Exam Two - RCT Part Two

Question 1

RCTs are level:

Answer 1

1b and 2b

Question 2

what does PEDro score?

Answer 2

internal validity

Question 3

how many questions does PEDro have? What is it scored out of? What does a higher score mean?

Answer 3

11
scored out of 10
higher score means greater internal validity

Question 4

What is considered a good PEDro score for this class?

Answer 4

greater than or equal to 6

Question 5

1

Answer 5

eligibility criteria was specified
* this question doesn’t get actual points

Question 6

2

Answer 6

subjective were randomly allocated to groups
“random number generator”

Question 7

3

Answer 7

allocation was concealed
“opaque, nontranslucent, numbered envelopes”

Question 8

4

Answer 8

the groups were similar at baseline regarding the most important prognostic indicators
(was random assignment effective??)

Question 9

5

Answer 9

there was blinding of all subjects
(must be blind at all points)

Question 10

6

Answer 10

there was blinding of all therapists who administered therapy
(must be blind at all points)
*very difficult to do

Question 11

7

Answer 11

there was blinding of all assessors who measured at least one key outcome
(must be blind at all points)

Question 12

8

Answer 12

measures of al least one key outcome were obtained from more than 85% of the subjects initially allocated to groups
- addresses potential loss of stat power and survivorship bias
- if several follow up time points, only required at one of the post tests

Question 13

10

Answer 13

results of between-group stats comparisons are reported for at least one key outcome
(could be between two different groups or a pre/post test)

Question 13

9

Answer 13

bonus points for NO drop outs
If no dropouts, you still get point if you used ITT analysis

Question 14

11

Answer 14

study provides both point measures and measures of variability for a least one key outcome
- average & SD most common. probs provided via graph

Question 15

survivorship bias

Answer 15

you stay in the study because you’re doing well

Question 16

is a p value required for a between group comparison?

Answer 16

no

Question 17

what could you use instead of a P value for a between group comparison?

Answer 17

confidence interval AND
- between group mean diff
- diff in proportions
- number needed to treat
- relative risk

Question 18

In PEDro, what is the mean score? how many article are a 6 or above?

Answer 18

5.2
40%

Question 19

what are the most common missing elements in PEDro?

Answer 19

1 - blind therapist
2 - blind subjects
3 - ITT analysis
blind assessors and concealed allocation tied for 4th

Question 20

does PEDro sub for your critical appraisal?

Answer 20

no

Question 21

does PEDro recognize inappropriate stats?

Answer 21

no

Question 22

does PEDro establish clinical relevance/magnitude of effect

Answer 22

no

Question 23

does PEDro evaluate for external validity

Answer 23

no

Question 24

does PEDro provide a comprehensive assessment of internal validity?

Answer 24

no (it won’t establish if the research design is even appropriate for the research question)

Question 25

does PEDro assess if outcomes were appropriate, reliable, and valid for the purpose of the study?

Answer 25

no

Question 26

does PEDro assess if groups were treated the same way (except for experimental intervention)

Answer 26

no

Question 27

What questions should you ask yourself when trying to integrate RCT results into your clinical practice?

Answer 27

• is it a high quality RCT? (appropriate stats? effect size?)
• is there a preponderance of evidence?
• does the study generalize well to my practice/pts?