Test 1 Flashcards
Define “Evidence-Based Medicine”
also referred to as “evidence-based health care” and “evidence-based practice”
The use of evidence in clinical decision making rather than unquestioning reliance on knowledge gained from experts or teachers or familiar practice habits.
What are the EBPT focus areas?
Examination, Evaluation, Diagnosis, Prognosis, Intervention, Outcomes
What is the EBPT process?
- Question formation
- Search for relevant evidence
- Critical appraisal of evidence
- Determination of applicability of evidence
- Consideration of evidence in combination with clinical expertise, patient/client values and preferences
What are the factors important to EBPT?
- Therapist knowledge and willingness to accept new evidence
- Access to evidence through electronic databases
- Time to participate in the EBPT process
What is evidence?
Empirical observation about the apparent relation between events
List the types of research designs from most bias control to least.
- Experimental designs
- Quasi-experimental designs
- Nonexperimental designs
- Case report/ anecdote
Why should you publish whether or not the experiment works?
You can prevent someone else from wasting their time and resources.
Explain an experimental design.
Groups are randomly assigned to an experimental group or a control group
Explain a quasi-experimental design.
It is similar to an experimental design but does not have a control group.
Explain a nonexperimental design.
surveys, questionnaires, expert opinions, historical reviews, curriculum design, etc.
Explain a case report.
An example would be reviewing patient records.
What does a blind study mean?
The patient doesn’t know which group they are being assigned to.
What does a double blind study mean?
Neither the patient nor the researcher know which group the patient is assigned to.
What is a variable?
A characteristic of a group or a person.
Example- demography, gender, age, weight
What is an independent variable?
A variable that can be changed based on the type of research you are going to do.
What is a dependent variable?
The variable that depends on the independent variable.
What are the different ways to think about research designs concerning time?
- Retrospective (already existing data)
- Prospective (new data in real time)
- Cross-sectional (a single point in time)
- Longitudinal (over an extended period of time)
What is the hierarchy of evidence quality from highest to lowest?
- Randomized clinical trials
- Cohort studies
- Case control studies
- Case-series study
- Expert opinion
Which type of research is often used in PT?
Systematic Reviews
Why do we do research and how to we start?
We do research when we have a question. We look up information in order to answer that question. We begin with a small-scale pilot study.
What is a SLAP injury?
Superior Labrum Anerio-Posterior
What might EBPT questions pertain to?
- Pathology
- Medical and surgical management options
- Tests and measures
- Predictive factors for health status
- Benefits and risks on interventions
- Outcomes
What kind of questions can we ask concerning pathology in PT?
Why does and injury happen?
What kind of questions can we ask concerning medical and surgical management options?
What type of treatment has been done?
What are some examples of tests and measures in PT?
Range of motion, proprioception, etc.
What kind of questions can we ask concerning predictive factors for health status?
How will the person recover from the injury?
What kind of questions can we ask concerning benefits and risks of interventions?
Does the treatment work?
How can we question clinical prediction rules?
Develop strategies for a person to reach certain standards (like a certain level=go back to work).
What kind of questions can we ask concerning Outcomes?
What is the end result?
What does a background question do?
Reflect desire to understand the nature of the problem, help clincians better understand and treat situations
This can affect precautions, contradictions, and exercise limits.
What does a foreground question do?
Allow clinicians to make decisions about specific clinical management issues
These can involve diagnostic tests, clinical measures, prognostic factors, interventions, clinical prediction rules, and outcomes.
What are the 4 key elements of a foreground question?
- Patient/Client details
- A specific factor of interest
- A basis for comparison of that specific factor
- The consequence of interest for the factor
What are the major EBPT databases?
- US National Library of Medicine (pubmed)
- Cumulative Index of Nursing and Allied Health Literature (CINAHL)
- Cochrane Library
- Physiotherapy Evidence Database (PEDro)
- APTA’s Hooked on Evidence
Which is the database most often used by PTs?
PEDro
What is research?
The studying of a problem in pursuit of a definite objective through employing precise methods with due consideration to the adequate control factors other than the variable under investigation and followed by analysis according to acceptable statistical procedures.
Define and give an example of deductive reasoning
Top-down (more general–>more specific)
Every day I leave for work at 8.
Every day I arrive on time.
If I leave for work at 8 today, I will be one time.
Define and give and example of inductive reasoning.
Bottom-Up (specific observation–>broader generalization)
Today I left at 8 and arrived on time
Therefore, every day I leave at 8 I will be on time.
Who can do research?
ANYBODY
What are the 5 general phases of the research process?
- Develop a research question
- Design of Study/ Methods
- Data collection
- Analysis
- Summary and Conclusion
What does the development of the research question involve?
rationale, review, research hypothesis
What does the design of study/ methods involve?
subject selection, testing methods, methods
What does the analysis involve?
reduction of data, testing hypothesis
What does the summary and conclusion involve?
reports, presentation
Which sections do you include in a research proposal?
Intro, Review, and Methodology
Which hypothesis are you striving to reject?
The null hypothesis
Where does statement of the hypothesis go?
Under methods
Where does the decision to accept or reject the null hypothesis go?
After analysis of data, before interpret findings
Explain basic research.
to obtain empirical data that can be used to develop, refine, and test theory. (Acquisition of new knowledge)
Explain applied research.
directed toward functional applications, testing
What are the types of nonexperimental research?
Descriptive, Historical, Evaluation, Methodology
What are some ethical issues in clinical research?
- Integrity of the researcher
- Use of control groups
- Protection of human rights
What are the elements of informed consent?
- Subjects must be fully informed
- Subjects information should be confidential and anonymous
- The informed consent form must be written in a simple language
- The researcher must offer to answer questions at any time.
According to the institutional review board, what are consent elements?
- consent must be voluntary
- Special consideration to subjects who are vulnerable
- subjects must be free to withdraw consent at any time
What are the different levels of measurement?
Nominal
Ordinal
Interval
Ratio
Describe the nominal level of measurement.
Mutually Exclusive- male and female, yes and no
Describe the ordinal level of measurement.
Manual muscle test (0,1,2,3,4,5) rank.
Describe the interval level of measurement.
Intervals between are consistent, but nothing is zero (equal intervals between numbers).