EBP Flashcards
Uses for evidence in clinical practice
- Selecting est techs to accurately identify and treat pt’s problems
- Enhance efficacy and effectiveness of interventions
Process of EBP (6 steps)
1) Generate a clinical question
2) Search for relevant evidence
3) Critique the results of the literature and how they may impact your clinical problem
4) Determine the applicability to your patient
5) Consider the evidence in reference to the patient’s values and preferences
6) Collaborate with the patient to identify and implement the next steps in their POC
Characteristics to consider when searching the evidence
- Does the study address my clinical question?
- Study subjects similar to my patient?
- Peer-reviewed?
- Technique/timing of the article congruent with current practice?
Three-Legged Stool of EBP
- Foundation of EPB
1) Best available evidence
2) Clinician’s experience
3) Patient perspective
Types of Research(8)
- Quantitative vs qualitative
- Basic vs applied
- Translational
- Experimental vs Non-experimental
- Quasi experimental
Quantitative Research (2)
- Measurement of outcomes using NUMERICAL DATA under controlled/standardized conditions
- Hypothesis driven
Advantage of Quantitative Research
Ability to perform STATISTICAL ANALYSIS on subject data
Qualitative Research(3)
- Generally conducted under less strict conditions
- Uses open-ended questions, interviews, observations
- May describe the state of conditions, explore associations between variables, or formulate a theory or hypothesis
Basic Research (4)
- Also called bench research
- Typically performed in a lab and to obtain data that can be used to develop/test a theory
- Not concerned with practical use of knowledge
- Not typically performed in PT
- Ex: “Hormones released in stressed out tiger fish”
Applied Research (3)
- Encompasses most clinical research
- Attempts to solve practical problems/tests theories which impact clinical practice
- Generally tested under actual clinical/practice conditions
Translational Research (2)
- Application of basic scientific findings to clinical practice and/or formation of scientific questions from clinical situations
- Mixture of bench and applied research
Experimental Research(3)
- Compares conditions/intervention groups
- Aims to find CAUSE-AND-EFFECT relationships!
- Has both randomization and a control group
Non-experimental (4)
- Aka observational research
- More DESCRIPTIVE/exploratory in nature
- No direct control over variables
- Lacks BOTH randomization and a control group
Quasi Experimental (2)
- Somewhere between experimental and non-experimental
- Either lacks randomization OR a control group
Levels of Evidence for PT Articles (10)
Level 1a: Systematic Review
Level 1b: Individual RCT with narrow CI
Level 1c: “all or none study”
Level 2a: Systematic Review of Cohort studies
Level 2b: Individual cohort study
Level 2c: “outcome resarch”
Level 3a: Systematic review of case-control study
Level 3b: Individual case-control study
Level 4: Case-series, cohort, or case-control study that it did define comparison groups adquately or did not measure outcomes objectively or have a sufficient follow-up
Level 5: expert opinion
“All or none”
Study in which some or all pts died before tx became available and now none die
Cohort study
- Two groups of subjects are followed for a period of time
- Could be classified as either quasi experimental or non-experimental
Outcomes Research
Non-experimental research that evaluates outcomes of care in real life clinical situations
Case-control
Retrospective, epidemiological research design used to evaluate the relationship between a potential risk factor and a disease
Sections of a Research Report (7)
- Abstract
- Intro
- Methods
- Results
- Discussion
- Conclusion
- References
Abstract (4)
- Prepared AFTER manuscript is completed
- Concise-
Intro(4)
- Begins with lit review which reflects the relevant background info that supports the theoretical rationale for the study
- Should end with a statement of the specific study purpose, variables that are going to be studied, and research hypothesis/questions
- innovation and significance
- Clear, concise, compelling
What goes in Methods (5)
- Description of subjects
- Statement regarding informed consent and IRB
- Description of equipment and data collection procedures
- Operational definitions for all variables
- Data analysis section
Results
-Report of results, including outcome of statistical tests
Two Primary Principles for Results section
1) Tables/figures should not duplicate the narrative
2) No discussion of results; just reporting the results!
Discussion
- Researcher’s interpretation of the results as they relate to the study purpose
- Author can express opinions here
To be included in the Discussion Section: (4)
1) Importance of the results
2) Limitations of the results
3) Suggestions for future research
4) Clinical Implications
Conclusion
Brief statement of the purpose and primary study findings
