Single-Subject Research

Question 1

Understanding _____ designs, analyses, and applications improves your ability to evaluate the evidence-based literature and eventually to answer your clinical questions.

Answer 1

single-case experimental

Question 2

Rigorous research with single participants can be applied to your patients, sometimes more ___ than the results of group RCTs.

Answer 2

directly

Question 3

In a typical single subject design (SSD), one participant is ____.

Answer 3

followed intensely

Question 4

SD typically creates ___ data, but on only one participant.

Answer 4

abundant

Question 5

_____ are repeatedly measured during a baseline period, before intervention begins.

This may occur over successive days or weeks.

Answer 5

Variables of interest

Question 6

The intervention period begins after ____ and then data are collected periodically on the single subject during the intervention.

Answer 6

baseline

Question 7

Then a period after _____ during which the participant is measured, but no treatment is given.

Answer 7

intervention

Question 8

The ____ in the variables during the treatment period is then compared to the variables during baseline and post-treatment periods.

Answer 8

change

Question 9

T or F

In contrast to an SSD, case studies are typically written prospectively and detail the characteristics of one case and the course of intervention for that case.

Answer 9

F (retrospectively)

Question 10

T or F

A case study is a controlled single-case experimental design.

Answer 10

F (NOT)

Question 11

T or F

A case study is not a two systematically reported single-patient example that does not include a controlled manipulation of intervention.

Answer 11

T

Question 12

A case study does not include other experimental controls that are implemented in an ____.

Answer 12

Single-Subject Design (SSD)

Question 13

Case studies may be helpful to our ____ but they lack systematic control, implementation, and evaluation of treatment.

Answer 13

clinical decisions

Question 14

_____ for SSDs is different from notation for other intervention designs.

Answer 14

Research notation

Question 15

___ refers to the phase of observation with measurement.

Answer 15

“A”

Question 16

T or F

“A” designates baseline or treatment withdrawal phases.

Answer 16

T

Question 17

“B”

Answer 17

Phase for intervention

Question 18

This stands for the phase of comparison interventions.

Answer 18

“C, D, etc.”

Question 19

T or F

Randomized Control Trials can be implemented using SSDs.

Answer 19

T

Question 20

For an RCT with single subjects, __ is randomly assigned to treatment condition A and the next subject is assigned to an alternative (comparison) treatment B.

Answer 20

1 subject

Question 21

_____ is standardized across subjects, just as in a group design.

Answer 21

Treatment protocol

Question 22

This is the benefit of using RCT with single-subject design.

Answer 22

Multiple measures are obtained on each subject

Question 23

RCT with single-subject design has repeated measures that document the natural fluctuations of the outcome of interest during phases of ____ and give insight into the trend and variability of responses to treatment.

Answer 23

no treatment

Question 24

T or F

A crossover design can also be used with a group of single subject studies.

Answer 24

T

Question 25

T or F In RCT with single-subject design, a subject is randomly assigned to treatment A. The outcome is measured and this is followed by the same subject receiving treatment B with measurements taken after the second treatment.

Answer 25

with crossover design

Question 26

Part A or appraising SSR designs

Answer 26

Determining the applicability of SSR

Question 27

This is the first question to consider in determining the applicability of SSR.

Answer 27

Is the study’s purpose relevant to my clinical question?

Question 28

Question 2: Is the ___ sufficiently similar to my patient to justify the expectation that my patient would respond similarly to the population?

Answer 28

study subject

Question 29

Question 3: | Are the inclusion and exclusion criteria clearly ____ and would my patient qualify for the study?

Answer 29

defined

Question 30

The disadvantage of group design is the ____ introduced with a large sample. This will reduce the likelihood of finding a significant difference between the effects of different interventions when they actually exist.

Answer 30

inter-subject variability

Question 31

In SSD, the subject acts as his own control, and the participant’s baseline and intervention periods are compared to detect possible ______.

Answer 31

treatment effects

Question 32

Another challenge of RCT designs is the application of _____ from a group to a single patient.

Answer 32

study findings

Question 33

T or F The trade-off between SSDs and group designs is that the treatment responses of a single participant are as powerful as the treatment responses from a group of participants.

Answer 33

F (NOT as powerful)

Question 34

Part B of appraising SSR designs.

Answer 34

Determining the Quality of SSR (Measurement)

Question 35

Question 4: | Are the outcome measures relevant to the _____ and are they conducted in a clinically realistic manner?

Answer 35

clinical question

Question 36

In SSR, measures are taken repeatedly on a single participant over the course of _____ before intervention is initiated.

Answer 36

several days or even weeks

Question 37

With group designs, participants’ measurements are typically taken ______ at baseline.

Answer 37

only once

Question 38

The _____ is a single measurement of many subjects versus multiple measures of a single person.

Answer 38

trade-off

Question 39

An important consideration for SSR is the possible impact of multiple measures on the _____.

Answer 39

outcome of interest

Question 40

Based on question 5, who should be blinded or masked in the study design?

Answer 40

Evaluators

Question 41

T or F Therapists must be reliable in their measurements, and the treating therapist should measure the subject during the study.

Answer 41

F (NOT measure)

Question 42

This blinding is often challenging in an SSD, but it is critical to the rigor of the study.

Answer 42

"treating therapist should not measure the subject"

Question 43

What is Question 6?

Answer 43

Is the intervention clinically realistic?

Question 44

T or F Question 7 aims to answer if the outcome measures are relevant to the clinical question and if they are conducted in a clinically realistic manner.

Answer 44

T

Question 45

T or F In SSD, the intervention is specific to the participant.

Answer 45

T

Question 46

____ designs are more costly and typically take longer to complete, but they do address the issue that no one treatment fits all.

Answer 46

Group

Question 47

What is Question 8?

Answer 47

Aside from the planned intervention, could other events have contributed to my patient’s outcome?

Question 48

SSDs should be rigorously _____.

Answer 48

controlled

Question 49

SSDs should include monitoring the patient for all possible ___ to outcomes during the study period.

Answer 49

contributions

Question 50

What is Question 9?

Answer 50

Were both visual and statistical analyses applied to the data?

Question 51

Published reports of SSR typically include the ____ to describe the study, and the data are reported according to the phases.

Answer 51

research notation

Question 52

Both visual inspection and statistical analysis are essential in the analysis of the data from single-subject studies. Therefore, the analysis of the results of a single-subject study should include _____.

Answer 52

graphs and statistics

Question 53

“Best fit” line through the data beginning in the first phase and extending through each phase in the study.

Answer 53

Celebration line

Question 54

The celebration line technique assumes that?

Answer 54

This technique assumes that the data can be fit with a linear function.

Question 55

Assist in describing increasing and decreasing trends in the data.

Answer 55

Celebration line

Question 56

Slopes for _____ in the study and the slope from the beginning of the study to the end visually capture the nature of change in the outcomes.

Answer 56

all phases

Question 57

What is Question 10?

Answer 57

Were data trends in the baseline removed from the | intervention data?

Question 58

Explain detrending data.

Answer 58

Repeated measures provide a description of the natural variation of the variables of interest during the baseline phase, before treatment initiation. Because this natural trend would be expected throughout the study, it must then be removed from the subsequent treatment phase. ``` The trend(s) that remains is then considered the result of the treatment with the natural fluctuation removed. ```

Question 59

There are a variety of methods to “detrend” the data but the important point in the appraisal of SSD is that this issue has been addressed in the ____ of the study.

Answer 59

analysis of the results

Question 60

The problem for statistical analysis is that repeated measures on the same person create dependency in the data, termed _____.

Answer 60

serial dependency

Question 61

T or F Repeated measurement of an individual has potential drawbacks. Performance may improve or be degraded through the repetition of measurement.

Answer 61

T

Question 62

Data points from the same person are positively correlated.

Answer 62

Autocorrelation

Question 63

A statistic used in combination with celebration line.

Answer 63

Two-Standard Deviation Band

Question 64

In using the Two-Standard Deviation Band, data must be normally distributed and not have a significant _____.

Answer 64

autocorrelation | coefficient

Question 65

T or F By convention, if two data points are above or below the 2SD bands in the treatment phase, the change is considered ___.

Answer 65

statistically significant

Question 66

What is Question 11?

Answer 66

Were outcome measures clinically important and meaningful to my patient?

Question 67

The relevance of the outcomes of SSR is based on what constitutes a successful may be statistically significant, but that significant difference may not be _____.

Answer 67

clinically relevant

Question 68

SSR could provide a ___ for your clinical practice.

Answer 68

framework

Question 69

Successful implementation of SSR requires the same rigor as implementation of an _____, but it is a convenient and effective design to measure the effects of your treatment with your specific patient.

Answer 69

RCT design

Question 70

Summarize SSR

Answer 70

* SSR is an alternative to group design research that can contribute to your clinical decisions. * Appraising the applicability and validity of SSR follows the same guidelines as the appraisal process for group designs, with the specific questions modified to fit the reduced number of participants, design alternatives, and statistics for analysis of SSR. * Although SSR requires additional clinic time, it can be conducted in most clinical settings.