Finals Flashcards
Why do we measure?
Determine the degree of impairment, limitation, participation restriction
Measure change overtime
Categorizing
is “the smallest amount of difference in individual
scores that represents true change” - beyond random
measurement error
Minimum Detectable Change MDC
represents the smallest
improvement considered worthwhile by a patient
The minimum clinically important difference also called
minimum important difference,
An estimate of how repeated measures of a person on the
same instrument tend to be distributed around the “true”
score
Standard Error of Measurement SEM
T or F
Reliability coefficients, MDC, and MCID are fixed properties of the test or measure
FALSE
Reliability coefficients, MDC, and MCID are not fixed
properties of the test or measure
Refers to the likelihood that a given test result would be expected in a patient with the target disorder compared to the likelihood that that same result would be expected in a patient without the target disorder
Likelihood Ratio
T or F
Sensitivity refers to a test’s ability to designate an individual with the disease as positive
TRUE
a short summary of evidence on a topic of interest, usually focused around a SPECIFIC clinical question
Critically Appraised Topic CAT
T or F
Sensitivity refers to a test’s ability to designate an individual who does not have a disease - negative
FALSE
Specificity refers to a test’s ability to designate an
individual who does not have a disease - negative
Important feature: it asks very specific questions about
very specific patients - has its upsides and downsides
Critically Appraised Topic CAT
T or F
Clinical Prediction Rules CPR is Diagnostic, prognostic, and/or prescriptive in nature
TRUE
Defined as a brief “summary of a search and critical
appraisal of the literature related to a focused clinical
question, which should be kept in an easily accessible
place so that it can be used to help make clinical decisions
Critically Appraised Topic CAT
are mathematical tools that are intended to guide PTs in everyday clinical decision-making
evidence-based tools to assist in patient management when determining a particular diagnosis or prognosis, or when predicting a response to a particular intervention
Clinical Prediction Rules CPR
Developed by a diverse group of people (experts, lay persons, patients, etc.) coming up with recommendations through the use of systematic reviews and/or meta-analyses
Clinical Practice Guidelines CPG
Used to describe a wide range of different information that
is produced outside of traditional publishing and distribution channels, and which is often not well represented in indexing databases
Grey Literature
“Information produced on all levels of government, academia, business and industry in electronic and print formats not controlled by commercial publishing” i.e., where publishing is not the primary activity of the producing body.”
Grey Literature
EBP triad consist of?
Clinical expertise
Best evidence
Patient values
Barriers to Integrating Evidence in Decision Making
● The intervention itself
● The individual profession, you
● The patient and family or legal guardian
● The social context - religion, culture
● The organizational context - hospital
● The economic and political context
Importance of Communicating Evidence
● It is practical - better communication leads to better decisions
● It is relational - healthy relationship between the patient and therapist
● It is ethical
Challenges of Communicating Evidence
● Communicating evidence to the critically-minded
○ They are educated, assertive, and well-informed, however they have sources as facebook
● Confidence in communicating evidence
● Maintaining therapist-client relationship
Steps in Effective Communication
● Identify the roles of everyone involved
● Identify the decisions to be made
● Gather and interpret research evidence
● Translate evidence into communication
Techniques in Communicating Evidence
● Attentive and receptive listening abilities
● Good eye contact
● Picking up on emotional and non verbal cues
● Building good rapport
● Letting your patient set the pace
● Appropriate reassurance and feedback
● Summarizing
Steps in Disseminating Evidence to Patients and Clients
● Understand the patient’s experience and expectations
● Builds partnerships
● Provide evidence, including a balanced discussion of
uncertainties
● Present recommendations
● Check for understanding and agreement
Ways of Presenting Evidence
Describe benefits and harms in general terms
Numerical translation of clinical evidence
Graphical representation of quantitative data
Decision aid programs
