L3 07/02 Flashcards

1
Q

In order to have base changes in practice on evidence we need to have what 2 things?

A
  • A good range of available evidence

- High quality of available evidence

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2
Q

How do we find the evidence we need to decide whether we change our practice or not?

A
  • Conduct literature searching as you would conduct research > Research questions THEN methods THEN results > Analysis of results THEN conclusion
  • Ask the right question > What are you looking for exactly?
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3
Q

Once we have found the question, where do we ask it?

A
  • Scope the databases so that you can adopt a logical and systematic plan for your search
  • Adopt a flexible approach
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4
Q

What are our key sources of information?

A
  • Journal data bases are searchable electronic storage of journal articles, conference proceedings and papers, reports, government and legal publications, patents, books
  • A search will give you the citations
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5
Q

What is the difference between a database and a search engine?

A
  • The search engine allows you to search the databases, but it is NOT a database and is only as good as the instructions you provide it
  • It doesn’t have the information you need but allows you to find it
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6
Q

Why is google scholar frowned upon?

A
  • Information not usually peer reviewed for accuracy

- Listing order is determined according to financial input

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7
Q

Lack of appropriate evidence can be due to one of two things…

A
  • A small evidence base

- Issues with the search strategy

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8
Q

Name 3 common search problems

A
  • Poor question
  • Spelling mistakes
  • Wrong key words
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9
Q

What is critical appraisal?

A

A systematic assessment of the quality of research evidence to determine whether it can inform practice.

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10
Q

What are the 3 aspects of appraisal?

A
  • Trustworthiness
  • Value
  • Relevance
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11
Q

What are 4 key questions - trustworthiness?

A
  • Is there any potential bias?
  • Is the method reliable?
  • Is the study valid?
  • Do we accept the results?
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12
Q

What are 4 key questions - value?

A
  • Are the results clinically important?
  • What is the strength of the effect?
  • How confident can we be in the results? (statistical significance)
  • Can we actually use the results?
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13
Q

What are 4 key questions - relevance?

A
  • Can the results be applied to the question?
  • Is the cohort the same?
  • Are these results actually useful to us?
  • Has the research been conducted on the same kinds of people and conditions as what we want to apply it to? (external validity - generalisability)
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14
Q

What is reliability and what does it involve?

A
  • If you do something repeatably you achieve the same answer/outcome
  • It is about consistency across time (test-retest reliability), across items (internal consistency), across researchers (inter-rater reliability)
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15
Q

What is validity and what does it involve?

A
  • Relates to how accurate the answer/outcome is
  • The extent to which the scores from a measure represent the variable they are intended to
  • Different types: face, external, internal, ecological
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16
Q

Critical appraisal demands the following skill set (6)

A
  • High level thinking skills
  • Knowledge of the subject area
  • Understanding of health research methods and statistics
  • Knowledge of the wider context
  • The ability to identify relationships between ideas and concepts
  • Developing judgements about study trustworthiness, value and relevance
17
Q

What are the 4 appraisal tools?

A
  • Jaded scale (Oxford quality scoring system)
  • McMaster critical review guidelines
  • CASP tools
  • SIGN checklists
18
Q

What does the the Jaded scale (Oxford quality scoring system) entail?

A
  • A simplistic method of evaluating clinical trials
  • Designed to assess the methodological quality of clinical trials
  • Simple scoring method based on key threats to validity in the design of a clinical trial (randomisation, blinding, attrition)
  • Limitations: Over simplistic, too much emphasis on blinding, not applicable to to other research designs
19
Q

What does the the McMaster critical review guidelines entail?

A
  • Detailed guidelines provided for different research designs in healthcare studies. No overt scoring method, but rather a set of questions to facilitate overall judgement of research quality
  • General set of questions/prompts to get you thinking about the research question
20
Q

What does the the CASP tools entail?

A
  • 3 sections: Are the results valid? Are the results clinically important? Will the results help locally?
  • 8 checklists covering different types of evidence: Trials, Reviews, Cohort studies, Case control studies, Qualitative studied, Economic evaluations, Diagnostic test studies, Clinical prediction rule
21
Q

What are SIGN checklists?

A

A series of checklists for different types of evidence:
Systematic reviews and meta-analysis, Randomised controlled trials, Cohort studies, Case-control studies, Diagnostic studies, Economic studies, Considered judgement pro-forma

22
Q

What is the hierarchy of evidence?

A

A way of ranking how useful different pieces of evidence are particularly in relation to evidence-based practice

23
Q

Suggest 4 appropriate search terms to locate evidence answering the following research question: What effect does an increased dose have on intellectual development in children undergoing radiotherapy?

A
  • Dose
  • Paediatric
  • Radiotherapy
  • Intellectual
24
Q

Suggest some real health or medical databases?

A
  • Medline
25
Q

Can any keyword can be used as a MeSH term?

A

No, there is a pre-determined list of MeSH terms so not any old keyword will be in there

26
Q

Is critical appraisal the process of assessing the quality of a piece of evidence?

A

Yes

27
Q

Is critical appraisal best summarised as finding the faults with articles in the evidence base?

A

No, as it can also include positive elements of the article

28
Q

Are reliable studies those that are likely to yield the same results if repeated?

A

Yes

29
Q

Are valid studies those that are clinically important and relevant to the research question?

A

No

30
Q

Give 3 recognised critical appraisal tools

A
  • CASP
  • Jaded scale
  • SIGN
31
Q

Hierarchy of evidence (increasing)

A
  • Animal studies
  • Editorials
  • Case reports
  • Cohort studies
  • Randomised controlled trials
  • Systematic reviews