Research

Question 1

Evidence based practice

Answer 1

Occupational practices ought to be based on scientific evidence

Providing the most effective care available with aim of improving patient outcomes

Question 2

3 intersecting components of evidence based practice

Answer 2

Evidence, Clinical Experience, Patient’s Expectations

Question 3

Evidence in evidence based practice comes from

Answer 3

clinical research - literature searching, application of formal rules of evidence evaluation

NOT intuition, unsystematic clinical experience, or pathophysiologic rationale

Question 4

Is intuition permitted in practice

Answer 4

Yes; it should be balanced with aspects of evidence based practice.

Question 5

Importance of evidence based care x 3

Answer 5

1 sound decision making
2 minimize risk to ptnt (benefit>harm)
3 evaluate literature and practice
4 expose gaps in literature
5 confident interaction with other professionals
6 ptnt receives care that fits their needs

Question 6

Aspects of pedorthic practice influenced by evidence based practice

Answer 6

Assessment findings
Testing
Treatment
Prevention

Question 7

Evidence

Answer 7

Knowledge from a variety of sources that has been found to be credible

Balance of empirical and experiential evidence; academic articles, expert opinion, clinical experience

Question 8

Proof process

Answer 8

Burden of proof on person making claim; burden on paper presenter; defend thesis against challenges from panel of judges

Question 9

Hypothesis rejected / refuted

Answer 9

Evidence contrary to predicted expectations

Question 10

Rule for evidence collection used by science

Answer 10

Collected systemically in attempt to avoid bias

Question 11

Cornerstone of evidence based medicine

Answer 11

Hierarchical levels of evidence

Question 12

Levels of evidence x6

Answer 12

Systematic reviews / meta analysis (top level),
Randomized controlled trials,
Cohort studies,
Case controlled studies, 
Case series / case reports, 
Editorial / Expert opinion (bottom)

Question 13

Assigning level of evidence

Answer 13

assigned to studies based on methodological quality of their design, validity, and applicability to patient cases

Question 14

Selection of evidence-based information

Answer 14

Select the highest level of evidence possible (ideally systematic reviews / meta analysis)

Question 15

Filtered information

Answer 15

Has been critically appraised (e.g. systematic reviews / meta analysis)

Question 16

Meta-analysis

Answer 16

Systematic review using quantitative methods to summarize results, such as by pooling data to determine influence on statistical power

Question 17

Systematic review

Answer 17

Study composed of systematic searches to appraise and summarize all medical literature on a specific topic (narrative or qualitative review)

Question 18

Randomized controlled trials

Answer 18

Randomized groups: experimental and control. Followed for variables and outcomes of interest. Rigorous study design.

Question 19

Cohort study

Answer 19

Non-randomized groups: one with variable of interest, one without. Follow groups to measure outcome.

Question 20

Case-controlled study

Answer 20

Patients with outcome of interest and control patients with same outcome; identify exposure

Question 21

Case series / case reports

Answer 21

Uncontrolled studies; outcome measure often not reported; possible confounding factors

Question 22

Editorial / expert opinion

Answer 22

Purely anecdotal evidence

Question 23

Non empirical evidence x3

Answer 23

Clinical experience,
‘n of one’ evidence gathered from patients,
Theory (non-research based)

Often lead to research; bottom of hierarchy

Question 24

Finding good evidence: research question

Answer 24

Develop a good research question with PICO: population, intervention, control, outcome measures

Question 25

Finding good evidence: Boolean operators

Answer 25

And = results containing both categories Or = results containing both categories and results for each category alone Not = one category is completely excluded from results

Question 26

3 conclusions of article critical appraisal

Answer 26

1 discard completely (flawed) 2 interpret with caution (questionable) 3 assimilate into practice (trustworthy)

Question 27

5 questions for article critical appraisal

Answer 27

``` 1 originality 2 who 3 study design 4 bias 5 size, follow-up ```

Question 28

Reliability of findings

Answer 28

CONSISTENCY extent to which outcomes are consistent when method repeated; quality of research

Question 29

Validity of findings

Answer 29

ACCURACY the extent to which the instruments or methods used are measuring what they are intended to measure; quality of research

Question 30

2 ways to consider quality of research

Answer 30

reliability + validity

Question 31

3 common bias types in clinical research

Answer 31

confounding variables selection bias measurement bias

Question 32

confounding variable

Answer 32

factor that influences the intervention and/or control group causing a suspicious association; influences outcome

Question 33

measurement bias

Answer 33

instrument or calibration is not rigorously controlled

Question 34

ROBIS

Answer 34

tool for BIAS risk assessment

Question 35

AMSTAR

Answer 35

tool for assessing METHODOLOGICAL QUALITY