Research And Eval Flashcards
1
Q
What is the gold standard of research
A
RCT
2
Q
What is the definition of Evidence Based Practice
A
The practice of health care in which the practitioner systematically finds, appraises, and uses the most current and valid research findings as the basis for clinical decisions
*Results in the best possible outcome for your patients**
3
Q
What is a meta-analysis
A
Pools data and statistically interprets is from several studies
4
Q
What is an efficacy trial
A
Attempts to learn if a drug, surgical procedure, or admin program works under ideal circumstances
5
Q
What is the Pearson correlation
A
The most common measure of correlation
6
Q
What is subject variation in measurement error
A
Variability of individual subjects
Like different answers on a survey
7
Q
What is non differential miscalculation
A
When the bias is random or equally present in each group ( case vs control )
8
Q
Does a chi square give any indication about the variable relationship strength
A
NO
9
Q
What is a histogram,
A
Is a bar graph, comprised of a series of columns, each representing one score or class interval
10
Q
What does a negative LR tell you
LR-
A
Is the proportion of diseased people with a negative test (1-sensitivity) divided by the proportion of non-diseased people with a negative test (specificity)
11
Q
What kind of study is a BP Study
A
A normative study
12
Q
What is evidence based medicine
A
To integrate clinical expertise with the best available evidence
13
Q
What are three types of experimental research designs
A
RCTs, (gold standard)
Single subject
Quasi-experiments
14
Q
What is non-experimental research
A
Refers to investigation that are generally more descriptive or exploratory in nature and that exhibit direct control over the studied variables
15
Q
What is misclassification bias
A
Occurs when those that have the disease are mistakenly put in the control group
16
Q
A random error is also know as
A
Chance variation
17
Q
What are the four paradigm shifts which have emerged in healthcare
A
- evidence based practice
- focus on translational research
- conceptualization of health and disability
- importance of Inter professional collaboration
18
Q
What it retrospective research
A
Examination of date that has been collected in the past
19
Q
What biases are Systematic and meta anylsis subject to
A
Inclusion/ exclusion criteria
20
Q
What is an example of a quantitative question
A
On a scale of 1-10 how is your pain
21
Q
What are two types of measurement errors
A
Systematic errors: are predictable errors of measurement
Random errors: are due to chance and can effect a subjects measurement in a unpredictable way
22
Q
What is a systematic review
A
Is a thorough, comprehensive, structured way of combining findings from several sources with an analysis of the methodological quality of the studies.,
It is an interpretation of the available medical literature
23
Q
What is observer variation in measurement error
A
Variability of measurements based on the fatigue of the observer, variations in training
24
Q
What intrarater reliability
A
Refers to the stability of data recorder by one individual across two or more trials
25
Do Cohort study’s develop relative risk
YES and Odds ratios
26
What does analytic research do
Analyzes associations
Investigates Relationships
TESTS hypotheses
27
What does a logistical regression do
Estimates the probability of an outcome associated with a dichotomous response for a single or multiple variables
28
What kind of research observe natural phenomenon
Observational
29
What is translational research
refers to the application of basic scientific findings to clinically relevant issues, and simultaneously, the generation of scientific questions based on clinical dilemmas.
30
What is a case report
A narrative in the professional literal that IDs a single incident and discusses pertinent factors related to the pt.
31
What is observational research
Phenomena are observed rather than manipulated
32
What is a paradigm
A set of assumptions, concepts, or values that make a framework for reality
-defines what questions are important
33
What is the formula for relative risk
EER
_____
CER
34
What is the fishers exact test
A non-parametric test, can be used with small or sparsely distributed data sets
35
What are the five study types of PICO questions
```
Therapy
Diagnosis
Prevention
Etiology
Prognosis
```
36
What minimizes bias
Empirical-ism
37
What is systems based practice
To asses, coordinate, and improve the silvery and effectiveness of health care and patient outcomes
38
What are two types of validity
Internal validity: within the confines of the study appear to be accurate and the interpretation of the results is supported
External Validity: result and interpretations of the study apply outside the studied population. Also called generalizability
39
What is social desire ability bias
People want to be seen in a favorable social light so they give more positive answers
40
If relative risk is less than 1
Negative associated, possibly protective
41
What is peer review
The process by which an authors peers and recognized researchers in the filled read and evaluate a paper submitted for publication
42
What are the steps to the research process
```
ID the research question
(Who, what, how)
Design the study
Implement the study
Analyze the data
Disseminate the findings
Close the loop
(Replication/ additional research)
```
43
What defines professionalism
On going profesional development
44
What increases the strength of a case control study
Adding multiple controls
45
What is information bias
Occurs when the means for obtaining information about subjects in the study are inadequate so that as a result some of the information regarding the exposure or outcomes are incorrect
46
What is recall bais
Is the main form of information bias in case control studies
When there is a differntional recall of exposure between cases and controls
47
What is the measurement of outcomes triad
- Structure: Assessed through organization standards
- Process: Quality assurance programs
- Outcomes: Morbidity, mortality, length of stay, and readmissions
48
What is qualitative research
Naturalist, humanistic or idealistic approach to research
Explore a social or human problem
49
What do cross sectional studies determine
Prevalence NOT incidence
50
What is clinical research
Structures process of investigation facts and theories and exploring connections
-utilizes a variety of quantitative and qualitative measurement tools
51
What part of a study tells you if the results are valid or meaningful
The methods section
52
What is an example of a qualitative question
Tell me about your pain ?
53
What reduces measurement errors
- Double blinding
- Independent observers
- Validating instruments
- Providing supervised training
- Using multiple observers and data sources
54
If Relative Risk is equal to 1
No association
55
What are descriptive statistics uses for
To characterize the shape, central tendency, and variability within a diet of data, often with the inten to describe a population
56
What is absolute risk reduction
The actual reduction in events in the treated group
Is the TRUE DIFFERENCE between the experiment and the control intervention
57
What is survivor bias
Can lead to erroneros associations between an exposure and outcome based on survivorship of the subject in a study
58
What are the strengths of a cross sectional study
Can asses multiple outcomes and exposures simultaneously
Lead to further studies
Can generate prevalence
Can calculate odds ratios
59
What are case control studies
Studies in which patients who already have a specific condition (cases)are compared with people who do not (controls)
60
What is the purpose of a case-control study
To determine if the frequency of an exposure or certain personal characteristics are different for those who did/ did not get the disease
61
What are two general types of errors
Unpredictable
| And errors made in a biased, systematic way
62
how do researchers use statistics
To estimate population parameters
63
Clinicians must be able to use what two types of sources
Primary and Secondary
64
Define internal validity
Within the confines of the study ,
| Results appear to be accurate interpretations of the investigations supported
65
What is a recall bias
The possible inaccuracy of recalling medical history or previous exposures
66
What does a positive LR tell you
(LR+)
is the reaction of the proportion of diseased people with a positive test result (sensitivity) to the proportion of non-diseased people with a positive result (1-specificity)
67
What is the scientific method
Defines as the systematic, empirical, and controlled critical examination fo hypothetical propositions about the associations of natural phenomena
68
What are two types of date
Categorical and continuous
69
What is the number needed to treat
Expresses the likelihood of the treatment to benefit an individual patient
70
What are confounding variables
Variable that correlates directly or indirectly with the dependent and independent variables
71
What does covariate mean
An extraneous variable that is statistically controlled in an analysis of covariance, so that the relationship between the independent and dependent variables is analysed with the effects of the extraneous factor removed
72
What is quantitative research
Measurement of outcomes using numerical date under standardized conditions
73
What are case series used for
Examine adveres events or effects
Catalog new diseases or outbreaks
Determine safety of a new treatment
Discuss potential efficacy of a new treatment
74
A LR+…..
| A LR-…
LR+ rules in the disease
| LR- rules out a disease
75
What are filtered resources
Evaluate how recently the summary or study was updated of revised
Examples: clinical practice guidelines
Cochran Database of systematic Reviews
76
What kind of research is a cross sectional study
Observational
77
What is the dependent variable
AKA the outcome variable
| Response of effect that is presumed to vary depending on the independent variable.,
78
What was the purpose of the Impact factor/ score
Was to support budgetary decisions of libraries, not to serve as a measure of scientific worth of individual studies
79
What is categorical data
Nominal data- classifications
| Ordinal Data- ranked or sequenced data
80
What is longitudinal research
Follows a cohort of subjects over time, repeated measurements at prescribed intervals
81
What are measurements
Defined as the process of assigning numeral to variables to represent quantities of characteristics according to certain rules
82
What is scientific research
The process of investigation facts and theories in a scientific way to examine relationships among clínical phenomena to generat evidence for decision making
83
What are the strengths of a meta analyses
Generate great statistical power
Confirmatory data analysis
And ability to extrapolate the general population
84
What is inferential statistics
Involve a decision making process allowing estimation of population characteristics from sample data
85
What type of square test would you use if the date was in paired samples
McNemar test for matched pairs
86
What is the Alternative hypothesis
H_a or H_1
The statement that establishes a relationship between variables being assessed
87
What does the chi-square for equality of proportion test
Computed the same way as the CI square test for independence, but instead tests the hypothesis that the distribution of some variable in the same in all populations
88
What is exploratory research
Cohort studies
Case Control Studies
-used to examine phenomena of interés and how it relates to other factors
89
What is outcomes research
Wusses of intervention in clinical practice
Encompasses outcomes: Morbidity, mortality, disease development, and disease readmissions
90
Is evidence alone enough to make a clinical decision
NO
91
What is the main form of information bias in case control studies
RECALL BIAS
92
What are limitations on systematic reviews
Very time and labor consuming
| May not be easy to combine studies
93
What is the most general and least precise measure of central tendency
The Mode
94
What does relative risk measure
The magnitude of an association between an exposed and non exposed group
95
What does a Odds ration tell you
It measures the strength of association between an exposure and a diseases
96
What is relative risk
Basic risk statements express the likelihood that a particular event will occur within a population
IDs what in our environment can lead to beneficial or adverse medical outcomes
97
What are variables
Characteristics of interest that assume different values for different subjects
Like age, gender, disease status
Must be clearly defined
98
What is a regression analysis
A method of predicting change in the dependent variable by changing one or more independent variable
Y=mx+b
99
What is the range of a LR-
0.0 to 1.0, null value 1.0
The smaller the better
Desirable 0.2 or less
100
What is the highest form of evidence
```
Systematic Reviews
Then Critically Appraised Topics
ThenCritically Appraised Individual Articles
Then RCT
Then COHORTS
Then Case Studies
Lastly expert opinion
```
101
What do case reports and series inherently lack
Sufficient methodological vigor
| -may be circumstantial evidence
102
What are the 5 types of Clinical questions
- therapy
- harm
- diff. Diagnosis
- diagnosis
- prognosis
103
What is the measurement error
The difference between the true value and the observed value
104
What does the chi square test of goodness of fit test?
In used to test the hypothesis that the distribution of a categorical variable within a population followed a specific patter of proportion
105
A RCT is what type of Resouce
Unfiltered
106
What is a sampling error
The tendency for sample values to differ from population values
107
What does “control” mean in the scientific method
Allows the researcher to understand how one phenomenon relates to another, controlling factors are not directly related to the variables in question.
108
What are the limitations of Meta Analyses
Difficult and time consuming to indemnity appropriate studies
Not all studies provide adequate data
Requires advanced techniques
Heterogeneity
Subject to many biases
109
What are the limitations of case- control studies
```
Only produce a single outcome
High risk for bias
High risk for confounding variables
CANT determine prevalence
CANT determine incidence
CANT calculate relative risk
```
110
What does the chi square of independence test
Tests the null hypothesis that the variables are independent of eachother, that there is no relationship between two variables
111
What is a funding bias
Characterizing as association owing to the absence or withdrawal of financial or other types of support
People are more motivated if you pay them
112
What is a relative risk reduction
The percentage difference in outcome between control and experimental groups
**makes insignificant findings seems significant **
113
What is qualitative research
More concerned with a deep understanding of a phenomenon through narrative description
114
A hospital guideline is what type of resource
Filtered
115
What is Postive predictive value
Estimates the likelihood that a pt who tests positive actually has the disease
116
What is a likelihood ration
Summarizes the same type of info a sensitivity and specificity, but can be used to calculate the probability of disease in a LOW PREVALENCE SETTING
-provides a indication of the tests discriminatory power
117
What is selection bias
Inappropriate selection of study participants that may lead to an erroneous association between an exposure and and outcome
118
What is the difference of cross sectional vs longitudinal studies
Cross sectional looks at a specific point in time.
| Longitudinal you repeatedly collect information from the same sample over an extended period of time
119
What is a non-inferiority trial
Done to show that the new treatment is an s good or better than the standard
120
What is frequency distribution
A table of ranch ordered scores that show the number of times each value occurs
121
Which type of error ( I or II) is worse
Type I is generally a worse error than type II
122
What are the four components of a clinical question
P.I.C.O.
123
Phase II trials
Explores efficacy by measuring relevant outcomes
124
What are the four main areas of methodological concern for RCTs
Enrollment- how was the population chosen
Allocation- Randomized and how’?
Follow up- length of patient following
ANALYSIS- how was data collected
125
Mesures of population characteristics are called…
Parameters
126
What is the manifest level
Basic level
| A descriptive account of the date
127
What is a publication bias
Tendency of researcher and editors to treat postive results from negative or inconclusive results, often with a preference of positive findings
128
What is the first step to minimize error
The power analysis is the first step in reducing errors
129
What is Hawthorne effect
People act different when they know they are being watched
130
What is surveillance bias
Occurs when outcome ascertainment is better in a monitored population than in the general population
131
What is “Validity of Data”
Degree to which a measurement represents a true value
132
What is the “noise” that gets in the way of finding the true value
Measurement error
133
What are phase III trial s
Compared the new treatment with standard care ,
| Large group of PTs
134
What are the PA Competencies
Patient Care
Professionalism
Systems- Based Practice
135
What are types of systematic error
Predictable errors or errors made by biases
Investigator or Interviewer Biases
Subject Biases
- Social Desirability: subjects respond with what they think is the right answer
- Hawthorne Effect : people may act different when they know they are being watched.
136
What does it mean to be “systematic”
To have a sequence that starts with the identification of a problem, then follows an organized collection and analysis of data and leads to interpretation of the findings
137
What are unfiltered sources
AKA primary sources
It’s up to the reader to determine quality and validity of the source
138
What is prospective research
Variables are measured through direct recording in the present tense
139
What kind of research is active intervention
Experimental
140
What is a superiority trail
Compared one treatment to another directly
141
What does “reliability” mean
Degree to which the measurements are reproducible
142
What is continuous data
Interval data: intervals along the scale are equal to one another
Ratios: characterized by the presence of absolute zero on the scale
(no negative values)
143
What are Boolean logic primary operators
Combining search terms with and, not, or
144
What is the simplest measure of variability
The range
145
What is a confounding variable
An extraneous variable that is related to the independent and dependent variable, but not the casual pathway.
146
What is basic research
Done in a lab to obtain empirical data
| Used to develop, refine, or test a theory
147
What is the latent level
Higher level
| A more interpretative analysis that is concerned with the response as well as what may have been inferred or implied
148
What are the limitations of cross sectional studies
No time reference
Only useful for common conditions
CANNOT calculate incidence
149
Can case-control studies determine relative risk
NO, they can make odds ratio that can be a close indicator of relative risk
150
What are the strengths of Cohort studies
Can identify temporal relationships between exposure and disease
Can help confirm cause and effect and magnitude of effect
Can measure incidence
Can calcule relative rise
151
What is the 68-95-99 rule
The standard deviation
That 68% of all scores fall within 1 stand. Div of the mean
And 95 % of all scores fall within 2
Stan. Div of the mean
And 99.7% of all scores fall within 3 standard divs of the mean
152
What is the most coming confounding fact
The selection factor
- Theory based
- Stats based
153
What does descriptive research emcompass
Observes associations
Shows patterns
Generates hypotheses
Provides clues to disease etiology
154
What does an Odds ration greater than 1 indicate
| Less than 1 indicate
> 1: increased occurrence
<1 decrease occurrence
(protective measure)
155
What is applied research
Directed toward solving immediate practical problems with functional application
156
What is a scoping review
A broad less structured approach that offers assessment of emerging evidence
157
What are background resources
Used to learn about a new topic or refresh knowledge
Usually in textbooks, medscape, up to date
158
What is the control bias “matching “
Selection of controls so they are similar to the cases.
159
What is the range of a LR+
1.0 to infinity, null value 1.0
The bigger the better
Greater than 5 is most desirable
160
What is a cohort
A group of people who share a common characteristic or experience and all remain in the group for a period of time
161
What is the strongest observational design
COHORT STUDY
162
What is a Type I error
Finding an effect that isn’t real
Rejecting the Null hypothesis when the association isn’t real
Like convicting an innocent man
163
What is a intention to treat analysis
Data is analyzed according to original random assignment, regardless of the treatment subjects actually receive
Helps reduce bias if there are dropouts in the study
164
What is the hierarchy of data
Ratio- best
Interval
Ordinal
Nominal- worst
165
What are the limitations of cohort studies
```
Expensive and time consuming
Inefficient for rare diseases
Lose participants to follow ups
Confounding variables
Recall biases
```
166
how is a quasistudy different from a RCT
In non randomized
167
What is descriptive research
Attempts to describe a group of individuals on a set of variables to document their characteristics
- patterns of growth
- Change over time
- Normative studies
168
What are the strengths of Systematic Reviews
Exhaustive
Less costly than a new study
Less time required than conduction a study
Results can be generalized
More reliable and accurate than studies on their own
Considered Evidence Bases medicine
169
What are the limitations of a Non-randomized control study
Characteristics are not balanced at baseline
| May have confounding variables
170
What are three types of variables
Independent
Dependent
And confounding variables
171
If the exposure is related to disease then the OR will be
Greater than 1
172
What two things are used to generate practice guidelines
Systematic review and meta-analyses
173
What is the “n”
| Distribution
The total number of scores in the distribution is give the symbol “n”
174
NNT for very effective treatments are usually in the range of …
2-4
175
What’s are the potential biases in Cohort studies
Selection Bias
Information Bias
Observer Bias
176
What is a equivalence trial
Done to show the new drug in no more or less effective that the standard
177
What is instrument variation in measurement errors
That not all instruments are perfectly accurate
Like different BP cuffs
178
What is a lost to follow up bias
Occurs when subject leaves a study different based on exposure bias
179
What is epidemiology
The study of distribution and determinants of health related states or events in specific populations, and the application of the study to control health problems
180
What is an epidemiological bias
An incorrect assessment of the association between exposure and an effect in the target population
Anything which erroneously influences conclusions about a study group
181
What is the independent variable
The variable that is presumed to cause a dependent variable,
The variable that is manipulated or controlled by the researcher
182
Describe the multi step process of epidemiology
- Determine an association between exposure and outcome
- Is the association causal ?
- Derive appropriate inferences about a possible causal relationship from patterns found
183
What are the strengths of Case- Control Studies
Good for studying rare outcomes
Simple and Fast
Inexpensive
Can Calculate odd rations
184
What three things combine to make evidence based practice
Best available research
Patient values and preferences
Clinical expertise
185
LR=
Like hood of a particulare result in someone WITH the disease
_____________________________
Like hood of the same result in someone WITHOUT the disease
186
What is a control event rate (CER) %
A measure of how often a particular even occurs within the scientific control group of an experiment
187
What does it mean to be empirical
To document objective data through direct observation
188
Odds ratios in case control studies are a good approximation of RR when…
The cases studies are representative of all people with the disease
When the controls are representative of all people with the disease
When the disease is common
189
If relative risk is greater than 1
Positive association, possibly casual
190
What are phase IV trails
Post marketing
| Looks at long term use
191
In a blinded study what mayst planned crossover have…
A washout period
192
What are the objectives of Epidemiology
To reduce morbidity and mortality
To determine the extent of disease in communities
The study the natural history of prognosis of a disease
Provide a foundation for developing policy related to environmental problems
193
What are some examples of descriptive studies
Care reports and Case Studies
194
What is secondary literature
Databases and Point of Care resources
195
What is outcome management
Interdisciplinary process aimed at determining best practices
196
A descriptive index computed from the sample data is called a…
Statistic
197
What are the progression of steps in clinical trials
```
Preclinical phase
(Basic research done in labs with animals)
```
Phase I, II, III, then IV trials
198
Define external validity
Ability to apply results obtained from a study population to a broader population
Aka generalizability
199
What is an effectiveness trial
Attempts to learn if the drug, procedure works under real world circumstances
200
What is the dependent variable
A response variable that is assumed to depend on or be caused by another (independent) variable.
201
What is primary literature
Original study
202
If the exposure is protecting of the disease then the OR will be
Less than 1
203
What are the strengths of RCT
```
Randomization
High internal validity
Can make inferences
Can estimate risk directly
**GOLD STANDARD**
```
204
What is experimental research
Researcher manipulates and controls one or more variables and observes the resultant variation of other variables
205
What are the limitations of RCT
```
Low external validity
Expensive
Time consuming
Resource intensive
Long term follow ups
Compliance
Possible ethical questions
```
206
What are phase I trails
Looks at treatment safety in small groups
207
In unplanned crossover of blinded study … what is the cause, and beat does it lean towards?
Intention to treat
Leans toward the null
208
What is the Chi-square test
One of the most common ways to compare two or more variables
209
What do scatter-plots do
Evaluate the strength of linear relationship or associations between variables
210
What is negative predictive power
Estimates the probability that a person who tests negative is actually disease free
211
If the exposure does not effect the disease then the OR will be
~1
212
What is practice-based learning and improvement
A systematic methodology
Locate, appraise, and integrate evidence from scientific studies
Apply knowledge from study designs and statistical methods, and to address personal biases
213
What is probability
The likely hood that any one event will occur, given all the possible outcomes, shown as p.
214
What is an independent variable
Something that will predict or cause the outcome
The intervention, the treatment, and the age, gender, martial status ect.
215
What is the simplified process of Evidence Based practice
```
Asses (identify need to gather info)
Ask (PICOTT)
Acquire
Appraise
Apply
```
216
What does a T-Test compute
A P value to test the null hypothesis
217
What is the “distribution”
The total set of score for a particular variable
218
WHAT INFLUENCES PATIENT CA
Current Scientific Literature
219
What is the Experimental Event Rate (EER) %
A measure of how often a particular event occurs within the expire to al group of a experiment
220
What is a type II error
Missing an effect that does exist
Retaining or failing to reject the null hypothesis when the association is real
Not convicting a guilty man
221
What is the null hypothesis
H_0
The statement of no difference or no relationship between the variables
222
What is a cohort study
An epidemiological investigation that follows groups with common characteristics over a specified period of time
