EBP Midterm

Question 1

PICO

Answer 1

P = patient/population/problem
I = intervention (frequency/duration)
C = comparison, if any
O = outcomes

Question 2

Stating the PICO question

Answer 2

What is the evidence…
for a patient P (with a specific problem or diagnosis)…
that for a specific intervention I (specific treatment) …
C compared to another intervention or no intervention …
produces a specific O outcome?

Question 3

Treatment vs no treatment

Answer 3

Go treatment every time (as opposed to a group receiving nothing)

Question 4

Steps in critical reflection on a treatment intervention

Answer 4

Understand basic science and logic of the disorder AND of the treatment
Determine if the basic science and logic of the treatment will address the basic science and logic of the disorder

Question 5

Before investigating research on effectiveness of a treatment, critically reflect on the

Answer 5

treatment

Question 6

When breaking a pico question into search concepts, you place each concept into

Answer 6

a different search block and separate them by AND

Question 7

Within a search block, when you are trying to search all synonyms and similar concepts, you use

Answer 7

OR between words

Question 8

On Scopus, you must use ______ around concepts with multiple words or it will search each word individually

Answer 8

quotations

Question 9

Controlled vocabulary

Answer 9

standardized words or phrases used to express a specific concept

Question 10

Conflicting evidence

Answer 10

when doing a search there are articles that support treatment of interest, and articles that do not

Question 11

Publication bias

Answer 11

Positive findings more likely to be published than negative findings

Question 12

Level I evidence

Answer 12

• Systematic review (meta-analysis) of RCTs

* Individual RCT (well-designed RCT of appropriate size, e.g., n>30)

Question 13

Level II evidence

Answer 13

• Systematic review of cohort studies

* Individual cohort study (including low quality RCT)

Question 14

Level III evidence

Answer 14

Evidence from well-designed trials without randomization, single group pre-post, cohort, time series, matched case-controlled studies

Question 15

Level IV evidence

Answer 15

Descriptive, non-experimental studies that include analysis of outcomes (single subject design, case series, cross-sectional studies and poor quality cohort and case controlled studies)

Question 16

Level V evidence

Answer 16

Opinions of respected authorities, based on clinical evidence, descriptive studies, or reports of expert committees

Question 17

Factors influencing bias

Answer 17

sample size, homogenous group, blinded intervention, blinded assessment, randomly assigned, proper outcome measure, comparison group, same dose

Question 18

Most/least bias in levels of evidence

Answer 18

Most: V
Least: I

Question 19

Systematic reviews

Answer 19

• Different than regular literature review
• comprehensive, less likely to be biased
• follow a rigorous methodology; gather all articles on a topic and critique the data quality (qualitative)

Question 20

Meta-analysis

Answer 20

• quantitative summary of literature
• more powerful than systematic review
• can only use if you have combinable data

Question 21

Primary variance

Answer 21

• only applies to treatment intervention (independent variable)
• Duration/length of treatment, frequency of treatment, administered by health care professional or trained individual, administered correctly
• You want to increase primary variance

Question 22

Secondary variance

Answer 22

• does not apply to the treatment intervention
• Good things decrease secondary variance
• Bad things increase secondary variance

Question 23

Good examples for secondary variance

Answer 23

randomization, control group, comparable patient characteristics, dose matched between the experimental and control, blinded intervention, blind observers

Question 24

Bad examples for secondary variance

Answer 24

Not randomized, receiving other treatments, parent raters, no or limited restrictions on age and diagnosis, comorbidities, medications, patients dropping out

Question 25

Error variance

Answer 25

- only applies to the measure (dependent variable) or statistics - Good things decrease error variance - Bad things increase error variance

Question 26

Good examples for error variance

Answer 26

standardized instrument

Question 27

Bad examples for error variance

Answer 27

uncalibrated instrument, non-standardized instrument, small sample size (less than 30 subjects), incorrect statistics

Question 28

Research design – schematic for independent variable

Answer 28

X

Question 29

Research design – schematic for dependent variable

Answer 29

O

Question 30

Research design – schematic for randomized or matched

Answer 30

R, M, or nothing

Question 31

Other parts of schematics

Answer 31

- Determine how many groups (treatment vs control/comparison group) - Determine how often dependent variables are measured for each group (how many O’s and where they go in the schematic)

Question 32

Categorical independent variable

Answer 32

Distinct groups of the independent variable | Ex) control group and experimental

Question 33

Measurable independent variable

Answer 33

Not distinct groups | Ex) age, weight

Question 34

Categorical dependent variable

Answer 34

Number of individuals .. (that have falls, showing abnormal sensory profile)

Question 35

Measurable dependent variable

Answer 35

ROM, strength, scores/measure on questionnaire | Data is normal or skewed