Review examples Flashcards
Why is a systematic review of RCTs the highest level of evidence?
it has less bias and is highly controlled
Regarding “Ways of Knowing,” what is the highest type of knowledge and why?
Scientific Evidence because it has the least amount of bias
What are the three pillars of evidence-based practice?
best available evidence, clinical experience, patient values & preference
Which type of research has the MOST bias control? Why?
Level 5: clinical experience, expert opinion, mechanism-based reasoning
Researchers want to know if adding kinesio-taping to standard physical therapy will improve pain levels in patients with knee pain. Researchers will randomly assign participants to receive either standard physical therapy or standard physical therapy with kinesio-taping. Pain will be measured before starting treatment and after completing a total of 8 sessions using the Numeric Pain Rating Scale. Change scores will be used in the analysis.
a. What is/are the independent variable(s)?
b. How many levels?
c. What is the dependent variable?
d. What is the level of measurement of the dependent variable?
e. Is this a true experimental design?
f. What is the name of this design? Be specific.
g. After the 6th PT session, two participants went for a 3-mile run, which substantially increased their pain and disability ratings. Name this threat to internal validity.
a. kinesio-taping; or treatment
b. 2 levels
c. NPRS (pain)
d. ordinal
e. yes; random assignment, IV manipulated; control group
f. one-way pretest-posttest control group design
g. history
Researchers want to know if adding kinesio-taping to standard physical therapy will improve disability levels in patients with knee pain. All participants will receive both treatments, and researchers will randomly assign the order of treatment. Disability will be measured before starting each treatment, and after completing 4 sessions of the treatment. Researchers will use the 6-minute walk test (meters) to quantify disability.
a. What is/are the independent variable(s)?
b. How many levels?
c. What is the dependent variable?
d. What is the level of measurement of the dependent variable?
e. Is this a true experimental design?
f. What is the name of this design? Be specific.
g. Part way through the study, the researchers learn that the treadmill required calibration and other maintenance. Name this threat to internal validity.
a. kinesio-taping; or treatment
b. 2 levels
c. 6-minute walk test (disability)
d. ratio
e. no; lacks control group = Quasi-experimental
f. one-way repeated measures design (or Crossover)
g. Instrumentation
Researchers want to know if adding kinesio-taping to standard physical therapy will improve disability levels in patients with knee pain. Researchers will allow participants to select their group assignment, either standard physical therapy or standard physical therapy with kinesio-taping. Disability will be measured before starting treatment and after completing a total of 8 sessions using the Lower Extremity Functional Scale. Change scores will be used in the analysis.
a. What is/are the independent variable(s)?
b. How many levels?
c. What is the dependent variable?
d. What is the level of measurement of the dependent variable?
e. Is this a true experimental design?
f. What is the name of this design? Be specific.
g. Participants were allowed to self-select their group assignment. Name this threat to internal validity.
a. kinesio-tapin; or treatment
b. 2 levels
c. LEFS (disability)
d. ordinal
e. no; lacks randomization
f. nonequivalent pretest-posttest control group design
g. selection
Researchers want to know if combining kinesio-taping with dry needling will improve hamstring flexibility in patients with knee pain. Researchers will randomize participants to one of two taping conditions (taping vs. sham taping) combined with one of two dry needling treatments (DN vs. sham). Flexibility will be measured before starting treatment and after completing a total of 8 sessions using a standard goniometer (degrees). Change scores will be used for analysis.
a. What is/are the independent variable(s)?
b. How many levels?
c. What is the dependent variable?
d. What is the level of measurement of the dependent variable?
e. Is this a true experimental design?
f. What is the name of this design?
g. Flexibility is measured using the mean of 3 trials. The researcher finds that flexibility has dramatically increased by the 3rd measurement. Name this threat to internal validity.
a. kinesio-taping AND dry needling
b. 2 levels each (4 total)
c. flexibility (ROM)
d. ratio
e. yes; random assignment, IV manipulated, control group(s)
f. two-way pretest-posttest control group design OR 2x2 factorial design for independent groups
g. testing
Researchers want to know if the intensity of ultrasound (0.8 w/cm2, 1.5 w/cm2, and sham US) applied to the lateral epicondyle affects wrist flexion range of motion. They plan to randomly assign your subjects to mutually exclusive groups. You will measure wrist range of motion in degrees, and will measure ROM immediately before and after four weeks of treatment. Change scores will be used for analysis.
a. What is/are the independent variable(s)?
b. How many levels?
c. What is the dependent variable?
d. What is the level of measurement of the dependent variable?
e. Is this a true experimental design?
f. What is the name of this design?
g. The participants in the sham US group became frustrated with their lack of improvement, and 30% of them withdrew from the study. Name this threat to internal validity.
h. While a 30% drop-out rate is concerning, the researchers proceed with their statistical analysis, and they analyze the participants according to their original allocation, regardless of whether they completed the study. What is this called?
a. Ultrasound
b. 3 levels
c. ROM
d. ratio
e. yes; random assignment, IV manipulated, control group(s)
f. one-way pretest-posttest control group design
g. attrition
h. intention to treat analysis
Researchers want to determine if one session of dry needling to pec major and latissimus dorsi improves shoulder flexion range of motion. All participants will receive the same dry needling treatment once. The researchers will measure ROM at the evaluation, perform dry needling, and then measure ROM at the end of each week for four weeks.
a. What is/are the independent variable(s)?
b. How many levels?
c. What is the dependent variable?
d. What is the level of measurement of the dependent variable?
e. Is this a true experimental design?
f. What is the name of this design?
g. A novice researcher is measuring range of motion, and over time becomes more skilled with the goniometer. Name this threat to internal validity.
a. time
b. 5 levels
c. ROM
d. ratio
e. no; lacks control group; all participants getting same treatment
f. one-group pretest posttest (repeated measures) design
g. instrumentation
You are designing a study to investigate PT utilization and pain medication usage in persons living with HIV. You plan to identify individuals with HIV, categorize them by whether or not they had physical therapy, and track their medication usage over a 5-year period. You will categorize medication usage as high (> 4 days per week) and low (< 4 days per week).
a. What is the exposure?
b. What is the outcome?
c. What is the level of measurement of the variables?
d. Are participants grouped by exposure or outcome? What design is this?
e. Is this prospective, retrospective or cross-sectional?
f. What is the biggest limitation of this type of design?
a. physical therapy
b. medication usage
c. nominal; dichotomous
d. exposure; cohort study
e. prospective
f. resource intensive; dropouts
You want to determine if time spent standing at work is a risk factor for developing plantar fasciitis. You plan to classify your participants by whether or not they had plantar fasciitis. You identify 50 individuals with plantar fasciitis and 50 individuals without plantar fasciitis, who were patients at your clinic. You look at their initial evaluation to find data on how many hours of the work-day they spend standing. You will categorize time spent standing as high (> 4hrs per day) or low (< 4 hrs per day).
a. What is the exposure?
b. What is the outcome?
c. What is the level of measurement of the variables?
d. Are participants grouped by exposure or outcome? What design is this?
e. Is this prospective, retrospective, or cross-sectional?
f. What is the biggest limitation of this type of design?
a. standing
b. plantar fasciitis
c. nominal; dichotomous
d. outcome; case-control study
e. retrospective
f. recall bias; insufficient documentation; already know the outcome, which may change how you look at the data
The talar tilt test has a specificity of 0.88 for detecting calcaneofibular ligament sprains. Interpret this value.
a. Does this test identify a high proportion of true positives or true negatives?
b. Is it better to rule in or rule out CFL sprains?
a. true negatives
b. ruling in
The slump test has a sensitivity of 0.84 for detecting lumbar disc herniation. Interpret this value.
a. Does this test identify a high proportion of true positives or true negatives?
b. Is it better to rule in or rule out disc herniations?
a. true positives
b. rule out
Researchers found a cluster of findings that could predict the presence of a vertebral compression fracture. Having 4 of the 5 positive findings yielded a +LR 20.4. Interpret this value.
a positive results (4 of the 5 findings) is 20.4 times MORE likely to occur in someone WITH the a vertebral compression fracture than WITHOUT. Large shift in posttest probability
