Evidence Flashcards
EBP
best research evidence + clinical expertise + patient values
steps
- identify problem/question
- Patient Intervention Comparison Outcome
- search for clinically relevant articles
- critically appraise - validity, impact, applicability
- integrate into clinical experience
- assess outcomes
levels of evidence for articles
- cochrane systematic reviews
- other SRs and meta-analysis
- evidence guidelines
- evidence summaries
- RCT, case cohorts, control studies
- clinical research critiques
- other reviews of literature
- case reports, case series, practice guidelines
- clinical reference texts
systemic review
comprehensive review of medical lit that uses explicit methods to systematically search, identify, appraise, and summarize all literature on a specific topic (usually restricted to RCT)
meta-analysis
systematic review that uses statistical technique to derive an estimate of effect size by pooling results of several randomized controlled trials to determine the overall effectiveness of a treatment
clinical guidelines
systematically developed statements to assist practitioner decisions about appropriate health care for specific clinical circumstances
- used to reduce inappropriate variations in practice and to promote the delivery of high quality, evidence-based health care
RCT
experimental research used to assess the relative effect of a specific intervention compared to a control
- random assignment reduces the risk of bias
cohort study
longitudinal, observational study
- individuals with a risk factor or exposure are followed over time to compare the occurrence of a disease in the exposed group to that of the group of unexposed individuals
- prospective or retrospective
cross-sectional study
observational study
- data or observations are made at only one point in time
- all subjects are tested/surveyed at relatively the same time
- can describe the prevalence and associations
- they cannot distinguish between newly occurring and long-established conditions
- they cannot identify causal relationships about what may have precipitated the condition
case reports or case series
in-depth description of an individual’s condition or response to treatment. neither can establish cause-effect
- case series: collection of observations of similar cases
- case reports: help to generate theories and hypotheses for future research. involves a report on the intervention and outcome for a single patient/client
cochrane reviews
- Conclusive: particular intervention is identified as superior to another or if interventions are equivalent
- Inconclusive: no decision can be made (94.3% of PT studies need more research)
descriptive research
recording, analyzing, and interpreting conditions that exist for the purpose of classification and understanding a clinical phenomenon
experimental research
comparing two or more conditions to determine cause and effect relationships
exploratory research
examines dimensions of a phenomenon of interest and its relationships to other factors
qualitative data
(categorical data)
represent different categories distinguished by a non-numeric characteristic
quantitative data
numbers that represent counts or measurements
nominal scales
Classification scale: values are exclusive, object/person can be assigned only to one category
- blood type, breath sound type, type of arthritis
ordinal scale
ranking scale: ranked on basis of property of variable, but intervals may not be equal
- manual muscle test grades, levels of assistance, pain, joint laxity grades
interval scale
intervals between adjacent values are equal but no true zero
- temperature, some functional status tests
ratio scale
intervals between values are equal and there is a true zero
- goni, distance walked, nerve conduction
measurement reliability
reproducibility or repeatability of measurements
- alternate forms of reliability
- internal consistency: do what it says it does
- intra-rater reliability: single rater
- inter-rater reliability: same test, multiple raters
- test-retest reliability: same test multiple times
measurement validity
degree to which a useful or meaningful interpretation can be inferred from a measurement
- face validity (appears to test what is intended)
- content validity (reflects meaningful elements)
- construct validity (is a theoretical idea being tested, logical?)
- criterion-related validity (compared to gold standard)
- concurrent validity (same time, EKG and pulse)
- predictive validity (predicts future behavior, GPA)
- prescriptive validity (suggests type of treatment, LBP classification)
population
complete collection of elements to be studied
sample
subset of elements drawn from a population to draw conclusions or make estimates about the larger population
sampling error
chance difference between the statistic calculated from a sample and the true value of the parameter in the population
probability sampling
uses some form of random selection
- simple random - systematic - stratified random - cluster
non-probability sampling
does not involve random selection
- convenience sampling - purposive sampling
descriptive statistics
summarize or describe characteristics of a population
- measures of center
- measures of variation
measures of center
describe center of data
- mean: average. add everything and divide by number
- median: central tendency. arrange from smallest to largest and it’s the middle number
- mode: number that occurs most often
measures of variation
describe how data vary
- percentiles
- quartiles
- range
- standard deviation
MCID
minimal clinical important difference
MDC
minimal detectable change
