Exam 1 - EBP practice Flashcards
What is verifiable knowledge on which to base belief and action?
evidence
What is an approach to public (population) health care practice in which the public (population) health nurse is aware of the evidence in support of his or her clinical practice, and the strength of that evidence?
Public health nursing evidence-based practice (EBPHN)
What does EBPHN use?
Uses the highest quality of knowledge in providing care to produce the greatest impact on a population’s health status and health care
What does EBPHN include?
- Knowledge & research*
- Clinical expertise & judgment
- Input from community members and other stakeholders
How is evidence brought together in public?
- Knowledge & research*
- Clinical expertise & judgment
- Input from community members and other stakeholders
Compared to EBN, EBPHN has what?
- Is more often based on quasi-experimental and observational rather than experimental designs
- Has a smaller volume of evidence
- Has outcomes which are longer
- Impacts team rather than individual decision-making
What does critical appraisal of evidence involve?
includes evaluating research for it’s quality, applicability and strength.
What do researchers use to assess the strength of scientific evidence?
ranking systems
What is level 1 of evidence?
Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs), or evidence based clinical practice guidelines based on systematic reviews of RCTs
What is level 2 of evidence?
Evidence obtained from at least one well-designed RCT
What is level 3 of evidence?
Evidence obtained from well-designed controlled trials without randomization (quasi-experimental)
What is level 4 of evidence?
Evidence from well-designed case-control and cohort studies (studies of prognosis)
What is level 5 of evidence?
Evidence from systematic reviews of descriptive and qualitative studies
What is level 6 of evidence?
Evidence form a single descriptive or qualitative study
What is level 7 of evidence?
Evidence from the opinion of authorities and/or reports of expert committees
What is a “summary of evidence, typically conducted by an expert or expert panel on a particular topic, that uses a rigorous process to minimize bias for identifying, appraising and synthesizing research findings to answer a specific clinical question and draw conclusions about the data gathered?”
systematic review
What 3 things does a systematic review include?
- a specific answerable question
- an explicit and repeatable process
- clearly identified criteria for studies to be included and excluded.
What is a specific method of statistical synthesis used in some systematic reviews, in which the results form several studies are quantitatively combined and summarized?
meta-analysis
True or false: systematic reviews of RCTs and meta-analysis provide stronger evidence than traditional reviews of the literature because of the rigor of the review.
true
What kind of study has an experimental group that receives a treatment or intervention (the independent variable) introduced or manipulated by the researchers, and a control group that receives standard care?
RCT
What about RCTs is special?
true experimental design and are the gold standard for evaluating cause and effect
What do RCTs support?
RCTs supporting health promotion or disease prevention interventions are hard to find.
What are RCTs appropriate for evaluating? what is the downside of RCTs?
a. many interventions in medicine
b. are often ethically or practically undesirable in public health.
What is a design in which the independent variable (e.g., treatment) is manipulated or introduced by the researchers, but where there is a lack of random assignment or a control group?
quasi-experimental
What is easier to find in quasi-experimental?
evidence
What is quasi-experimental used to establish?
cause and effect
What type of sample does a quasi-experimental study use?
convenience sample`
what type of study is one which researchers select a group of people with an outcome of interest (cases) and another group without that outcome (control)?
case-control study (retrospective)
What are case-control/retrospective studies used for?
rare conditions or disease outbreaks.
What do case-control/retrospective studies determine?
a factor (exposure, intervention or experience) is associated with a particular outcome.
what type of study is a longitudinal, usually prospective study, where a cohort is broken into groups based on exposure (such as diet, exercise, oral contraceptives)?
cohort study
What happens with groups in a cohort study?
The groups are followed over a period of time to determine health outcomes.
What are case-control or cohort studies used to establish? not establish?
Both these studies are used to establish the magnitude of associations and risk, not cause and effect.
What kind of studies describe, observe, or document a phenomenon?
descriptive studies
What kinds of studies are those that collect data in non-numerical terms using techniques such as interviews, observation, case studies, participatory observation, participatory action research, and focus groups.
qualitative studies
What kind of data is collected in qualitative studies?
often subjective data
What is the purpose of qualitative studies?
with a purpose of understanding and tends to be holistic in nature.
What kind of design are descriptive studies?
cross sectional design
what is unique about the timing of data collection in descriptive studies?
All data (personal characteristics, potential risk factors, exposures, health status and health outcomes) is collected at the same point in time.
What kinds of studies examine the relationship between exposure and disease with population-level data rather than individual-level data?
ecological studies
What are are compared in ecological studies? rather than what?
Demographics and statistics for groups or geographical areas are compared. Rather than individuals’ characteristics.
Studies that use participatory observation collect data through what?
through personal involvement (participating and possibly living) with a group of people or community
What is a self reflective inquiry that researchers and participants undertake together to improve the health of a community?
Participatory action research or PAR
What is a form of research where data is collected from an group of people answering questions and interacting with each other?
a focus group
What is the lowest level of evidence based on?
based on expert opinions (not supported with a higher level of evidence).
What are also included in the lowest level of evidence?
(non systematic) literature reviews.
What type of design is used in some studies where more than one design/method and so the evidence generated may fall into more than one level?
mixed method design
