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CMHL1001 > Exam Revision > Flashcards

Exam Revision Flashcards

1
Q

What are the 5 steps of EBP?

A

1: Ask - convert information needs into answerable questions
2: Acquire - track down best evidence to answer these questions
3: Appraise - critically appraise validity and usefulness of evidence
4: Apply - implement evidence into clinical practice
5: Evaluate - evaluate performance

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2
Q

What is the difference between primary and secondary research?

A

Primary research is findings from a single study.

Secondary research reports synthesised findings from a range of studies.

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3
Q

What 5 questions need to be asked when assessing the quality of a study?

A

1: Who wrote the paper?
2: Are the title and abstract appropriate and informative?
3: Was the research design appropriate to the question?
4: Why was the study needed?
5: Do the results answer the question?

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4
Q

Define qualitative research

A

Research that begins with an intention to explore a particular research area, then uses data to generate a hypothesis. Qualitative research utilises non-numerical data.

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5
Q

Define quantitative research

A

Research that begins with a hypothesis, then uses numerical data to draw conclusions.

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6
Q

What are the levels of evidence?

A

I: Systematic reviews of RCTs
II: RCTs
III: (1)Pseudo-RCTs/(2)Cohort/(3)Case-control
IV: Cross-sectional/Case series/Correlational
V: Anecdotes

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7
Q

When is PICO used and what question is asked?

A 
PICO stands for:
Population
Intervention
Comparison
Outcome
It asks: Is there are relationship between INTERVENTION and OUTCOME when compared to COMPARISON in POPULATION?
It is used for quantitative studies.
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8
Q

When is PE(C)O used and what question is asked?

A 
PE(C)O stands for:
Population
Exposure
Comparison (if relevant)
Outcome
It asks: Is there a relationship between EXPOSURE and OUTCOME when compared to COMPARISON in POPULATION?
It is used for quantitative studies.
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9
Q

When is PICo used and what question is asked?

A 
PICo stands for:
Population
Interest
Context
It asks: What is the INTEREST of POPULATION in CONTEXT?
It is used for qualitative studies.
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10
Q

What is allocation bias?

A

Differences between treatment and control conditions at the start of the experiment.

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11
Q

What is detection bias?

A

Differences in how the treatments and control groups are assessed or measured.

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12
Q

What is performance bias?

A

Events other than intended treatment happening during the experiment.

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13
Q

What is attrition bias?

A

Dropout rates causing unwanted differences in participant characteristics between groups.

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14
Q

What is measurement bias?

A

Outcomes measured inaccurately.

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15
Q

What sampling methods fall under probability sampling?

A

Simple random: every participant has an equal chance of selection
Systematic random: systematically chosen from a list
Stratified random: population divided into strata, then simple or systematic random
Cluster: divide participants into clusters, randomly sample some clusters
Multistage: primary populations divided into sub-populations

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16
Q

What sampling methods fall under non-probability sampling?

A

Convenience: recruiting participants through convenience
Snowball: identifying someone who meets inclusion criteria and asking them to recommend others
Purposive: finding cases that provide rich information about the research area
Quota: participants chosen according to pre-specified quotas

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17
Q

What are the two types of sampling error?

A

Random: under/overrepresentation of certain groups
Systematic: inconsistencies/errors in sampling frame

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18
Q

What is the percentage of scores in normal distribution?

A

68% scores fall within 1 SD of mean
95% scores fall within 2 SD of mean
99% scores fall within 3 SD of mean

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19
Q

What is negatively skewed distribution?

A

Where the mean is lower than the median and mode.

20
Q

What is positively skewed distribution?

A

Where the mean is higher than the median and mode.

21
Q

What is Type I error?

A

False positive - the null hypothesis is wrongly rejected. Here, the p-value would be >0.05

22
Q

What is Type II error?

A

False negative - the alternative hypothesis is wrongly rejected. Here, the p-value would be <0.05

23
Q

What are the levels of measurement? Provide an example for each.

A

Nominal: classifies people, place, objects or events into named groups (eg: male and female)
Ordinal: records rank order of items in a set (eg: gold, silver, bronze)
Interval: every point on the scale is separated by the same amount (eg: temperature)
Ratio: same as intervals, except 0 is defined as nothing (eg: weight)

24
Q

What are the two types of measurement error?

A

Random: affects only the variation around the mean, affects SD.
Systematic: affects the mean, does not affect SD.

25
Q

Define p-values.

A

p-values indicate the probability that the result has occurred by chance. p<0.05 indicates the result is statistically significant; the null hypothesis should be rejected and the alternative hypothesis accepted. p>0.05 indicates the results are not statistically significant; the null hypothesis should be accepted and the alternative hypothesis rejected.

26
Q

What are confidence intervals?

A

For mean difference: if CI crosses 0, the results are not statistically significant
For RR/OR: if CI crosses 1, the results are not statistically significant

27
Q

What is Relative Risk?

A

If RR = 1, the risk in exposed is equal to the risk in unexposed.
If RR > 1, the risk in exposed is greater than the risk in unexposed. It should be written as: “The risk in the exposed is x times greater than the risk in the unexposed.”
If RR < 1, the risk in exposed is less than risk the risk in unexposed. This number should be converted to a percentage: (1 - RR) x 100 and written as “The risk in the exposed is x% less than the risk in the unexposed.”

28
Q

What is Odds Ratio?

A

If OR = 1, the risk in exposed is equal to the risk in unexposed.
If OR > 1, the risk in exposed is greater than the risk in unexposed. It should be written as: “The risk in the exposed is x times greater than the risk in the unexposed.”
If OR < 1, the risk in exposed is less than risk the risk in unexposed. This number should be converted to a percentage: (1 - OR) x 100 and written as “The risk in the exposed is x% less than the risk in the unexposed.”

29
Q

What are the 3 necessary factors when determining correlation?

A

Direction (r-value)
Strength (r-value)
Significance (p-value)

30
Q

When analysing r-value, what are the numbers for each level of strength?

A 
1 or -1 = perfect
\+/-0.75 to +/-0.99 = strong to very strong
\+/-0.5 to +/-0.75 = moderate to strong
\+/-0.25 to +/-0.5 = weak to moderate
\+/-0.01 to +/-0.25 = weak
31
Q

Name and describe the 7 ethical principles.

A

Autonomy: patients are free to determine their own actions
Beneficence: acting to benefit humankind
Justice: obligation to treat fairly
Non-maleficence: avoiding/minimising harm
Respect: respect for human dignity
Confidentiality: maintenance of privileged information, including the right to privacy and anonymity
Veracity: obligation to tell the truth

32
Q

Name the qualitative research methodologies.

A

Ethnography: study of cultures and people
Phenomenology: focuses on participants’ lived experiences and their interpretation of these experiences
Grounded theory: starts with no preconceptions and develops ideas as data is collected and analysed about an idea of interest
Case studies: clear definition of the case being researched and behaviours explored.

33
Q

Name the qualitative research methods.

A

Interviews (in-depth or semi-structured)
Focus groups
Document analysis
Participant observation

34
Q

Define mixed-methods research.

A

The planned mixing of quantitative and qualitative components within a single study.

35
Q

What are the types of mixed-methods studies?

A
  • Convergent: qualitative and quantitative arms are run concurrently but separately, then the results are converged through analysis and interpretation and the results are reported together (eg: questionnaire and focus group data used to draw conclusions)
  • Sequential: one arm is conducted first and the data is collected, then the other. Results usually reported separately (eg: results from a focus group informing the questions used on a survey)
  • Multiphase: using qualitative and quantitative study designs to answer the same question in populations with different sizes (eg: teachers and students)
  • Embedded: combination of qualitative and quantitative methods throughout the study (eg: survey with standard and open-ended questions)
36
Q

What does Clinical Judgment involve in EBP?

A
  • Integrated care pathways (combining evidence-based recommendations with the realities of local services)
  • Clinical experience
37
Q

What does Scientific Evidence involve in EBP?

A
  • Clinical guidelines (eg: standards for practice)

- Quality evidence

38
Q

What do Patient Values and Preferences involve in EBP?

A
  • Patient-reported outcome measures (PROMS)
  • Decision aids
  • Option grids
39
Q

Describe RCTs.

A

Participants are randomised, and a baseline and follow-up measures are taken. The treatment and control groups are separate but can be either parallel or crossover. This is an experimental design.

40
Q

Describe Quasi Experimental Trials (also known as Pseudo-RCTs).

A

Similar to RCT but does not involve randomisation, and the study population is divided into groups based on similar characteristics. This is an experimental design.

41
Q

Describe Cohort studies.

A

Where an entire group is examined and followed up over many points in time. Can be prospective or retrospective. This is an observational design.

42
Q

Describe Case-Control studies.

A

Involves a case group (who have developed outcome) and a control group. Always retrospective. This is an observational design.

43
Q

Describe Cross-sectional studies.

A

Descriptive study of a group at one point in time, often using surveys or questionnaires. This is an observational design.

44
Q

Describe Correlational design.

A

Investigates a relationship between IV and DV but does not control for confounding variables. This is an observational design.

45
Q

Describe Case series design.

A

Investigates groups of similar presenting cases with no control group. This is an observational design.

46
Q

Describe anecdotal evidence.

A

Medical practitioners/subject matter experts reporting personal observations or opinions. This is an observational design.

CMHL1001 (1 decks)

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