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Flashcards in Final exam Deck (67)
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1
Q

Evidence cycle

A

Ask–acquire–appraise–apply

2
Q

Hayward’s evidence cycle

A

Adds in assess

3
Q

Making a health decision takes what into consideration

A

Patients circumstance, research evidence, clinical expertise, and patients values/preferences

4
Q

Background question components

A

Question + condition

Ex: (what causes) +(Lyme disease)

5
Q

Foreground question components

A

“PICO”

Patient +intervention+ comparison + outcome

6
Q

Diagnostic PICO

A

P: describe the patient
I: new diagnostic test
C: gold standard test
O: condition to be detected

7
Q

Prognostic PICO

A

P: describe patient
I: prognostic factor
C: no prognostic factor
O: health state

8
Q

Harm PICO

A

P: describe the patient
I: exposure
C: lack of exposure
O: health state

9
Q

What is EBCP

A

Recognize problems, asking questions, evaluating and applying evidence

10
Q

Clinical research

A
  • offers direct clinical applicability
  • designed to replicate authentic/functioning environments
  • direct solutions to practical problems
  • theory based knowledge
11
Q

Basic science research

A
  • little clinical relevance
  • performed in controlled lab setting
  • address theoretical issues
12
Q

6 Levels of the hierarchy pyramids

A
  1. (Lowest-least) in vitro research
  2. Animal research
  3. Case series, case studies, surveys
  4. Cohort studies, case control studies
  5. RCT
  6. Meta analyses, systematic reviews
13
Q

Likelihood of bias

A
  1. Systematic reviews
  2. RCT
  3. Cohort studies
  4. Case studies, case series
  5. (Bottom- most bias) clinical experience
14
Q

Case control studies or cohort studies

A

Start with patients who have the disease
Match them with controls
Retrospective

(+) ethnically challenging diseases, rare conditions, limited resources

15
Q

Best study to show causation

A

RCT

16
Q

Meta-analysis or systematic review

A

Combines the results of many studies

17
Q

Sensitivity

A

Probability of a positive test in someone who has the disease

“PID”

In a 4*4 it’s the top left/ total left column

18
Q

Specificity

A

Probability of a negative test in someone who doesn’t have the disease

“NIH”

In a 4*4 it’s the bottom right/ total right column

19
Q

Positive predictive value

A

Probability that a patient with a positive test really does have the disease

In a 4*4 it’s the top left/ top row

20
Q

Negative predictive value

A

The probability that a patient with a negative test really does not have the disease

In a 4*4 it’s the bottom right/bottom row

21
Q

Positive likelihood ratio

A

ratio (+in disease/ total in disease)/ (+ no disease/ total no disease)

22
Q

What are examples of exposures

A

Survey, file review, interview

23
Q

Interpretation of + likelihood ratio

A

1: test is 5 times more likely in patients w/ disease than without

24
Q

Statistical Test to use if:

Describe one group

A

Normal: mean, SD

Non-normal: median

25
Q

Statistical Test to use if:

predict value from another measured variable

A

normal: simple linear regression or non linear regression

non-normal: non parametric regression

26
Q

Where do you look for prognostic factors

A

Table 1

27
Q

How to detect similar outcome?

A

Did they use the same method to measure what you are researching

28
Q

How to find if the follow up sufficiently complete?

A

Number of starters and follow up with are equal, usually a flow chart

Was there enough time to see factors

29
Q

Risk ratio, odds ratio?

A

Rr= times

Odds ratio= association

30
Q

Paired groups vs unpaired groups

A

Paired- taking data from 1 patient in two instances, grouping two points of data

Unpaired- not comparing groups of data

31
Q

Normal distribution of data matches what

A

A bell curve

32
Q

T test

A

Compares two groups
Can be pried or unpaired
Gives t value, but look at p value

33
Q

P value

A

Significant significance if p

34
Q

Mann-Whitney

A

Difference between 2 unpaired groups

Gives u p r values

35
Q

Wilcoxon test

A

Paired groups

36
Q

ANOVA

A

Compares 3 or more groups

Report f and p value

37
Q

Pearson test

A

Test of association

38
Q

Spearman

A

Test of association

Use with non normally distributed data

39
Q

Linear regression

A

Asses relationship between 2 or more variables to see if there is a prediction

40
Q

Doe def

A

Disease oriented evidence

41
Q

Poem def

A

Patient oriented evidence that matters

42
Q

Doe examples

A

Insight into patient physiology
Of interest to health provider
BP, reflexes, nervoscope

43
Q

Poem examples

A

Self reported by patient
Of interest to patient and clinician
Pain rating, level of function, quality of life

44
Q

Outcome measure examples

A

Pain, mental status, disability measurement tool, energy, etc

45
Q

What type of question do you use to find outcome measure

A

Background question

46
Q

Clinimetric properties

A

Reliability, validity, sensitivity to change, and internal consistency

Don’t try to make up your own outcome measure

47
Q

Outcome measure for pain

A

Quadruple vas

NRS

48
Q

Outcome measure for spine

A
Oswesty
Bourne neck questionnaire 
Neck disability index
Roland Morris scale
Headache disability index
49
Q

Outcome measure for general health

A

Health status questionnaire

50
Q

Outcome measure for upper extremity

A

Upper extremity functional index

51
Q

Outcome measure for lower extremity

A

Foot ankle outcome score
Hip dysfunction and osteoarthritis outcome score
Knee and osteoarthritis outcome score
Lower extremity functional scale

52
Q

Outcomes for general extremity

A

Rheumatoid and arthritis outcome score

53
Q

VAS

A

10 cm line

Please make a vertical line where your pain is at

54
Q

Vertical VAS works best for who

A

Elderly

55
Q

NRS

A

Scale 1-10

56
Q

Quadruple VAS

A

Pain right now?
Typical or average pain?
Pain at its best?
Pain at its worst?

57
Q

Pain diagrams

A

Body and you color in where the pain is

58
Q

ODI

A
10 sections of daily activity 
6 choices in each
Scored 0-5
Add each section for overall disability 
Multiply by 2 for %
59
Q

NDI

A

Neck disability

Modified ODI by Howard Vernon

60
Q

RMQ

A

Low back disability

24 statements

61
Q

Bournemouth

A

7 items
Each on scale of 10
Take total points and divide by 70%

62
Q

Headache disability index

A

2 subscales

Emotional and functional

63
Q

UEFI or LEFI

A

20 items
Scored 0-4
Total score /80 x 100=%
Score gets higher with lower pain

64
Q

Foot and ankle, hip dysfunction, knee, RA

A

6 areas- symptoms, stiffness, pain, ADL, sports/recreation, quality of life
Scored 0-4
Total score /168 x 100=%
Needs a change of 10% for meaningful improvement

65
Q

General Health Status Questionnaire

A

8 sub-scales of general health
2 summary measures
overall score
3 individual diagnostic questions

66
Q

8 sub-scales of general health

A

physical functioning, role physical, body pain, general health, vitality, social functioning, role emotional, mental health

67
Q

2 summary measures

A

Physical health and emotional health