Week 11 Part 1

Question 1

Prediction/Decision Rules and Practice Guidelines

Answer 1

Have the potential for great “real-world” value

Question 2

Clinical Prediction Rule

Answer 2

the process of identifying a cluster of findings to assist clinicians in:

making a diagnosis
establishing a prognosis
selecting an optimum prescriptive intervention

Question 3

CPRS have the ______ to improve decision making

Answer 3

potential

Question 4

CPRS ____ decrease the need for more expensive intercessions

Answer 4

may

Question 5

CPRS estimate the: _____ of a condition

Answer 5

diagnosis

clinical syndrome in lieu of anatomical gold standard

Question 6

CPRS estimate the: _____ for the recovery of function

Answer 6

prognosis

Question 7

CPRS estimate the _______ probability of a response to a particular intervention

Answer 7

Prescriptive

Question 8

CPRs in physical therapy allow ?

Answer 8

us to classify a patient into a more homogenous subgroup based on the patient’s likely response to a specific treatment approach

Question 9

The prediction/decision making rule for clinicians typically include three or more variables derived from the:

Answer 9

1. history
2. physical exam
3. special tests

Question 10

Step 1 Derivation

Answer 10

identification of factors with predictive power to develop the rule

Question 11

Step 2 Validation

Answer 11

reproduction of the rule in a different setting and/or population of patients

Question 12

step 3 Impact Analysis

Answer 12

evidence that the rule changes clinician behavior, reduces the cost of care, and improves patient outcomes

Question 13

Sample size considerations

Answer 13

criticality, precision, and frequency

Question 14

larger for cervical spine trauma x-ray necessity than need for spinal manipulation in LBP

Answer 14

the crticality

Question 15

larger sample sizes will help narrow the CI which allows for a more _____ estimate of the probability

Answer 15

precise

Question 16

prevalance of the condition

Answer 16

the frequency

Question 17

the larger the prevalence or the likelihood of a desirable outcome

Answer 17

the smaller the number of subjects that need to be enrolled in the study

Question 18

diagnostic

Answer 18

direct visulization, imaging

Question 19

prognostic

Answer 19

defined level of function

Question 20

intervention

Answer 20

reasonable standard of improvement

pain, function, influential impairment, patient satisfaction

Question 21

sensitivity (SNOUT)

Answer 21

rules OUT condition

Question 22

specificity (SPIN)

Answer 22

rules IN conditions

Question 23

likelihood ratios

Answer 23

shifts in probability

Question 24

Step regression

Answer 24

each variable is entered into the regression model and removed one at a time until the predictive power is compromised

Question 25

less is better

Answer 25

A CPR should strive to have the fewest number of predictive indicators as possible without compromising the statistical accuracy