L2 Evidence Based Practice and Assessment

Question 1

what is evidence-based practice

Answer 1

“the integration of the best research evidence with clinical expertise and patient values” (Sackett, Straus, Richardson, Rosenberg, & Haynes,
2000; 1)

Question 2

three pillars of assessment-based practice

Answer 2

• scientific evidence - journals, research etc
• clinical expertise - experience as a clinician
• patient values - this is especially important in a multicultural society

Question 3

what is TEKA

Answer 3

Total evidence and knowledge approach

Question 4

eminence based practice

Answer 4

relying on the opinion of a medical specialist or other prominent health official when it comes to health matters, rather than relying on a careful assessment of relevant research evidence

Question 5

habit-based practice

Answer 5

relying on doing the same thing over and over again because you know it works, over examining the evidence and coming up with the best plan for a specific patient

Question 6

convenience-based practice

Answer 6

relying on something because it is the most convenient way to do it, rather than examining the relevant evidence to come up with the best care plan

Question 7

levels of evidence

Answer 7

• Levels of evidence provide a hierarchical order for a range of research designs based on their potential for bias
  1. Systematic reviews
  2. Critically-appraised topics (evidence syntheses)
  3. Critically-appraised individual articles (article synopses)
  4. Randomized control trials (RTCs)
  5. Cohort studies
  6. Case-controlled studies, Case series/reports
  7. Background information/Expert opinion
• 1-3 consist of filtered information
• 4-6 consist of unfiltered information

Question 8

sensitivity

Answer 8

• of all the people who have a disease (ie. are positive for a disease), what proportion of them actually test positive
  
  • ie. how many positive people the test will actually identify
  • determined by the function of the characteristics of the test itself, not affected by the prevelance of the disease

Question 9

specificity

Answer 9

of all the people who are negative, what proportion of them actually test negative
different to positive and negative predictive values - these relate to the incidence rates of the disease not the test itself

Question 10

reliability

Answer 10

• the degree to which a test or tool produces similar results under consistent conditions
  
  • ie the precision of the test

Question 11

intra-rater reliablility

Answer 11

the degree of agreement among repeated administrations of a diagnostic test performed by a single rater

Question 12

inter-rater reliability

Answer 12

the degree of agreement among independent observers who assess the same phenomenon

Question 13

validity

Answer 13

the degree of agreement among independent observers who assess the same phenomenon