EBP Quiz 2

Scientific method

Systematic, empirical, controlled, critical examination of relationships among natural phenomena

Systematic research

Logical sequence from identifying a problem through data collection, analysis, and interpretation

Empirical research

Uses objective data from direct observation to minimize bias

Control

Managing factors unrelated to the variables being studied

Critical examination

Testing findings and allowing scrutiny by others

Scientific method assumption #1

Nature is orderly, regular, and somewhat predictable

Scientific method assumption #2

Events are not random and have causes that can be discovered

Addressing a gap in knowledge

Filling something that is currently unknown

Expanding knowledge

Building on what is already known

Replicating knowledge

Repeating previous work to see if findings hold

Adding voices to knowledge

Including perspectives or experiences not previously represented

Ultimate purpose of research

Improve physical therapy practice

Clinical research

Structured, systematic investigation of clinical conditions and outcomes

Evidence-based practice

Clinical decisions based on the best available scientific evidence

Patient-centered care

Incorporating patient values and preferences into decisions

Evidence-based clinical decision-making

Balance of research evidence, clinical expertise, and patient values/preferences

Quantitative research

Objective numerical data that may be statistically analyzed

Quantitative research purpose

Tests theory

Qualitative research

Subjective narrative information analyzed descriptively

Qualitative research purpose

Helps formulate theory

Mixed-methods research

Combines quantitative and qualitative methods

Experimental research

Research designed to examine cause and effect

Nonexperimental research

Observational research without true manipulation/testing

Randomized controlled trial (RCT)

Controlled comparison using random assignment

True experiment

Requires manipulation, a control group, and randomization

Independent variable

Variable intentionally manipulated by the researcher

Dependent variable

Outcome measured in response to the independent variable

Pragmatic clinical trial

Real-world effectiveness trial in typical patients/settings

Explanatory trial

Highly controlled trial designed to establish cause and effect

Internal validity

Emphasized in highly controlled explanatory trials

External validity

Emphasized in real-world pragmatic trials

Efficacy

Benefit of an intervention under controlled conditions

Effectiveness

Benefit of an intervention under real-world conditions

Quasi-experimental research

May lack randomization, a control group, or both

Single-subject design

Repeated measurements of one or a few subjects under experimental conditions

N-of-1 trial

Another term for a single-subject experimental design

Cohort study

Observational study that typically follows exposed subjects forward in time

Prospective

Typical direction of cohort studies

Case-control study

Compares cases and controls and examines prior exposure

Retrospective

Typical direction of case-control studies

Correlation

Examines whether variables vary together

Regression

Uses one or more variables to predict another

Methodological study

Study used to establish reliability or validity of a measurement tool

Developmental research

Studies patterns of growth and change over time

Normative research

Establishes normal values for a population

Case report

Description of one patient and their condition or recovery

Case series

Description of several similar patients or cases

Historical research

Reconstructs past events to inform current perspectives

Mixed methods

Combination of quantitative and qualitative research

Incidence

Number or percentage of new injuries/events during a defined period

Prevalence

Current number or percentage of people with a condition

PICOTS

Patient/population, Intervention, Comparison, Outcome, Time, Setting

P in PICOTS

Patient or population

I in PICOTS

Intervention

C in PICOTS

Comparison

O in PICOTS

Outcome

T in PICOTS

Time

S in PICOTS

Setting

Good research question

Important, new, ethical, feasible, and appropriate in scope

Feasibility

Depends on sample size, resources, scope, and expertise

Sensitivity

Ability to correctly identify people with the condition

True positive

Person has the condition and the test is positive

Specificity

Ability to correctly identify people without the condition

True negative

Person does not have the condition and the test is negative

Positive likelihood ratio (+LR)

How much more likely a positive test is in someone with the disorder

Negative likelihood ratio (-LR)

How much a negative test changes the likelihood of disease

Good -LR

Small value

Ottawa Ankle Rules

Example of a highly sensitive clinical tool

Lachman Test

Example of a relatively specific clinical test

Five steps of EBP

Ask, Acquire, Appraise, Apply, Assess

Ask

Formulate a clinical question

Acquire

Find relevant research literature

Appraise

Critically evaluate the literature

Apply

Use findings in clinical decision-making

Assess

Determine whether the EBP process was successful

Inductive reasoning

Specific observations leading toward a general conclusion

Deductive reasoning

General principles leading toward a specific conclusion

Theory

Set of related concepts or propositions explaining relationships among variables

Overuse

Using a treatment too broadly because it is familiar

Underuse

Failing to provide newer beneficial interventions

Misuse

Inappropriate clinical decisions or errors

Clinical decision-making

Uses evidence, expertise, patient values, and clinical circumstances

Level 1 evidence

Highest level for intervention questions

Systematic review of RCTs

Level 1 intervention evidence

N-of-1 trial evidence level

Level 1

Randomized controlled trial evidence level

Level 2

Observational study with dramatic effect

Level 2 intervention evidence

Nonrandomized controlled cohort study

Level 3 intervention evidence

Follow-up study

Level 3 intervention evidence

Case series evidence level

Level 4

Case-control study evidence level

Level 4

Historical controls

Level 4 intervention evidence

Mechanistic reasoning

Level 5 intervention evidence

Evidence hierarchy

Level 1 is strongest; Level 5 is weakest

Clinical Queries

PubMed tool for therapy, diagnosis, prognosis, etiology, and guidelines

MeSH terms

Standardized terms used to index PubMed articles

Advanced Search

PubMed feature used to build more complex searches

Respect

Ethical principle emphasizing autonomy and dignity

Beneficence

Ethical principle emphasizing benefit and minimizing harm

Justice

Ethical principle emphasizing fair treatment and distribution of burdens/benefits