Exam 1: EBP Flashcards
what is EBP?
process used to review, analyze, and translate the latest scientific evidence
6 setps
- develop a clinical question
- efficiently search online database for the best available evidence
- select and critically appraise the evidence
- examine clinical expertise and integrate evidence with clinical practice
- assess the outcome
- disseminate the findings
6 A’s
- ask
- acquire
- appraise
- apply
- assess
- audience
types of clinical questions
background
foreground
- intervention/ therapy
-etiology
- diagnosis
- prognosis
- meaning
disablement models
ensure whole person health, improve POE, help guide clinical question and decision making
difference between medical and social perspective
provide a framework to examine the influence that societal and environmental factors have on your patient’s health conditions. help describe the relationship between your patient’s health condition and the consequences of the health condition. came from the medical perspective and the social perspective to be the combination of both in the frameworks we use today
Nagi diablement model
origin- pathology
organ level - impairment
person level - functional limitation
societal level - disability
types of reaserch designs
case study
case series
time series
survey
cross sectional
case study
a descriptive study that follows a group of patients who have similar diagnosis or who are undergo the same procedure over a certain period of time-
- describe novel treatments
- typically cannot generalize the results and lack rigorous study design
do thermal 3 MHz ultrasound and joint mobilization increase ROM in the wrist in patients with decreased ROM due to trauma?
case study
time series
the observation of a participant or a group of participants over multiple time instances, and measurements are compared with prior time instances that are of interest to you
- each participant or sample serves as their own control and the outcome is repeatedly measured during one or more baseline and treatment period
- examine trends and fluctuations within the course of treatment or intervention
are patients with low back pain more vulnerable to quadriceps inhibition after isometric, fatiguing lumbar extension exercises than healthy patients over time
time series (single- subject design)
survey
very common
survey tool must be validated and found to be reliable
relatively easy and inexpensive way to collect data
cross- sectional
snapshot in time
help determine the prevalence of a condition or the total number of cases of a condition in a given population at a specific point in time
- cannot be used to draw relationship between variables
does knowledge, sex, or institutional level of athletic trainers affect reported incidence of MRSA?
cross sectional
evaluative studies
used to determine the existence and strength of a possible association between intervention and an outcome
- associated with high levels of evidence due to the rigor of the research design
observational studies
used to determine the incidence (# of new cases within a defined time period) and natural history of a condition and can be prospective or retrospective
case- control
participants are chosen based on the condition to the studies, participants must have the condition
- the aim is to identify predictors of an outcome through examination of exposure that ma have been contributed to one group developing the condition while the control group does not
experimental studies
randomized
non-randomized
randomized
-considered to be one of the most robust type of research
randomization of participants into predetermined groups- reduce bias within the study design and outcome
limitation is withholding treatment form the control group, may not be feasible in the clinical setting
non randomized
quasi - experimental design. no randomization while placing participants into groups
considered to be less rigorous due to lack of randomization
can more easily be completed in the clinical setting
quantitative studies
the research strategy that focuses on quantifying the collection and analysis of data. it is formed from a deductive approach where emphasis is placed on the testing of theory
complication studues
-systematic review
narratives of the critical evaluation of the research question through and exhaustive search of the evidence and involves an appraisal and synthesis of the selected evidence
1. define question
2. search literature
3. assess studies
4. combine results
5. place findings in context of clinical questions
- meta- analysis
variables
independent and dependent variable
research question
specific aims
research hypotheses (directional and non- directional)
the type of alternative hypothesis, directional or nondirectional, makes a considerable difference in the type of significant test that is run. A nondirectional hypothesis is used when a two-tailed test of significance is run, and a directional hypothesis when a one-tailed test of significance is run
null hypothesis
the hypothesis that there is no significant difference between specified populations, any observed difference being due to sampling or experimental error
AMA format
prosepctive vs retorspective
prospective - type of longitudinal study where researchers will follow and observe a group of subjects over a period of time to gather information and record the development of outcomes
retrospective - (historical) the researcher looks at historical data for a group
epidemiology studies
is the study (scientific, systematic, and data-driven) of the distribution (frequency, pattern) and determinants (case, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhood, school, city, state, country)
types of sampling
random
convenience
purposeful
snowball
inclusion and exclusion criteria
inclusion - identify the study population in a consistent, reliable, uniform, and objective manner
exclusion - factors that would make the study ineligible to be included
3 components
- clinical expertise
- patient values and preferences
- best available research
intervention/ therapy question
questions about the effectiveness of interventions in improving outcomes in sick patients/ patients suffering from a condition.
- most frequently asked
randomized controlled trail
prevention questions
questions about the effectiveness of an intervention or exposure in preventing morbidity and mortality
- RCT or prospective study
diagnosis questions
questions about the ability of a test or procedure to differentiate between those with and without a condition or disease
- RCT or cohort study
prognosis questions
questions about the probable cause of a pateint’s disease or the likelihood that he or she will develop an illness
- cohort study and case control series
etiology questions
questions about the harmful effect of an intervention or exposure on a patient
meaning questions
questions about patient’s experiences and concerns
- qualitative study
