EBD & Types of Studies (Final Exam)

Question 1

3 components of EBD:

Answer 1

• Best available scientific evidence
• Clinical skills & judgement
• Patient needs & preferences

Question 2

(T/F) EBD will tell practitioner’s what they should or should not do

Answer 2

False

Question 3

(T/F) EBD can facilitate, but does not guarantee, making better decisions in the provision of dental care

Answer 3

True

Question 4

“Application of the current, best evidence in making decisions about the care of individual patients.”

Answer 4

Evidence-based Practice

Question 5

EBD steps (5 steps)

Answer 5

1. Formulate clinically relevant question
2. Find best available evidence
3. Review evidence for its validity and applicability, strengths & weaknesses
4. Integrate best research evidence with your clinical expertise and patient’s needs, desires and values
5. Evaluate your efforts and seek ways to improve (self-evaluate)

Question 6

What are the two best levels of evidence?

Answer 6

• Systematic reviews

- RCT’s

Question 7

Quality of information hierarchy:

Answer 7

1. RCT
2. Cohorts, Case-control, non-randomized clinical trials
3. Cross-sectional studies
4. Case reports
5. Personal opinion

Question 8

In regards to diagnosis, prognosis or causation, which two types of studies are appropriate?

Answer 8

• Longitudinal studies

- Cohort studies

Question 9

“A comprehensive search for all relevant studies on a specific topic and those identified are then appraised and synthesized according to predetermined and explicit criteria.”

Answer 9

Systematic Literature Review

Question 10

“Study of distribution of diseases and determinants of disease frequency in populations.” (Study of “causes” of diseases)

Answer 10

Epidemiology

Question 11

What is the goal of Epidemiology?

Answer 11

Control health problems & improve health at population level. Operationally, it identifies factors that are “causes” and are potentially modifiable.

Question 12

“Usual occurrence of a disease in a given population.”

Answer 12

Endemic

Question 13

“Meaningful increase in occurrence of a disease in a given population.”

Answer 13

Epidemic

Question 14

“Spread of a disease across a large region or worldwide”

Answer 14

Pandemic

Question 15

“Exposure of interest”

Answer 15

Independent variable (E)

Question 16

“Outcome of interest”

Answer 16

Dependent variable (D)

Question 17

“A factor, which if present, increases probability of disease occurrence.”

Answer 17

Risk Factor

Question 18

4 Quantification scales in epidemiology?

Answer 18

1. Nominal (names)
2. Ordinal (follows order based on severity)
3. Interval (follows mathematical order but has NO true zero)
4. Ratio (follows mathematical order and has a defined zero)

Question 19

= # of cases/# person in population at specified time

Answer 19

Prevalence

Question 20

= # of new cases of disease/ population at risk over a time period

Answer 20

Incidence rate

Question 21

____ is NOT a rate, however, ____ is a rate and is not meaningful without a time unit.

Answer 21

Prevalence; Incidence

Question 22

____ rates are concerned with the number of new cases among persons at risk for a specific follow-up period

Answer 22

Incidence rates

Question 23

In what type of study do you observe the outcome without intervening?

Answer 23

Observational study

Question 24

In what type of study does the researcher manipulate the exposure (usually drug or tx) to compared it to the standard of care?

Answer 24

Experimental study

Question 25

What are the three different types of observational studies?

Answer 25

1. Cohort 2. Case-Control 3. Cross-Sectional

Question 26

In what type of observational study are subjects selected based on their exposure status?

Answer 26

Cohort studies

Question 27

What type of observational study is good for assessing rare exposures and rapidly fatal diseases?

Answer 27

Cohort studies

Question 28

In what type of observational study can you calculate incidence among exposed and unexposed?

Answer 28

Cohort studies

Question 29

What are some disadvantages of Cohort studies?

Answer 29

- Expensive - *Inefficient for rare disease - Long follow-up

Question 30

In what type of observational study are subjects selected based on their disease status?

Answer 30

Case-Control studies

Question 31

In a case-control study, the cases and controls should be different only in regards to their ______.

Answer 31

Past exposure

Question 32

In which type of observational study do participants have an equal chance of being exposed?

Answer 32

Case-Control studies

Question 33

What type of observational study is efficient for rare disease?

Answer 33

Case-Control studies

Question 34

What type of observational study is NOT optimal for rare exposures?

Answer 34

Case-Control studies

Question 35

What type of observational study is the most basic study design where selection of subjects is neither based upon exposure or disease status?

Answer 35

Cross-Sectional studies

Question 36

What are two types of Experimental Studies?

Answer 36

- RCT | - Community intervention trials

Question 37

What type of study are sub-types of cohort studies in which exposure (i.e Tx) is randomly assigned by the investigator?

Answer 37

RCT's

Question 38

In which type of RCT does the participant NOT know, but the investigator does know tx assignment?

Answer 38

Single-blinded RCT's

Question 39

In which type of RCT do neither the participants nor investigators know tx assignment?

Answer 39

Double-blinded RCT's

Question 40

What is the purpose of blind-studies?

Answer 40

Remove bias or systematic error

Question 41

What type of bias involves drawing different conclusions depending on their knowledge of which study arm a particular patient is in?

Answer 41

Information bias

Question 42

What type of bias involves study recruiters being eager to recruit "sick persons" into experimental arm?

Answer 42

Selection bias

Question 43

What are the 4 key elements in Randomized Clinical Trials?

Answer 43

1. Selection of study population 2. Allocation of tx/intervention 3. Study conduct and compliance 4. Follow-up and establishing outcomes

Question 44

"A systemic complete summary of the literature" is described as ____.

Answer 44

Systematic reviews

Question 45

"Combined analysis of data from different studies following strict guidelines."

Answer 45

Meta-analysis

Question 46

"The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients."

Answer 46

Evidence-based Medicine

Question 47

"Must be the first disclosure containing sufficient info. to enable peers to assess observations, repeat experiments and to evaluate intellectual processes."

Answer 47

Primary source

Question 48

"Includes most books, review articles and indexes to the literature and usually summarizes, reviews or organizes info."

Answer 48

Secondary source

Question 49

This process is, "a form of quality control and it provides high quality publications but is not infallible."

Answer 49

Peer-reviewed process

Question 50

"Measure of a particular journal's impact based on how often that journal's articles are cited."

Answer 50

Impact Factor (IF)

Question 51

Impact Factor (IF) = ______

Answer 51

Citations in year/Total # articles published in past 2 years

Question 52

"Degree to which results of a study are likely to approximate to the truth"

Answer 52

Internal validity

Question 53

What are the threats to Internal validity?

Answer 53

- Bias - Error - Confounding

Question 54

"Extent to which the effects observed are applicable to a broader population; inference can only correctly be made to the population from which the sample was drawn."

Answer 54

External validity (generalizability)