OCS Chap 1

Question 1

what is rational thinking

Answer 1

generating a hypothesis (abductive reasoning), collecting data (deductive, inductive or probabilistically) to make a conclusion w/ best available evidence

Question 2

what is rationalization

Answer 2

starts w/ the answer then uses hypotheses and data that supports the answer with disregard for the data that do not (is a logical fallacy)

Question 3

what is reasoning?

Answer 3

process of thinking about something in a logical manner

Question 4

deductive reasoning

Answer 4

logic - attempts to use a reasoned approach to link all the components of evidence together in a linear fashion to prove that something is true beyond a reasonable doubt

Question 5

inductive reasoning

Answer 5

collects disconnected pieces of evidence that increases the probability of something being true - never create absolute proof that something is true

Question 6

abductive reasoning

Answer 6

used to generate and modify hypotheses

Question 7

most common logical fallacies: post hoc ergo proper hoc and cum hoc ergo proper hoc

Answer 7

after this therefore because of this and with this therefore because of this

Question 8

ad hominem

Answer 8

individual attacks somebody personally instead of discussing the problems w/ evidence

Question 9

appeal to authority

Answer 9

individual will state that something is true because an authoritative source has said that it is true

Question 10

straw man

Answer 10

somebody counter argues a point that a person has made by creating an argument to refute a point that the individual never made

Question 11

appeal to ignorance

Answer 11

assumption that a statement must be true if it cannot be proved false

Question 12

bandwagon

Answer 12

suggest because everybody else is doing it that it is the best way to do it

Question 13

red herring

Answer 13

info that misleads the clinician or distracts the clinician from what is important

Question 14

confirmation bias

Answer 14

clinician only uses evidence that supports their point of view and disregards the higher quality evidence with a low risk of bias that does not support their POV

Question 15

hindsight bias

Answer 15

after events unfold, clinician treats the outcome as being predictable or foreseeable

Question 16

anchoring bias

Answer 16

clinician is overly influenced by the first evidence they collect and the hypothesis it generates

Question 17

false consensus bias

Answer 17

clinician overestimates how much his/her peers agree with their clinical approach

Question 18

recall bias

Answer 18

tendency of a clinician to remember their favorable results and not remember the less than spectacular outcomes

Question 19

scientific method

Answer 19

reasoning process that uses observational inductive reasoning to formulate questions

Question 20

frequentist statistical methodology

Answer 20

traditional, most frequent use, makes several assumptions (sample reps population, statistical tools choice made before data collected, use p-value to accept or reject the null hypothesis, what is meaningful, reports the truth)

Question 21

Bayesian Statistical Methodology

Answer 21

not one and done, iterative process that uses prior knowledge and outcomes to construct the probability of something being accurate or true (what the truth is probabilistically) - process most like the clinical reasoning process

Question 22

EBP

Answer 22

process that starts by asking a clinically meaningful question, seeks to find the best available evidence that can be used to answer the question, combines the best available evidence in the context of the clinician’s clinical experience, and the values of the patient, and evaluates the efficacy of the process based on the pt’s response

Question 23

interactive reasoning

Answer 23

deductive and/or inductive involves strategic communication to establish a therapeutic alliance w/ the patient

Question 24

collaborative reasoning

Answer 24

deductive and/or inductive communicative process used to ensure that the clinician’s values and beliefs align w/ the pt’s values and beliefs

Question 25

diagnostic reasoning

Answer 25

deductive - attempts to create a linear relationship between the pt's activity/participation restrictions, physical impairments, pathology of body structures, pain mechanisms, personal factors, and environmental factors

Question 26

musculoskeletal pain irritability

Answer 26

related to persistence of pain and the aggrav activities that produces a pt's symptoms

Question 27

narrative reasoning

Answer 27

inductive - gather info related to personal and environmental factors relevant to the pt

Question 28

intervention procedures reasoning

Answer 28

deductive and/or inductive - includes the choice and execution of interventions that should help the pt if the hypothesis formulated is accurate

Question 29

predictive reasoning

Answer 29

deductive and/or inductive - using musculoskeletal pain irritability and the response of the hypothesis testing through intervention during the first visit to establish a prognosis

Question 30

pt edu reasoning

Answer 30

deductive and/or inductive - formulating diff ways to edu pt and ensuring that the edu was received

Question 31

ethical reasoning

Answer 31

deductive and/or inductive - doing what is in the best interest of the pt given the best available info

Question 32

Bayesian reasoning

Answer 32

application of probability theory to deductive and inductive reasoning

Question 33

what causes errors in clinical reasoning

Answer 33

inadequate knowledge, faulty data gathering, faulty data processing, faulty metacognition, inability to recognize logically fallacious thinking and cognitive biases

Question 34

therapeutic alliance

Answer 34

relationship between the PT and the pt that involves mutual agreement on clinical goals and the interventions that will be used to attain those goals

Question 35

deductive errors related to diagnosis - premature closure clinic

Answer 35

clinician fails to consider other alternatives after initial dx is made

Question 36

deductive errors related to diagnosis - framing effect

Answer 36

clinician may frame the question in the positive or negative related to the pt

Question 37

deductive errors related to diagnosis - commission bias

Answer 37

somebody erroneously thinks that they need to use a specific intervention to make the pt feel better when they may likely just get better as a result of natural recovery

Question 38

deductive errors related to diagnosis - extrapolation error

Answer 38

extend previous and occurring events into those that may arise in the future

Question 39

deductive errors related to diagnosis - verification bias

Answer 39

results of a single diagnostic test keep the clinician from selecting a more accurate test

Question 40

symptom modification approach

Answer 40

to reduce symptoms and to improve function using a variety of clinical approaches

Question 41

3 mechanisms based sources of symptoms

Answer 41

central sensitization, peripheral neuropathic, nociceptive

Question 42

nociplastic (central sensitization)

Answer 42

pain that is disproportionate, non mechanical, unpredictable and diffuse

Question 43

nociplastic symptoms strong association w/

Answer 43

maladaptive behaviors related to presence of neg beliefs (fear-avoidance), lack of positive beliefs related to self-efficacy and dyskinetic movement related to kinesiophobia

Question 44

peripheral neuropathic (radicular or referred)

Answer 44

symptoms that are referred in a dermatomal (radicular) or cutaneous (referred) distribution - have hx of nerve injury, pathology, or mechanical compromise of the nerve w/ symptom provocation w/ mechanical testing

Question 45

nociceptive

Answer 45

symptoms that are localized to an area or injury or dysfunction, provocation and/or alleviation are clearly identifiable and proportionate, match known mechanical and anatomical distribuitions, symptoms are usually intermittent and start w/ the onset movement or mechanical provocation, and the quality of symptoms may be constant dull ache or throb at rest

Question 46

novice clinical reasoning

Answer 46

use type 2 processing (process of analysis), hypothetico-deductive approach, have very few patterns to recognize, standardized and data driven, do not recognize that clinical reasoning is a collaborative process between the clinician and pt

Question 47

experts clinical reasoning

Answer 47

use type 1 processing (involves snap judgements), rely on pattern recognition, use hypothetic-deductive approach w/ complex pts, reasoning is individualized to the pt and includes the context element related to pt-clinician interaction

Question 48

metacognitive process

Answer 48

thinking about thinking through reflection

Question 49

reflection on action

Answer 49

most often used by novice, clinical reasoning "on action" is the reflective metacognitive process on (what went well, what did not go well, what should be done in the future)

Question 50

reflection in action

Answer 50

use by expert, clinical reasoning "in action" can recognize what is going well, what isn't going well, and involves the ability to make on the spot corrections in real time

Question 51

clinical questions should be formulated using PICO

Answer 51

P- patient or problem I - intervention C - comparison intervention O - outcomes

Question 52

PEDro scale

Answer 52

11 criteria (1st criteria related to presence of inclusion and exclusion criteria in the study's external validity. 2-11 used to determine the internal validity of the study) 6 or greater for criteria 2-11 is required to determine if the study has respectable level of internal validity

Question 53

sensitivity

Answer 53

SnNout - a test with high sensitivity that is negative helps to rule out

Question 54

Specificity

Answer 54

SpPin - high specificity that is positive helps to rule something in

Question 55

likelihood ratio

Answer 55

test's ability to modify the pretest probability of a dx being present or absent to the post test probability of a dx being present or absent

Question 56

positive likelihood ratio

Answer 56

reflects the probability that a person who tests positive DOES have the disorder (>5)

Question 57

negative likelihood ratio

Answer 57

reflects the probability that a person who tests negative really DOES NOT have the disorder (<.20)

Question 58

common biases in diagnostic studies - sampling bias

Answer 58

only screened participants that were thought to meet inclusion/exclusion criteria instead of screening all potential participants with the condition

Question 59

common biases in diagnostic studies - verification bias

Answer 59

when not all participants are assessed by the reference standard in the same fashion (can lead to overestimation of accuracy)

Question 60

common biases in diagnostic studies - incorporation bias

Answer 60

reference standard is included in the diagnostic test being studied

Question 61

common biases in diagnostic studies - spectrum bias

Answer 61

participants are not representative of the population in which the test is likely to be used

Question 62

prognosis

Answer 62

predicted level of function that the pt will attain within a specific timeframe

Question 63

what is clinical reasoning

Answer 63

reflective process of inquiry and analysis carried out by a health professional in collaboration with pt with the aim of understanding the pt, their context, and their clinical problems in order to guide EBP