EBP: foundations

Question 1

3 pillars of ebp

Answer 1

-clinical expertise/expert opinion
-client/patient/caregiver perspectives
-external scientific evidence

Question 2

6 steps of ebp practice

Answer 2

1. ask - formulate an answerable question
2. search
3. appraise - evaluate evidence
4. integrate
5. evaluate - evaluate effectiveness
6. disseminate

Question 3

PICO

Answer 3

P - patient/problem
I - intervention
C - comparison/contrast
O - outcome

Question 4

patient/problem

Answer 4

what kind of patient or problem are we looking at

Question 5

intervention

Answer 5

what tx is gonna be used

Question 6

comparison

Answer 6

the intervention used compared to something (no tx, a different one, etc.)

Question 7

outcome

Answer 7

what is the measure, how you will know the answer to your question

Question 8

where to find evidence

Answer 8

Pubmed, ebsco, google scholar, library database - search engines

systematic reviews - normally stated in the title

clinical best-practice summaries - asha website

Question 9

systematic review

Answer 9

reviews other studies to give a big picture about the question
systematic refers to defining what their searching for before they search

Question 10

metanalysis

Answer 10

systematic review + statistical analysis on the results they found

Question 11

clinical best-practice summaries (guidelines on asha)

Answer 11

clinical expertise

Question 11

best practices on documenting lit search

Answer 11

-heading: where you searched & search terms
-include a link to article location
-list notes below the citation about the article’s usefulness for your current purpose
-document every search, so you dont repeat your work later
-reorder citations within each search from most to least useful
-make notes to self on future searches to try

Question 11

how to read research article quickly

Answer 11

1) abstract - is this article relevant
2) find the research question (in the intro)
3) find answers in conclusion
4) start from the top, get context from lit review
5) methods evaluate study quality
6) results: evaluate rigor

Question 11

when is it allowed to use prisoners as participants in a research study

Question 12

when might it be acceptable to lie to participants about the purpose of a research study?

Answer 12

-it has to be necessary in order to conduct the study and it cannot do the participants any harm
-participants must be informed at the very end
-be prepared for possible consequences coming from the lie

Question 13

informed consent

Answer 13

-informed of procedures, risks, alternatives
-understand, make free choice to participate (reading level 6-8th grade)

Question 14

coercion, fair compensation

Answer 14

rewards cannot be too enticing (too much money sways beyond comfort, difference in cultural values)

can quit anytime and still get compensation

Question 15

vulnerable populations

Answer 15

includes anyone whose capacity for decision-making is diminished (people living in poverty, pregnant women, prisoners, intellectual disabilities, etc.)

students - if you feel like you have to participate for your grade or something like that

-extra protections

Question 16

deception

Answer 16

-only when the truth upfront would make the experiment impossible
-must minimize risks of harm due to deception
-must debrief at end

Question 17

participant selection

Answer 17

-fair distribution of risks and benefits
-minimize selection bias (this includes convenience and vulnerable populations)

Question 18

withholding treatment

Answer 18

no trreatmet control groups: may feel unfair to let people go untreated

-you dont know yet if the treatment works so its not unenthical

Question 19

conflicts of interest

Answer 19

-when researcher has another role/interest related to the research/outcomes
-clinicians shouldnt recruit their own clients unless they have to, if they do involve disinterested monitors