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CSH600- Evidence Based Practice > wk 3- searching > Flashcards

wk 3- searching Flashcards

1
Q

how to navigate evidence, using what model?

A

The higher you are in the pyramid, the more work has been done for you in collecting, sifting and synthesising the evidence base. Healthcare questions typically are lower down the list

6S pyramid
systems- computerised decision support systems
summaries - evidence based clinical practice guidelines/textbooks
synopses of syntheses- evidence based journals
syntheses- systematic reviews
synopses of studies
original studies -RCT

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2
Q

boolean operators are?

A

using AND, OR, NOT
and- both words only
or- either words
not- not present

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3
Q

wildcard

A

searches different forms of spelling and plural forms through a ? instead of letter

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4
Q

truncations what are they?

A
  • at the end of a word to search different endings
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5
Q

describe the basic principles of efficient searching (4)

A
  1. carefully define your clinical question in PICO format
  2. choose your key search terms
  3. broaden your search with synonyms and variant words
  4. use boolean operators to construct your database search
  5. choose a database that works for your type of clinical question and level 1/2 study designs for those questions (prognostic, diagnostic, intervention or patient experience)
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6
Q

what are the major online evidence based resources

A

PubMed, Cochrane library, EMBASE

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7
Q

Cochrane library is good what for clinical questions?

A

cochrane database of systematic reviews for

-intervention
-diagnostic
-qualitative (experience)

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8
Q

PubMed is good for what clincial q’s

A

systematic reviews/RCT/etc
clinical queries: with categories - prognosis, diagnosis, therapy, aetiology, clinical prediction

PubMed Health Services Research Queries: category- qualitative research

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9
Q

EMBASE is goof for what q’s

A

clinical queries: therapy, diagnosis, prognosis, aetiology, economics and qualitative studies, as well as systematic reviews.

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10
Q

What databases can you find qualitative studies?

A

CINAHL, PubMed/MEDLINE, EMBASE and PsycINFO

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11
Q

what does P-value tell us?

A

the probability the difference is due to chance alone 0.02= low probably its chance and is statistically significant, 0.15= high probability due to chance

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12
Q

what is the null hypothesis

A

saying their is no difference between groups

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13
Q

what is the alternative hypothesis

A

saying there is a difference between groups

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14
Q

probability is a scale from what?

A

0 (100% certain it will not occur bc of chance)
to 1 (100% certain it will)

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15
Q

when is the probability of chance done?

A

before the study begins as it tells us if it is statistically significant or not

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16
Q

statistically significant means

A

reject the null hypothesis (there is a diff between groups, not chance).

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17
Q

not statistically significant means

A

accept the null hypothesis, theres no difference between groups.

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18
Q

what test prove statistical significance?

A

P-value and confidence intervals
A statistical significance level of 5% (p=<0.05)
Estimates of the intervention effect are presented with 95% confidence intervals and p-values.

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19
Q

type 1 error is?and relates to what

A

reject the null hypothesis when it is actually true (theres no difference)

level of statistical significance, if its set at 0.05 then have a 5% chance of a type 1 error occurring

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20
Q

type 2 error is? and what is typically the reason for this error?

A

accept the null hypothesis when it is actually false (theres a difference)

relates to power of the study, if its set at 80%, then there is a 20% chance of a type 2 error

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21
Q

p-value tells you what?

A

the likeliness that the null hypothesis is true

22
Q

what does the confidence interval tell you?

A

tells you the likely (95% confidence) range containing the true value (lower and upper limits)

there is a 95% probability that the confidence interval contains the true value- narrow CI show a good precision

23
Q

when looking at a ratio (relative risk or odds ratio) what makes the confidence interval not statistically significant? (no effect line)

A

if the interval includes 1

24
Q

when looking at the mean difference between 2 groups, what makes the confidence interval not statistically significant? (no effect line)

A

if the interval includes 0

25
Q

risk and odds means what

A

risk- same as probability (probability of it occurring)
odds- same as chance (how many times will it happen)

26
Q

experimental event rate (eer) is determined by what formula

A

number of experimental arm participants with the outcome of interest / total number of participants in experimental arm

27
Q

control event rate (cer) is determined by what formula

A

number of control arm participants with the outcome of interest / total number of control arm participants

28
Q

relative risk (risk ratio for RCT)

A

compares the amount of one outcome in a group to that in another

experimental event rate divded by the control event rate

or the risk/probability of the outcome occurring in the intervention group divided by that in the control group

29
Q

interpreting relative risk and also odds ratio

A

RR= 1 no difference between groups
RR = >1 increased probability of outcome in experimental group
RR= <1 reduced probability of outcome in the experimental group

30
Q

absolute risk reduction

A

the absolute drop in risk going from the control to the experimental group

31
Q

odds ratio does what

A

compares how likely outcomes are between the two groups

32
Q

clinical significance

A

judges whether the differences between statistically significant results are worthwhile in real life

33
Q

number needed to treat

A

number of patients who must be treated with the intervention, compared to control, for one to benefit.

must be a whole number so round up

the lower number of people needed to treat, the better.

34
Q

number needed to harm

A

the number of patients treated for one to have an adverse outcome, compared with the control intervention

is a whole number, rounded down.

want this number to be large

35
Q

confidence interval and p value key concepts

A

CI- likely range containing the true value
P-values- probability of observing the data if the null hypothesis is true (should be interpreted on a continuum)

36
Q

if something is clinically significant than it has to be?

A

statistically significant

37
Q

internal validity

A

study is methodologically sound

38
Q

external validity

A

generalisability of the result of a study

can we apply these results to people outside of the study

39
Q

different types of bias? and what subtypes under both of them?

A

systematic error
-selection bias
-methodology

random error
-chance
-measurement bias?

40
Q

how to prevent selection bias

A

define groups clearly (inclusion/exclusion criteria)
randomisation
sample size
follow up/retention

41
Q

random errors occur from?

A

a shift from true values due to chance

42
Q

confounding

A

the distortion of the association between the independent and dependent variables because a third variable is independently associated with both. or

A mixing or muddling of effects that can occur when the relationship we are interested in is confused by the effects of something else.

43
Q

association define

A

a statistical relationship between two or more things

44
Q

causation

A

something that plays an essential role in producing an effect

45
Q

types of numerical data

A

continuous- scale (1.25m)
discrete- whole number only (2 children)

46
Q

types of categorical (non-numerical) data

A

nominal - yes/no
ordinal- low, normal, high

47
Q

descriptive statistics

A

summarises data, does not give cause

48
Q

incidence

A

new cases of a disease

49
Q

prevalence

A

proportion of a population affected by the condition of interest

50
Q

inferential statistics

A

has some form of error because they take information from a sample and apply to a population

CSH600- Evidence Based Practice (11 decks)

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