Research Midterm

what are examples of background sources for databases?

McGraw-Hill access, clinicalkey, clinicalkey student, LWW health library, uptodate & lexidrug

Why should we use background sources of databases?

- general information about topics, conditions, medications, diagnostic tests

definitions, facts, health statistics, recommended care, and more

what are the mcgraw hill access collections?

accessMedicine + case files, accesspharmacy, accessanesthesiology, accessphysiotherapy

what is clinicalkey?

more than 1,000 medical books. Includes practice guidelines, point of care info, journal articles

What is clinicalkey student?

shorter forms of selected medical books. Videos and images ranging from demostations to dissections to clinical examples

What is LWW health library?

several collections that support medical and health professionals (board review series. clerkship/clinical rotations, medical education)

What are examples of research databases?

PubMed@Duquesne, Embase, CINAHL, Cochrane library, PEDro, etc.

why should we use research data bases?

find research studies, literature, reviews, clinical practice guidelines

what are the basic database search methods?

AND, OR, Nesting (use AND & OR at the same time)

what is pubmed most commonly used for?

biomedical database

what is embase?

largest biomedical database, available to DU students and faculty

what is cinahl?

alternative index for rehabilitation literature

What s cochrane Library?

premier source of systematic reviews

what is peer review?

the evaluation of work by one or more people of similar competence to the producers of the work

how do you know if the article is good?

ask questions such as where is it published, who published it, journal impact factor, etc.

what is scientific productivity?

individual, institutional, and/or country's contribution to the universe of knowledge

how is the scientific productivity measured?

publications, research grants, patents, technologies transferred, and citation analysis

What is quantitative research

objective, deductive reasoning used to synthesize data, focus--narrow and concise, basis of knowing (cause and effect relationships), tests theory

what is qualitative research?

subjective, focus--complex and broad, develops theory, basis of knowing (meaning and discovery)

what is the structure of a scientific article?

abstract, introduction, materials and methods, results, discussion, conclusion

what is an impact factor of a journal?

a measure reflecting the yearly average number of citations to recent articles published in that journal

what is predatory publishing?

Accepting articles quickly with little or no peer review, High publishing fees, fake editorial boards

what is the goal in evaluating research?

to be able to critique a research article by identifying the strengths and weaknesses of each component of the research

what is a literature review?

to place current study incontext of what is known/not known

what is a case report?

a detailed report of the diagnosis, treatment and follow-up of an individual patient

what are disadvantages and advantages to case reports?

disadvantage: could be a bias result

advantage: good opportunity to study a rare disease

what is a cross sectional study?

measures the prevalence of health outcomes or determinants of health or both, in a population at a point in time or over a short period

advantages of cross-sectional studies?

prevalence of all factors can be measured, suitable for descriptive analysis, multiple outcomes can be researched at once, quick to conduct

what is a case control study?

compares 2 groups of people: those with the disease or condition, and a very similar group of people who do not have the disease or condition

what is the distinction between case control and cross sectional?

case control were looking at the exposure in the past, cross sectional could look at the exposure in the past but also snapshots from now (more complex)

when would you look for a case control study?

exposure data are difficult/expensive to obtain, disease is rare, disease has long induction/latent period

what does relative risk in case control studies tell you?

number of times more likely cases are to get disease than controls given exposure

what are cohort studies?

type of research design that follow groups of people over time

what are advantages of cohort studies?

cause precedes effect, low recall bias, multiple outcomes can be studied

what is an example of dose-response?

incidence of coronary heart disease-associated smoking

what are randomized controlled trials?

prospective studies that measure the effectiveness of a new intervention or treatment (considered the gold standard of a cause and effect relationship)

what is the purpose of randomized control trials?

determine if treatment, agent, or program causes an effect on onset of disease, course of illness, or other outcomes

what are parallel arms RCT?

random assignment to experimental group/control group, experimental gets exposure/treatment, follow groups prospectively

what are crossover RCT?

random assignment to experimental group/control group, experimental gets exposure./treatment, after a period of time, groups switch treatment , washout period to eliminate "residual treatment effect"

what is stepped wedge RCT?

all subjects eventually get treatment, randomized to begin treatment at different times, each subject is their own control, useful for interventions with strong evidence of being useful

what is the comparison or control group?

no treatment at all, inactive treatment

what is single blinding?

subjects do not know

what is double blinding?

subjects/observer do not know

what is triple blinding?

subjects/observer/reviewer do not know

what studies fall under clinical research?

case reports, case series, case control studies, cohort studies, randomized controlled double blind studies, systematic reviews and meta-analysis

what studies fall under pre-clinical research?

in animal research and in vitro research

what is a randomized clinical trial?

a more specific randomized control trial, also the gold standard, RCT will publish a protocol paper

what is randomization?

isolate effect of intervention, equal probability of being in either group, avoids confounding and investigator bias

what are examples of nonrandom bias?

suppose seriously ill want treatment, suppose less seriously ill patients want treatment, results confounded/difficult to interpret, randomization prevents self-selection

what is phase 1 of the drug approval process?

small number of healthy volunteers (20-100), safety, low dose, close monitoring

what is phase 2 of the drug approval process?

small, select patient population to treat a specific disease (100-300), safety, effective dose, , method delivery

what is phase 3 of the drug approval process?

large group of patients (thousands) for safety and effectiveness, application can now be sent to FDA for NDA, 12 months review, examine long term effects

what is post marketing surveillance?

general population to detect uncommon adverse reactions

what is phase 4 of a clinical trial?

pediatrics, special populations, ongoing analysis of original participants, the follow-up by FDA is not entirely clear

is clinical research recent knowledge?

no, it began in 3000 BC and continued to develop from there in multiple countries

who was one of the first to go through a dissect human bodies?

leonardo de vinci

what was the first modern clinical trial?

to find a treatment for scurvy

what was the first large scale trial?

investigated "animal magnetism", first to introduce masking (blinding), introduced idea of placebo

who is louis pasteur

found germ theory, fermentation, pasteurization of wine and milk, further vaccination development

who is marie curie?

discovered several elements, laid foundation for study radiation, found that radiation killed cancer cells much faster than healthy cells

who is florence nightingale

pioneer in nursing, statistician and pioneer in visual representation and mapping of statistical data which she used to drive sanitation reform

what is the flexner report?

research is regarded as absolute necessity to medical education and medical schools become research hubs

who is paul ehrlich

modified arsenic to create first antimicrobial and cured syphilis (magic bullet)

what is the nuremberg code of 1947?

formulated through the prosecution of Nazi physicians who ran experiments in concentration camps

what is the declaration of helsinki of 1964

medical research involving human subjects (2014 most recent version)

what is surgeon general requires IRB of 1966?

informed consent documents required

what are essentials of clinical trials today?

must be registered on clinicaltrials.gov, it needs a person in charge, needs hypothesis, subjects, defining timeline, having one primary outcome, defining secondary outcomes, defining how measures will be made and protected from bias

what consists of the research process?

identify research topic, design study, collect data, process and analyze data, interpret findings, disseminate findings

what are measures of central tendancy?

mean, median, mode, quartiles

what are measures of dispersion/variation?

standard deviation, variance, range

what are the 4 levels of measurement in descriptive statistics?

ratio, ordinal, nominal, and interval

what is the nominal measurement of descriptive statistics?

martial status, hair color, and race/ethnicity

what is the ordinal measurement of descriptive statistics?

education level or likert scales

what is the interval measurement of descriptive statistics?

IQ test scores, temperature, SAT score

what is the ratio measurement of descriptive statisitics?

number of children, income

which levels of measurement for descriptive statistics categorical?

nominal and ordinal

which levels of measurement for descriptive statistics are continuous?

interval and ratio

when should you use mode?

best for nominal and ordinal level data

when should you use median?

interval and ratio level data

when should you use mean?

interval and ratio level data (normally distributed)

descriptive statistics in practice should?

describe the sample, provide basic information about key study variables, and highlight potential associations among variables

what is descriptive statistics?

presenting, organizing and summarizing data

what is inferential statistics?

drawing conclusions about a population based on data observed in a sample

what is hypothesis testing?

a specific statement of prediction describing, in concrete terms, what you expect will happen in your study

what type of research studies do not have hypothesis?

descriptive and exploratory

what are the steps in testing a hypothesis?

state your hypothesis, collect data, perform an appropriate statistical test, decide whether to reject or fail to reject the null hypothesis and present the finding in your results and discussion section

define H0

there is no difference between the groups

define H1

there is a difference between the groups

what is the alpha in hypothesis testing?

the probability that you will (incorrectly) reject the null hypothesis when it is true

what does the p-value tell us?

the probability of obtaining an effect at least as extreme as the one in your sample data, assuming the truth of the null hypothesis

explain the process of obtaining and understanding the p-value

alpha = .05, conduct appropriate test; get p-value, p .05, fail to reject H0

what does H0 mean in terms of vaccine testing?

vaccine has no effect on disease X

what does H1 mean in terms of vaccine testing?

vaccine has an effect on disease X

what is the significance of a p-value?

statistical significance does not always equal clinical significance

what does MID stand for?

minimal important difference

what is a dependant variable?

the primary outcome of interest

what is the independent variable?

the predictor/exposure/cause under investigation

what is the covariate variable?

related to the DV but not necessarily of interest

what are types of quantitative data analysis?

univariate, bivariate, and multivariate

what tests are considered bivariate/bivariable tests?

T-tests, analysis of variance, correlation, regression