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OT 897 Lecture 1 > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

The process of evidence-based practice?

A

1) Ask an answerable question
2) Access the evidence
3) Appraise the evidence
4) Apply the appropriate evidence
5) Assess the process

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2
Q

How is a bias caused?

A
  • extraneous variables may effect study variables
  • may MASK or INCREASE effect of independent variable
  • bias matters as we may not get the truth.
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3
Q

What does bias threaten?

A

Validity. Also affects confidence in study findings.

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4
Q

What are types of bias in quantitative research studies?

A
  • systematic error (something that happens b/c of some things that are done systematically)
  • can occur from: choice of study design, methods, analysis, reporting, interpretation
  • conscious or subconscious
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5
Q

What is the goal in quantitative research?

A
  • minimize extent of bias that may affect the outcome – what criteria of merit does this address?
  • look at how different designs minimize bias
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6
Q

8 threats to internal validity (Campbell and Stanley)

*review threats to external validity

A
  • history
  • maturation
  • testing
  • instrumentation
  • statistical regression
  • selection biases
  • experimental mortality
  • selection - maturation interaction
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7
Q

True Experimental Designs

A

Randomized Control Trial

- elements: randomization, control group, manipulation (when the investigator puts the intervention in place) *** quiz

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8
Q

Quasi Experimental Design

A

Variations on RCT, but w/o randomization
- no random assignment of participants to groups –> participants from ‘intact’ groups available to the researcher (ex: exercise class)
or ‘matched’ groups (age, gender, height, weight)

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9
Q

Pre-experimental Designs

A

Non-randomized, used to collect preliminary information.

  • characteristics: no random assignment, may not have control
  • elements: intervention and outcome
  • can’t say intervention caused the outcome
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10
Q

Notation symbols

R

A

R = random sample selection

*any r is random allocation

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11
Q

Notation symbols

r

A

r = random assignment

*any r is random allocation

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12
Q

Notation symbols

O

A

O = outcome - observation or measurement

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13
Q

Notation symbols

X

A

X = intervention or exposure to an experimental variable for which the effects are to be measured (*manipulation)

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14
Q

When are quasi-experimental designs most valuable?

A

When you can’t randomly allocate, better to do a group all together, ethics issues

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15
Q

When are pre-experimental designs most valuable?

A
  • answering a level 1 question - can describe intervention and outcome, can’t say intervention caused O
  • pilot testing an intervention protocol or measurement approach (exploratory)
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16
Q

Elements of Observational Studies (epidemological studies)

A
  • researcher does not provide the intervention (no manipulation)
  • comparison group
  • naturally - occurring (not randomized groups)
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17
Q

What level question do you answer with descriptive studies?

A

Level 1

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18
Q

What level question do you answer with analytic studies?

A

Level 3 - cause and effect

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19
Q

What are observational studies called?

A
  • cohort study - fwds in time
  • case - control study - backwards in time
  • cross- sectional (analytic) - interaction
20
Q

Why are they different?

A

the direction of the outcome they provide

21
Q

What is a cohort study?

A
  • prospective - measure fwd in time - outcome measured after intervention
22
Q

What is a case-control study?

A
  • retrospective - start with outcome, then look back in time if they were exposed to the treatment
23
Q

What is a case study or case series?

A

prospective

  • target population - treatment, treatment effect
  • measure these two things w/ no control
24
Q

What is the world view for quantitative research?

A
  • only one reality - looking for the truth
25
Q

What are the 4 criteria of merit in quantitative research?

A
  • internal validity - within the study, have you reached a valid answer. Controlled all you can control.
  • external validity - can you transfer the findings ?
  • reliability - research can be repeated, get the same outcome
  • objectivity - minimizing bias, distance between researcher and population
26
Q

Hierarchy of evidence for Therapy

A
  • background info
  • unfiltered information: case controlled studies, cohort studies, RCT
  • filtered information: critically appraised individual articles, critically-appraised topics (evidence syntheses), systematic reviews
  • ebm pyramid

Question on the quiz - bias decreases as you go up the pyramid - quality of evidence increases

27
Q

What is a problem with counterbalance designs?

A
  • adherence; acute conditions can change w/ different interventions
  • need people w/ a chronic condition that doesn’t change over time so they go back to baseline
28
Q

Interrupted Time series

A
  • consistent patterns before and after interventions show no change - intervention not successful
29
Q

Factorial designs

A
  • randomized or observational
  • previous designs involved testing one independent variable
  • evaluate effect of two or more independent variables and the effect of the interventions on different factors/levels – allocation to groups may be randomized or may be occurring naturally
30
Q

Non - experimental designs

A
  • survey research
  • correlation research
  • secondary analysis of data
31
Q

Survey research

A

provides quantitative (numeric) description of trends, attitudes, or opinions

  • mailed, emailed, phone
  • level __
32
Q

Correlational research (passive observation designs)

A
  • examines relationships among variables
  • regression studies - explain or predict changes in dependent variable on baiss of changes on other factors
  • level 2 questions
33
Q

Secondary analysis of data

A
  • see ex post facto designs

- level __

34
Q

Sources of bias in quantitative studies about ‘therapy’

A
  • allocation to groups
  • sample selection for non-randomized group
  • methods
  • analyses and interpretation
    reporting
35
Q

What is random allocation?

A
  • determined by chance
36
Q

What should be indicated in the article to ensure that appropriate randomization has occurred?

A
  • method of allocating interventions to participants - ie, sequence generation, flip coin
  • concealment of allocation sequence to ensure adherence
  • evidence that randomization worked
37
Q

Why is random allocation done?

A

To avoid systematic differences between groups.

- both groups should have similarities in characteristics

38
Q

Double blind study

A
  • researcher and subject don’t know what group they’re in
39
Q

single blind study

A
  • subject doesn’t know what group they’re in - researcher knows
40
Q

blind assessment

A
  • person doing the assessment doesn’t know what group the participants are in
  • why?
41
Q

How could bias caused by lack of blinding affect outcomes?

A
  • increase or decrease effect you might see
42
Q

How can blinding reduce biases?

A
  • may help equalize attention/group
  • may help avoid differential attrition (control group may not be motivated to stay in the study)
  • may help avoid expectation of better/worse outcomes
43
Q

What is the magnitude and direction of the bias, ie how could it affect the results?

A

Think about this…

44
Q

Which criteria of merit will these affect?

A

Think about this…

45
Q

What is reported that indicates efforts to minimize bias?

A

Think about this…

46
Q

Elements of quantitative studies

A
  • study design - determined by question and chosen to minimize bias - analytic, descriptive - best design to reduce bias
  • methods - care taken to minimize bias - allocation to groups or sample selection, quantity of intervention/group, outcome assessment - outcome measures, testing, equipment, interviewers, assessors
  • adherence to the protocol - minimize bias

OT 897 Lecture 1 (2 decks)

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