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Research Flashcards

1
Q

The basic objective of research is to acquire _______

A

new knowledge and justification for decision making in

medical practice

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2
Q

______ refers to the ‘true’ answer, which must

be relevant, complete and accurate

A

Validity

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3
Q

Three significant questions that evaluate validity are:

A

• Is the study useful or is the result inconclusive?
• Do you accept the results of this study as applied
to the source population?
• Do the results apply to the population in which
you would be interested?

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4
Q

________ refers to the adequacy of the

study methods in reference to the study population

A

Internal validity

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5
Q

_________refers to the generalisability of

the results to the general population

A

external validity

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6
Q

______ refers to the stability of question-andanswer
response and is most successfully measured
by testing and then retesting (repeatedly).

A

Reliability

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7
Q

The most frequently used method of testing for __________is to repeat application of the test.

A

repeatability

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8
Q

_______ and _______, which are integral to
validity, are important considerations in decision
making in medicine, particularly in choosing
appropriate investigations for disease diagnoses

A

Sensitivity and specificity

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9
Q

The_______ of a test depends on the proportion
of people with the characteristic (disease) in whom
the test is positive

A

sensitivity

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10
Q

_____ is (i.e. percentage positive with disease).

A

Sn

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11
Q

The________of a test depends on the proportion
of people without the characteristic (disease) in
whom the test is negative (i.e. percentage negative
of healthy people).

A

specificity

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12
Q

The ultimate specific test is one

that detects all the_____

A

truly negative (disease-free) cases

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13
Q

A _____test is one that is as close to 100%

specificity and 100% sensitivity as possible.

A

gold standard

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14
Q

Predictive values that are useful indices of validity

can be expressed as ______ and _____

A

positive and negative values

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15
Q

______ refers to the number of new cases of a disease (or factor of interest) occurring in a defined population within a specified period of time.

A

Incidence

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16
Q

______ refers to the total number of
individuals who have the disease (or factor of
interest) at a particular time in a population. Thenumber is divided by the number of people in the population at that time

A

Prevalence

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17
Q

This is any effect occurring during the investigation that tends to produce results that depart systematically from the true values

A

Bias

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18
Q

types of bias
1.
2.
3.

A
  1. measurement bias (
  2. confounding bias
  3. selection bias
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19
Q

This is a situation in which a measure of the effect of exposure on risk is distorted by the association of exposure with other (known or unknown) factors that influence the outcome

A

Confounding

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20
Q

A ______ is a factor that distorts the apparent magnitude of the effect of
a study on risk.

A

confounder

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21
Q

The reasoning process of the researcher is based on the ________that is, an experimental group does not differ from a control ‘normal’ group in outcome.

A

null hypothesis

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22
Q

Two basic components of subject selection are ______ and _______ The latter should
be selected in a well-controlled manner

A

sample size and sample representativeness.

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23
Q

A useful rule is to aim to approach

_______patients if you wish to work with a sample size of n .

A

3n

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24
Q

The two broad categories of research in general practice are _______research, which is based on observation and talking with people, and ____ research, which is based on measurement and analysis
of data collection

A

qualitative

quantitative

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25
Q

Research can also be classified as _____ research, which includes both qualitative and quantitative methods, and _____research, which involves
systematic reviews and meta-analysis.

A

primary

secondary

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26
Q

This research is basically concerned with evaluating human behaviour from the subject’s perspective.

It is based on close observation and is expressed in a descriptive way.

A

Qualitative research

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27
Q 
Qualitative approaches to research
1
2
3
4
A
  • Phenomenology
  • Ethnography
  • Grounded theory
  • Biography (life story, narrative enquiry)
  • Case study
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28
Q

Methods used in qualitative research

A
  • interviews (open-ended, semi-structured)
  • focus groups
  • participation observation
  • document analysis
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29
Q

What type of research

The central focus of philosophy/method is the lived experience of the world of everyday life

A

Phenomenology

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30
Q

What type of research

• effects of Viagra (and other agents) on marital/
sexual relationships
• experience of carers in Alzheimer disease
• effects of workplace bullying on absenteeism

A

Phenomenology

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31
Q

This examines cultures, peoples and societies
including subgroups, e.g. adolescents. It is the basis of anthropology.

The investigator usually identifies one
or more key witnesses (informants) and interviews them to clarify observations.

A

Ethnography

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32
Q

This is the development of new theory through the collection and analysis of data. It seeks to identify the core social processes within a given context in order
to build theory that is grounded in the reality of those being studied

A

Grounded theory

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33
Q

_____is research based on the collection of data in numerical quantities and asks a specific narrow question, such as ‘What is the chance that . . .?’ or ‘What proportion of . . .?’

A

Quantitative research

34
Q

Quantitative research:

It can be classified broadly as _____ which includes case control, cross-sectional and cohort studies, and ____
which includes the classic controlled trial

A

observational,

experimental,

35
Q

is an observational study in which people with a disease (cases) are compared with those without it (control group).

A

Case control (or retrospective) stud

36
Q

What type of research?

A

Patients with mesothelioma

were investigated for exposure to asbestos or other agents;

37
Q

_________follows a correlation approach using existing databases.

It is a survey of the frequency of disease, risk
factors or other characteristics in a defined
population at one particular time

A

Cross-sectional or prevalence study

38
Q

What type of study?

The prevalence of diabetes
mellitus (diagnosed and undiagnosed) was
investigated in an Aboriginal community
living in a particular area of metropolitan
Sydney.
A

Cross-sectional or prevalence study

39
Q

_______ is also referred to as ‘follow-up’. The study follows a group (cohort) of individuals with a specified characteristic or disease over a period of time.

Comparisons may be made with a control group

A

Cohort (or prospective) study

40
Q

What type of research?

A

120 patients with chronic sciatica
were followed over 10 years to determine
the outcome of their pain and neurological
deficit. These were compared with a matched
group who had undergone laminectomy

41
Q

______ is an experimental
study that tests for hypothesised outcomes.
An intervention is conducted on a randomly
selected group of people and compared with a matched control group not subject to the specific intervention.

A

Clinical controlled trial

42
Q

What is the objective of a Clinical controlled trial?

A

The objective is to establish a

causal relationship between the intervention and the hypothesised outcome

43
Q

The ideal scientific
trial is a ______ where neither staff
nor the participating patient are aware the
participant is in the intervention or control
group.

A

double-blind trial

44
Q

______ is the process that systematically assesses compatible randomised controlled trials by merging the data (from usually smaller and
inconclusive trials) to draw a ‘firmer’ conclusion from
larger numbers of subjects

A

Meta-analysis

45
Q

___________) is a process of basing clinical practice on validated information

A

Evidence-based medicine (EBM

46
Q

_______is the integration of the best available scientific evidence with your clinical expertise and knowledge, your intuition, your wisdom’.

A

EBM

47
Q

Steps for EBM

A

The proposed five steps of EBM are similar to
basic research methodology: 14
1 Construct a clinical question or define the
problem.
2 Search for the evidence.
3 Appraise the quality and relevance of the
evidence.
4 Apply it to the care of an individual patient.
5 Evaluate how effective it is.

48
Q

What level of evidence?

Evidence obtained from a systematic review of all relevant randomised trials

A

1

49
Q

What level of evidence?

Evidence obtained from at least one properly
designed randomised controlled trial.

A

2

50
Q

What level of evidence?

Evidence from well-controlled trials that are not randomised, or well-designed cohort or case-control studies, or multiple time series (with and without the
intervention).

A

3

51
Q

What level of evidence?

Opinions of respected authorities; based on clinical experience; descriptive studies; or reports of expert
committees.

A

4

52
Q

What is the strength of EBM

A

The strength of EBM is that it can provide the
answers to very important everyday decisions,
especially in screening and preventive medicine, where
guidelines have fluctuated over the decades

53
Q

The absolute difference in event rates between two intervention or treatment
groups. It gives an indication of the baseline risk and treatment effect.

A

ARR

54
Q

What does an ARR of 0 mean?

A

An ARR of 0 means no difference and

thus the treatment has no effect

55
Q

A UK journal on EBM with excellent summaries on NNT for a host of common interventions

A

Bandolier: www.medicine.ox.ac.uk/bandolier/

56
Q

This allows comparisons between

the means of two samples of similar populations with a normal distribution.

A

Analysis of variance

57
Q

The statistically derived range of

values around a trial result in which the probability is that the true result will be within the range.

A

Confidence interval

58
Q

It is a measure of the

certainty that the figures are correct

A

Confidence interval

59
Q

_________ The percentage of subjects

in the control group that experienced the event of interest.

A

Control event rate (CER)

60
Q

_______The percentage of subjects in the intervention group that experienced the
event of interest

A

Experimental event rate (EER)

61
Q

measures the agreement between
the evaluations of two raters when both are rating the same object.

A value of 1 indicates perfect agreement.
A value of 0 indicates that agreement is no better than chance.

A

Cohen’s kappa

62
Q

The number of people who must be treated over a given period of time with
the experimental therapy (specific intervention) to achieve one good outcome or prevent one adverse
outcome.

A

NNT

63
Q

T or F

the lower the NNT, the better the treatment

A

T

64
Q

How to compute NNT

A

It is calculated as 100/ ARR (%); that is, the reciprocal of

the ARR.

65
Q

T or F

The NNT will be different for different patient
populations depending on their baseline risk for developing the outcome of interest

A

T

66
Q

The probability of the occurrence of an

event to its non-occurrence

A

Odds ratio

67
Q

The probability that an observed

difference occurred by chance.

A

P value

68
Q

What is the standard convention for obtainiing P value?

A

The standard
convention is that there is only a 5% (1 in 20)
probability that the difference would fall outside this
range by chance alone (i.e. a P value of 0.05 or 5%).

69
Q

The ratio of the risk of the outcome

(e.g. disease or death) in the treatment/exposure group compared with the control/unexposed group

A

Relative risk (RR)

70
Q

How to compute RR

A

RR = EER / CER

71
Q

How to interpret RR

A

RR = 1 means no difference, so treatment has no
effect
RR > 1 means the treatment increases the risk of
disease/death
RR < 1 means the treatment decreases the risk

72
Q

The proportional reduction
of adverse events between the treatment/experimental
and the control groups in a trial`

A

Relative risk reduction (RRR)

73
Q

How to compute RRR

A

RRR is the ratio of the absolute risk reduction to the risk of the outcome in
the control group)

74
Q

An alternative way to calculate the

RRR _____

A

is to subtract the RR from 1 (i.e. RRR = 1 - RR ).

75
Q

_______ is probably the most commonly reported measure of treatment effects but the _____ gives a more realistic
picture

A

RRR

ARR

76
Q

_____ The probability that an event (death or disease) will occur.

A

Risk (R)

77
Q

_______The likelihood of a difference
between two groups being real.

It is the possibility that the difference occurred by chance alone.

A

Statistical significance

78
Q

_____error occurs when a study

concludes that there is a difference between two groups when there is no difference

A

A type I

79
Q

occurs when a study
concludes that no difference exists between groups
when there is a true difference

A

Type II error

80
Q

Questions to ask in critical appraisal

A

1 What were the objectives of the study?
2 Were the ethical aspects properly followed?
3 What was the study design?
4 Were there any potential problems associated
with the design

81
Q

Questions to ask in critical appraisal

A

5 Were all the patients who entered the study
properly accounted for at its conclusion?
6 What were the important results?
7 How would you interpret and explain these
results?

MC (90 decks)

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