CI Test 1

Question 1

Evidence Based Practice

Answer 1

includes standardized outcomes, standardized terminology, personalized care, and constantly evolving practice

Question 2

International Classification of Function

Answer 2

A model of health and disability; labels health conditions based on its effects on body sxs/fxns, activities, participation, environmental factors, and personal factors

Question 3

Body Structures/Functions (ICF)

Answer 3

Addresses where the impairment is; includes things such as pain, limited ROM, weakness,

Question 4

Activities (ICF level)

Answer 4

Actual activity effected by the impairment; could include walking, climbing stairs, bed mobility, balance

Question 5

Participation (ICF level)

Answer 5

How the limited activity actually effects daily life; things such as cannot deliver mail because they can’t walk, cannot be an usher at church, cannot wash the dishes; could include mobility activities, community activities

Question 6

Environmental Factors (ICF)

Answer 6

things that could effect the individual’s function/limitations that are in the environment; weather, climate, roads, disability access

Question 7

Personal Factors (ICF)

Answer 7

Factors within the individual that could effect an individual’s outcome in recovery; depression, motivation

Question 8

Evidence Based Practic

Answer 8

the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients; requires clinical expertise, research evidence (valid/relevant), and patient values

Question 9

Steps of Evidence Based Medicine

Answer 9

1. Determine need
2. Create Question
3. Search Database
4. Triage
5. Critical Appraisal
6. Integration
7. Application

(DCST CIA)

Question 10

Determine Need (EBM)

Answer 10

Step 1

The patient creates need for clinically important information

Question 11

Create Question (EBM)

Answer 11

Second step

Information needs to be converted into an answerable question

Question 12

Search Database (EBM)

Answer 12

3rd step in EBM

Search for answer to clinical question using relevant sources

Question 13

Triage (EBM)

Answer 13

Fourth step in EBM

Determine best evidence source for the solution to the problem

Question 14

Critical Appraisal (EBM)

Answer 14

Step five

Evidence is appraised for validities and applicability

Question 15

Integration (EBM)

Answer 15

Step 6

Integrate the evidence, experience and patient values to develop a plan of care

Question 16

Application (EBM)

Answer 16

Step 7

Evidence is applied and clinical outcomes are evaluated

Question 17

How do we prevent PTs from not maintaining EBP after they graduate?

Answer 17

Encourage use of standardized outcome tools, keep track of outcomes, and assess performances

Question 18

Autonomy

Answer 18

The ability to make one’s own decisions and to act on them; “self-determination”

Question 19

Beneficence

Answer 19

The obligation to attend to the well-being of participants;

The need to maximize benefits and minimize harm

The need to critically evaluate the risk/benefit relationship

Question 20

Justice

Answer 20

Fairness in a study; equitable distribution of benefits and burdens

There is an equal chance of being assigned to intervention groups

Question 21

Control Groups in Clinical Research (maintaining ethical action)

Answer 21

The best way to determine the effect of an intervention is to compare to a control group;

To make it ethical, offer a treatment option to the control group

There might not be any treatments that have been shown to be effective, so in this case it may be justified in comparing no treatment to a new treatment

Question 22

Nuremberg Code

Answer 22

First formalized guidelines for research; evolved from Nazi war crimes trials;

Every individual must give informed consent for participation

Question 23

Declaration of Helsinki

Answer 23

Independent review of research protocols by an impartial committee; research findings obtained without this review should NOT be published

Question 24

Institutional Review Board

Answer 24

Reviews research protocols to ensure rights of participants are protected; must consist of at least 5 members of a diverse make up from different social, cultural, and occupational backgrounds

Question 25

IRB Reviews Research Proposals Based on:

Answer 25

``` Scientific merit Competence of investigators Risk to participants Feasibility based on resources available Risk-benefit ratio ```

Question 26

Full IRB Review

Answer 26

For experimental procedures that have never been performed; with more than minimal risk; also for vulnerable populations;

Question 27

Expedited Review

Answer 27

for very minimal risk experiments that uses standardized protocols frequently used in the past; reliability studies of the common clinical examination tools fall under this Only a partial board convenes

Question 28

Exempt REview

Answer 28

Surveys, interviews, as long as the information remains anonymous/ cannot be identified; Studies of existing records

Question 29

Elements of Informed Consent

Answer 29

Invitation to participate; Information, consent, and authorization Elements

Question 30

Information Elements of Informed Consent

Answer 30

Disclosure of information; what is going to happen during the study to the subject; What risks are there? What steps minimize these risks? What would happen in the case of harm? What are the benefits? How are they ensuring confidentiality? How long are they keeping info? Where can a participant go if they have questions? Form written in lay language

Question 31

Consent Elements

Answer 31

The assurance that participation is voluntary and the subject must be able to provide consent for themselves, otherwise they need a responsible party to sign Is there compensation? The subject is free to withdraw at any time

Question 32

Authorization Elements

Answer 32

Consent to use data and other materials for publication and dissemination

Question 33

Who gets authorship in a research study?

Answer 33

Made Substantial contributions to conception and design OR acquisition of data OR analysis and interpretation of data AND Drafted the article or revised it critically for important intellectual content AND Contributed to final approval of the version to be published

Question 34

Population (N)

Answer 34

The larger group to which you want to generalize your findings

Question 35

Sample (n)

Answer 35

A smaller, hopefully representative, subgroup from the population used to determine truths about the population

Question 36

Process of Sampling

Answer 36

Define target population (clearly define the criteria for the group), identify accessible population (identify the portion of the target pop that has an equal chance of being selected), obtain sample

Question 37

Inclusion Criteria

Answer 37

Characteristics that you decide must be present; primary trains of your target population that should be relevant to the research question; more of these strengthens INTERNAL validity but creates more restrictions so there is a lower EXTERNAL validity

Question 38

Homogenous Sample

Answer 38

Makes generalization difficult; could be easier to study, however may be difficult to apply to a large group

Question 39

Exclusion Criteria

Answer 39

Factors that would disqualify individuals from participating in your study; confounding factors that may interfere with interpretation should be considered; closely related to inclusion criteria

Question 40

Probabilistic Sampling

Answer 40

Ideal scenario; uses a randomly selected sample from the accessible population

Question 41

Non-Probabilistic Sampling

Answer 41

Used when it is not possible to obtain a true random sample; non-probabilistic

Question 42

Random Selectin

Answer 42

Probabilistic; every individual in the accessible population has an equal chance of being included in the study; Every individual has an equal chance of having some of the characteristics in the target population Should help prevent "sampling bias"

Question 43

Sampling Bias

Answer 43

Individuals either over-represent or under-represent characteristics of the population;

Question 44

Sampling Error

Answer 44

Difference between sample statistics and population parameters is due to chance; Probabilistic: can estimate this error Non-probabilistic: cannot estimate sampling error

Question 45

Simple Random Sampling

Answer 45

Accessible population often defined by membership, directories, or lists Each member has an equal chance of being selected Random number generator, throw dice, names in hat, etc.

Question 46

Systematic Sampling

Answer 46

Systematically select individuals on an interval basis (every other, every third, etc.) Sample Interval= number in the accessible population divided by the desired number for the sample (N/n)

Question 47

Stratified Random Sampling

Answer 47

Identify relevant population characteristics; partition the population into homogenous, non-overlapping strata based on characteristics; draw random or systematic samples from each strata

Question 48

Disproportional Sampling

Answer 48

When stratified sampling is being used, but the strata have very different representation in the population; results in insufficient sample sizes in some groups Select random samples of adequate size from each category; must weight the scores for data analysis to correctly represent the sub strata

Question 49

Weighting Data

Answer 49

Score is multiplied by the weighting factor in the analysis; makes the scores from the more highly represented individuals count for more in the analysis

Question 50

Cluster/Multistage Sampling

Answer 50

Strategy to link members of the accessible population to an already established grouping; successive random sampling of a series of groups in the population Ex: if we already have geographical groupings; in large multi enter trials; during every step of reducing groups we randomly select; (regions of the US)

Question 51

Convenience Sampling

Answer 51

Recruiting individuals as they become available (consecutive sampling) or ask for volunteers and wait for the phone to ring

Question 52

Quota Sampling

Answer 52

Uses stratification (attempts to represent each strata in the same proportion as in the target population); recruiting stops once quota has filled

Question 53

Purposive Sampling

Answer 53

Individuals are hand picked for inclusion by the research based on certain criteria; large potential for bias

Question 54

Snowball Sampling

Answer 54

Stage 1: a few participants who meet criteria are tested Stage2: these participants then identify others who qualify Step 3: it continues Often used for hidden or hard to reach populations

Question 55

Recruitment

Answer 55

Must not coerce (caution when using own patients), must be able to withdraw from study at any time;

Question 56

Statistical Power

Answer 56

Ability to find differences between groups if they exist; small sample size generally indicates a lower power

Question 57

Reliability

Answer 57

Reproducibility, consistency

Question 58

Validity

Answer 58

Accuracy, correctness; are you on the mark?

Question 59

Systematic Error

Answer 59

Consistent, however it always overestimates/underestimates; errors from measurement to measurement are predictable; (reliable not valid)

Question 60

Random Error

Answer 60

Error due to chance; errors from measurement to measurement are unpredictable; Observed score = true ability +/- random error

Question 61

Reliability Coefficients

Answer 61

Reliability is a measure of how much total variance is attributed to true differences between scores; as error increases, reliability coefficient approaches zero; as error decreases, reliability coefficient approaches 1.0 T/(T+E) ``` T= true score variance E= error variance ```

Question 62

Test-Retest Reliability

Answer 62

Used to establish that an instrument/tool is capable of measuring variable consistently; used for self-report questionnaires or mechanical/digital read outs; Has limitations from one session to the next Test-Retest Intervals: far enough apart to avoid learning/carryover (testing)/memory effects; impact of fatigue; close enough to avoid genuine growth

Question 63

Intrarater Reliability

Answer 63

Stability of one person's measurement across 2 or more trials; blind the tester to control for bias

Question 64

Inter rather Reliability

Answer 64

Variation between two or more raters who measure the same group of people; best assessed in a single trial

Question 65

Discrete Data

Answer 65

Described by whole units; (could be dichotomous- a discrete variable with only two values)

Question 66

Nominal Measurements

Answer 66

Classify/label; mutually exclusive categories (male/female); numbers ONLY represent a category; have no relationship with each other (names of states, names of plants)

Question 67

Ordinal Measurements

Answer 67

Designates a ranking/order, but the intervals are NOT assumed to be equal; numbers represent a rank-order; Freshman, sophomore, junior, senior Professor, affiliate, guest

Question 68

Continuous Data

Answer 68

A number that theoretically can take on any value along a continuum; an indefinitely large number of fractional values

Question 69

Interval Measurements

Answer 69

Designates equal intervals, order, but no true zero; intervals are equal; numbers represent a value, but not absolute quantity; Temperature, 0-10, 11-20, etc.

Question 70

Ratio Measurements

Answer 70

Designates equal intervals, order, and a true 0; numbers represent a value, absolute quantity from 0 Height, weight, time, goniometry

Question 71

Direct Variables

Answer 71

Concrete characteristics gathered by the Rater; focus on precision and calibration; ROM (angles), height, HgB

Question 72

Indirect Variable

Answer 72

Indicators of an attribute used to represent an abstract concept; use some form of direct observation to then infer a value for the variable Force, temperature

Question 73

Operational Definitions

Answer 73

Helps us define variables; should inform the reader of: | What, how, who, how often (frequency), how long (duration)

Question 74

Confounding Variables

Answer 74

We need to identify and control extraneous variables so they don't become confounding variables; age, gender, socioeconomic status

Question 75

Randomized Control Trial in PEDro

Answer 75

compares at least 2 interventions that are related to PT; must involve human subjects; must be randomized and published in a peer review journal

Question 76

Systematic Review

Answer 76

a systematic analysis of available research (RCTs); rates each trial based on specific criteria; second highest level of evidence

Question 77

Clinical Practice Guideline

Answer 77

a guideline for the best course of treatment based on research; highest level of evidence

Question 78

Trends in Studies in PT

Answer 78

increased # of RCTs (last 30 years), systematic reviews (last 15 years), and clinical practice guidelines (last 10 years)

Question 79

International Classification of Function

Answer 79

a model of labeling health and disability