting individuals as they become available (consecutive sampling) or ask for volunteers and wait for the phone to ring

52
Q

Quota Sampling

A

Uses stratification (attempts to represent each strata in the same proportion as in the target population); recruiting stops once quota has filled

53
Q

Purposive Sampling

A

Individuals are hand picked for inclusion by the research based on certain criteria; large potential for bias

54
Q

Snowball Sampling

A

Stage 1: a few participants who meet criteria are tested

Stage2: these participants then identify others who qualify

Step 3: it continues

Often used for hidden or hard to reach populations

55
Q

Recruitment

A

Must not coerce (caution when using own patients), must be able to withdraw from study at any time;

56
Q

Statistical Power

A

Ability to find differences between groups if they exist; small sample size generally indicates a lower power

57
Q

Reliability

A

Reproducibility, consistency

58
Q

Validity

A

Accuracy, correctness; are you on the mark?

59
Q

Systematic Error

A

Consistent, however it always overestimates/underestimates; errors from measurement to measurement are predictable; (reliable not valid)

60
Q

Random Error

A

Error due to chance; errors from measurement to measurement are unpredictable;

Observed score = true ability +/- random error

61
Q

Reliability Coefficients

A

Reliability is a measure of how much total variance is attributed to true differences between scores; as error increases, reliability coefficient approaches zero; as error decreases, reliability coefficient approaches 1.0

T/(T+E)

T= true score variance
E= error variance
62
Q

Test-Retest Reliability

A

Used to establish that an instrument/tool is capable of measuring variable consistently; used for self-report questionnaires or mechanical/digital read outs;

Has limitations from one session to the next

Test-Retest Intervals: far enough apart to avoid learning/carryover (testing)/memory effects; impact of fatigue; close enough to avoid genuine growth

63
Q

Intrarater Reliability

A

Stability of one person’s measurement across 2 or more trials; blind the tester to control for bias

64
Q

Inter rather Reliability

A

Variation between two or more raters who measure the same group of people; best assessed in a single trial

65
Q

Discrete Data

A

Described by whole units; (could be dichotomous- a discrete variable with only two values)

66
Q

Nominal Measurements

A

Classify/label; mutually exclusive categories (male/female); numbers ONLY represent a category; have no relationship with each other (names of states, names of plants)

67
Q

Ordinal Measurements

A

Designates a ranking/order, but the intervals are NOT assumed to be equal; numbers represent a rank-order;

Freshman, sophomore, junior, senior

Professor, affiliate, guest

68
Q

Continuous Data

A

A number that theoretically can take on any value along a continuum; an indefinitely large number of fractional values

69
Q

Interval Measurements

A

Designates equal intervals, order, but no true zero; intervals are equal; numbers represent a value, but not absolute quantity;

Temperature, 0-10, 11-20, etc.

70
Q

Ratio Measurements

A

Designates equal intervals, order, and a true 0; numbers represent a value, absolute quantity from 0

Height, weight, time, goniometry

71
Q

Direct Variables

A

Concrete characteristics gathered by the Rater; focus on precision and calibration;

ROM (angles), height, HgB

72
Q

Indirect Variable

A

Indicators of an attribute used to represent an abstract concept; use some form of direct observation to then infer a value for the variable

Force, temperature

73
Q

Operational Definitions

A

Helps us define variables; should inform the reader of:

What, how, who, how often (frequency), how long (duration)

74
Q

Confounding Variables

A

We need to identify and control extraneous variables so they don’t become confounding variables; age, gender, socioeconomic status

75
Q

Randomized Control Trial in PEDro

A

compares at least 2 interventions that are related to PT; must involve human subjects; must be randomized and published in a peer review journal

76
Q

Systematic Review

A

a systematic analysis of available research (RCTs); rates each trial based on specific criteria; second highest level of evidence

77
Q

Clinical Practice Guideline

A

a guideline for the best course of treatment based on research; highest level of evidence

78
Q

Trends in Studies in PT

A

increased # of RCTs (last 30 years), systematic reviews (last 15 years), and clinical practice guidelines (last 10 years)

79
Q

International Classification of Function

A

a model of labeling health and disability

DPT: Critical Inquiry (1 decks)

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