EBP II Final Exam

clinical practice guidelines

what is CPG?

both a systematic review of research evidence AND explicit recommendations regarding clinical decisions

what does a high quality CPG include?

broader

CPGs tend to be ________ than systematic reviews.

multiple aspects of care (diagnosis, prognosis, interventions, etc.) associated with a particular condition

what do CPGs address?

within the past 5 years or if no other significant research has been published?

when is a CPG considered to be relevant?

compare the publication date to the day I am reading it

how do you determine if a CPG is more than 5 years old?

reliability; establish the extent to which multiple items within an outcome measure reflect the same construct

internal consistency is a type of what? describe it?

0-1, item correlations

what does a Cronbach alpha score tell you? what is its range?

individual items of the measure do not correlate with each other → low internal consistency

a Cronbach alpha score closer to 0 indicated what?

individual items have high, positive correlation → high internal consistency

a Cronbach alpha score closer to 1 indicated what?

the extent to which an outcome measure produces the same result when repeatedly applied to a patient who has not experienced change in the characteristic being measured

what does test-retest reliability establish?

the consistency with which an outcome measure has the same score when used by the same therapist on the same patient

what does intra-rater reliability refer to?

the consistency with which different raters produce the same score for the same patient.

what does inter-rater reliability refer to?

continuous

what kind of data do we use ICC for?

oridinal

what kind of data do we use spearman's rho for?

nominal

what kind of data do we use kappa for?

informal evaluation by users or experts that a measure appears to measure what it is intended to measure

what is face validity based on?

that an outcome measure includes all the characteristics that it purports to measure

what does content validity establish?

a panel of experts subjectively establishes content validity

WHO establishes content validity?

the validity of an outcome measure by comparing it to another, more established measure (a gold standard or a reference standard)

what does criterion validity establish?

concurrent and predictive validity

what are the two types of criterion validity?

when researchers demonstrate that an outcome measure has a high correlation with a criterion measure taken at the same point in time

what is concurrent validity established?

when researchers demonstrate that an outcome measure has a high correlation with a criterion measured in the future

when is predictive validity established?

criterion = more tangible, construct = more abstract

describe criterion vs. construct validity?

the ability of an outcome measure to assess an abstract characteristic or concept; clinical reasoning

what does construct validity establish? give an example

known groups, convergent, and discriminant

what are the 3 types of construct validity?

that an outcome measure produces different scores for groups with known differences on the characteristic being measured

what does known groups validity establish?

establishes that a new measure correlates with another measure thought to assess a similar characteristic or concept

what does convergent validity establish?

establishes that a measure does not correlate with a measure thought to assess a distinctly different characteristic or concept

what does discriminant validity establish?

the association of two measures; -1 to 1

what does a spearman's rho reflect? what is the score range?

no association between variables

what does a spearman's rho of 0 indicate?

perfect association between variables

what does a spearman's rho of -1 or 1 indicate?

the outcome measure of interest compared to the gold/reference standard

(regarding criterion validity), authors report the correlation between what 2 things?

after time has passed

for predictive validity, how is correlation with the criterion measure assessed?

the correlation between the outcome measure of interest and another established measure

what do convergent and discriminant validity studies asses?

you would expect a positive correlation between the two measures.

what kind of correlation would you use for convergent validity?

you would expect a negative correlation between the two measure

what kind of correlation would you use for discriminant validity?

difference; through groups study uses inferential statistics, most often analysis of variance (ANOVA)

what do known group studies test for? how?

an outcome measure's ability to provide the clinician and the patient with consequential information

what does Clinical meaningfulness refer to?

valid and reliable AND assist us in interpreting change in our patients

to have clinical meaning, what must an outcome measure be?

floor/ceiling effects, MDC, MCID

what are the 3 types of clinical meaningfulness?

An outcome measure that is unable to differentiate lowest scores well; specific to patient population

what is a floor effect? what is it specific to?

an outcome measure that is unable to differentiate highest scores well (opposite to floor effect); specific to patient population

what is a ceiling effect? what is it specific to?

The percentage of participants having a maximum or minimum score

what indicates the presence of a ceiling or floor effect (respectively)?

5 to 10?

In most cases related to physical therapy outcome measures, what percentage of participants is acceptable? (regarding floor/ceiling effects)

Minimum amount of change required on an outcome measure to exceed anticipated error and variability

what is MDC (meaningful detectable change)?

Minimum amount of change on an outcome measure that patients perceive as beneficial and that would justify a change in care.

what is MCID (minimal clinically important difference?

how far of an improvement of ROM does it take for a patient to be like omg I notice/feel a difference

give an example of MCID?

a type of quantitative research that involves studying in detail the behavior of EACH of a small number of participants (typically around 2 to 10)

what is a single-subject research design?

phase of observation with measurement; designates baseline or treatment withdrawal phases

what does the "A" stand for in single-subject research?

intervention

what does the "B" stand for in single-subject research?

comparison interventions

what does the "C,D, etc." stand for in single-subject research?

a visual inspection of results; trend line

what are visual analyses? give an example.

two-standard-deviation band method

what are statistical analyses? give an example.

significant = suggests a potential effect of the intervention

(regarding single study design)), if two consecutive data points are above or below the 2SD bands in the treatment phase - what the change considered?

deeper insights into real-world problems; gathers participants' experiences, perceptions, and behavior

qualitative research explores/provides what? what does it gather?

not trying to collect numerical data; looking for themes and patterns that can be difficult to quantify

what is qualitative research NOT trying to do? what IS it looking for?

stand-alone study, purely relying on qualitative data OR could be part of mixed-methods research that combines qualitative and quantitative data

how can qualitative research be structured (2 options)?

phenomenology, ethnography, grounded theory

what are the 3 most common study designs for qualitative research?

"lived experiences" of the participants and aims to examine how and why participants behaved a certain way, from their perspective

what does phenomenology look into?

a systematic description of a culture that is based on direct observation of a particular group

what does ethnography refer to?

develop a theory to explain the phenomena of interest; explains how and why an event occurs or how and why people might behave a certain way

what does grounded theory develop? what does it explain?

they are selected specifically because they can contribute to the understanding of a topic, typically a small selected group

how are participants selected for qualitative research?

purposive and snowball sampling; NON random

what are 2 common sampling strategies for qualitative research? both of these strategies are what?

a non-random sampling technique where researchers intentionally select participants based on specific characteristics relevant to their research question

what is purposive sampling?

a non-random sampling method where existing participants help recruit new participants by making referrals within their social networks; applied when samples with the target characteristics are not easily accessible

what is snowball sampling? when is it applied?

HOW it was collected

what does research need to report when collecting data for qualitative research?

triangulation

what method is often used to add rigor to a qualitative research study?

the use of different perspective to study the identified process (basically combining data from multiple sources); multiple methods such as interviews, focus groups, and records review might be used within a single study

what is triangulation? give an example.

member checking; a tool to enhance trustworthiness where data/results are returned to participants to check for accuracy and resonance with their experiences

in qualitative research, what method is used to derive themes/concepts from the data? explain.