Week 4 Flashcards

1
Q

what is critical appraisal?

A
  • appraises research for its strengths, limitations, and value for practice
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2
Q

what is the first step in the critical appraisal of QNR

A
  • determining match between the clinical question and research design
    ex. should it be QL or QN
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3
Q

the critical appraisal process for QN focuses on 3 broad questions:

A
  • are the results of the study valid (validity)
  • what are the results? (reliability)
  • will the results help me in caring for my pts ? (applicability)
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4
Q

what is study bias (2)

A
  • anything that distorts study findings in a systematic way arising from the methodology of the study
  • something consistently occurring that could distort the outcomes & compromise the validity of the findings
    ex. instrumentation that isnt valid or reliable, or confounding or extraneous variables
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5
Q

what is internal validity (3)

A
  • anything that happens within the study that confounds our understanding of the relationship between the IV and DV
  • what is the strength of the evidence that the IV rather than extraneous, confounding variables , or the instruments used caused the outcome
  • the extent to which it is possible to make inference that the IV truly caused/influenced the DV
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6
Q

what is external validity (2)

A
  • what is the strength of evidence that observed relationships are generalizable across people, settings, and time?
  • being able ton generalize findings to population outside of the study
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7
Q

what is study validity

A
  • refers to whether the study results can be believed (internal validity) and whether the results can be generalized to other settings/pt populations (external validity)
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8
Q

what is instrument validity (2)

A
  • refers to whether the study measurements are measuring what they are supposed to be measuring
  • can serve as a threat to internal study validity
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9
Q

what is study reliability (2)

A
  • refers to the repeatability of the study

- if the study were repeated under the same circumstances, would the results be the same?

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10
Q

what is instrument reliability

A
  • refers to the consistency of the instruments

- will the instruments yield the same results under the same conditions?

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11
Q

what can we ask to assess internal validity? (2)

A
  • did the IV truly influence the DV?

- what competing explanation could there be for the results of the study?

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12
Q

what can help control internal validity (2)

A
  • be aware of confounding variables

- instrument tools

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13
Q

what are 8 threats to internal validity

A
  • history
  • mortality
  • selection
  • maturation
  • knowledge of who receives the intervention
  • recall bias
  • loss to follow up
  • contamination
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14
Q

describe the history threat to internal validity

A
  • other events co-occurring with casual factor that could also affect outcomes
  • any other event that may occur along the same time as the IV is being measured in realation to its impact on the outcome
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15
Q

describe the mortality threat to internal validity

A
  • differential loss of participants from different groups
  • drop out of study
    = attrition bias
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16
Q

describe the selection threat to internal validity

A
  • ## biases arising from preexisting differences between groups being compared
17
Q

what is the single biggest threat to studies that do not use an experimental design

A
  • selection
18
Q

how can selection bias be addressed/prevented? (2)

A
  • randomization

- imp to test demographic differences that could impact the outcome

19
Q

describe the maturation threat to internal validity

A
  • processes that result simply from the passage of time

ex. natural wound healing is expected to occur with or without intervention

20
Q

describe knowledge of who receives the intervention r/t internal validity

A
  • can occur if subjects or those measuring outcomes know subject group assignment
  • may cause the participants to be more motivated to help the researcher get a positive response
    = performance bias
21
Q

how can performance bias be reduced

A
  • by blinding
22
Q

describe recall bias

A
  • can occur when subjects are asked to recall past actions or events (such as in case-control studies)
  • subjects may give answers that are socially acceptable or what they “think” is what happened (may not remember correctly)
23
Q

describe recall bias

A
  • can occur when subjects are asked to recall past actions or events (such as in case-control studies)
  • subjects may give answers that are socially acceptable or what they “think” is what happened (may not remember correctly)
24
Q

describe how loss to follow up can be a threat to internal validity

A
  • attrition could occur due to unforeseen side effects of the intervention or burdensome data collection procedures, leading to noncomparable groups
25
Q

describe the contamination threat to internal validity

A
  • can occur if intervention & control groups have interaction and info is shared, especially if the intervention is educational in nature
26
Q

how can contamination be prevented

A
  • implement the intervention to 1 group at a different time period
27
Q

what is the type of bias that occurs because the subject gets better at something due to the passing of time

A
  • maturation threat
28
Q

what is the testing effect

A
  • occurs when you give a knowledge survey, and give it to the same individual multiple times after an education intervention
  • the individual then starts to learn (memorize) what the right answer is
29
Q

external validity is about…

A
  • generalizability
30
Q

define generalizability

A
  • the extent to which study findings can be applied to other groups & settings, and wider population that is similar to the study group
  • dependant on reliability and validity of study procedures
31
Q

what are some threats to external validity (2)

A
  • inadequate sampling of study participants (if too small, may say theres no diff when there actyally is)
  • unfortunately, enhancing internal validity can have adverse effects on external validity (more controls = behavior/context more artificial)
32
Q

what are some preliminary questions to ask prior to critical appraisal of quantitative studies (7)

A
  • why was the study done?
  • what is the sample size?
  • are the measurements of major variables valis and reliable?
  • how was the data analyzed?
  • were there any untoward events during the conduct of the study?
  • how do the results fit w previous research in the area?
  • what does this research mean for clinical practice?
33
Q

what are the main concerns r/t reliability of a study (2)

A
  • size of the intervention’s effect (effect size)

- precision in effect measurement (CI)

34
Q

what are the main concerns for the applicability of a study

A
  • will the study findings help me to care for my pts?