Exam 1 Flashcards
Internal evidence
expertise of the PROFESSIONAL
Patient evidence
values and expectations of the: patient/client/student
Research evidence
best available research
What are the 3 sources of evidence we use to inform our clinical decisions?
internal, patient, and research
What are blinders?
limited to just research evidence, may make you miss something
Decision (clincial) making
integrating best research evidence + clinical experience + patient values
Information gathering
systemic process of getting:
- information history
- observation
- palpation
- clinical tests
Differential Diagnosis
purposeful info gathering = develop multiple possibilities
Knowledge
purposeful linking info = develop meaning
Meaning
ability to explain & predict
Wisdom
- knowledge refinement
based on: - experience
- deliberate practice
- careful resolution
Ethos
establishing:
- credibility
- character of writer
- pertaining to authority
Logos
ability to build + argue thru sound reason
- presentation of evidence to support proposition
Pathos
dependent on perspective of reader
Beneficence
benefit-to-risk relationship
2 factors for Respect for Persons
1) informed consent
2) individuals are autonomous
Justice
person has rights to results or findings of research
Implied Consent
assuming the individual would give consent in the situation but physically cannot verbalize it
Diagnosis
“through knowledge”
- ability to explain and predict
Spot Diagnosis
recognize a pattern based on lots of experience
Validity
strength
Invalid
weakness
Peer review
other experts looking over paper before publish = to approve/disprove
Internal Validity
Cause and Effect
External Validity
Generalization = inference = general population
Retrospective Study
look into the past
- 1 point in time from past measured
Prospective Study
predicts future
- minimal = 2 time points to establish cause-effect
What are the 2 time points in a prospective study?
- baseline point
- follow-up point
Parameter
population
Statistic
sample
What are the 4 essential elements of a profession based on Cruess & Cruess?
- unique body of knowledge
- code of ethics
- public sanction and recognition
- professional authority
What are society’s 6 expectations of professionals?
- guaranteed competence
- altruistic service
- morality and integrity
- promotion of public good
- transparency
- accountability
What are professionals’ 6 expectations of society?
- autonomy
- trust
- monopoly
- status and rewards
- self-regulation
- functioning health-care system
What is scientia?
knowledge derived from systemic observations
What is phronesis?
practice wisdom honed from direct experience
Tacit knowledge
personal knowledge = can’t be easily shared w/ others
Codified knowledge
written down knowledge
Personal knowledge
internal knowledge
Cultural knowledge
shared knowledge
ie: common sense
What type of evidence is personal knowledge?
internal evidence
What type of evidence is codified knowledge?
external evidence; research evidence
Professional knowledge
info we link to allow us to explain + predict clinical phenomena associated w/ our social contract w/ public
What are the 5 types of research evidence?
- epidemiology
- diagnosis
- etiology
- prognosis
- therapy
Hypothesis
rule (what we think the rule is)
“place under”
Etiology
study of cause and risk
Prognosis
future knowledge
Therapy
serve others
Good clincial practice
amalgam of scientia and phronesis
What are the 3 ethical principles within the common rule that need to be addressed to ensure human participant protection?
- respect for persons
- beneficence
- justice
What are the 2 ethical convictions that the ethical principle Beneficence incorporates?
- do no harm
- maximize possible benefits
- minimize possible harms
- benefits = denominator
ex: no randomized control for parachutes
What are the 4 phases of the clinical scientific method?
- observation/description of problem
- make/refine hypothesis to explain problem
- make/refine hypothesis to predict outcomes for problem
- make interventions based on hypothesis to change course of problem
Of the 4 phases of the clinical scientific method, the first 3 are associated with what?
our ability to observe
What are the main 2 categories of clinical evidence derived from the clinical scientific method?
- observational (bigger)
- intervention (experimental)
Epidemiology
trend
Diagnosis
key features
What type of study is associated with internal validity?
prospective study
What is the difference between primary and secondary research?
primary = original research studied conducted, peer-reviewed
secondary = summarizes available studies in the form of literature reviews
What are the 3 main categories of primary research studies that you might read related to a clinical problem?
- bench = basic research
- applied = clinical research
- epidemiological = population research
What are 5 characteristics of Bench Research?
- foundational
- prospective study
- animal, cell, genetic studies
-generalizability sacrificed for control - allows to establish rule (hypothesis)
What are 3 characteristics of Applied Research?
clinical = patients
applied = healthy people
- balance btwn control and generalizability
- studies trends at individual patient levels
- use case studies to randomize control trials
What are 3 characteristics of Epidemiological Research?
- control > generalizability
- studies trends at population (from specific groups to populations)
- looks at patterns (time, person, place) AND frequency (rare or common)
What are the 7 components of a primary research manuscript?
1) title
2) Abstract
3) Introduction
4) Methods
5) Results
6) Discussion
7) References/Bibliography
What is the “Title” component of primary research manuscripts?
captures readers’ attention
Topic and info about authors
What is the “Abstract” component of primary research manuscripts?
brief synopsis of study
What is the “Introduction” component of primary research manuscripts?
builds the case
What is the “Methods” component of primary research manuscripts?
details of how the study was conducted
- allows readers to demonstrate and replicate
- includes: procedures, instruments, variables measured
What is the “Results” component of primary research manuscripts?
facts of the data; mean, median, and mode
What is the “Discussion” component of primary research manuscripts?
interpretation of results
implications of study
can have conclusion at end
What word precedes “purpose” statement?
therefore
In the “Methods” section, what are the main components that we need to consider for helping us understand the study design?
- study population
- type of study
- unit of observation
- measuring technique
- calculation of sample size
Which 4 factors are critical for informing us about external validity?
- study population = inclusion/exclusion criteria
- unit of observation = what level is being studied (cell, organ, self, society)
- type of study
- calculation of sample size
Which 2 factors are critical for informing us about internal validity?
- question to be answered
- measure technique (should be a prospective study)
Endemic
already existing in a population
Epidemic
thrust upon a population
Pandemic
affects everyone, all populations
What are the 3 measures of central tendency?
mean, median, mode
Mean
average
Median
middle
Mode
most
Which measure of central tendency is considered unbiased? Why?
Mean because everyone contributes to it
Standard deviation
measures dispersion around the mean
how much individual variation happened around the mean
SD = 0 = precise
How do you know if the mean is a precise estimator?
use standard deviation
smaller it is = more precise = more reliable
Prevelance
how many people have condition at this time
retrospective
Incidence
of new cases over period of time
Descriptive statistics
study of population
- patterns formed by person, place, time
- patterns –> diagnosis
In hypothesis testing, which type of hypothesis is evaluated?
Null hypothesis
Null hypothesis
hypothesis statistical procedure is designed to test
- determines if results are random/by chance
- fail to reject = difference observed compare to chance
Type 1 error
false positive
Type 2 error
false negative
a priori
beforehand of study
What are the 2 main types of data that can be captured through research
qualitative
quantitative
Qualitative data
categorical
Quantitative data
metric
What are the 2 main categories of Qualitative data?
- nominal = name
- ordinal = order (scales, range, etc)
What are the 2 main categories of Quantitative data?
- continuous = like a decimal point allows a result to be continuous
- mean
- discrete = whole definitive number
Why is it important to have an estimate of dispersion/variability around a point of measure?
determines how well you can generalize results from a sample to population
Frequency
rate/prevalence
how common the condition is
Cross sectional study
seeing what trends occur within 1 group of a population
How is sample size determined in qualitative research?
when data saturation is achieved = no longer seeing/hearing any new info
