Research Flashcards
1
Q
Ethics in palliative care research
A
- validity
- value
- benefit to subjects
- crossover design so subjects more likely to benefit
- better than RCT? placebo vs control
- minimization of risks to patients
- ensuring capacity to make decisions difficult
- protecting voluntariness
2
Q
Validity and Value
A
Validity
- valid study design adn analysis
- intend to produce knowledge that can be generalized
Value
- studies must offer value
- likelihood that results will improve well being and health
3
Q
Benefit to research subjects
A
- crossover design more beneficial as subjects more likely to benefit
- descriptive studies can give a more careful description of pain, for ex
- open label extension or reduced rate so that patient can access once trial is over
4
Q
Minimizing risks and burdens
A
- minimize unneccessary interviews, investigations, study visits
- placebo
- is this ethical in end of life?
- access to alternative rescue medications
- sham procedures - ethical?
- must be low risk
- crossover design can mitigate concerns about patient access
5
Q
Consent and capacity
A
- high prevalence of cognitive impairment
- comorbidities may impact capacity
- may require formal assessment to ensure consent
- SDM and patient’s assent
- anticipate possibility of loss of capacity or fluctuating
6
Q
PRotecting voluntariness
A
- ensure enrolment is voluntary with knowledge of available alternatives
- option to withdraw at any time
7
Q
Needs in future palliative care research
A
- sufficient sample size population
- national and international funding
- training of clinicians and scientists in palliative care research
8
Q
Steps in planning a research study in palliative care
A
- Describe the clinical problem
- Discuss relevance and validity
- Carry out comprehensive literature review to assess prior knowledge
- Formulate research question and ensure aim is clear, precide and specific
- Define patient population
- Decide on study design
- Decide on outcomes to be measured
- Write protocol
9
Q
List key components of evidence based medicine
A
- best research evidence
- clinical expertise
- patients values and experiences
10
Q
List the types of studies in order of best evidence to worst evidence
A
- RCT
- pseudo RCT
- cohort study
- case control study
- case study/case series
11
Q
Critical appraisal
A
- Assess the patient / problem
- Ask the question
- Acquire the knowledge (lit review)
- Appraise - is the evidence valid and applicable?
- Apply - talk with patient, integrate evidence, clinical expertise
- Evaluate - evaluate the patient’s outcomes and performance
12
Q
Barriers to Evidence Based medicine in palliative care
A
- paucity of evidence
- limited research skills in palliative care
- lack of motivation
- lack of funding!
13
Q
P Values
A
- probability of finding a difference in treatment effect by chance alone when there is no true effect
- < 0.05 is significant
- Type 1 error
14
Q
Qualitative research
A
- Aims to understand lived experience
- interview, focus groups
15
Q
Grounded theory in Qualitative research
A
- analytical categories to look at relationships between them
- social processes
- Observation
- focus groups
- interviews
- explores attitudes and beliefs
