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Aural Rehabilitation > Evidence Based Practice (chapter 5) > Flashcards

Evidence Based Practice (chapter 5) Flashcards

1
Q

Step 1 of EBP

A

Formulating the Clinical or Research Q

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2
Q

Step 2 of EBP

A

Searching for the evidence

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3
Q

Step 3 of EBP

A

Evaluating the evidence

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4
Q

Part A of Step 3

A

Determine the level of evidence

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5
Q

Part B of Step 3

A

Rate the risk of bias of the evidence

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6
Q

Part C of Step 3

A

Grade the cliical recommendation under consideration

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7
Q

Step 4 of EBP

A

Integrating Scientific Evidence,
Clinical Expertise, and
Patient Preferences into Clinical Decision-Making

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8
Q

Step 5

A

Evaluating the Process

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9
Q

PICO stands for

A

Population
Intervention
Comparison (intervention)
Outcome

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10
Q

PICO

A

a helpful procedure in framing research questions

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11
Q

Most rigorous class level of evidence

A

Class I

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12
Q

Least rigorous class level of evidence

A

Class VI

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13
Q

Two types of variables in an experiment

A

independent & dependent

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14
Q

Independent variables

A

manipulated by the experimenter who is trying to test a hypothesis

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15
Q

Dependent variable

A

The one that is measured

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16
Q

Treatment/intervention

A

Refer to applications or procedures that health professionals administer to lessen the effects of, or cure, a disease or a disorder.

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17
Q

Placebo

A

inactive medications or procedures that are administered the same exact way as the experimental treatment and serve as a comparison

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18
Q

Class I

A

Well-designed systematic reviews with meta-analysis of more than one double-blinded, randomized, controlled clinical trial

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19
Q

Class I research methods

A

May involve either primary measurement methods or secondary measurement methods

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20
Q

Primary measurement methods

A

involve investigators collecting and analyzing their own data for a single experiment

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21
Q

Secondary measurement methods

A

Involve investigators experimenters or clinicians considering or analyzing data collected in one or more studies conducted by other investigators

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22
Q

Example of secondary measurement methods

A

Conducting a systematic review of the evidence assessing the effectiveness of a particular diagnostic procedure or treatment of hearing impairment

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23
Q

Systematic reviews

A

Can be a qualitative review of the evidence or quantitative review

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24
Q

quantitative review

A

Involves a meta-analysis, or the use of special statistical procedures that combine the results of more than one investigation in order to measure the magnitude of a treatment effect.

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25
Q

systematic review with meta-analysis

A

Permits the the combining of the results of several studies together to increase the magnitude of the effect of the study

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26
Q

Effect size

A

a special metric that determines the degree of impact of significant findings

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27
Q

Why are systematic reviews with meta-analysis important?

A

They are needed to validate research because causality between treatment and positive patient outcomes cannot be established on the basis of a single investigation.

28
Q

5 reasons for systematic reviews with meta-analysis

A

1) Get to the “bottom line” of all studies involving a particular treatment or intervention
2) To estimate precisely the amount of benefit derived from a treatment or intervention
3) To increase the number of patients in clinically relevant subgroups
4) Helps solve discrepancies among the findings of studies; can help sort conflicting results
5) can help plan future studies

29
Q

Class II

A

Double-Blinded, Prospective Randomized, Controlled Clinical Trials

30
Q

DBPRCT

A

Acronym for Double-Blinded, Prospective Randomized, Controlled Clinical Trials

31
Q

Double-blinding

A

means that neither the experimenter nor the participant has knowledge of administration of the treatment/intervention or placebo

32
Q

Prospective randomized

A

describes studies in which patients are

1) enrolled as participants prior to conduction of the experiment
2) randomly assigned to groups receiving either the treatment or a placebo
3) Measured after some period of time
4) Compared for any statistically significant differences attributable to the treatment or intervention

33
Q

Advantage of DBPRCTs

A

Neither the experimenter nor the participant knows whether the treatment or placebo is being administered, eliminating both experimenter and participant bias

34
Q

Experimenter bias

A

anything that the experimenter does that has measurable influence on the dependent variable that is not attributable to the independent variable

35
Q

Participant bias

A

anything a participant does that has a measurable influence on the dependent variable that is not attributable to the independent variable

36
Q

Outcome measures

A

data collected to determine the benefit of treatment

37
Q

Another advantage of DBPRCTs

A

participants are randomly assigned to either a control or treatment group

38
Q

Random assignment

A

implies that each participant has a 50-50 chance of being assigned to receive the experimental or placebo treatment

39
Q

benefit of random assignment

A

reduces sampling bias

40
Q

Sampling bias

A

Measurable influence that assignment of participants to treatment or control groups has that is directly not attributable to the independent variable. (Assignment of participants must be based on chance alone)

41
Q

DBPRCTs

A

gold standard for scientific evidence

42
Q

disadvantage of DBPRCTs

A

difficult to design, execute, & complete

43
Q

another disadvantage of DBPRCTs

A

describes outcomes for treatment variables in highly-controlled situations, no those found in the “real world”

44
Q

another disadvantage of DBPRCTs

A

ethical dilemma due to random assignment of participants to treatment and control groups

45
Q

another disadvantage of DBPRCTs

A

Requires a great deal of time in validating treatment regimens, delaying their availability to the public

46
Q

fifth disadvantage of DBPRCTs

A

optimal experimental circumstances necessary for clinical trials research may have limited external validity in the real-world clinical practice involving all types of patients across a wide variety of afflictions, behaviors, and service delivery sites

47
Q

Class III

A

Non randomized Intervention Studies

48
Q

Non Randomized Intervention Studies

A

also called quasi-experimental studies

49
Q

Nonrandomized intervention studies

A

use designs that lack characteristics of DBPRCTs (Lacks random assignment of participants into experimental and control groups)

50
Q

Nonrandomized intervention studies/quasi-experimental studies

A

most common in Communication Sciences and Disorders because they are more conducive to the realities of a busy speech & hearing clinic

51
Q

Nonrandomized intervention studies/quasi-experimental studies

A

Involves grouping of participants by convenience

52
Q

Potential weakness of Quasi Experimental studies

A

The experimenter cannot be sure that the groups are equivalent at baseline or at the beginning of the study; the groups should be matched for critical variables such as age, gender, and so on to strengthen the study

53
Q

Class IV

A

Nonintervention studies:
Cohort studies,
Case-controlled studies,
Cross-Sectional Surveys

54
Q

Non intervention studies

A

Can be prospective or Retrospective

55
Q

Prospective studies

A

Recruit participants prior to the collection of data

56
Q

Retrospective studies

A

Data are collected after some sort of event or occurrence

57
Q

case-controlled studies

A

participants are recruited after they have developed some type of pathology along with a disease-free control group; are measured on some type of predictor variable; and then statistically compared for significant difference on (a) predictor variable(s) suggesting possible cause(s) or associative variable(s) for developing NIHL.

58
Q

Case-controlled studies

A

are retrospective studies

59
Q

Cohort studies

A

can be prospective or retrospective

60
Q

prospective cohort studies

A

Those in which participants are recruited in the present, before an outbreak of a disease or disorder to assess who does and does not develop a particular condition in teh future

61
Q

2 purposes of prospective cohort studies

A

1) to determine the incidence of certain outcomes over time (i.e. descriptive)
2) to analyze associations b/w and/or among risk factors and those outcomes

62
Q

Incidence

A

the number of new cases of a disease or disorder that develop over a specified period of time per the number of individuals at risk

63
Q

Associations

A

Connections made b/w risk factors and certain diseases

64
Q

Retrospective cohort study

A

identifies a sample of individuals who already have a disorder and then measures predictor variables

65
Q

Prevalence studies

A

Cross-sectional studies

66
Q

Prevalence studies/cross sectional studies

A

Determine the number of individuals that have a particular disorder or disease at one point in time per the number of people at risk

67
Q

Prevalence

A

Number of persons per some number of the population that have some sort of condition

Aural Rehabilitation (7 decks)

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