Translating Evidence Into Practice Flashcards

1
Q

Describe Biologic Plausibility

A
  • Suggests that something makes practical sense based on knowledge of anatomy, biomechanics and physiology, and provides a logical pathway from basic science to clinical application
  • Used when a treatment has yet to be proven by research
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2
Q

What are Basic Research and Applied Research?

A
  • Basic Research - Bench - mostly on animals and in controlled lab setting, limited clinical applicability beyond biologic plausibility
  • Applied - Done on clinical populations, directly applies to clinical practice
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3
Q

What are the three basic types of research design?

A
  • Analytical
  • Descriptive
  • Experimental
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4
Q

Describe Analytical Research

A
  • Attempts to explain phenomena and analyze existing data, including systematic reviews
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5
Q

Describe Descriptive Research

A
  • Describe an observation or relationship
  • Include surveys, correlations and epidemiological
    studies
  • Human performance investigations such as biomechanical analysis and EMG are also considered descriptive
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6
Q

Describe Experimental Research

A
  • Follows the scientific method to demonstrate a change in a dependent variable
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7
Q

What are the three sub types of experimental design?

A
  • Pre-experimental: Pre-post-testing of one or more
    groups
  • True experimental: Randomized groups with pre and post-testing, often including a control group
  • Quasi-experimental: Designed to fit real-world applications while controlling threats to internal validity by using a pseudo control group
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8
Q

Describe the Levels of Evidence (1-5)

A
  • 1: High-quality, randomized clinical trial (RCT), prospective or diagnostic study Systematic reviews with homogeneity of RCT
    1. Lesser-quality RCT, retrospective study, cohort, or untreated control RCT Systematic reviews of cohort studies
    1. Case-controlled studies or systematic reviews of case-controlled studies
    1. Case series
    1. Expert opinion
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9
Q

What are the four research databases that provide the most comprehensive search of RCTs for Physical Therapy.?

A
  • Central
  • PEDro
  • PubMed
  • EMBASE
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10
Q

What are the two basic types of statistics?

A
  • Descriptive

- Experimental

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11
Q

Describe Descriptive Statistics

A
  • Identify central tendency (mean, mode, median), variability, and confidence intervals
  • Also include correlation between two variables
    without noting cause-and-effect
    -Include Regression Analysis
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12
Q

Describe Experimental Statistics

A
  • Used for experimental designs and are based on probability within a normal distribution
  • Identify cause-and-effect while maximizing ‘true’ variance and minimizing error variance
  • Sometimes referred to as inferential statistics
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13
Q

Which Guidelines are used for different types of research designs?

A
  • Consort - RCT
  • Strobe - observational studies (descriptive research), including cohort, case control and cross-sectional research
  • Stard - Diagnostic Studies
  • Prisma - SR and meta analysis
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14
Q

What is Internal Validity?

A
  • The ability of a study to correctly measure and identify differences
  • Exists when changes in the dependent variable are due to changes in the independent variable
  • Indicates good control of the research design
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15
Q

What is External Validity?

A
  • Ability to generalize the results of a study to a given population
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16
Q

What are confounding variables?

A
  • Anything that may have an effect on the dependent variable outside of the independent variables
17
Q

What is Observation Bias?

A
  • Refers to examiners potentially rating variables more or less favorably with knowledge of the subject’s grouping
18
Q

What is Selection Bias?

A
  • Refers to the use of improper subjects for the study, who are usually not representative of the population being studied
  • Threat to external validity
19
Q

What are questions to ask when examining a study for external validity?

A
  • Are the patients described in detail so one can
    decide whether they are comparable to those seen
    in practice?
  • Are the treatments or assessments described well
    enough so one can provide the same to patients?
  • Was the clinical outcome relevant and clinically
    significant?
20
Q

What is Type 1 error?

A
  • Overcalling it

- Occurs when there really weren’t differences even though they were found in the analysis (false positive)

21
Q

What is Type 2 error?

A
  • Undercalling it

- Occurs when there were differences but they were not found in the analysis (false negative)

22
Q

How are Type 1 and Type 2 Error controlled?

A
  • Type 1: Significance value (alpha)

- Type 2: Statistical Power

23
Q

What is a p value?

A
  • Probability that the difference between groups is due to random chance
24
Q

What is Effect Size?

A
  • Standardized value of the relationship between two variables, and provides the magnitude and direction of a treatment effect
  • Determined by the difference between the variable means divided by the standard deviation [DM/SD]
  • Cohens D is common name
25
Q

How are Effect Sizes (Cohens D) Interpreted?

A
  • 0.2 - small
  • 0.5 - moderate
  • 0.8 - large effect size
  • sample size is related to the effect size; lower effect sizes require higher sample sizes to detect meaningful differences
26
Q

What does the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) do?

A
  • Captures how people with a health condition function in their daily life rather than focusing on their diagnosis or the presence or absence of disease
27
Q

What is Minimally Cliniical Important Difference (MCID)?

A
  • Smallest improvement considered worthwhile by the patient
28
Q

What is the interpretation of 95% confidence interval?

A
  • Repeating the study would result in a value

within that range 95 percent of the time

29
Q

What is the Absolute Mean Difference?

A
  • Measures the difference in means between the treatment and control groups without standardization
30
Q

What is an Odds Ratio?

A
  • Gives the probability or odds of an event happening or not
  • Used in case-control and epidemiological studies, and are determined by dividing the incidence in one group by another comparison group
31
Q

What is Relative Risk?

A
  • Determined by dividing the proportion of the outcome or incidence of the treatment group by the incidence in the control group
  • A value of 0 means there was no effect
  • Relative risk of <1 indicates a reduced risk or effectiveness of the intervention
  • Relative risk of >1 indicates no effect or increased risk.
32
Q

What is the Absolute Risk Reduction (ARR)?

A
  • Decrease in risk following treatment in relation to a control
  • 20% risk in control and 5% in experimental
  • ARR would be 15%
33
Q

What is Numbers Needed to Treat?

A
  • Average number of patients in a clinical trial who need to be treated for a patient to benefit compared to a control
  • NNT is the inverse of absolute risk ratio (NNT = 1/ARR)
34
Q

What is Prevalence?

A
  • Number of cases that exist within a population at any given time whether diagnosed or not (including those at risk for developing the condition)
35
Q

What is Incidence?

A
  • Number of newly diagnosed cases during a time period
36
Q

What is Sensitivity?

A
  • Ability to correctly identify those with the condition
  • Values are noted as the percentage of patients who have the problem and test positive
  • If a clinical test for an ACL tear is done in 100 patients WITH a tear and the test is positive in 60 patients, it has a 60 percent sensitivity
37
Q

What is Specificity?

A
  • Ability to correctly identify those without the condition
  • Values are noted as percentage of patients who don’t have the problem and test negative
  • If a clinical test for an ACL tear is done in 100 patients WITHOUT a tear and the test is was negative in 95, the
    test has 95 percent specificity
38
Q

How is Pearsons R Interpreted?

A
  • ranges from -1 to 1
  • If r=1: perfect linear correlation, the increase in one variable is directly dependent on another
  • If r=-1: Inverse relationship, increase in one variable is dependent on the decrease of another
  • If r=0: no relationship; the variables are independent
39
Q

What are the “Grades” of Evidence?

A
  • A: Consistent, Level I studies
  • B: Consistent Level II or III, or extrapolation of from Level I studies
  • C: Level IV studies or extrapolations from Level II or III studies
  • D: Level V evidence or troubling, inconsistent, or inconclusive studies of any level