Research Exam 1

Evidence Based Practice

best available research, clinical expertise, patient values and clinical circumstances

The process of EBP

1. ask

2. acquire

3. appraise

4. apply

5. assess

EBP Ask (background questions)

who, what, where, when, how, or why

EBP Ask (foreground questions)

ask for specific knowledge to inform clinical decisions or actions

PICO format

Quantitative research is based on the philosophy of ___

positivism

factual knowledge obtained through observation and measurement

based on logical and controlled relationships among defined variables

Qualitative research is based on the philosophies of ____

constructivism & interpretivism

subjective experiences, meanings, and interpretations

Level 1 Evidence

Systematic review

Level 2 Evidence

RCTs, observational studies with strong designs

Level 3 evidence

retrospective cohorts

Non randomized controlled cohort

follow-up study

Level 4 evidence

case studies

case control study

level 5 evidence

mechanistic reasoning

expert opinion

Three primary questions in appraising the literature

1. is the study valid

2. are the results meaningful

3. are the results relevant to my patient

knowledge translation

adaptation of quality research into relevant priorities

the creation and application of knowledge

Deductive reasoning

using general ideas to come to a specific conclusion

inductive reasoning

drawing a conclusion from going specific to general

Challenges of research

funding

time

research mentors

multidiscinipalry research teams

ethical concerns

The importance of research in health professions

helps the profession...

social contract

public support

satisfy the healthcare economic imperative

retain relevance and value

OT's use research for 3 clinical tasks

1. identifying occupations and occupational performance patterns that are familiar and valued by a specific client population

2. selecting assessments and evaluation procedures

3. planning intervention

The research process (5 steps)

1. identify the research question

2. design the study

3. implement the study

4. analyze the data

5. disseminate the findings

3 types of research questions

1. descriptive

2. intervention

3. assessment

Descriptive research question

describes a specific condition, predict an outcome, or gain insight about the clients lived experiences

ex. what are the symptoms of a stroke?

assessment research question

questions about assessments used to evaluate clients

questions about reliability and validity of assessment measures

ex. What assessments should I be using when working with people with strokes?

intervention research question

intervention effectiveness

ex. clinical task =planning intervention

Quantitative

data is structured, presented via statistical analysis, conclusions are objective

ex. experiments & standardized assessments

Qualitative

data is unstructured, presented via summary, conclusions are subjective

ex. interviews, focus groups, & observations

Experimental Research Design

participants are randomly assigned to 2 groups who are subjected to varying degrees of the independent variable

Quasi Experimental Research Design

No random assignment but still 2 groups, lacks degree of rigor

Basic Research Definition

investigations performed primarily in a lab or controlled setting to test a specific phenomenon or theory

sometimes lacks applicability to practical environments

highly controlled environment

Applied Research Definition

researchers seek to solve practical problems or dissmeninate information that is useful for practice

applied in natural contexts

interventions are hard to reproduce

Transformative Research Definition

designed to bring about change in a practical context, challenges existing beliefs to transform traditional thought patterns

brings a new theory they have developed

Nominal

classification, no order

ex. blood type, gender, hair color, diagnosis

Ordinal

Rankings

used as counts and percentages, median used for central tendency

ex. manual muscle test, function, pain levels

Interval

continuum of = intervals

no true 0

can add or subtract

ex. temperature

Ratio

amounts

highest level

has true 0

all arrhythmic properties

ex. age, weight, height

Critical appraisal definition

a skill that assists with organizing and differentiating vast bodies of diverse interrelated professional research

strength of evidence

broad term determined by

1. the level of evidence of the study design

2. the quality of the evidence

3. statistical precision

Plagiarism definition

using another's words/ideas and presenting them as your own

3 strategies to avoid plagiarism

quoting

paraphrasing

summarizing

Research Ethics- Nuremberg Code (1947)

mandated voluntary consent for experimental studies of humans

Research Ethics- Declaration of Helsinki (1964):

written by the World's Medical Association to provide guidelines for physicians conducting clinical trials

Research Ethics: Belmont Report (1979):

published by the U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research to define key research principles, and is a foundational document for the current U.S. federal policy for protecting human research participants (the Common Rule)

prioritizes:

1. respect for persons

2. beneficence

3. distributive justice

Belmont Report Respect for Persons

emphasizes autonomy, informed consent, voluntariness, and protection of vulnerable individuals

autonomy: only an individual is authorized to decide whether or not to participate in a research study

Belmont Report Beneficence

study should do good by maximizing possible benefits and minimizing potential harms

Nonmalfience: the study should do no harm

Belmont Report Distributive justice

requires the benefits and burdens of a research study to be fairly allocated

Informed consent

individual's voluntary decision to participate in a research study after reviewing essential information

statement must be clear and using simple language

is a process, not a piece of paper

Understood Consent

requires evidence that a potential study participant comprehends the study's benefits, risks, and procedures

knows their rights as a participant prior to agreeing to participate

Clinical Bottom Line

Differs from an abstract as the clinical bottom line is the takeaway of the methodology

Gives us implications of how the research can be used

Analyzing an abstract for relevance to a research question

Identify the study's purpose and topic

Look for keywords related to your question

Check if methods and results align with research focus

Research Question

A very specific clinical/scientific problem or a very narrow gap/contradiction in knowledge that research aims to resolve

Feautures of an answerable research question

clear & focused

specific & measurable

feasible to investigate

relevant to the field

addresses a gap or problem