Quiz 1 Flashcards
Results or inferences that systematically deviate from the truth ‘or the processes leading to such deviation
Bias
The abstract for an article says: we examined the association between regular exercise and low back pain over a five year period. What is the most likely study design A. Case study B. Cohort study C. RCT D. N=1 clinical trial
B. cohort study
A prospective epidemiologic research design used to evaluate the relationship between a potential exposure (e.g., risk factor) and an outcome (e.g., disease or disorder); two groups of subjects-one of which has the exposure and one of which does not-are monitored over time to determine who develops the outcome and who does not
cohort design
The inability or restricted ability to perform actions, tasks, and activities related to required self-care, home management, work (job/school/play), community, and leisure roles in the individual’s sociocultural context and physical environment
disability (Nagi model)
types of observational studies
- cohort design
2. case control
depicts the clinical aspects of a patients/clients situation, as well as social context that shapes perceptions of health, wellness, illness, and disability for each individual
disablement model
uneven weighing of likelihood based on therapist fear
i.e. “don’t want to miss it” “won’t do, too risky”
value bias
Alterations in the anatomical, physiological or psychological structures or functions that both (1) result from underlying changes in the normal state and (2) contribute to illness
impairment (Nagi model)
types of experimental studies
randomized control trials
Evidence Based Practice
the integration of the best research, clinical expertise, and patient values
Background question
normal physiology or behavior, pathophysiology, or basic patient diagnostic and treatment information
Foreground question
selection and interpretation of diagnostic tests or clinical measures, prediction of specific patient, prognosis, comparative risks and benefits of various treatment strategies, potential outcomes and their measurement
A retrospective epidemiologic research design used to evaluate the relationship between a potential exposure (e.g., risk factor) and an outcome (e.g., disease or disorder); two groups of subjects-one of which has the outcome (i.e., the case) and one which does not (i.e., the control)-are compared to determine which group has a greater proportion of individuals with the exposure
case control design
A detailed description of the management of a patient/client that may serve as the basis for future research
case report
A description of the management of several patients/clients for the same purposes as a case report; the use of multiple individuals increases the potential importance of the observations as the basis for future research
case series
A research design in which the behavior of randomly assigned groups of subjects is measured following the purposeful manipulation of an independent variable(s) in at least one of the groups; used to examine cause-and-effect relationships between an independent variable(s) and an outcome
experimental design
A statistical method used to pool data from individual studies included in a systematic review
meta-analysis
A research design in which controlled manipulation of the subjects is lacking1; in addition, if groups are present, assignment is predetermined based on naturally occurring subject characteristics or activities
observational design
A research design that follows subjects forward over a specified period of time
prospective design
A clinical study that uses a randomization process to assign subjects to either an experimental group(s) or a control (or comparison) group
experimental group = receive the intervention or preventive measure of interest
control group = comparison group who did not receive the experimental manipulation
randomized control trial
A research design that uses historical (past) data from sources such as medical records, insurance claims, or outcomes databases
retrospective design
A method by which a collection of individual research studies is gathered and critically appraised in an effort to reach a conclusion about the cumulative weight of the evidence on a particular topic
systematic review
conclusions based on previously held expectations
i.e. jumping to conclusions
ascertainment bias
selectively focuses on info that confirms hypothesis
i.e. I am sure I need treatment X
confirmation bias
easily remembered due to recent patient examples
i.e. a run of this disorder
recency effect
draw conclusions only from patients that return
i.e. “all my patients get better”
representativeness exclusivity
1) Patient/problem
2) Intervention - what are you going to do/want to do
3) Comparison - what are you doing now
4) Outcome
PICO question
types of descriptive studies
cross sectional
ecological
case series
case report
alternating treatment designs and interaction designs to evaluate more than one experimental treatment and the interaction of the two - in these designs, investigators may randomize the order in which the interventions are designed
n=1 study design
statistical analysis of data from subjects according to the group to which they were assigned despite noncompliance with the study protocol
intention to treat
based on ability to control for bias and to demonstrate cause and effect in humans
hierarchy of research designs
What would be the best patient centered design to test whether a specific treatment will work on a specific patient you are currently treating A. Case study B. Case series C. Randomized clinical trial D. N = 1 clinical trial
N = 1 clinical trial
The abstract for an article says: The primary aim was to compare the effects of the Mckenzie method and motor control exercises on trunk muscle recruitment in people with chronic low back pain classified with a directional preference A. Diagnostic test study B. Cohort study C. Randomized control trial D. Case study
randomized control trial
EBP is defined as the conscientious, explicit, and judicious use of the current best evidence in A. Diagnostics of patient care B. Use of therapeutic interventions C. Care of individual patients D. In supporting healthcare reform
care of individual patients
The abstract for an article states the following: The 4 patients in this series had clinical evidence and magnetic resonance imaging confirmation of an acetabular labrum tear and underwent a similar treatment protocol consisting of 3 phases. What is the most likely study design? A. Cohort study B. Case series C. Randomized control trial D. N of 1 randomized clinical trial
case series
When asking a clinical question about effectiveness of a specific treatment, which of the following is most important A. more general B. the more articles the better C. Best asked using PICO format D. all the above
best asked using PICO format
Proficiency of clinical skills and abilities, informed by continually expanding knowledge, that individual clinicians develop through experience, learning, and reflection about their practice
clinical expertise
Occur when impairments result in a restriction of the ability to perform a physical action, task or activity in an efficient, typically expected, or competent manner
functional limitations (Nagi model)
Problems in body functions or structure such as a significant deviation or loss
impairment (ICF model)
the conscientious, explicit, and judicious use of current based evidence in making decisions about the care of individual patients
evidence based medicine
a framework for describing and organising information on functioning and disability. It provides a standard language and a conceptual basis for the definition and measurement of health and disability
ICF model
A study that collects data about a phenomenon during a single point in time or once within a defined time interval
cross sectional study
- The study addresses the specific clinical question the PT is trying to answer
- the subjects in the study have characteristics that are similar to the patient whom the PT has a clinical question
- the study was published in peer reviewed medium
- the context of the study and or technique of interest are consistent with contemporary health care
4 desirable characteristics of research
a prediction that the outcome of an investigation will demonstrate ‘no difference’ or ‘no relationship’ between groups (or variables) in the study other than what chance alone might create
statistical hypothesis (null hypothesis)
A prediction that the outcome of an investigation will demonstrate a difference or relationship between groups (or variables) in the study that is the result of more than chance alone
research hypothesis (alternative hypothesis)
The extent to which an intervention produces a desired outcome under ideal conditions
efficacy
The smallest treatment effect that would result in a change in patient management, given its side effects, costs and inconveniences
Minimal clinically important difference (MCID)
the probability that a statistical finding occurred due to chance
p value
Experimental design that lacks random assignment
quasi-experimental design
Three paradigm shifts in medicine
focus on outcome research to document effectiveness
application of models of health and disability
Attention given to EBP
