Final Exam Review Flashcards
What are the purposes of systematic analysis?
- Most common: effectiveness of interventions
● Address the accuracy of diagnostic and measurement tools
● Identify prognostic or risk factors
● Develop recommendations for clinical practice guidelines
Which research analysis results provide a structured approach to examining data to inform practitioners in their
decisions to maintain, alter or discard methods of clinical practice and to researchers in designing further research
Systematic Reviews
What is a meta-analysis?
An extension of a systematic review that incorporates statistical pooling from clinical homogenous studies
○ Meta-analysis is a statistical method of combining the results of a series of independent, previously published studies carried out for the same general purpose
What are the major advantages of a meta-analysis?
■Increase power by increasing sample size
■ Improve estimates of effect size
■ Resolve uncertainty when collecting results occur
■ Improve the generalizability of findings
Which research analysis effects size from individual studies?
Meta-analysis
What is a pooled effect size in meta-analysis research?
a) A measure of the average sample size in a study
b) An index of the degree of difference between groups, weighted by sample size
c) The total combined effect of multiple interventions
d) A measure of statistical power in hypothesis testing
Correct Answer: b) An index of the degree of difference between groups, weighted by sample size
The larger the difference the greater the “effect” of the intervention.
What is the difference & similarity between systematic analysis & meta-analysis ?
A systematic review attempts to gather all available empirical research by using clearly defined, systematic methods to obtain answers to a specific question. A meta-analysis is the statistical process of analyzing and combining results from several similar studies.
What is PRISMA & what elements of the search don’t include?
PRISMA → Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) is a 27-item checklist used to improve transparency in systematic reviews. These items cover all aspects of the manuscript, including title, abstract, introduction, methods, results, discussion, and funding.
What are the benefits of using PRISMA?
●Demonstrate quality of the review
● Allow readers to assess strengths and weaknesses
● Permits replication of review methods
● Structure and format the review using PRISMA headings
The following is an example of ___ flow diagram?
PRISMA Flow Diagram
What are the major elements of a “Search Strategy” for including studies in a systematic review?
Search strategy: to amass a comprehensive list of relevant references (needs updating every 3-5 years)
● Selection of online databases: most common: MEDLINE, EMBASE, SCOPUS, CINAHL, and the Cochrane Collaboration, hand search is also included
● Should have sensitivity to find all relevant references, although it will also retrieve some irrelevant studies
● Key search terms used
● Years of publication
● Language of publication
What is the level of evidence on the hierarchy of evidence?
Level 1=
○ Strongest evidence to establish Cause & Effect
Level 2=
○ Strong evidence to establish Cause & Effect
Level 3=
○ Varying strengths for establishing cause & effect
Level 4=
○ Very weak ability to establish cause & effect
Level 5=
○ Cannot establish cause & effect
What distinguishes strong evidence at Level 1 on the hierarchy of evidence?
a) Anecdotal evidence from individual case studies
b) Systematic review without random assignment or control group
c) Meta-analysis or systematic review with random assignment and control group
d) Evidence from qualitative research methods
Correct Answer: c) Meta-analysis or systematic review with random assignment and control group
What constitutes Level 1 evidence on the hierarchy of evidence?
a) Evidence from observational studies with large sample sizes
b) Evidence from expert opinions and case reports
c) Strong evidence from at least one systematic review of multiple well-designed randomized controlled trials
d) Evidence from single randomized controlled trials without systematic review
Correct Answer: c) Strong evidence from at least one systematic review of multiple well-designed randomized controlled trials
What characterizes Level 2 evidence on the hierarchy of evidence?
a) Evidence from non-randomized observational studies
b) Strong evidence from at least one properly designed randomized controlled trial of appropriate size
c) Evidence from single case reports or expert opinions
d) Evidence from qualitative research methods
Correct Answer: b) Strong evidence from at least one properly designed randomized controlled trial of appropriate size
What are the criteria for a properly designed randomized controlled trial (RCT) at Level 2 evidence?
a) Observational design with matched control groups
b) Random assignment, a control or comparison group, and at least 5 subjects per group
c) Random assignment, a control or comparison group, and at least 10 subjects per group
d) Cross-sectional design with a large sample size
Correct Answer: c) Random assignment, a control or comparison group, and at least 10 subjects per group
What characteristic may be present in Level 3 evidence studies?
a) Randomization and control groups
b) Large sample sizes with statistical power analysis
c) Prospective design without a time element
d) Lack of randomization, control/comparison group, or a time element in the study design
Correct Answer: d) Lack of randomization, control/comparison group, or a time element in the study design
A well designed quasi-experimental study can be almost as accurate as an RCT for showing causation while a pre-post cohort or straight cohort study design is much less strong. This statement reflects which level of evidence on the hierarchy of evidence?
Level 3
What distinguishes Level 4 evidence on the hierarchy of evidence?
a) Strong ability to establish cause and effect relationships
b) Lack of a time element and a focus on understanding associations between predictor and outcome variables
c) Inclusion of randomized controlled trials from multiple research sites
d) Emphasis on longitudinal study designs with repeated measures over time
Correct Answer: b) Lack of a time element and a focus on understanding associations between predictor and outcome variables
What is a common characteristic of studies categorized as Level 4 evidence?
a) Longitudinal study designs with multiple data collection points
b) Single-center studies with randomized controlled trials
c) Single data collection point for each subject recruited from multiple research sites
d) Case-control studies with retrospective designs
Correct Answer: c) Single data collection point for each subject recruited from multiple research sites
Which level of evidence is used to identify topics to look for stronger evidence to support them?
Level 5
What is Effect size typically used in Meta-analysis?
Effect size values (by Cohen d)
● 0.8 or higher = large effect size
● 0.5 to < 0.8 = medium effect size
● 0.2 to 0.5 = small effect size
Which of the following are threats to internal validity?
- History
- Maturation
- Attrition
- Testing
- Instrumentation
- Regression to the mean
- Selection
- Fieldity
- History
- Maturation
- Attrition
- Testing
- Instrumentation
- Regression to the mean
- Selection
What are some social threats to internal validity?
○Diffusion or imitation: are subjects receiving interventions as intended?
○ Compensatory equalization: are researchers adhering the protocol for all
groups?
○ Compensatory rivalry or resentful demoralization: are subjects’ responses
influenced by their knowledge of other group treatments?
What is conceptualization of variables?
how variables are conceptualized & how well experimental results can be generalized within the desired clinical contex.
Which threat to the conceptualization of variables involves defining how constructs are defined in a study?
a) Operations definitions
b) Comprehensive measurements
c) Subgroup differences
d) Time frame
Correct Answer: a) Operations definitions
What term describes the phenomenon where participants may act differently to please a researcher or themselves if they know they are being observed?
a) Experimental bias
b) Hawthorne effect
c) Subgroup differences
d) Time frame
Correct Answer: b) Hawthorne effect
What are strategies to Control for Subject Variability?
● Random assignment
● Homogeneous samples
● Blocking variables
● Matching
● Repeated measures (using subjects as their own control)
● Analysis of covariance (ANCOVA)
____ has a broader perspective on data gathering (than systematic reviews), intended to provide an overview of existing evidence and does NOT include methodological assessments.
A ) Meta-Analysis
B ) Scoping Reviews
C ) Evidence Maps
B ) Scoping Reviews
