exam 2 Flashcards

1
Q

What does the Pearson Product Moment Correlation Coefficient describe?

A

The direction and degree of relationship between 2 variables.

Reported as a single number that represents the direction and degree of relationship between 2 variables
Values are between –1 to 0 to +1 (.80 or higher is strong relationship)

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2
Q

Which of the following statements is true regarding unexpected statistical findings in a research study?

A

Unexpected results may indicate a flaw in the researcher’s logic.

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3
Q

A Type I error indicates

A

indicates that there is a significant difference when there is not.

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4
Q

Which situation will involve the use of inferential statistics?

A

An examination of the differences between control and experimental group scores

it is a conclusion or judgment based on evidence, judgments are made based on statistical result

examples:
-Pearson product-moment correlation coefficient
-regression
-chi-square
-t-test
-ANOVA
-ANCOVA

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5
Q

Which statistical test is used to predict the value of a variable when the value of one or more other variables is known?

A

Regression analysis

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6
Q

Which statistical test is used to examine the mean differences between two groups?

A

t-test

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7
Q

Identify a common challenge to successful adoption of mHealth.

A

Digital and health literacy.

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8
Q

Major concerns with mHealth technologies include the protection of human subjects, confidentiality, privacy, and data security.

A

True

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9
Q

Which statistical test is used to examine differences among 3 or more groups?

A

Analysis of variance (ANOVA)

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10
Q

Which best describes digital health?

A

The broad use of information and communication technologies (ICT) to support health and health-related fields.

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11
Q

prospective

A

means looking foward and is usually more accurate

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12
Q

major literature review

A

is conducted at the BEGINNING of the research process

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13
Q

limited review

A

is conducted AFTER the study is completed to identify studies published since the original literature review

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14
Q

cross-sectional design

A

collects data at one data point

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15
Q

longitudinal design

A

collects data at multiple points, “repeated measures design”

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16
Q

causality

A

cause and effect relationship between the variables
-descriptive and correlational do not examine
-use quasi-experimental and experimental to examine causality or a new intervention

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17
Q

multicausality

A

presence of multiple causes or “interrelating variables” for an effect

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18
Q

retrospective

A

means looking backward
-have no control over the accuracy of data
-studies that use chart reviews and are non-interventional

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19
Q

bias

A

a slant or deviation from the truth

-can distort findings within several elements of a research study

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20
Q

control

A

having power to direct or manipulate factors to achieve a desired outcome
-increasing control is a method to decrease bias
-improved accuracy of findings
increased control in quasi-experimental
greatest control in experimental

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21
Q

probability

A

the likelihood of accurately predicting an event
-the cause will probably result in an effect

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22
Q

manipulation

A

form of control used in quasi-experimental and experimental studies during the implementation of the intervention

-must manipulate the intervention (independent variable)

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23
Q

study validity

A

measure of the accuracy of findings

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24
Q

design validity

A

strengths and threats to the quality of a study design
Types:
-construct -measures what is supposed to ?
-internal - warrant casual conclusion?
-external - related to real world?
-statistical conclusion - relatioship between cause and effect?

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25
construct validity
begins with the fit between the conceptual definition and operational definitions of variables and how is it measured -conceptual definitions provide the basis for operational definitions threats: -inadequate definitions -experimenter expectancies - rosenthal effect
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internal validity
the study results are a true reflection of reality threats: -participant selections -history -maturation
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external validity
the study findings can be generalized beyond the study threats: -interaction of setting + intervention -interaction of selection + intervention -interaction of history + intervention
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statistical conclusion validity
conclusions about relationships between variables accurate reflection of the real world threats: -low statistical power type 2 error -unreliable measurement methods -intervention fidelity concerns -extraneous variables
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descriptive designs
-simple descriptive: used to examine variables in a single sample -comparative descriptive: used to describe variables and examine differences in variables in two or more groups
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correlational designs
-descriptive correlational: describes variables and examines relationships among them -predictive correlational: to predict the value of one variable based on the values obtained for another variable -model testing
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what is an ePatient?
-uses technology to actively participate in his or her healthcare -manages responsibility for his/her own health and wellness
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what is eHealth?
emerging field in the medical informatics, public health and business, referring to health services for information - also a state of mind, a way of thinking, an attitude, to improve health care locally, regionally, and worldwide by using information and communication technology
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driving forces for eHealth?
-personal computers and web -access to health and wellness tracking tools -evolution of the internet -policy and legislative influences
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Evolution of the Internet
web 1.0: read only web 2.0: social web with a community feel web 3.0: web with browsers and devices that behave more like personal assistants and search capabilities that harness user experience behavior to display content of interest including personally tailored advertising web 4.0: mobile web web 5.0: (emerging) intelligent systems that have the capacity to measure individual's emotions, wants and desired based on detection and predictive algorithms
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what are the quantified selfers?
-Blood Pressure -exercise -sleep -dietary intake
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21st century cares act
2016 - expected to increase choice and access -required to promote interoperability of health information and prohibit information blocking -clinical notes are on electronic info that must not be blocked and made available for free
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when was the EHR adoption and patient access through personal health record portals (PHR) promoted
2009
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guided discovery
developing a SHARED hypothesis and including the ePatient in creating a plan to manage care' -a way for ePatients to interact with healthcare
39
challenges to eHealth
-current models may not be properly structured to support patient-centeredness -clinicians may find it difficult to find the time and resources to fully engage with the ePatients who come with a well-prepared agenda -patient collected data through digital health are not yet integrated into their medical record
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intervention
"independent variable" -expected to impact the dependent variable (physiological, psychosocial, educational or any combination) -should be consistent
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experimental group
this group is given the intervention/treatment and acts on the dependent variable
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control/comparison group
are not exposed to the intervention and receive standard care and acts on the dependent variable
43
quasi-experimental designs
used when control is not possible types: -pretest/posttest design with comparison group - most commonly used -posttest only design with comparison group - threats to validity and has no comparisions
44
experimental design
more control than quasi-experimental through randomization types: -pretest/posttest designs with experimental and control group -post-test only with control group design
45
Randomized Clinical Trial (RCT)
-gold standard -may use blinding -uses large # of subjects to test a treatment's effect & compare results with a control group who did not receive the treatment -RANDOMIZED subjects is essential -usually multiple geographic locations are used subjects come from a reference population
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Essential elements of experiments
-random assignment of subjects to groups -precisely defined intervention/independent variable -researcher - controlled manipulation of independent variable -control/comparison group -clearly identified sampling critieria -carefully measured dependent variable/outcome
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2020 CARES act
coronavirus aid relief
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EHR Interoperability and Standards
1. vocabularies and terminologies 2. data or document content 3. transport of messages 4. privacy and security 5. unique identifiers
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administrative applications
Registration systems: demographics, insurance, procedures, allergies Financial applications: billing claims Other: staffing, scheduling, human resources
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ancillary applications
labratory radiology pharmacy cardiology resp. therapy physical therapy
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Computerized Provider Order Entry (CPOE)
1. Demonstrates reduction in medication errors 2. allows orders to be entered, processed, tracked, updated, completed 3. uses alerts to assist in decision support 4. can flag abnormal results or reminders
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Specialty (niche) Applications
information systems: -maternity -newborn -surgical -ER department
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clincial decision support
Alerts: -duplicate orders -allergies -medication dosing errors -changes in patient condition -abnormal labs -diagnostic test results -reminders DANGER of alert fatigue
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EHR benefits
-benefits all healthcare providers -cost savings -access to patient info quality and safety
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EHR challenges
-privacy and confidentiality -standard language -documentation burden -consumer access EHR -ownership -patient-generated -data integrity
56
P-Value
the probability that a difference is due to chance alone - not standard error -results are statistically significant between 2 or more groups -significant IF < .05 EXAMPLE: *r = 0.56 (p = 0.03) - moderate relationship statistically significant *r = –0.13 (p = 0.2) - weak relationship, not statistically significant *r = 0.65 (p < 0.002) - moderate relationship, statistically significant
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Type 1 error
Reject Ho when Ho is true the results indicate that there is a SIGNIFICANT DIFFERENCE, when in reality there is not
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Type 2 error
Fail to reject Ho when Ho is false the results indicated that there is NO significant difference when there is a difference -more likely to occur where there is a small sample size
59
Pearson Product Moment Correlation Coefficient (r)?
-measure of strength of a linear association between 2 variables -reported as a single number that represent the direction and degree of the relationship -1 to 0 to +1 .80 or higher is a STRONG relationship
60
Regression analysis
used to predict the value of one variable when the value of one or more other variables is known multiple regression - predicting 2 values of variables??
61
Chi-square test of independence
determines whether 2 variables are independent of related look at the X2 number and p-value
62
T-test
analyzes the difference between 2 means There is a significant difference between the mean of 2 groups independent t-test paired t-test
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ANOVA
analysis of variance a statistical test for testing mean differences among 3 or more groups
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ANCOVA
analysis of COvariance -allows the researcher to examine the effect of a treatment apart from the effect of one or more cofounding variables
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Significant and predicted results:
-Agree with those predicted by the researcher -Support the purpose, questions or hypotheses, variables, framework, and measurement tools -Must consider the possibility of alternative explanations for the positive finding
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Nonsignificant results
called "negative" results and may be a true reflection of reality -the reasoning or theory used to develop the hypothesis is in error -may stem from a type 2 error -the study failed to find any relationships or differences
67
mixed results
-most common outcomes -one variable may uphold predicted characteristics and another one does not
68
connected health
mobile health AKA mHealth is a catalyst for healthcare change
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Digital health
includes mHealth, telehealth, and telemedicine -connects and empowers people and populations to manage health and wellness, augmented by accessible and supportive provider teams working within flexible, integrated, interoperable, and digitally enabled care environments that leverage digital tools, technologies and services to transform care delivery
70
MHealth
the WHO's global observatory for eHealth - "medical and public health practice supported by mobile devices like phones, patient monitoring devices, personal digital assistants, and other wireless devices " Tools: mobile phones with video capability can be used for telehealth to deliver care at a distance Applications: mobile apps are important tools for phone and tablet devices Sensors: provide links from mobile phones to an external device for longitudinal data collection or patient monitoring - data can be synced to mobile devices for monitoring (AliveCor - heart monitor )
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Client education and behavior change
Focuses on improving knowledge, modifying attitudes, and supporting behavior change Examples in Healthcare Settings: Smoking cessation programs, Medication adherence support, Appointment reminders
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Data collection and reporting
Allows data to be directly deposited into central servers from mobile device Examples of Functions: SMS, Voice communication, Digital forms Examples in Healthcare Setting: Health surveys, Disease registration
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Electronic health records
Examples of Function: Digital forms, Mobile web (WAP/GPRS) Examples in Healthcare Setting: Personal and healthcare facility-based
74
Driving Forces in digital health
1. technology (access, reduced cost, ad its increasing functionality) 2. the consumer/patient engagement movement 3. global health or connected health (expanding health care services) 4. research, policy, and business (cost savings and earnings potential)
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benefits to mHealth
potential to address and overcome disparities i health service access, shortage of healthcare providers, health inequities, and high costs for healthcare
76
Direct Measures (concrete)
weight blood pressure temperature
77
Indirect measures (abstract)
pain coping depression
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Content Validity
the measurement method or scale includes all major elements or items relevant to construct being measured
79
Construct Validity
whether the instrument is actually measuring the construct (which examines the fit between conceptual and operational definitions)
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