Evidence-Based Practice (EBP) Foundations
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Questions and Answers

Which statistical procedure is most appropriate for comparing the average scores of two different treatment groups on a continuous outcome measure?

  • Chi-Square
  • T-Test (correct)
  • Repeated Measures ANOVA
  • Analysis of Variance (ANOVA)
  • A researcher wants to determine if there is a significant difference in the proportion of patients who experience a positive outcome after receiving either a new medication or a standard treatment. Which statistical procedure is most appropriate for this analysis?

  • Analysis of Variance (ANOVA)
  • Repeated Measures ANOVA
  • Chi-Square (correct)
  • T-Test
  • In the context of research, what does "intention-to-treat" analysis mean?

  • Analyzing data only from participants who completed the study, regardless of their initial group assignment.
  • Analyzing data only from participants who adhere to the treatment protocol.
  • Analyzing data from participants who received the intended treatment, even if they dropped out of the study.
  • Analyzing data using all participants', regardless of whether or not they completed the study. (correct)
  • What does "effect size" in research refer to?

    <p>The magnitude of the difference between two groups or treatments. (D)</p> Signup and view all the answers

    A researcher finds a large effect size (Cohen's d > 0.8) in their study. What can be concluded based on this finding?

    <p>The difference between the groups is likely to be clinically meaningful. (C)</p> Signup and view all the answers

    What is the primary purpose of "Number Needed to Treat" (NNT)?

    <p>To determine how many patients need to be treated for one patient to benefit from the treatment. (C)</p> Signup and view all the answers

    Which of the following is NOT considered a barrier to evidence-based practice (EBP)?

    <p>Lack of time constraints for clinicians. (C)</p> Signup and view all the answers

    Which of the following BEST describes the concept of "shared informed decision-making" in therapy?

    <p>The therapist and patient work together to make decisions about treatment based on the best available evidence. (C)</p> Signup and view all the answers

    What is the primary goal of Evidence-Based Practice (EBP)?

    <p>To ensure the best available evidence informs patient care. (D)</p> Signup and view all the answers

    Which of the following best defines 'Clinical Expertise' in the context of EBP?

    <p>Knowledge gained from cumulative years of patient care. (D)</p> Signup and view all the answers

    Which step comes immediately after identifying the need for information in the EBP process?

    <p>Search for the best possible research evidence. (B)</p> Signup and view all the answers

    What type of research question seeks to provide a summary of specific features of the world?

    <p>Descriptive questions. (B)</p> Signup and view all the answers

    How does EBP benefit patient treatment?

    <p>It allows for personalization of treatment based on individual values. (D)</p> Signup and view all the answers

    Which of the following is NOT considered a pillar of Evidence-Based Practice?

    <p>Cost-effectiveness analysis. (B)</p> Signup and view all the answers

    What is an essential component of a predictive research question?

    <p>A longitudinal study design. (D)</p> Signup and view all the answers

    What does the 'Evaluate' step of EBP involve?

    <p>Evaluating the impact of evidence-based changes. (D)</p> Signup and view all the answers

    What is the main distinction between prediction and causation in research?

    <p>Prediction is about future expectations, while causation determines cause-and-effect. (B)</p> Signup and view all the answers

    Which study design is primarily used to establish causality?

    <p>Randomized controlled trial (A)</p> Signup and view all the answers

    What is the purpose of randomization in research?

    <p>To reduce the risk of bias by evenly distributing confounding variables. (B)</p> Signup and view all the answers

    What does a narrow confidence interval suggest about a study's findings?

    <p>The study can provide high clinical utility. (B)</p> Signup and view all the answers

    What is an example of a surrogate outcome in a clinical study?

    <p>Blood pressure as a predictor of heart disease. (A)</p> Signup and view all the answers

    Which type of error occurs when a statistically significant difference is incorrectly concluded to exist?

    <p>Type I Error (D)</p> Signup and view all the answers

    What does the term 'blinding' refer to in research studies?

    <p>The method of keeping certain information hidden from researchers and participants. (A)</p> Signup and view all the answers

    Which of the following is NOT a measure of variability in statistics?

    <p>Median (D)</p> Signup and view all the answers

    What does the 'alpha level' typically represent in hypothesis testing?

    <p>The threshold for statistical significance, usually set at 0.05. (C)</p> Signup and view all the answers

    In a randomized controlled trial, what is the sham group used for?

    <p>To apply a placebo effect while controlling for psychological impacts. (C)</p> Signup and view all the answers

    Which of the following is considered a type of inferential statistic?

    <p>P-value (B)</p> Signup and view all the answers

    What is the main concern regarding conflicts of interest in research studies?

    <p>They may bias the study outcomes based on funding sources. (C)</p> Signup and view all the answers

    What type of reliability assesses the consistency of measurements by the same therapist?

    <p>Intra-rater reliability (B)</p> Signup and view all the answers

    Flashcards

    Evidence-Based Practice (EBP)

    Integration of research evidence, clinical expertise, and patient values in care.

    Goals of EBP

    To inform patient care with the best evidence and optimize therapy benefits.

    Three Pillars of EBP

    Scientific research, clinical expertise, and patient values/circumstances.

    Scientific Research

    Empirical evidence gained from systematic hypothesis testing, including clinical and non-clinical studies.

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    Clinical Expertise

    Knowledge gained from years of patient care and refining therapy practices.

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    Patient's Values

    Beliefs, preferences, and cultural identifications relevant to therapy.

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    Five Steps of EBP

    1. Identify the question; 2. Search evidence; 3. Appraise evidence; 4. Integrate; 5. Evaluate.
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    Descriptive Research Questions

    Aim to describe a situation using quantitative data for an overview.

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    Predictive Research Questions

    Seek to understand future events through current information and studies.

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    Causal Study

    Research aiming to identify treatment targets and risk factors, or estimate outcomes from treatments.

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    Descriptive Study Designs

    Research methods to summarize and characterize data without manipulating variables.

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    Predictive Study Designs

    Methods that anticipate future conditions based on current data.

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    Randomization

    Assigning participants to groups randomly to reduce bias in research results.

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    Blinding

    Keeping participants or researchers unaware of group assignments to minimize bias.

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    Sham Group

    A control group given a placebo to test psychological effects of treatments.

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    P-value

    The probability that the observed effect is due to chance; less than 0.05 is statistically significant.

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    Confidence Intervals (CIs)

    A range of values that likely contains the true population mean; a narrow CI indicates more precise estimates.

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    Type I Error

    Incorrectly rejecting the null hypothesis, concluding there is a difference when none exists.

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    Type II Error

    Failing to reject the null hypothesis, concluding no difference when one exists.

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    Intra-rater Reliability

    Consistency of measurements made by the same observer across multiple trials.

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    Inter-rater Reliability

    Consistency of measurements made by different observers.

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    Nominal Scale

    A measurement scale using categories without a defined order.

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    Ordinal Scale

    A categorical measurement scale where data can be ranked, but distances aren't uniform.

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    Hypothesis Testing

    A method to determine if there is enough evidence to reject the null hypothesis in a study.

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    Standard Error of Measurement (SEM)

    Assesses the variability of the standard deviation against probabilities of variation.

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    Chi-Square

    Compares observed frequency with expected frequency for nominal data.

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    T-Test

    Statistical test to compare the means of two groups.

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    Effect Size

    Measures the magnitude of the difference between treatments.

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    Number Needed to Treat (NNT)

    The number of patients needed to treat for one to benefit.

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    Intention-to-Treat (ITT) Analysis

    Analyzes data as if all participants remained in their assigned groups.

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    Shared Informed Decision

    A choice made through collaboration between therapist and patient based on evidence.

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    Appraisal Process

    Four-part process for evaluating research studies effectiveness.

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    Study Notes

    Evidence-Based Practice (EBP) Foundations

    • EBP integrates best research, clinical expertise, and patient values for optimal patient care.
    • EBP guides treatment choices and highlights effective vs. ineffective approaches.
    • EBP optimizes therapy benefits and patient responsiveness.

    The Three Pillars of EBP

    • Scientific Research: Empirically tested hypotheses using clinical (human subjects) and non-clinical studies (healthy humans, animals, etc.).
    • Clinical Expertise: Accumulated knowledge of physical therapy gleaned from experience and improved techniques.
    • Patient Values & Circumstances: Patient's beliefs, preferences, medical history, access to care, and family environment.

    Five Steps of EBP

    • Identify: Formulate a focused clinical question.
    • Search: Gather the best research evidence.
    • Appraise: Critically assess the evidence's quality and applicability.
    • Integrate: Combine evidence with clinical expertise and patient factors.
    • Evaluate: Assess the effectiveness and identify improvements.

    Types of Research Questions

    • Descriptive: Summarizes a situation (e.g., patient demographics).
    • Predictive: Foresees future outcomes based on current data (longitudinal studies).
    • Causal: Aims to show cause-effect relationships (e.g., intervention vs. control).

    Study Designs

    • Descriptive: Cross-sectional, longitudinal surveys, clinical notes, health system data.
    • Predictive: Cross-sectional, longitudinal surveys, clinical notes, health systems data, observational cohort studies, qualitative studies.
    • Causal: Randomized controlled trials (RCTs), quasi-RCTs, controlled cohorts, natural experiments, case-control studies, longitudinal or mediation analyses.

    Key Concepts in Research

    • Prediction vs. Causation: Predicting future outcomes vs. proving cause-and-effect.
    • Randomization: Random assignment to groups to avoid bias.
    • Blinding: Concealing treatment group information from participants, clinicians, or both (single, double, or triple blinding).
    • Sham Group: Used as a control to account for placebo effects.

    Literature Searching

    • Google Scholar: Comprehensive search engine for peer-reviewed and non-peer-reviewed research.
    • PubMed: Medical database with MeSH terms for refined searches, clinical queries and citations.
    • PEDro: Physiotherapy Evidence Database.
    • Cochrane Library: Systematic reviews and summaries.
    • AHRQ: Agency for Healthcare Research and Quality.

    Study Appraisal

    • Applicability: How well the study fits the specific patient population and setting.
    • Quality: Rigorous study design and execution.
      • Realistic Intervention, Relevant Outcomes, Adequate Follow-up, Participant Attrition, Original Group Preservation.
    • Surrogate Outcomes: Indirect measures of clinical outcomes.
    • Conflicts of Interest: Financial or other interests that could bias the study.
    • Reporting Bias: Potential for published studies to overrepresent positive findings.

    Statistical Concepts

    • Descriptive Statistics: Summarize data (mean, median, mode, standard deviation).
    • Inferential Statistics: Draw conclusions from data using probability (p-value, confidence intervals (CIs)).
    • Reliability: Consistency of measurements (inter-rater, intra-rater).
    • Validity: Measures what it's intended to measure.
    • Scales of Measurement: Nominal, ordinal, interval, ratio.
    • Statistical Tests: T-tests, ANOVA, chi-square, ICC, Spearman's Rho, Kappa, etc.

    Clinical Relevance

    • Effect Size (Cohen's d): Magnitude of treatment differences (small, medium, large).
    • Number Needed to Treat (NNT): How many patients need to be treated for one to benefit.

    Barriers to EBP

    • Time constraints, lack of research skills, limited resources, inconsistent EBP culture.

    Shared Informed Decision

    • Collaborative decision-making based on evidence and patient values.

    Appraisal Process Summary

    • Four parts:
      • Applicability
      • Quality
      • Results
      • Clinical Bottom Line

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    Description

    Explore the essential components of Evidence-Based Practice (EBP) in healthcare. This quiz covers the integration of scientific research, clinical expertise, and patient values, along with the critical steps involved in applying EBP for optimal patient care. Test your understanding of how these elements work together to enhance treatment outcomes.

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