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a4 scientific injuriery PT > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

what is Systematic

A

methodical process of examining relationships or theories

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2
Q

what is empirical

A

results are observable, documented and examined for validity

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3
Q

what are 3 scientific paradigm of clinical research

A

Outcomes research
Models of health and disability
Evidence-based practice

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4
Q

what are some healthcare quality assessed

outcomes

A

structure
process
outcomes

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5
Q

what is structure of healthcare quality

outcomes

A

– what are the organizational standards

the organization of the institution. Who reports to whom?
Example: University, Colleges, Departments, etc.

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6
Q

what is the process of healthcare quality

outcomes

A

– quality assurance programs

how do we go about accomplishing our tasks? Reports generated, charges, etc.

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7
Q

what are the outcomes of healthcare quality

outcomes

A

– patient related outcomes

patient specific. Morbidity, mortality, length of stay, readmissions, etc.

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8
Q

why is a large data based used

A

to have detail insurance coverage, utilization of services, functional outcomes, demographic information, etc

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9
Q

what happens to patients after a study

A

they are followed over time after discharge

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10
Q

what are some different view of health care

A 
biomedical model
disablement model ( Nagi)
ICF from WHO
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11
Q

what is biomedical model

A

this is a linear relationship with pathology and impairment. Health is the absence of disease and that injury or disease can be treated and cured.

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12
Q

what is the biomedical model lacking

A

Model generally lacking because successful outcome isn’t always “curing” something.

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13
Q

what is the nagi model

A

pathology- impairment- fx limitation- disability

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14
Q

what is pathology of that of the nagi model

A

disturbed function. Could be weakness, inflammation, etc. Rotator cuff tear.

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15
Q

what is impairment of that of the nagi model

A

abnormality. Can’t elevate arm.

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16
Q

what is fx limitation of that of the nagi model

A

can’t perform activity normally. Can’t reach overhead.

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17
Q

what is disability of that of the nagi model

A

can’t perform activity in socially defined roles. Can’t works as an electrician.

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18
Q

what is the ICF model

A

This is from the WHO !!

Less emphasis on disability, more on how people live with a health condition. this focus is on LIFE

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19
Q

what can the ICF be related to

A

the nagi it has many of the same definitions like that of…
health condition- nagi patho
body fx= nagi impairment
participation= nagi disability

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20
Q

what set the ICF aside from the nagi

A

capacity

performance

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21
Q

what are capacity and performance of the ICF in reference to

A

the environment
- person has the capacity to work but does not have the right environment they cant do anything. but once the environment is fixed so they can work at capacity their performance will go up

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22
Q

what is ICF capacity

A

standardized optimum environment which may be real or assumed

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23
Q

what is ICF performance

A

current or actual environment in whcih the individual participates

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24
Q

what is evidnece based practice

A

Find the best evidence & critically appraise it
Change your behavior
Remember to incorporate patient’s beliefs & values!
Assess results

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25
Q

what should EBP be asking

A

relevant clinical questions

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26
Q

what are the components of a good clinical question

A

PICO

P= patients 
I= intervention
C= comparison
O= outcomes
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27
Q

what other things must be consider when making a clinical decision

A

clinical expertise
best research evidence
patients values
clinical circumstances and settings

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28
Q

how do pt know what to do

A 
tradition
authority 
trial error
logical reasoning
scientific method
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29
Q

why do you use tradition in PT

A

it is useful in that it offers a common foundation for communication BUT should not be taken for its knowledge because some traditional things might not be validity or they haven’t been tested again

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30
Q

why do you use authority in PT

A

these would be specialist and experts

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31
Q

what is trial and error

A

haphazard, time consuming, potentially harmful, INQUIRY STOPS WHEN “SATISFACTORY” SOLUTION FOUND, NOT NECESSAIRLY THE “BEST”. Usually, unsuccessful attempts are NOT reported

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32
Q

what is logical reasoning

A

experience & critical thought.
deductive
inductive

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33
Q

what is deductive

A

general to specific

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34
Q

what is inductive

A

specific to general.

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35
Q

what is the best order of research

A 
scientifc method 
logical 
trial and error
authority
tradition
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36
Q

what is the element in control

A

is what sets scientific method apart—attempts to control factors that are not directly related to the variables in question
– scientific method

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37
Q

what is assumption

A

orderly, regular, consistent and predictable.

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38
Q

what is research

A

Asking questions
Finding answers
Generating more questions

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39
Q

research is

A

Structured
Systematic
Empirical- can be observed
Critical- of self and other

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40
Q

what is Quantitative

A

quantify variables (numbers).

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41
Q

what is Qualitative

A

describe (nouns, verbs, etc.).

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42
Q

what is Basic

A

bench science. Rigid control.

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43
Q

what is applied

A

taking lab research & applying it in the world. Less control, more generalizable. Clinical; applied with patients

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44
Q

what is Translational

A

taking experimental findings (such as with human genome project) and translating these discoveries into practical applications.

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45
Q

what is Experimental

A

variable or variables manipulated

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46
Q

what is Non-experimental

A

natural state”.

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47
Q

what is internal validity

A

issue of control

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48
Q

what is external validity

A

generalizability

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49
Q

what is step 1 of research

A 
dentify problem (1)
Review literature (2)
Identify variables (3)
State hypotheses (4)
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50
Q

what is step 2 of research

A

Design methods (and identify sample) (5)

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51
Q

what is step 3 of research

A

Collect & reduce data (6)

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52
Q

what is step 4 of research

A 
analyze data (7)
interpret findings (8)
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53
Q

what is step 5 of research

A

report findings (9)

54
Q

what need to be minimized in research

A

bias as it can have a control over your findings

55
Q

what are the 3 principles of research

A

1 automony
2 beneficence
3 justice

56
Q

what is automony

A

choice to participate

57
Q

what is beneficence

A

risk/ benefits needs to be small as possible

58
Q

what is justice

A

subject shoudl come from population most likely to benefit all shoudl have equal probability of assignment to groups

59
Q

what are control groups

A

not always not treatment

60
Q

read

A

about the nurember code

61
Q

what is a exempt ( the review all proposed research )

A

doesn’t need to be reviewed ( no subjects)

62
Q

what is a expedited ( the review all proposed research )

A

when their is minimal risk and all are adults

63
Q

what is a Full ( the review all proposed research )

A

with vunerale population

( kids, pregs, prisoner, ) AND all IRB needs to be present

64
Q

what is measurements

A

The process of assigning numerals to objects to represent quantities of characteristics according to certain rules

65
Q

what are numerals

A

have no mathematical meaning

0 = male, 1 = female

66
Q

what are numbers

A

tell how much of something is present

3 grams, 12 seconds

67
Q

what is dichotomous ( number scales)

A

con only have two values

yes or no

68
Q

what is continuous ( number scales)

A

infinite number of values
limited by measurement device (or skill of measurer)
Example: Weight=19 lbs 6.5 oz

69
Q

what is discrete ( number scales)

A

whole values only

children, heart rate, etc

70
Q

what is precision

A

places beyond decimal
none may be best
Example: How important is it to know weight is 19lbs 6.5 oz?

71
Q

what is IQ and temp in relation to measurements

A

they are very abstract ( indirect)

72
Q

what is height and lenght

A

these are direct measurements

73
Q

what are constructs

A

“a function of many interrelated concepts or multiple dimensions”

Examples
Velocity (distance/time)
Work (force x distance)

74
Q

what are some abstract variables in indirect measurements

A

disability

injury

75
Q

what is there confidence in measurement

A

there are different difficulty levels
easy heart rate
hard strength

76
Q

what are some rules of measurements

A
  • must be agreement (ROM” easy / Muscle tone” difficult)
  • equality (a = b or a  b, but not both)
  • rank order (if a > b and b > c, then a > c)
  • Permissible” mathematical operations
77
Q

what are the scales of measurement

A

Nominal
Ordinal
Interval
Ratio

78
Q

what is nominal

A 
name only 
letter 
numeral 
symbol 
***can change the label and it wouldnt change anything
79
Q

what is ordinal

A

rank order as well as name
– interval not equal ( fair and good)
strong and weak
– can have negative values

80
Q

what are the measures of central tendency

A

mean
median
mode

81
Q

what is mean

A

—”sum of a set of scores divided by the number of scores (n)”
Basically, the average

82
Q

what is median

A

divides a rank-ordered distribution into 2 equal halves

83
Q

what is mode

A

the score that appears most frequently

84
Q

what is interval

A

equal interval w/o natural zero
( temp)

Can transform but otherwise not directly compare same phenomenon with different scales
16 lbs is not he same as 16kg (or 16 stones?)

85
Q

what is ratio

A

there is a natural zero

  • height mass rom
    • any math operation
86
Q

what is the order of scale of measure in precision

A

ratio, interval, ordinal, nominal

87
Q

how can you convert the scales of measure

A

Can convert to less precise, but not more precise

ratio to ordinal, but not reverse

88
Q

what happens the information when you convert the scale off measure

A

info is lost

89
Q

what things can be reliable

A

Person
Instrument
Test

90
Q

what is validity

A

is the test measuring what it is intended to measure. Need both validity and reliability in clinical practice and research.

91
Q

what is reliable mean

A

that is consistent and free of error

92
Q

what are some characteristics of reliable

A 
Reproducible
Dependable
Repeatable 
Consistent
Free from error
93
Q

will there ever be a perfect measurement

A

NO there will always be some error

94
Q

what are sources of error

A

rater
instrument
inherent variability

95
Q

what does a small error mean

A

larger reliability

96
Q

what does rater error normally mean

A

using the instrument incorrectly.

97
Q

what does instrument error normally mean

A

incorrect calibration, fluctuations in environment causing a change in the reading (voltage fluctuations, temperature changes, etc.).

98
Q

what does inherent variability error normally mean

A

of the phenomenon being measured; this is the hardest to deal with. Heart rate, time on a functional task, etc. All are subject to variability.

99
Q

how can you reduce errors

A

protocol

A protocol dictates the methods to be used to measure something; if potential errors can be identified, the protocol can be developed to control for the errors.

100
Q

what is systematic error

A

wrong calibration of instrument, wrong use of the instrument, etc. A consistent inflation or deflation of the true score. Correct by using the properly calibrated instrument correctly.

101
Q

what is random error

A

everything else. These are the focus of reliability issues in research.

102
Q

what is the regression toward the mean

A

slide 7

The tendency for higher scores to decrease, lower scores to increase

103
Q

how do you estimate reliability

A

If we measure something (balance, blood pressure, heart rate, height, etc.) multiple times, the scores will vary somewhat. There will be a variance of the true score (inherent variability in the phenomenon), as well as variance of the measured score

104
Q

what is variance

A

this is an indicator of how variable the data set is

105
Q

can you know a true score for reliability

A

NO but you can conceptually

observed score = true + error

106
Q

what happens when error variance approaches 0

A

reliability increases

107
Q

what happens when true variance approaches 0

A

reliability decreases

108
Q

what is poor coefficient reliability

A

less and .5

109
Q

what is moderate coefficient reliability

A

.50-.75

110
Q

what is good coefficient reliability

A

greater than .75

111
Q

what is perfect reliability coefficient

A

1

112
Q

what is correlation

A

this is an association NOT agreement

113
Q

what are some types of reliability

A

Test-Retest
Rater
Equivalence
Internal Consistency

114
Q

what is test retest reliability

A

Measure subjects twice
Calculate coefficient (Pearson, Spearman,
Difference between measurements is considered error

115
Q

what is the testing effect

A

changes in score in results of the test

- ROM measured, tissue stretches

116
Q

what are some issues with test retest

A

Rater bias

Test-retest interval

117
Q

what is the two type of rater reliability

A

intrarater

interrater

118
Q

what is intrarater

A

relates to a single rater over several measurements (more than two is usually better). Should be established for each study, regardless of the “experience” of the raters.

119
Q

what is interrater

A

relates to separate raters obtaining the same measurement from a single group of subjects. For some measurements, the desired independence and simultaneous nature of the measurement can be obtained

120
Q

what are some way the rater will mess up

A

Rater may be the instrument
Rater may observe phenomena
Rater may be part of instrument
Rater may read a gauge or recording

121
Q

what is intraclass correlation coeffiecient

A

correlation and agreement

122
Q

what is kappa

A

proportions of correlation by chance

123
Q

what is standard error of measurement

A

standard deviation of measurement errors

124
Q

when are alternate forms used

A

when subjects are likely to recall responses to tests

125
Q

what is split half reliability

A

a test is constructed with twice the needed items, and the score on half the items is correlated with the score on the other half. Don’t want to compare first half to second half (fatigue, etc.). Better to scatter items throughout test. “Lie” score on MMPI.

126
Q

what is test item reliability

A

examine each item on the examination for reliability with the overall test score. Expectation is that those who do well on the test overall will do well on individual items (if a greater proportion of the subjects who score poorly get an item correct than those who score well, the item probably has something wrong with it).

127
Q

what is the classical reliability theory

A

true score is fixed, fluctuations due to error

128
Q

what is generalization theory

A

assumes measurement is specific to conditions when measurement was obtained; variability is in facets

129
Q

what is population specific reliability

A

can’t take a reliability measurement for a hand-held dynamometer obtained on a population of 25 year old men and apply it to a group of 58 year old women.

130
Q

what is pilot testing

A

is often used to establish reliability. Want the pilot testing situation to be as close to the real situation as possible.

a4 scientific injuriery PT (3 decks)

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