EBP updated 10/10

what is the first step to the research process? - identify a research problem/question

the \_______ method is a systematic, empirical, and controlled critical examination of hypothetical propositions about the associations among natural phenomena - scientific

the \______ component of research refers to the necessity for documenting objective data through direct observation (minimizes bias) - empirical

the purpose of research is to:
A) address gaps in knowledge
B) expand knowledge
C) replicate knowledge
D) add voice to knowledge
E) all of the above - E!

What is the difference between quantitative and qualitative data? - quantitative \= objective, numerical, can be analyzed statistically (test a theory)

qualitative \= subjective, narrative, analyzed descriptively (formulate a theory)

(qualitative/quantitative) is considered "hard core science". He calls this the "meat and potatoes" - quantitative

(experimental/nonexperimental) refers to cause and effect; something is based on conditions to show a comparative test. - experimental

\_______ is exploratory in nature; this is based on observations rather than tests and simply describes what happens - nonexperimental

A randomized controlled trial (RCT) is made of an experimental intervention, \______, sham, or usual care condition. - placebo

\____-experimental designs are comparative designs that do not have a control group or randomization - Quasi
(allows for repeated measurements over prolonged periods due to document trends)

a \______ clinical trial (PCT) focuses on real-world outcomes and issues that are important to patients, their quality of life, their finances, and the implementation of practice. - pragmatic

correlation refers to variables varying together while \_____ refers to using one or more variables to predict another - regression

\___-\____ studies are observational studies that compare patients with and without an disorder/outcome of interest. The two groups are compared on their exposure to a risk factor to determine the relationship between the risk factor and disorder.

Is the patient (with/without) the disorder considered the case? - case-control; with

\____ studies are where one or more cohorts of individuals are follows prospectively to determine their status compared to a disease/outcome. This study design can also happen retrospectively/ - cohort

\______ research investigates patterns of growth and change over time - developmental

\________ establishes normal values for specific variables and acts as a guide for diagnosis and treatment - normative

\___ \___ research is a combo of quantitative and qualitative methods - mixed methods

(efficacy/effectiveness) refers to a controlled environment - efficacy (effectiveness refers to the "real world")

when a pragmatic trial showcases the "real world", is this (internal/external) validity? - external (internal would be in a controlled environment)

what does PICOTS stand for? - Population
Intervention
Comparison
Outcomes
Timing
Setting

what are the 4 types of research? - comparison
exploratory
descriptive
methodological

the (independent/dependent) variable is what we manipulate - independent
(dependent is the outcome that we measure)

with high \_____, a positive test rules IN the diagnosis - specificity (SPIN)

with high \____, a negative test rules OUT the diagnosis - sensitivity (SNOUT)

LRs always refer to a (positive/negative) test - positive

a + LR means a positive test is 5-10x more likely to have what? - the disorder/outcome

\_____ is the number or % of injuries in a given amount of time - incidence

\_____ is the current number or % of injuries ~at this time~ - prevalence

which type of reasoning is specific to general? - inductive
(deductive is general to specific)

5 As to the EBP process - 1. Ask
2. Acquire
3. Appraise
4. Apply
5. Assess

the clinical decision-making model is made up of 3 parts:
1) research evidence
2) clinical expertise
3) ? - patient values

is a systematic review of RCTs or nonrandomized controlled study stronger in evidence? - review of RCTs

\____ reasoning is the weakest level of evidence - mechanistic

case control studies usually fall under what level of evidence strength? - 4 (fairly weak)

*slide 54 in week 1 lecture

N-of-1 trial is very important for what type of question? - intervention

\_____ refers to the obligation to attend to the well-being of individuals and ensure that benefits are maximized while harm is minimized - beneficence

\____ is a value that refers to fairness in the research process - justice

what is the order of the levels of measurement? - "NOIR knights"

nominal
ordinal
interval
ratio

\___ measurement are category labels and can refer to gender, blood type, etc. - nominal

(ratio/interval) has a true zero - ratio

which type of measurement has no quantitative value, has mutually exclusive categories, and is categorical? - nominal

which type of variable is rank-ordered and descriptive? - ordinal

\____ variables are rank-ordered and have no true zero? - interval

what are the 2 types of measurement error? - systematic & random

when you always overestimate/underestimate, what kind of error is that? - systematic

an error due to chance, from unpredictable measurement to measurement is what type of error? - random

what are the 3 sources of measurement error? - 1. rater
2. instrument
3. variability of characteristic being observed (natural variability)

which ICC is best for clinical measurements?

A. \>0.75
B. \>0.99
C.

what is ICC in research? - intraclass correlation coefficient;

a magnitude of interpretation of data.. basically just something that measures reliability

the measurement observed \= true measurement + \_____? - error

what is the difference between reliability and validity? - reliability \= consistency and reproducibility/dependability

validity \= accuracy, correctness

what are some ways you can improve reliability? \- -standardize measurement methods
-train observers
-blind to reduce differential bias across groups
-calibrate instruments

what is regression to the mean? \- -Just due to chance, extreme scores tend to regress toward mean
-Problem when comparing effect of tx on low and high performers

what is the old approach to reliability? what are the 2 problems with it? - correlation coefficients;

problems:
1. assesses relationship not agreement
2. only 2 raters or occasions could be compared

what are the 2 new approaches to reliability? - ICCs (for continuous) and Cohen's kappa coefficients (categorical)

BOTH capture strength of relationship plus agreement

is a "r" of 0 or 1 perfect reliability? - 1\= perfect
0\= no reliability

when true variance is larger, will the reliability coefficient (r) be (smaller/larger)? - larger

what is inter-rater reliability? - variation between 2 or more raters who measure the same group

T/F: inter-rater reliability is best assessed in multiple trials - F; best in a single trial

What is intra-rater reliability? - The consistency with which an individual takes measurements across 2 or more trials

What is test-retest reliability? - the consistency of measures when the same test is administered to the same person twice (makes sure instrument/tool is capable of measuring consistently)

what is parallel forms reliability? - focuses on whether different forms of the same measurement instrument, when measuring the same subjects, will produce similar results (measure with ICC)

(external/internal) consistency is often used to construct and evaluate scales/questionnaires - internal

What is split-half reliability? - dividing the test into two equal halves and assessing how consistent the scores are

what are the 3 main types of clinical reliability? - 1. test-retest
2. intra-rater
3. inter-rater

\____ is the extent to which a test measures what its supposed to measure - validity

Can a test be valid if it is unreliable? - NO! but a test can be reliable and not valid

you want a valid test to be able to discriminate, evaluate, and \____ - predict

what is face validity? - does this test actually measure what it claims to? (subjective)

what are examples of face validity? - ROM, strength, balance

what is content validity? - do measurements represent a concept or concepts

(questionnaires!!)

what is criterion validity? - can the outcomes of instrument be substituted for a gold standard (higher form of validity!!)

what are the 2 types of criterion validity? - 1. Concurrent
2. Predictive

what is concurrent validity? - measurements between tests taken at same time

ex. DASH vs quickDASH

What is predictive validity? - the accuracy to with which a test predicts future performance on a related task.
ex. do GREs predict 1st year success in grad school?

what is construct validity? - how well a tool measures an abstract concept (complicated)

what are the three types of construct validity? - convergent validity, divergent validity, and known groups method

what is known groups method? - do test results differ between 2 groups

what is convergent validity? - do test results correlate with other similar tests
ex. pain & disability

what is divergent validity? - low correlation with different tests?
ex. pain score and height

\____ to change is the ability of an instrument to detect change beyond measurement error and is represented by MDC (minimal detectible change) - sensitivity

\____ is the ability of an instrument to detect minimally important change (MCID) - responsiveness

what is MCID? - smallest difference in a score that a patient perceives as beneficial

Is MCD or MCID more related to validity? - MCID (MCD is more on the reliable side)

What is probability sampling? - each member of the population has a specifiable probability of being chosen

what is nonprobability sampling? - a sampling technique in which there is no way to calculate the likelihood that a specific element of the population being studied will be chosen

what is simple random sampling? - A simple random sample gives each member of the population an equal chance of being chosen.

what is systematic sampling? - Systematic sampling is used when an ordered list of all members of the population is available. The process involves selecting every Xth individual on the list, using a starting point selected randomly.

What is stratified random sampling? - Population is split into CATEGORIES and then pure random selection of certain number of people within each category

what is cluster sampling? - Dividing the population into a group/cluster then selecting a sample from each cluster (large populations!!)

what is disproportional sampling? - when certain characteristics are underrepresented in the population, subjects with those characteristics are oversamples to make sure there is stronger representation

what are the 4 types of non-probability sampling methods? - 1. convenience
2. quota
3. purposive
4. snowball

What is convenience sampling? - Selecting sample based on whoever is convenient

what is quota sampling? - Selecting sample based on convenience until a certain number of participants are selected from each category (e.g., 10 male, 20 female)

What is purposive sampling? - recruiting and studying certain types of participants i.e. participants with specific qualities (hand-picked)

what is snowball sampling? - a method for acquiring a sample of people, in which existing participants suggest names of future participants to be recruited

T/F: all RCTs do not need to include a CONSORT figure - F; they do

what makes sham different than placebo? - sham is the same as placebo but is used when treatments require physical or mechanical intervention
Ex. instead of dry needling he used a nail in that one study

double blind study - An experiment in which neither the participant nor the researcher knows whether the participant has received the treatment or the placebo

do explanatory or pragmatic trials have more control and more internal validity? - explanatory (pragmatic \= real world so less control; more external validity)