EBP prep

Categorical (Qualitative) Data

Nominal and Ordinal Data are what types of data?

Nominal: "order" doesn't matter (blood type)

Ordinal: "order" matters (Stage 1, II cancer)

What's the difference between Nominal and Ordinal Data

1. state Ho and Hi

2. compute statistics

3. decision making

4. conclusion

4 steps to significance testing

< 0.05

At what p-value should we reject the Ho?

relative risk

comparing probablility to disease in two different groups

odds ratio

measure of association between an exposure and an outcome

Evidence based practice

combining the best research to make patient/population centered decisions

1. formulate focused question

2. identify articles and evidence-based resources

3. critical appraisal of evidence

4. apply evidence

5. evaluate application of evidence

Steps of EBPP

primary literature

Raw data and articles are examples of which type of literature?

secondary literature

Guidelines and systematic reviews are examples of which type of literature?

tertiary literature

Lexicomp and micromedex are examples of which type of literature?

surrogate outcome

using an outcome to reflect another (ex.fasting plasma glucose, HbA1C)

outcomes that matter

clinically relevant outcome and provide direct measures of disease (ex. stroke, self report of nerve pain)

primary outcome

what the study is designed around; most important reflection

secondary outcome

not the most important outcome/ main ones influenced by intervention

national research act

requires informed consent for research studies

respect for persons, beneficence, justice

belmont report principles

1. identify requestor

2. define the true question

3, patient background

4. categorize question

5. systemic search for answer

6. analyze info

7. disseminate info

8. document and follow-up

steps of formulating focused questions

absence of background info, false perception that DI questions don't pertain to a specific patient

What are the barriers to formulating focused questions?

PPAARE or PICOT

2 ways to write a question

background info, patient factors, disease factors, medication factors

What should be considered when formulating a response?

timely, current info, well references, not too long,

Desired characteristics of a response

Clair AI

Which AI can we use to find sources?

epidemiology

the study of diseases and their intervention at the population level

case definition

set of standard criteria for classifying whether a person has a particular disease, syndrome, or health condition

web of causation

the idea that theres no single cause for a disease and things like lifestyle, ethnicity, gender, and cormorbidities

pre-disposing factors

factors that make individuals more or less likely to adopt healthy or risky behaviors

enabling factors

factors that help people adopt and maintain healthy or unhealthy behaviors

precipitating factors

factors that are the catalyst for an illness, episode or symptom

reinforcing factors

people that reinforce good or bad habits

host, agent, environment

epidemiological triangle consists of

If the researchers provided the exposure it's experimental

What's the difference between experimental and observational studies?

experimental

Study that tells us efficacy

quasi-experimental

Study that tells us performance

observational

Study that tells us effectiveness

cohort, case control, cross sectional

What are the 3 types of observational studies?

cohort

study that looks at exposure first then determines outcome

case-control

study that looks at outcome first then determines what exposure caused it

cross-sectional

study that looks at one point in time to determine exposure at the time of outcome

decrease

study limitations, inconsistency of results, indirectness of evidence, imprecision and publication bias are examples of factors that (increase/decrease) quality of evidence

RCT's

gold standard of clinical trials

case report

information about a single patient in a unique scenario

diagnostic, treatment, educational

3 types of case reports

case series

more than one patient with similar treatment or diagnosis

internal validity

the degree to which the result of a study are correct for the sample of subjects being studied (accuracy of our results)

Internal: truth in the study

External: truth in real life

Difference between internal and external validity

bias, random chance

Threats to internal validity

control groups, randomization, meticulous data collection and analysis

How to offset threats to internal validity

secondary literature

A clinical practice guideline is this type of literature

respect for persons, beneficence, justice

The Belmont Report developed these basic ethical principles

False

(T/F) Most of the time drug information questions do not pertain to a certain patients

SBAR method

The best way to verbally communicate the answer to a drug information question

supported by best evidence, timely

The desirable characteristics of a drug information responses

EMBASE

This database allows you to search using PICO format and provides international biomedical journal coverage

PubMed

A secondary resource that can assist in finding original research papers

Drug Interaction

A patient asks if it is okay to take oxycodone, acetaminophen, omeprazole, and clonazepam together. What category of drug information resources is most appropriate to reference?

AI always provides an answer

A major concern of using AI to answer drug information questions

True

(T/F) By searching databases and getting irrelevant results you may develop phrases to exclude irrelevant evidence

agent, host, environment

Components of the epidemiological triad

Healthy People Initiative

Epidemiological program providing objectives to improve American health

simple home page, prioritized information, simplified search, minimal scrolling necessary

Characteristic making an internet site high quality and accessible to patients of varying health literacy

PMC, MEDLINE, Bookshelf

NLM literature resources that PubMed can search

It may point to other relevant sources

The purpose of reviewing articles cited in an article found while searching databases

Randomized Control Trial (RCT)

Gold standard study type with high level of evidence

True

(T/F) When researchers introduce an exposure, it makes the study experimental

Case series follow more than one patient (up to 20) with similar treatment or diagnoses, case reports are on one patient

The difference between case reports and case series

Special populations, off label medication use, adverse reactions

Common clinical questions that case reports and series investigate

temporal relation

The most essential factor of causality

+ 1 or - 1

Pearson coefficient showing strongest linear relationship

Journal Quality

Databases

Peer Review

Impact Factor

Predatory Journal

Predatory Journal

-more open access journals

-dilution of scientific credibility

-poor peer-review process

-lower impact factor

Trustworthiness of Positivistic (Quantitative) Evidence

Internal Validity

External Validity

Reliability

Objectivity

Internal Validity

Did the study accurately measure what it intended to measure?

External Validity

Can the results be generalized to a population or to a real-life context?

Reliability

Were the data measured consistently?

Objectivity

Was the conduct of the study unbiased?

False

True/False: Coefficient of 0.80 and less = trustworthy

True

True/False: Internal & External validity have an inverse relationship.

False

True/False: If a journal is open access, it is always untrustworthy.

Introduction

Purpose

Hypothesis

Research Question

Methods

Research Design

Research Protocol

Sample

Data Collection

Results

Sample

Data Analysis

Findings

Discussion & Conclusion

What's after results?

The greater significance within discipline

The higher the JCR...

SJR

What contains the visibility of Journals in Scopus Database?

True

True/False: An article analyzed by the intention-to-treat analysis will use a method to input the data for the participants that drop out early.

Abstract

Methods

Results

Conclusion

Place the following sections of a research paper in order from first to last

Sampling

If you go from parameters to statistics, what is that called?

Inference

If you go from statistics to parameters, what is that called?

Descriptive Statistics

To organize, summarize & display data to make them more understandable.

Inferential Statistics

To provide predictions about population characteristics based on information from a sample drawn from that population.

Nominal

Unordered mutually exclusive categories

Binary (Male/Female)

Multinominal (martial status)

Ordinal

Mutually exclusive categories that are ordered in some meaningful way

Course grades

Numerical

Quantitative data with finite numbers or counts (discrete) or infinitely values (continuous)

True

True/False: Ordinal data can be numerical & nominal.

Interval

Numerical values without a true zero point.

Zero doesn't indicate a complete lack of the quantity being measured.

Ex. degrees Celsius

Ratio

Numerical values with a true zero point.

Ex. Weight & BP

Estimation (point estimate & confidence interval)

Hypothesis test

2 Approaches to Statistical Inference

Rare Event Rule for Inferential Statistics

If, under a given assumption, the probability of a particular observed event if exceptional small, we conclude that the assumption is probably not correct.

Level of Significance

Alpha

It gives the probability of incorrectly rejecting the null hypothesis when it is actually true.