EBCP Final Exam: Review Questions

What type of study is a report of the presentation, treatment and outcome of a patient that has educational value?

case report

Which logical fallacy does the following statement examplify: If chiropractors advertise that they are good at helping patients with low back pain, then we will never get to treat anything else

slippery slope

Why is randomization important in RCTs?

to equalize the unknown prognostic factors between groups

Which type of study is a summary of all the research on a specific topic?

systematic review

What study type is best to investigate the risk of being exposed to chemicals that might cause cancer?

case control study

What type of study is considered an experiment in which variables are controlled so that a cause and effect relationship can be established?

randomized controlled trial

When comparing two articles, which study should hold more weight for you?

the study with the highest sample size

A 25 year-old soccer player has knee pain every day after practice and wants to know if there is anything he can do to help the pain. He has heard of glucosamine sulfate supplements and wants to know if taking those supplements would be better than the over the counter pain killers he is currently using. Which study would be the most accurate for him?

adult athletes with knee pain

EBCP consists of what 3 components?

1. best avaliable evidence

2. your clinical expertise

3. the patient's values and preferences

Which of the following is true of EBCP?

your clinical expertise is necessary to make decisions when there is no research

Choose the correct PICO question for the scenario:

A 6 week-old patient who cries 4-5x/day for 2-3 hours at a time and retracts her lower extremities. She is otherwise healthy. The parents were advised by their pediatrician to give 30% oral glucose solution, but they want to know if chiropractic care can help

in infants with colic is spinal manipulation more effective than 30% oral glucose solution in reducing crying frequency and time?

Which of the following is true of foreground questions?

the format for phrasing these questions is P.I.C.O

Where can you usually find out if the groups in a RCT were equal at baseline?

in table 1 of the results

Which statement indicates that follow up was complete in an RCT?

1 patient dropped out of the study because he moved away and his data was still included

Interpret: ROM change = +10 degrees (-5, 95). [mean (95% CI)]

ROM is increased but CI is very wide and crosses 0

Choose the correct interpretation of: Mean (95% CI) VAS pain change was -4.5 (-3, 7)

on average pain decreased by 4.5cm on the VAS but the result is NOT statistically significant

Which of the following is a way to describe something about the central tendency of a group of data?

mean, median and average

Which of the following is a way to describe how wide your data is spread out?

standard deviation and range

Choose the correct interpretation of: age = 63 (1.7). [mean (SD)]

average age of study participants is old with narrow variability

Choose the correct interpretation of p = 0.07. The result is:

NOT statistically significant because there is greater than 5% chance the result is due to random error

Interpret: ROM change = +10 degrees (-5, 95). [mean (95% CI)]

ROM is increased but CI is very wide and crosses 0

Patients in a study were recruited from a medical center where they were being treated for terminal cancer. Are the results of that study applicable to patients in the average chiropractic practice?

no

You want to study whether or not a cleaning chemical increases your risk for cancer. What type of study should you do?

observational study

What is defined as the probability of a positive test in someone who has the disease?

sensitivity

What is defined as the probability of a negative test in someone who doesnt have the disease?

specificity

What is defined as the probability that a patient with a positive test result really does have the disease?

positive predictive value

What is defined as the probability that a patient with a negative test result really doesnt have the disease?

negative predictive value

Choose the correct interpretation for: PPV = 74%

with a positive test there is 74% chance of the patient having the disease

What type of study involves putting together a group of people and following them forward in time to see what diseases develop and what exposures may be responsible?

cohort study

What type of study involves assembling a group of people with a disease and matching them to similar people without the disease?

case control study

Which statement indicates that follow up was complete in a RCT?

data was collected from all 158 patients except the 2 drop outs who moved away

What is "intention to treat analysis" in a RCT?

all patient data is analyzed in the groups the patients were assigned to

What type of study attempts to summarize all clinical trials about a topic utilizing rigorous methods for selection and appraisal of articles to be induced?

systematic review

Publication bias is bias in the healthcare literature because:

trials with negative results often don't get published

What does the size of the squares in a forest plot represent?

relative size (weighting) of the effect of that study

Your pretest probability is 50%, your LR+ is 20, estimate your post-test probability

95%

Data that follows a bell-shaped curve is called:

normal data

True or False? Researchers need to know if their data is normally distributed or not so they choose the correct statistical test

true

Testing between group differences in improvement in patients in a RCT would require a statistical test that is for:

unpaired groups

Testing within group differences in improvement in patients in a RCT would require a statistical test that is for:

paired groups

Which test is best for describing a group of data where one data point is significantly larger than the rest?

median

Interpret this: The between group VAS difference was 22mm (t = 1.34, p<0.001, 95% CI = 18 to 26)

the t test showed that the difference between groups was real

Which of the following would be an example of using POEMs the right way in health care?

measuring your patient's pain in order to assess their progress and improvement with your care

Nerve conduction velocity is an example of:

DOE

Linear regression is used to test:

if one variable can predict another (like class attendance and predicting a grade)

In a RCT comparing exercise to drug therapy, the exercise group can be tested to see if the improvement from the beginning to the end of the study is real or due to random chance using a:

within group statistical test

Which of the following is a research question that would be more appropriate to answer with a cohort study but not with a RCT?

does exposure to cigarrete smoke increase the risk of lung cancer?

Clinically significant means:

the difference was enough to be important to patients

True or False? It is possible for a difference between groups to be statistically significant but not clinically significant

true

What type of information (DOE/POEM) is blood pressure?

DOE

What type of information (DOE/POEM) is the number of degrees of lumbar spine range of motion?

DOE

What type of information (DOE/POEM) is a measure of a patients' ability to get dressed in the morning?

POEM

What type of information (DOE/POEM) is the level of electrical acitivty of the muscles of the lumbar spine?

DOE

Regression testing (simple, linear, multiple linear, non-parametric linear) is used for what?

to find out if one (or more) variable(s) can predict another

The Mann-Whitney test indicated that improvement with medicare care (median = 5) was greater than improvement with placebo (median = 1), U=67.5, p=0.034, r=0.38. What does this indicate for the results?

the between group difference is real

The "C" in CRAPP test stands for:

currency