Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psyc4121 > Evidence-based Practice > Flashcards

Evidence-based Practice Flashcards

1
Q

What is the aim of critical appraisal?

A

To understand strengths, weaknesses and potential for bias in research before you apply it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List 4 considerations used to determine if evidence is valid

A
  1. Is it clinically significant?
  2. Is it clinically important?
  3. Is the evidence applicable
  4. Is the evidence relevant?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 4 tools in the Critical Appraisal Skills Program (CASP)?

A
  1. Systematic Reviews
  2. RCTs
  3. Case Control Studies
  4. Cohort Studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List 2 screening questions you should ask when appraising systematic reviews

A
  1. Did the review address a clearly focused question?
  2. Did the author look for the right type of papers?

Should answer YES to both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List 8 detailed questions you should ask when appraising the evidence from systematic reviews

A
  1. Were all important, relevant studies included?
  2. Did the author do enough to assess quality of included studies?
  3. If results were combined, was it reasonable to do so?
  4. What were overall results of the review?
  5. How precise were results?
  6. Do results apply to population?
  7. Were all important outcomes considered?
  8. Are the benefits worth the harm and cost?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the appraisal method RAMMbo stand for?

A

R - Recruitment

A - Allocation

M - Maintenance

M - Measurement

b - blind testing
o - objective and standardised measures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give 1 question you should ask when appraising a models Recruitment (RAMMbo)?

A
  1. Are Ps representative of population?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give 2 question you should ask when appraising a models Allocation (RAMMbo)?

A
  1. Was the assignment to treatments randomised?

2. Were the groups similar at the start of the trial?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give 2 question you should ask when appraising a models Maintenance (RAMMbo)?

A
  1. Were the individuals in the groups treated equally?

2. Were the outcomes ascertained and analysed for most Ps?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give 2 question you should ask when appraising a models Measurements (RAMMbo)?

A
  1. Were the Ps and clinicians blinded?

2. Were measurements objective and standardised?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the CONSORT Statement?

A

An evidence based, minimum set of recommendations for reporting RCTs.

A 25 item checklist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does CONSORT stand for?

A 
CONsolidated
Standards
Of
Reporting 
Trials
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is statistical significance the same as clinical significance?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is clinical significance?

A

The practical importance of a treatment effect

Whether it has a real genuine, palpable, noticeable effect on daily life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is a treatment effect clinically relevant?

A

A small therapeutic benefit may be important for a highly fatal disease, but may not be enough to justify a new intervention in a disease with a good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does clinical importance require?

A

A substantial change in an outcome that matters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What calculations can you use to ascertain clinical significance?

A
  1. Event rare
  2. Absolute and relative rate
  3. Number needed to treat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the Absolute Risk of a disease?

A

Your own risk of developing the disease over a period of time

Expressed as 1 in 10, 10%, or 0.1 risk

19
Q

What is Relative Risk?

A

Used to compare the risk in two different groups of people

Eg. Smokers have a higher risk of lung cancer relative to non smokers

20
Q

What is the Event Rate?

A

The proportion of people in control/treatment conditions of an experiment who experience a particular event (response to drug)

21
Q

Name the 2 types of Event rates

A
  1. CER- Control event rate

2. EER - Experimental Event rate

22
Q

What is Number Needed to treat?

A

The number you need to treat to prevent a bad outcome

23
Q

What is the Absolute Risk Reduction (ARR)?

A

The AAR is the difference between the event rates in the 2 groups or the size difference between 2 treatments

24
Q

What does the AAR tell you?

A

The AAR tells you the size of the treatment effect

25
Q

How do you calculate AAR or Absolute Risk Reduction?

A

CER - EER

(Control event rate minus experimental event rate)

Difference between event rates in the 2 groups

26
Q

If 20% of patients die with no treatment (A) and 15% die with treatment (B), what is the Absolute Risk Reduction?

A

5%

CER-EER
0.20-0.15 =0.05 or 5%

This means that for every 100 patients enrolled in the treatment group about 5 deaths would be prevented

27
Q

What is another way of expressing the Absolute Risk Reduction?

A

The Number Needed to treat NNT

The number of patients that need to be treated in order to have an impact on 1 person to prevent additional bad outcomes

28
Q

How do you calculate the Number Needed to Treat NNT?

A

NNT= 1/ARR

Number Needed to Treat = 1 divided by the Absolute Risk Rate

29
Q

What is the Number Needed to Treat in a clinical trial of a drug preventing migraines if 2 out of 100 people taking the drug experience migraines (2%) compared to 4 out of 100 taking a placebo?

A

ARR = CER- EER =0.02

NNT = 1/ARR = 1/0.02 = 50

The number you need to treat for 1 person to benefit is 50

30
Q

What is Relative Risk Reduction RRR?

A

RRR is the difference in event rates between 2 groups expressed as a proportion of the event rate in the untreated group

The relative or proportional difference

31
Q

What is the Relative Risk Reduction if 20% of patients die with no treatment A and 15% die with treatment B. ?

A

There is a 5% Absolute Risk Reduction with treatment B. The Relative Risk Reduction is 25%

RRR = (CER - EER)/CER
= (0.2 - 0.15)/0.2 = 25

This means that the disease was reduced by 25% in the treatment group compared with the Control group

32
Q

What are the similarities between Absolute Risk Reduction ARR and Relative Risk Reduction RRR?

A

Both calculations explain the same difference BUT in different ways

33
Q

What are the differences between Absolute Risk Reduction ARR and Relative Risk Reduction RRR?

A

ARR explains the simple difference between rates

RRR describes the Relative or proportional difference

34
Q

What is the Odds Ratio (OR)?

A

Odds Ratio is a measure of association between an exposure and an outcome.

The OR represents the odds that an outcome will occur given a particular exposure compared to the odds of the outcome occurring in the absence of that exposure

35
Q

What is the Odds Ratio OR if 100 patients with lung cancer and 100 patients without lung cancer were recruited into a study and questioned about their tobacco use over the past 20 years. 90 with lung cancer and 10 without reported smoking?

A

OR= exposed to smoking & have cancer / exposed to smoking and don’t have cancer

Calculate cross product

OR = 90x90/10x10=81

If you have lung cancer you’re 81 times more likely to have smoked than if you don’t have cancer

36
Q

What is the standard effect size?

A

Provides an indication of the size of treatment effects

is the magnitude sufficient to be of practical relevance?

37
Q

What calculation is used to find effect size?

A

Cohen’s d

Cohen’s d = (M1-M2)/SDpooled

Take the mean difference between 2 treatments and divide by the pooled variance

38
Q

How do you interpret standard effect size?

A
  1. 2 = small
  2. 5 = moderate
  3. 8 = large
39
Q

List 3 ways to assess whether results apply to your clients

A
  1. Assessment of their individual baseline risk
  2. Judgment about whether the evidence can be extrapolated to your client
  3. Understanding of factors that may increase the benefits or harm their experience
40
Q

List 4 considerations when applying evidence results

A
  1. Do the results apply to my client?
  2. What are my clients values and preferences?
  3. Can the practice be implemented in this setting?
  4. How can I help my client make a decision?
41
Q

What are the benefits of qualitative research?

A

Provides guidance in deciding whether findings apply to clients

Determines how people feel about things and what their experiences were

42
Q

What is the efficacy of a treatment determined by?

A

Clinical trials which many variables are carefully controlled to demonstrate that the relationship between the treatment and outcome are relatively ambiguous

43
Q

What do efficacy studies emphasise?

A

Internal validity of the experiment

  • controlling types of Ps
  • using manuals for standardisation
  • training and monitoring therapists
  • controlling number of treatment sessions
  • random assignment and blind testing
44
Q

What do effectiveness studies seek to examine?

A

The outcomes of interventions under circumstances that are similar to the real world (external validity)

Psyc4121 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions