ASSESSING MEDICAL LITERATURE

Question 1

What is the goal of evidence based medicine?

Answer 1

seeks the highest levels of published of research based on sound scientific design and ethical standards to improve patient care and life long learning for doctors

Question 2

Grade for level I evidence or consistent findings from multiple studies of level II,III,IV

Answer 2

Grade A

Question 3

Grade for level II,III or IV evidence and findings are generally consistent

Answer 3

Grade B

Question 4

Grade for level II,III,or IV evidence, but findings are inconsistent

Answer 4

Grade C

Question 5

Grade for Level V: Little or no systematic empirical evidence

Answer 5

Grade D

Question 6

what are some methodologies that are research based?

Answer 6

randomized clinical trials

• experimental
• analytical
• expensive

cohort, case controlled, case studies

• observational
• descriptive
• dominate surgical literture
• no interference
• easier to conduct
• less costly

Question 7

what type of literature based review is this?

review and collection of data

Answer 7

narrative review

Question 8

what type of literature based review is this?

conducted in an area of interest with low evidence, based on quality of evidence

Answer 8

scoping review

Question 9

what type of literature based review is this?

specific clinical question
comprehensive literature search
explicit selection criteria
assess methodologies

Answer 9

systematic review

Question 10

what type of literature based review is this?

takes data from papers and combines them to conduct a statistical analysis and summary from a randomized control study?

Answer 10

meta analysis

Question 11

T/F, systematic review and meta analysis are not a formal experimental study but rather a non experimental or descriptive study?

Answer 11

T

Question 12

how is a RCT conducted?

Answer 12

apply inclusion and exclusion criteria

randomization consisting of doctor (experimental), blinding (placebo) , and patient (control)

Question 13

that are the different types of blinding?

Answer 13

single, double, measurement blinding

Question 14

what are the two types of observer reliability?

Answer 14

intra observer

inter observer

Question 15

what are some difficulties with the performance of RCT?

Answer 15

who want to be randomized
placebo surgery, risk vs reward
not all RCT are well designed

Question 16

what are the two types of validity?

Answer 16

internal and external validity

Question 17

what is this type of validity?

the ability of a trial to come to the correct conclusion regarding the question being studied

Answer 17

internal validity

Question 18

what is this type of validity?

the ability of trial to produced results that are generalizable to a larger population of patients with disease?

Answer 18

external validity

Question 19

what is meant by confounding?

Answer 19

the effect on treatment and subsequent outcome altered as a result of preexisting risk factors

Question 20

what are the alternatives to RCT?

Answer 20

cohort studies that consist of case controlled, case series, case report

provide date for comparison
sampling based on exposure
allow for calculation of risk

Question 21

what are the two types of observational studies?

Answer 21

prospective and retrospective study

Question 22

what are some important points about observational studies?

Answer 22

not randomized
cannot control for confounding factors
only establish associations that exist between predictor and outcome variables
can’t establish associations identified as cause and effect
improved by greater attention

Question 23

what is this type of study?

focuses on a specific outcome or interest

looks at favorable vs unfavorable outcome

usually retrospective

Answer 23

case controlled study

Question 24

what is this type of study?

patients treated one way
outcome is important 
target pop must be definable
reproducible
retrospective
relys on medical records

Answer 24

case series study

Question 25

what are the threats to reproducible science?

Answer 25

``` publication bias failure to control for bias low statistical power poor quality control P-hacking ```

Question 26

what is this type of method of analysis called? use of an estimation from a sample population to a target population

Answer 26

statistics

Question 27

what are the four types of bias?

Answer 27

observation bias selection bias literature bias publication bias

Question 28

what type of bias is this? systematic variation between the true outcome and the outcome observed

Answer 28

observation bias

Question 29

what type of bias is this? a flaw in sample selection -loss to follow up

Answer 29

selection bias

Question 30

what type of bias is this? English language only

Answer 30

literature bias

Question 31

what type of bias is this? predatory journals

Answer 31

publication bias

Question 32

T/F, clinical significance is unrelated to statistical significance?

Answer 32

T