CREBM II

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55 Terms

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Closed ended questions

Questions that encourage one or two preselected answers (Quick & easy)

Ex: Yes or no; Check all that apply

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Disadvantages of closed-ended questions

- Lead in certain direction

- Limits scope of answer

Fixed by = adding "Other, please specify"

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Open-ended questions

Questions that encourage a more elaborate response

"Describe how you feel about this."
"Why do you think...?"

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Open-ended questions are often used in the ___________ phase

Exploratory phase (can form basis of closed ended questions)

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Disadvantages of open-ended questions

- Less complete
- Require qualitative methods or special systems (Coding)

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The statistical aspects of a systematic review are called _________

Meta-analysis

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Systematic Review becomes __________ when statistics are utilized

Meta-Analysis

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Meta-Analysis

Statistical approach (quantitative index) to combining the data derived from a systematic-review

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Systematic review

Entire process of selecting, evaluating, and synthesizing all available evidence (of all relevant, completed studies)

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Systematic Review + ___________ = Meta Analysis

Statistical analysis

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Experimental study

Evaluate cause & effect relationship between independent and dependent variables

- True experimental design

- Clinical trials

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True experimental design

Subjects randomly assigned to at least 2 comparison groups

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Clinical Trials

PRCT (prospective randomized controlled trial)

Used to describe experimental studies that examine the effects of interventions on pts/community

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Clinical trial design

- Pre-clinical research

- Phase I: Safety; MOA

- Phase II: Effective; response rate

- Phase III: Compares to standard (Randomized, blinded)

- Phase IV: Populations (risks, benefits, optimal use)

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Quasi experimental

Used where ethical concerns prevent a control group (involve non-equivalent groups)

Same as experimental but lacks random assignment or comparison groups

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Example of quasi experimental

You hypothesize that a new after-school program will lead to higher grades.

Children who attend different schools, one of which implements the new program while the other does not.

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Single Subject Design

Allow conclusions about effects of treatment based on the response of a single pt (N=1)

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Randomized Controlled Trial

allows for conclusions about causality between a manipulated independent variable and an observed/measured dependent variable

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Investigational studies (two types)

Therapeutic: effect of a treatment or intervention of a disease

Preventative: whether a procedure/agent reduces risk of developing a disease.

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Observational studies

Gather information on human attributes and environmental characteristics that interact to control human behavioral responses -> data collected as they naturally exist

- Observational exploratory

- Observational descriptive

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Observational exploratory studies

Test relationships supported by theory -> used to develop prognostic and diagnostic factors

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Observational descriptive studies

structured around set of guided research questions/objectives to generate data or characterize a situation of interest-> used as basis for formulating a research hypothesis

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Descriptive studies

Document the nature of existing phenomena and describe how variables change over time --> Research hypotheses

Ex: distributions of disease and health related characteristics in the general population

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Developmental research

method used to document change

Ex: Cross-sectional method

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Cross-Sectional Studies

Observations are made on a single occasion with no follow up period (think snapchat); examine associations

Linked to prevalence

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What is the best design for causality?

Randomized control trial (RCT)

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hierarchy of evidence pyramid

Meta analysis
Systematic review
Randomized control trial
Prospective (blind comparison to gold standards)
Cohort studies
Case control studies
Case series/Case report
Animal research

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Incidence

The proportion of people who develop a given disease/ condition w/i a specified time period

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Incidence is linked to ________

Cohort studies

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Prevalence

The # of existing cases of a disease/condition at a given point in time (proportion of the total population at risk)

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Prevalence is linked to _________

Cross-sectional studies

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Cohort Studies

Observations made in a group of subjects that is followed over time (think facebook)

Linked to incidence

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Cohort studies can be prospective meaning

begin in present and follow subjects into future

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Cohort studies can be retrospective meaning

examine info and specimens that been collected in the past

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Advantages of cohort retrospective studies

- Less cost & time

- Subjects already assembled

- Follow up period has already taken place

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Case control studies

Begins by choosing one sample of people who have the outcome of interest (Case) and another sample w/out (Control)

Investigator works backwards

Useful for generating hypotheses

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Quantitative research

Involves measurement of outcomes using numerical data under standardized conditions

Advantages:

- Preferred

- ability to summarize scales and use statistical analysis

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Case control studies can be used for studying _____________

Studying rare diseases

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Qualitative research

Measurement based on open ended questions, interviews, and observations

- Under less structured conditions

- Can generate hypothesis/theories

- Serious limitations to inference, causality & conclusion

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Applied Research

Solving immediate practical problems with functional applications and testing theories that direct practice

- Carried out in actual practice conditions

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Bench (Basic) Research

Obtains empirical data used to develop, refine, or test theory

- Acquire new knowledge

Ex: How do children acquire new languages?

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A study design that randomly assigns participants into an experimental group or a control group. As the study is conducted, the only expected difference between the control and experimental groups in __________________ is the outcome variable being studied.

RCT

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A study that retrospectively compares patients who have a disease or outcome of interest, with patients who do not have the disease or outcome, and looks back retrospectively to compare how frequently the exposure to a risk factor is present in each group to determine the relationship between the risk factor and the disease.

Case control study

Outcome of interest = Case
Pt w/o disease/outcome = Control

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Research in which the investigator cannot randomly assign units or participants to conditions, cannot generally control or manipulate the independent variable, and cannot limit the influence of extraneous variables.

Quasi-Experimental

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What type of research we use to develop testing instruments?

Methodologic studies

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Goal of qualitative research

To examine experiences using a holistic approach concerned with patient perspective/view

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Methodologic studies

Involves development and testing of measuring instruments for use in research or clinical practice (decision rules, etc)

- Reliability/validity of measure

- Use correlation

- Does NOT involve Tx effectiveness

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Exploratory research

Examines the phenomena of interest and explores its dimensions, including how it relates to other factors

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Epidemiology

Examines associations to describe and predict risks for conditions or disease

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Blinding

Strategy for enhancing accuracy that does not ensure the overall accuracy of the measurements, but it can eliminate differential bias

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Inclusion criteria

Specifying populations relevant to the research question and efficient for study (Demographics, clinical characteristics, geographic, temporal)

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Exclusion criteria

Specifying subsets of the population that will not be studied

- high lost follow-up

- provide poor data

- high risk of ADR

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Steps in prospective cohort studies

- Define selection criteria
- Recruit sample
- Measure the predictor variables
- Store data
- Follow cohort over time
- Measure the outcome variable(s) during follow up

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Steps in retrospective cohort study

- Identify existing cohort that has some predictor information already recorded
- Assess loss to follow up
- Measure outcome variables that have already occurred

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Limitations of scientific method

- Not perfect for studying human behavior

- Complexity/variability of nature

- Issues of generalizability (Cause does not always equal effect)

- Extraneous influences