Intro

Question 1

What is the best available research evidence, combined with clinical expertise and patient values?

Answer 1

Evidence-based Chiropractic Practice

Question 2

EBC was started up by a group of medical educators at McMaster’s university when?

Answer 2

1980’s

Question 3

Chiropractic interventions are difficult to investigate by what?

Answer 3

Experimental Methods

Question 4

Because chiropractic interventions are difficult to investigate by experimental methods there are fewer chiropractic articles that use what?

Answer 4

Placebo Control Group

Question 5

EBC is unique because chiropractors commonly utilize what?

Answer 5

Multiple Treatment Modalities

Question 6

What are the multiple treatment modalities that chiropractors use?

Answer 6

Manipulations
Exercises
Ergonomic Advice
Physiotherapy

Question 7

Clinical trials often utilize what?

Answer 7

One Modality (to isolate and compare it w/placebo or alternative)

Question 8

What was limited for chiropractic research in the past which hampered progress?

Answer 8

Finances

Question 9

What has changed as far as finances for chiropractic research?

Answer 9

Federal Funds available

Question 10

What is clinical expertise?

Answer 10

Skills and knowledge gained by clinicians through clinical experience and practice.

Question 11

EBC relies heavily upon the practitioners past what?

Answer 11

Clinical Experience

Question 12

EBP is the integration of the best evidence with the past training and expertise of the clinician which results in?

Answer 12

Better patient care

Question 13

Evidence is added to patient care to replace what

Answer 13

Outdated information

Question 14

What are patient preferences?

Answer 14

Personal Values, Concerns, Expectations that pts have about their care.

Question 15

The belief patients have about care that is being offered to them is known as?

Answer 15

Personal Values

Question 16

Personal values may be related to?

Answer 16

Philosophical or Religious issues

Question 17

What are some patient concerns?

Answer 17

Finances
Time Constraints
Office Location

Question 18

The degree that patients accept a doctors recommendations is known as what?

Answer 18

Patient Expectations

Question 19

Patient expectations often are wide-ranging and can have a significant impact on?

Answer 19

Clinical Results

Question 20

Practitioners may not have enough information to answer clinical questions for what?

Answer 20

Complicated Cases

Question 21

Practitioners need to stay current in light of an overwhelming amount of?

Answer 21

New Research

Question 22

The best practices uses the most valid clinical tools available which are established through?

Answer 22

Research

Question 23

EBP is good to determine the most effective form of?

Answer 23

Treatment

Question 24

EBP utilizes valid and reliable what?

Answer 24

Diagnostic Tests

Question 25

Insurances often pay for services when provided with an explanation grounded in credible evidence that justifies what?

Answer 25

Clinical Procedures

Question 26

Patients who present for care with unusual conditions that are unknown to the practitioners is what?

Answer 26

Patient Specific

Question 27

EBP is good for what?

Answer 27

Specific Conditions

Question 28

EBP is good to self educate by attending

Answer 28

Seminars and Conferences

Question 29

Pracititioners gather the best available evidence how?

Answer 29

On their own

Question 30

Because some elements of EBP are difficult to master make time to do what?

Answer 30

Read Journals | Search for Answers to Clinical Questions

Question 31

What are the 5 steps of EBP?

Answer 31

1. Ask clinically relevant question 2. Search literature to find evidence to answer question 3. Appraise evidence for validity and applicability to clinical circumstances 4. Apply relevant evidence to clinical situation 5. Evaluate effectiveness in carrying out 1-4 and revise

Question 32

Clinical questions should be clinically relevant and a good question will help guide the search for?

Answer 32

Evidence toward relevant material

Question 33

What are the 2 types of questions?

Answer 33

1. Background Q | 2. Foreground Q

Question 34

Background Q are simple 2-part questions that address what?

Answer 34

Basic facts about a pt's health problem

Question 35

Background Q don't fully address the best what?

Answer 35

Diagnostic or Treatment options

Question 36

Foreground questions are more complex than?

Answer 36

Background Q

Question 37

Foreground Q are derived from

Answer 37

Primary Sources | Secondary Sources

Question 38

What are the elements of a good clinical question (PICO)?

Answer 38

P-patient or problem I-intervention C-comparison intervention O-outcome of interest

Question 39

What is patient oriented evidence that matters (POEMs)?

Answer 39

Outcome in a study that should be something patients care about.

Question 40

What is disease oriented evidence (DOE)?

Answer 40

Studies that involve outcomes that may be of interest to researchers and practitioners, but are of little interest to patients.

Question 41

What is something that is helpful in forming a conclusion or judgement?

Answer 41

Evidence

Question 42

Evidence is found primarily in journal articles that deal with what?

Answer 42

Effectiveness and safety of treatments Validity and reliability of diagnostic tests Incidence and prevalence of disease in populations

Question 43

What is considered to be the gold standard for determining if a treatment is effective?

Answer 43

Systematic Reviews | RCT's

Question 44

What are the four C's below RCT's on the pyramid?

Answer 44

Cohort Case-Control Case Studies Case Reports

Question 45

What typically begins with case reports/series then advances to observational studies then to RCT's?

Answer 45

Clinical Investigation

Question 46

Studies that rank higher on the hierarchy of evidence pyramid are not what?

Answer 46

Always better

Question 47

Evidence rating systems are used to rate what?

Answer 47

Quality and Class structure of evidence | Guideline formation

Question 48

The relative strength of evidence depends on what?

Answer 48

Position of hierarchy of study designs Critical Appraisal Study's validity

Question 49

The degree of confidence that one may have in evidence depends on what?

Answer 49

Strength of research | How various pieces of research on that topic blend together.

Question 50

When there is little or no evidence the practitioner must decide whether or not to do what?

Answer 50

Render treatment

Question 51

Lack of evidence is not the same as?

Answer 51

Evidence of Lack