Evidence-Based Medicine and Scientific Method in Clinical Practice Quiz
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Questions and Answers

What is one of the limitations mentioned regarding the use of evidence alone in medical studies?

  • Gold standard studies always capture the significance to the patient
  • Improvement seen on average may not translate to benefiting every patient (correct)
  • Professional judgment and creativity are overly emphasized
  • Limitations do not exist in using evidence alone
  • What is the third step in the process of Evidence-Informed Practice (EIP) according to the text?

  • Evaluate performance
  • Critically appraise/evaluate the evidence (correct)
  • Find the best available evidence
  • Formulate an answerable research question
  • Why is critical appraisal considered essential in understanding and applying research properly?

  • To ensure proper application of research findings (correct)
  • Research conclusions are always free from bias
  • It helps in generating attention and interest in the media
  • It is unnecessary and adds complexity to the process
  • What is a common issue highlighted in the section about funding in medical trials?

    <p>Statistically significant pro-industry findings due to industry funding</p> Signup and view all the answers

    What is the key factor in bias according to the text?

    <p>Systematic</p> Signup and view all the answers

    Why do exciting headlines like 'Study reveals that smelling your partner's farts is the secret to a longer life' pose a challenge?

    <p>They are aimed at generating attention rather than ensuring accuracy</p> Signup and view all the answers

    'Doesn’t capture significance, meaning to the patient' refers to a limitation of relying solely on:

    <p><strong>Evidence</strong></p> Signup and view all the answers

    Which type of bias involves the difficulty in accurate recollection when asked about past events?

    <p>Recall bias</p> Signup and view all the answers

    In terms of causation, what principle refers to the cause preceding the effect?

    <p>Temporality</p> Signup and view all the answers

    Which relationship provides good evidence of a cause/effect relationship based on varying amounts of cause resulting in varying amounts of the effect?

    <p>Dose-response relationship</p> Signup and view all the answers

    What type of study may have limitations in determining temporality according to the text?

    <p>Cross-sectional study</p> Signup and view all the answers

    Which principle of causation emphasizes that a stronger association provides better evidence of a cause/effect relationship?

    <p>Strength</p> Signup and view all the answers

    What term did Archie Cochrane introduce in 1992 to shift decision-making in medicine?

    <p>Evidence-Based Medicine</p> Signup and view all the answers

    What was the time gap between the introduction of 'Evidence-Based Medicine' and its implementation in practice?

    <p>17 years</p> Signup and view all the answers

    What is the main objective of Evidence-Based Medicine?

    <p>To base decisions on systematic review of evidence</p> Signup and view all the answers

    What did the term 'Evidence-Informed Practice' aim to address?

    <p>To shift decision making from intuition to evidence</p> Signup and view all the answers

    Which term refers to the need to critically evaluate published health research?

    <p>Critical appraisal</p> Signup and view all the answers

    What concept refers to mistakenly attributing a relationship between variables due to a third factor?

    <p>Correlation</p> Signup and view all the answers

    What type of bias is described in the scenario where participants in the treatment group spend significantly more time with researchers compared to the control group?

    <p>Performance bias</p> Signup and view all the answers

    In which scenario might participants who have a negative reaction or no benefit from the study treatment drop out more often than those who find the treatment helpful?

    <p>Attrition bias</p> Signup and view all the answers

    What type of bias is highlighted in a study where more cases of skin cancer are discovered in patients who report working with radioactive material?

    <p>Detection bias</p> Signup and view all the answers

    When participants are aware of being observed and modify their behavior as a result, which type of bias is at play?

    <p>Observation bias</p> Signup and view all the answers

    Which type of bias might occur if a researcher genuinely believes that a particular drug will help treat psoriasis and underestimates the measurement of psoriasis skin lesions when aware of who received the real drug?

    <p>Observation bias</p> Signup and view all the answers

    What type of bias is described when participants who experience different levels of care due to their group allocation may impact study outcomes?

    <p>Performance bias</p> Signup and view all the answers

    What term refers to the phenomenon where heavy smokers are more likely to consume more alcohol, posing a risk of confounding in studies on cigarette smoking and lung cancer?

    <p>Reversibility</p> Signup and view all the answers

    Which factor strengthens the cause for cause/effect when examining the relationship between cigarette ingredients and cancer based on our current knowledge of disease mechanisms?

    <p>Biological plausibility</p> Signup and view all the answers

    In the context of cause and effect relationships, what does the absence of specificity indicate?

    <p>It weakens the evidence against the cause.</p> Signup and view all the answers

    Which term refers to the phenomenon where one cause leads to one specific effect, such as vitamin C deficiency causing scurvy?

    <p>Specificity</p> Signup and view all the answers

    What strengthens the relationship between cause and effect when there are examples of well-established causes that are similar to the one being studied?

    <p>Analogy</p> Signup and view all the answers

    Why is consistency across various studies essential in establishing the link between a cause and its effects?

    <p>It helps confirm the validity of conclusions drawn.</p> Signup and view all the answers

    Which statement accurately describes confounding in a study?

    <p>Confounding happens when an additional variable affects the dependent variable and leads to incorrect conclusions.</p> Signup and view all the answers

    Which scenario illustrates reverse causality?

    <p>More drowning cases are linked to higher ice cream sales.</p> Signup and view all the answers

    What does selection bias refer to in research studies?

    <p>Selection bias results from inadequate randomization causing systematic differences between groups.</p> Signup and view all the answers

    Which factor makes establishing a causal relationship very difficult?

    <p>Random chance influencing study outcomes.</p> Signup and view all the answers

    How does bias impact research conclusions?

    <p>Bias systematically distorts comparisons and influences conclusions.</p> Signup and view all the answers

    Why is causation generally difficult to prove?

    <p>Causation is complex and often affected by confounding variables.</p> Signup and view all the answers

    What was the purpose of introducing the term 'Evidence-Based Medicine' in 1992?

    <p>To increase the use of scientific, clinically relevant research in decision-making.</p> Signup and view all the answers

    Which of the following best describes the research/practice gap that existed after the introduction of 'Evidence-Based Medicine'?

    <p>17 years</p> Signup and view all the answers

    What concept does 'Evidence-Informed Practice' aim to tackle?

    <p>Reliance on intuition and clinical experience</p> Signup and view all the answers

    What was Archie Cochrane's view on treatment decision-making before the introduction of 'Evidence-Based Medicine'?

    <p>It was mostly not based on systematic review of evidence.</p> Signup and view all the answers

    Which term was introduced by Archie Cochrane in 1992 to change the landscape of decision-making in medicine?

    <p>'Evidence-Based Practice'</p> Signup and view all the answers

    What was identified as one of the primary benefits of 'Evidence-Based Medicine' in the text?

    <p>Shifting decision-making towards scientifically sound research.</p> Signup and view all the answers

    What is the significance of temporality in establishing causation?

    <p>It indicates that the cause preceded the effect.</p> Signup and view all the answers

    In terms of bias, what issue does attrition refer to?

    <p>Participants dropping out of a study due to negative outcomes</p> Signup and view all the answers

    What does the principle of reversibility state in terms of causation?

    <p>Once a cause is removed, the effect must disappear.</p> Signup and view all the answers

    Why is consistency crucial in establishing causation across different studies?

    <p>To confirm the relationship between cause and effect is not due to chance.</p> Signup and view all the answers

    What is the key factor that strengthens the cause for a cause/effect relationship?

    <p>Biological plausibility based on current knowledge</p> Signup and view all the answers

    Why does a dose-response relationship provide good evidence of a cause/effect relationship?

    <p>Because varying amounts of the cause result in varying amounts of the effect.</p> Signup and view all the answers

    Which of the following is NOT listed as an argument against using clinical experience alone in the text?

    <p>Facilitates efficient use of resources</p> Signup and view all the answers

    What is an argument FOR relying more on evidence-based practices according to the text?

    <p>Enhanced communication and collaboration among professions</p> Signup and view all the answers

    Which statement aligns with the argument against practitioners relying solely on proven effective modalities?

    <p>May reduce treatment options for modalities under study</p> Signup and view all the answers

    What is a concern mentioned in the text about exclusively using modalities or treatments proven effective by empirical means?

    <p>Undermines naturopathic philosophy of individualization</p> Signup and view all the answers

    Which aspect is highlighted as a limitation when a practitioner solely uses treatments proven effective by empirical means?

    <p>'Lost art' of individualization in care</p> Signup and view all the answers

    Which argument is not listed as a reason to avoid biases from clinical experience alone according to the text?

    <p>'Just google it' approach for sourcing information</p> Signup and view all the answers

    What term refers to the concept that one cause leads to one specific effect, such as vitamin C deficiency causing scurvy?

    <p>Specificity</p> Signup and view all the answers

    In the context of causal relationships, which principle is exemplified when people who quit smoking still have low cancer risk?

    <p>Reversibility</p> Signup and view all the answers

    Which aspect of cause and effect relationships emphasizes that the relationship should be consistent with our current understanding of disease mechanisms?

    <p>Biological plausibility</p> Signup and view all the answers

    What strengthens the link between cause and effect when there are well-established causes analogous to the one under study?

    <p>Analogy</p> Signup and view all the answers

    Which type of relationship is weakened when there is more than one effect attributed to a single cause?

    <p>Specificity</p> Signup and view all the answers

    When considering the association between cigarette ingredients and cancer in cell cultures and animal models, which factor provides strong evidence for causation?

    <p>Biological plausibility</p> Signup and view all the answers

    When assessing the quality of different types of research designs, what is a key consideration for determining their relevance to practice and individual patients?

    <p>Relevance to current understanding of disease mechanisms</p> Signup and view all the answers

    Which type of study methodology typically involves doing something to the patient and observing the outcomes?

    <p>Randomized controlled trials</p> Signup and view all the answers

    In the hierarchy of evidence, which type of study is considered the highest quality based on the methodology hierarchy mentioned in the text?

    <p>Randomized controlled trials</p> Signup and view all the answers

    What is a significant strength of systematic reviews compared to other types of clinical epidemiological studies?

    <p>Comprehensive analysis of existing research</p> Signup and view all the answers

    When faced with conflicting information from different types of research, what should be a primary focus for a researcher or practitioner?

    <p>Assessing the relevance of each study to practice</p> Signup and view all the answers

    What type of blinding is achieved when the person delivering the intervention and the person assessing the outcome are both unaware of the participant's group?

    <p>Double blind</p> Signup and view all the answers

    Which factor can influence the sample in a study based on the method of recruitment?

    <p>Newspaper ad readership</p> Signup and view all the answers

    What does the term 'generalizability' in research refer to?

    <p>Inclusion and exclusion criteria</p> Signup and view all the answers

    Why is clear reporting of the planned measurements (methods) in the results section important for research studies?

    <p>To ensure transparency</p> Signup and view all the answers

    What is the primary purpose of a power calculation in a research study?

    <p>To estimate sample size needed</p> Signup and view all the answers

    What is a potential challenge when applying non-pill interventions in research studies?

    <p>Addressing rare or distant outcomes</p> Signup and view all the answers

    In terms of Jadad scale for reporting randomized controlled trials, how many points are assigned for blinding?

    <p>2 points</p> Signup and view all the answers

    What is a potential limitation of cross-over intervention studies?

    <p>Necessity for a treatment washout period</p> Signup and view all the answers

    Which type of intervention study involves participants choosing between different treatment options?

    <p>Preference-controlled study</p> Signup and view all the answers

    In the context of intervention studies, what design involves assessing changes before and after the intervention where participants are aware of the treatment?

    <p>Pre/post design</p> Signup and view all the answers

    What type of relationship is minimized in preference-controlled intervention studies where participants choose between treatments?

    <p>Selection bias</p> Signup and view all the answers

    What type of study design is characterized by comparing individuals with and without cardiovascular disease to investigate current meat intake?

    <p>Cross-sectional study</p> Signup and view all the answers

    In observational studies, what is a major limitation due to participants not being randomly assigned to exposure groups?

    <p>Selection bias</p> Signup and view all the answers

    What is a strength of case reports and case series in medical research?

    <p>They can lead to further medical actions</p> Signup and view all the answers

    What aspect of observational studies allows them to be less expensive or faster than intervention studies?

    <p>Non-random assignment to exposure groups</p> Signup and view all the answers

    What is a critical consideration when appraising the quality of observational studies with respect to exposure assessment?

    <p>Measurement or classification bias</p> Signup and view all the answers

    What distinguishes N of 1 studies from other types of research designs?

    <p>Multiple crossover comparisons in an individual patient</p> Signup and view all the answers

    What is the main focus of observational studies where exposure is not controlled by the researcher?

    <p>Examining the relationship between a risk factor and an outcome</p> Signup and view all the answers

    In a cohort study, what is the primary objective when recruiting the cohort?

    <p>To assess risk/health factors before the outcome is present</p> Signup and view all the answers

    What characteristic distinguishes a cross-sectional study from a case-control study?

    <p>Assessing current disease status and exposure levels</p> Signup and view all the answers

    Which study design compares participants with a specific exposure to those without that exposure over time?

    <p>Cohort study</p> Signup and view all the answers

    In the context of observational studies, what does 'prospective' refer to?

    <p>Following participants over time from the beginning</p> Signup and view all the answers

    What differentiates cohort studies from case-control studies in terms of participant selection?

    <p>Cohort studies focus on groups with similar exposures</p> Signup and view all the answers

    What is the primary focus of experimental/intervention studies?

    <p>Changing the likelihood of outcomes by treating the patient</p> Signup and view all the answers

    In clinical epidemiological studies, what is a key factor for assessing quality based on design and relevance to practice/patients?

    <p>Generalizability</p> Signup and view all the answers

    What distinguishes randomized controlled trials from case-control studies?

    <p>Comparison of participants with and without exposure</p> Signup and view all the answers

    Which study methodology involves 'doing something to the patient' to observe outcomes?

    <p>Whole systems research</p> Signup and view all the answers

    What is the primary objective when recruiting a cohort for a study?

    <p>Observing participants with a specific exposure over time</p> Signup and view all the answers

    What is the primary focus of observational studies where exposure is not controlled by the researcher?

    <p>Assessing the relationship between a risk factor and an outcome</p> Signup and view all the answers

    In a cohort study, what is the main objective when assessing risk/health factors?

    <p>Creating a comparison group for the cohort</p> Signup and view all the answers

    What distinguishes a longitudinal cohort study from cross-sectional and case-control studies?

    <p>Following participants over time for outcome development</p> Signup and view all the answers

    Why is confounding a major concern in observational studies without exposure control?

    <p>It can lead to inaccurate associations between risk factors and outcomes</p> Signup and view all the answers

    What distinguishes cross-sectional studies from cohort studies in terms of assessing the relationship between exposure and outcome?

    <p>Comparison of current disease status and current exposure</p> Signup and view all the answers

    How is a case-control study different from a cohort study when comparing participants?

    <p>Focus on prior exposure in diseased individuals</p> Signup and view all the answers

    What is the primary focus of a narrative review?

    <p>Focus on individual research studies in detail</p> Signup and view all the answers

    What is the main limitation highlighted about pre-clinical evidence in the text?

    <p>Lack of generalizability to humans</p> Signup and view all the answers

    In research, why are systematic reviews considered more reliable than narrative reviews?

    <p>They incorporate explicit and rigorous methods for data analysis</p> Signup and view all the answers

    What is a key consideration when monitoring patient response in a clinical setting?

    <p>Documenting risks and benefits</p> Signup and view all the answers

    Why is it important to consider the dose when evaluating the effects of soy phytoestrogen on breast cancer treatment?

    <p>To establish the maximum safe dosage for humans</p> Signup and view all the answers

    What distinguishes a narrative review from a systematic review in terms of methodology?

    <p>Narrative reviews incorporate explicit methods while systematic reviews do not</p> Signup and view all the answers

    What is the main purpose of a Randomized Controlled Trial (RCT) according to the text?

    <p>To confirm cause/effect relationships</p> Signup and view all the answers

    Why is randomization essential in a Randomized Controlled Trial (RCT)?

    <p>To account for confounding factors like placebo effects</p> Signup and view all the answers

    How is blinding beneficial in a Randomized Controlled Trial (RCT)?

    <p>To reduce the bias caused by participants' expectations</p> Signup and view all the answers

    What method is considered ideal for achieving random assignment in a study?

    <p>Computer-generated sequence</p> Signup and view all the answers

    Why is it necessary to describe how randomization was done in a study?

    <p>To ensure validity and transparency of the research</p> Signup and view all the answers

    What is the primary purpose of having a control group in a Randomized Controlled Trial (RCT)?

    <p>To provide a basis for comparison with the treatment group</p> Signup and view all the answers

    What is the primary difference between Randomized Controlled Trials (RCTs) and naturopathic medicine in terms of interventions?

    <p>RCTs involve uniform interventions, while naturopathic medicine uses individualized interventions</p> Signup and view all the answers

    In whole practice/systems research, what is the goal of a WSR trial design?

    <p>To study an entire system of care as it is practiced in the real world</p> Signup and view all the answers

    What type of study design involves assessing changes before and after the intervention, where participants are aware of the treatment?

    <p>Intervention Study</p> Signup and view all the answers

    When comparing individualized acupuncture treatments to testing 3 set acupuncture points, what type of study methodology is being employed?

    <p>Intervention Study</p> Signup and view all the answers

    Which methodology focuses on the assessment of an entire system of medicine versus individual therapy?

    <p>Intervention Study</p> Signup and view all the answers

    Study Notes

    Limitations and Biases in Medical Studies

    • Relying solely on evidence can overlook significant contexts and patient meanings, leading to potential misinterpretations.
    • Accurate recollection bias affects participants' responses when reflecting on past experiences.
    • Funding for medical trials often leads to conflicts of interest, impacting the integrity of research outcomes.
    • Bias can be influenced by the researcher's expectations, which may skew data interpretation and results.

    Evidence-Informed Practice Steps

    • The third step in Evidence-Informed Practice involves critically appraising the evidence to properly apply research findings.
    • Critical appraisal is essential for evaluating the relevance and reliability of research, ensuring informed decisions in practice.

    Causation Principles

    • The principle of causation states that a cause must precede its effect for a true causal relationship to exist.
    • A dose-response relationship provides strong evidence as variations in cause lead to corresponding changes in effect.
    • A stronger association indicates a more reliable causal link between two variables, bolstering the claims of causation.

    Research Methods and Design

    • Randomized controlled trials are considered the highest quality design in the hierarchy of evidence due to their methodological rigor.
    • Cohort studies focus on recruiting groups based on exposure status to examine health outcomes over time.
    • Cross-sectional studies differ from cohort studies as they assess relationships at a single point in time without tracking longitudinal data.

    Confounding and Selection Bias

    • Confounding occurs when a third variable influences both the cause and effect, leading to misleading conclusions.
    • Selection bias emerges when participants in a study are not representative of the population, limiting generalizability.
    • Attrition bias impacts results when participants drop out of studies disproportionately based on outcome.

    Evidence-Based Medicine

    • The term "Evidence-Based Medicine" was introduced in 1992 to improve clinical decision-making using the best available evidence.
    • A significant gap between the introduction of Evidence-Based Medicine and its practical implementation has been observed.
    • Evidence-Informed Practice seeks to integrate clinical expertise with the best research evidence and patient values.

    Study Design Considerations

    • Clear and thorough reporting of methods is vital for replicability and validating findings in research.
    • Power calculations are employed to determine the sample size needed to detect a significant effect, ensuring robust study conclusions.
    • Preference-controlled intervention studies allow participants to choose their treatment, minimizing biases associated with coercion.

    Observational and Experimental Studies

    • Observational studies, while cheaper and faster, risk limitations due to the absence of random assignment, influencing data validity.
    • Case reports and series provide valuable insights when larger studies are impractical, focusing on individual patient experiences.
    • Experimental studies maintain strict controls over exposure, aiming to establish cause-effect relationships effectively.

    Consistency and Specificity

    • Consistency across various studies enhances the credibility of the causal link between exposure and health effects.
    • Specificity of cause indicates that a particular cause leads to a specific outcome, strengthening evidence for causation.
    • The principle of reversibility demonstrates that eliminating a risk factor can reduce the incidence of an effect, reinforcing causal connections.

    Factors Influencing Research Validity

    • Generalizability refers to how findings of a study can be applied to broader populations or different settings.
    • Recruitment methods can significantly affect study outcomes and participant selection bias, altering result interpretation.
    • Longitudinal studies track exposures and outcomes over time, providing robust data for causal inferences.

    Research Gaps and Challenges

    • Identifying a significant challenge in translating research findings into practice has highlighted the research/practice gap.
    • Exciting headlines can distort public perception of research significance, leading to misinterpretation of findings for patients.

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    Test your knowledge on Evidence-Based Medicine, the scientific method, critical appraisal of health research, causation and correlation. Explore the underlying concepts of Evidence-Based Medicine and the scientific method in clinical practice.

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