EBM lectures (both) Flashcards
project purpose includes
- method
- population
- setting, timeframe
SMART goal
- specific
- measurable
- attainable
- relevant
- time based
primary variable of interest that are essence of project
outcome variables
DV
exposures of interest, predictors of outcome, variables that define subgroups
predictor variables
IV
directly measure how a patient feels, functions or survives
clinically meaningful endpoints
laboratory measure or physical sign intended to be used a substitute for a clinically meaningful endpoint
surrogate endopoint
provides strong evidence of temporality
cohort study
forward directionality
participants are enrolled and followed forward in time to see if they develop the outcome of interest
cohort study
backwards directional study where participants are defined based on disease status
case control study
non directional study
exposure and outcome captured at the same time
cross sectional study
use groups of people, geographically based
ecologic study
most common study design to determine medical test performance
cross sectional
compilation of data from multiple studies to answer a study question that has been repeatedly addressed in literature
meta analysis
- allows for one individual to serve as their own control
- each individual receives both the intervention and control in sequential order
case crossover study
allows for unbiased assignment of study participants from one group to another
randomization
uses secondary data originally collected for a different purpose
nested case control
compare populations
ecologic study
assesses exposure and outcome at one point in time and does not involve assigning control groups
cross sectional
participants selected on the basis of a case, then matched to control group
case control
after the primary outcome is defined, what is the next step?
participant selection and study setting
conducts comprehensive study of literature to address a specific clinical question
systematic review
when conducting a systematic review it is critical to
organize and properly cite the information
critical to QI success
engaging stakeholders
3 aspects of a stakeholder analysis
identify
prioritize
understand
how to satisfy and manage high power stakeholders
- full communication and consultation
- should be recruited to team
- regularly review with them
how to monitor and inform low power stakeholders
valuable allies but…
can be ignored if resources are tight
what phase
identify the problem, set goal, and develop specific time table
plan
what phase
successful intervention is ready to be implemented system wide
act
what stage
de-novo intervention ready to be implemented
do
what types of interventions are most widely accepted and most effective?
high impact, easy to do
most effective interventions to change practice
forcing functions and placing constraints
least effective interventions to change practice
rules, policies, education, and checklists
can be ignored
a work flow diagram can help identify
where delays or problem points exist
a fishbone diagram can help identify
key aspects and areas missed previously
identifies the origins of the problem
fishbone diagram
root cause analysis allows for
problem identification
a common fishbone diagram contains
places
procedures
people
policies
model for improvement
aim
measures
changes
examines process and outcome measures
model for improvement
waiting times and time until appointment are […] measures
process
patient satisfaction is an […] measure
outcome
when an intial change takes place in the PDSA framework
Do
when the change is being measured in the PDSA cycle
study
pareto principle
20% of time or resources account for 80% of results/outcomes
setting time bound goals that are specific and relevant to the problem
SMART goal
population is outcome free at baseline, then followed forward in time to observe outcomes
cohort study
researchers control the exposure assignmnment while ensuring that comparison groups are balanced on all other factors
randomized controlled trial
uses data collected in the past and participants are “followed” forward in time
retrospective cohort study
study design classically used to trace foodbourne outbreaks
case control
allows for rapid identification of possible exposures
case control
cases identified through medical offices
case control
researchers start with a group of people at some set point and follow them into the future
prospective cohort study
one time administration of a survey
cross sectional study
both the exposure and outcome of interest are assessed simultaneously
cross sectional
