Intro Chapter Flashcards
Improve knowledge of intro chapter, clinical decision making, nomogram, likelihood ratio, important people
1
Q
Objectives of APTA Vision 20/20
A
Autonomous PT Practice Direct Access Doctoral Level Lifelong Education EBP Professionalism
2
Q
_____/_____ people will have back pain but _____% will have serious pathology
A
6/10
1%
3
Q
The Red Flags article which cites low back pain and serious pathology was written by
A
Greenhalgh and Selfe
4
Q
Clinical Skills include the following combination of implicit and learned characteristics
A
Intellectual Aptitude Personality (eg. Humility, Curiosity, and Empathy) Knowledge Organization Communication Manual Skills Thinking Skills
5
Q
The study of Expert Versus Novice Clinical Decision Making was done by:
A
Wainwright Et Al
6
Q
Things that help Informative Factors and Directive Factors to come together for clinical decision making are:
A
Mentorship
Information from Literature
Clinical Experience
Critical Thinking
7
Q
Experts are good ______
A
Thinkers
8
Q
Characteristics of Evidence Based Practice Are:
A
Barriers
Conscientious, Explicit, and Judicious use of current best evidence
Evidence alone is never sufficient to make a clinical decision
The integration of best research evidence with clinical expertise and patient values.
Evidence Hierarchy
9
Q
Characteristics of Evidence Informed Practice Are:
A
More Qualitative Emphasis
Evidence from Empirical Observation
The Hierarchy is not absolute
The Time Honored Craft of caring for the sick
Use of statistics in a way that is readily usable for clinical decision making
10
Q
Barriers are a characteristic of evidence _____ practice
A
Based
11
Q
________ stated “Conscientious, Explicit, and Judicious use of current best evidence
A
Sackett Et Al
12
Q
“Conscientious, Explicit, and Judicious use of current best evidence” is a characteristic of evidence ______practice
A
Based
13
Q
Evidence alone is never sufficient to make a clinical decision is a statement from ______
A
Guyatt G et al
14
Q
Evidence alone is never sufficient to make a clinical decision is a characteristic of evidence ______ practice
A
Based
15
Q
The integration of best research evidence with clinical expertise and patient values is a characteristic of evidence _____ practice
A
Based
16
Q
Evidence Hierarchy is a characteristic of evidence ____ practice
A
Based
17
Q
There is more qualitative emphasis in evidence _______ practice
A
Informed
18
Q
Evidence from empirical observation and finding the relationship between events is a characteristic of evidence ____ practice
A
Informed
19
Q
_____ stated “The Hierarchy is not absolute”
A
Guyatt G et al
20
Q
“The Hierarchy is not absolute” is a characteristic of evidence _____ practice
A
Informed
21
Q
“The Time Honored Craft of Caring for the Sick” is a quote from
A
Guyatt G et al
22
Q
“The Time Honored Craft of Caring for the Sick” is a characteristic of evidence _____ practice
A
Informed
23
Q
Use of statistics in a way that is readily usable for evidence informed decision making is a characteristic of evidence _____ practice
A
Informed
24
Q
The emphasis of evidence based practice has been
A
Deduction
Clinical decisions based on prospective studies, designed to answer specific clinical questions or test specific clinical research hypotheses
25
Emphasis of evidence informed practice is becoming
Induction
Abdication
Deduction (as appropriate)
Clustering
26
A challenge to evidence based practice is that it denigrates clinical ____________
Experience
27
A challenge to evidence based practice is it ignores patient _______
Values and Preferences
28
A challenge to evidence based practice is it De-emphasizes ________
Basic Science Research
29
A challenge to evidence based practice is that many aspects of PT have __________
No Evidence
30
Evidence based practice is challenging because it requires new skills in ________ and ________ literature
Searching for and appraising
31
Challenges to the use of evidence is that it may not fit your ________ and it may ______ with other evidence
patient, conflict
32
Who stated and when did they state "A continuing challenge for evidence based medicine will be to better integrate the new science of clinical medicine with time-honored craft of caring for the sick
Guyatt G et al
33
What are the three parts of the three legged stool
Clinical Expertise, Research Evidence, Patient Characteristics
34
What part of the three legged stool describes "The ability to use skills and past experience to rapidly identify each patients unique health state and weight potential interventions"
Clinical Expertise
35
What part of the three legged stool describes "clinically relevant research into diagnostic tests, prognostic markers, interventions"
Research Evidence
36
What part of the three legged stool describes "unique patient preferences, concerns, and expectations of each patient which must be integrated into decision making"
Patient Characteristics
37
Who described the three legged stool
Sackett et al
38
What are the pathways of clinical decision making?
```
Algorithms/Arborization
Exhaustion
Hypothetical-Deductive
Pattern Recognition
Sense-Making and Small Wins
```
39
We often don't search for the alternative that is optimal, just the first one that is
Acceptable
40
The type of bias which makes us systematically overconfident in our judgement is:
Clinically Delusional
41
Clinically Delusional Bias makes us :
Systematically overconfident in our judgements
42
The tendency to escalate commitment to a course of action that they have a lot of investment is:
Sunk-Cost Effect
43
Sunk Cost Effect Bias makes us:
Tend to escalate commitment to a course of action that we have a lot of investment in
44
Having too much emphasis on information and evidence that is most readily available to us when we are making a decision is ______ effect or _______ bias
Recency Effect or Availability Bias
45
Recency Effect or Availability Bias is
Putting too much emphasis on information and evidence most readily available to us when we are making a decision
46
Recency Effect (Availability Bias) would let us get fooled by recent _______
Hot Streaks
47
The most prevalent form of bias is
Confirmation Bias
48
A tendency to gather and rely on information that confirms our preexisting hypotheses is
Confirmation Bias
49
Confirmation Bias is:
A tendency to gather and rely on information that confirms our preexisting hypothesis
50
A type of bias that allows and initial reference point to distort our estimates is
Anchoring Bias
51
Anchoring Bias Allows for an _______ to distort our estimates
Initial Reference Point
52
Jumping to a conclusion about a relationship between two variables when no relationship exists is an
Illusory Correlation
53
An illusory Correlation is one in which
We jump to conclusions about the relationship between two variables when no relationship exists
54
Hindsight Bias is when we look back at past events and
Judge them as easily predictable when they were clearly not easily foreseen
55
A type of bias in which we judge past events as easily predictable when they were clearly not easily foreseen is ______
Hindsight Bias
56
Its important when combating biases to
Review past work after an action review
Not repeating mistakes
Having an effective group dynamic
57
The progression of the diagnostic process down one of a large number of potential, preset paths by a method in which the response to each diagnostic inquiry automatically determines the next inquiry to be carried out is ____________
arborization
58
The canadian C spine rules are an example of which type of clinical decision making pathway?
Arborization
59
The clinical decision making pathways were first described by who?
Sackett DL et al
60
The clinical decision making pathway that is characterized by a step by step protocol of pathways is _________
algorithm
61
The components of the ICF model are
```
Condition,
Body Structures/Functions (Impairments)
Activities
Participation Restrictions
Environmental Considerations
```
62
The ICF model was originally described by who in the PT literature
Atkinson and Nixon Cave
63
The clinical decision making pathway in which a search for all medical facts is conducted followed by sifting through the data for a diagnosis is
Exhaustion
64
The clinical decision making pathway in which early clues about a patient come up with a list of diagnoses and then maneuvers are performed to reduce that list of diagnoses are
Hypothetico-Deductive Reasoning
65
The Hypothetical Deductive Model was first named by who?
William Whewell
66
Scientific inquiry proceeds by formulating a hypothesis in a form that could be _________ by a test on observable data
Falsified
67
A test that could and does run contrary to the predictions of the hypothesis is taken as a _________ of the hypothesis
Falsification
68
A test that could but does not run contrary to predictions of the hypothesis ________ the hypothesis
Corroborates
69
Qualification of corroborating evidence is sometimes raised as __________ (The Raven Conflict)
philosophically problematic
70
The instantaneous realization that the patient's presentation conforms to a previously learned picture (or pattern) of disease is the clinical decision making pathway known as
Pattern Recognition
71
Pattern recognition is also known as ________
Thin Slicing
72
Who came up with the term thin slicing?
John Gottman PHD
73
How do our minds make sense of a lot of new information in a very short time (Fast and frugal work in our adaptive unconscious)
Pattern Recognition/Thin Slicing
74
How is Pattern Recognition learned?
Experience
75
What other clinical decision making pathway is pattern recognition paired well with
Hypothetico-Deductive
76
What are other terms for Occam's Razor
Law of Parsiomony, Economy, or Succinctness
77
What is the principle that recommends that, from among competing hypothesis, selecting the one that makes the fewest new assumptions usually provides the correct one
Occam's Razor
78
What is the principle that the simplest explanation will be the most plausible until evidence is presented to prove it false?
Occam's Razor
79
Novices don't have the necessary experience to engage in the clinical decision making pathway of _________
Pattern Recognition
80
What situations obscures our pattern recognition ability?
Highly complex or ambiguous situations
81
When using pattern recognition you must be careful not to focus on the similarities between two analogous situations and downplay the __________
differences
82
What clinical decision making pathway focuses on finding cause and effect relationships and reflecting and learning from those experiences?
Sense Making
83
What clinical decision making pathway focuses on step by step processes for difficult, complexs, overwhelming problems?
Small Wins
84
What clinical decision making pathway focuses on breaking large, complex problems into smaller parts and then improving on those smaller parts
Small Wins
85
The determination of the predicted optimal level of improvement in function and amount of time needed to reach that level, also including a prediction of levels of improvement that may be reached at various intervals during the course of therapy is
Prognosis
86
What is the process of knowing how to estimate our patient's likely clinical course over time and anticipate likely complications of the disorder
Prognosis
87
Prognosis should progress through these factors:
```
Qualitative Factors (Options for Outcome),
Quantitative Factors (Probability of having that Outcome),
Temporal Factors (Time for the outcome)
```
88
"clinical decisions based primarily on the advice of an expert" is an example of _________
Abdication
89
Who stated "If I have seen further than others, it is by standing upon the shoulders of giants", in a letter to whom, and what is it in relationships to
Sir Issac Newton to Robert Hooker on Abdication.
90
What is the tool that allows you to take pre-test probability and use data to find a post-test reliability
Likelihood Ratio
91
This tells us how much the odds of having a disorder change with either a positive or negative test
Likelihood ratio
92
What is a moderate and great shift in probability with a positive likelihood ratio
Moderate - 5-10
| Great Shift - >10
93
What is the formula for a Positive Likelihood ratio
Sensitivity/(1-Specificity)
94
What is a moderate and great shift in probability with a negative likelihood ratio
0.25-.1 Moderate
| <0.1 - Great Shift
95
What is the formula for a Negative Likelihood ratio
(1-Sensitivity)/Specificity
96
The visual representation of the change in pre and post-test odds for a disorder is a _________
Nomogram
97
Nomograms are based on ________ Theorem
Bayes
98
Pre-Test odds for a likelihood ratio may be based on
Prevalence studies or a scientific estimate
99
The article for using a Nomogram to test Bayes Theorem was written by _____
Fagan TJ in N Engl J Med
100
The Masters do the Basics Well is an "________" by _________
Axiom for a friend - Jeff Ellis (1960-2001)
101
Talent is not a thing, it is a process is an "________" by _________
Axiom for a friend - Jeff Ellis (1960-2001)
102
Good habits are built by practice, practice, practice (Precise Practice) is an "________" by _________
Axiom for a friend - Jeff Ellis (1960-2001)
103
Steal from the best and get rid of the rest is a quote by __________ but it is in the section __________ by ___________
David Lamb, Axiom for a friend - Jeff Ellis (1960-2001)
104
Don't Stop your Curiosity, Don't Stop Yourself from Learning is a quote by
Jim Beazell (1960 - 2010)
105
When formulating a prognosis, qualitative factors are also known as
Options for outcome
106
When formulating a prognosis, quantitative factors are also known as
Probability for having that outcome
107
When formulating a prognosis, Temporal factors are also known as
Time for an outcome
