Evidence Based Practice I Week 2 - Comprehensive Literature Searches
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Questions and Answers

In research, what critical distinction differentiates a predictive study from an associative or correlative one?

  • Predictive studies aim to forecast future outcomes based on current events, while associative studies identify relationships without projecting forward. (correct)
  • Predictive studies utilize larger sample sizes to ensure statistical power.
  • Predictive studies analyze historical data to uncover hidden patterns, whereas associative studies focus on real-time data collection.
  • Predictive studies rely solely on randomized controlled trials (RCTs) to establish causality.

Why might interpreting the relationship between ankle surgery and recovery time incorrectly lead to a flawed conclusion regarding causality?

  • Because the study design failed to account for patient age and overall health, impacting recovery rates regardless of surgery.
  • Because the severity of the initial ankle sprain, which influences the need for surgery, is a confounding variable, not the surgery itself. (correct)
  • Because surgery is always the direct cause of prolonged recovery due to complications.
  • Because patients who undergo surgery are typically more compliant with rehabilitation protocols, speeding up their recovery.

In the context of research study design, what is the primary reason for the emphasis on distinguishing between 'causal' and 'casual' relationships?

  • To prevent unintentional misspellings in academic papers, thus upholding professional standards.
  • To encourage researchers to adopt a more relaxed and flexible approach when interpreting data.
  • To highlight the difference between cause-and-effect relationships versus informal or coincidental associations. (correct)
  • To ensure that the research findings are easily understandable and relatable to a general audience.

What is the most significant challenge in determining causality when conducting observational studies, and how can researchers address it?

<p>The inability to randomly assign participants to different conditions; researchers address this through careful selection of research designs and statistical techniques. (A)</p> Signup and view all the answers

What specific strategy can minimize the risk of misinterpreting associations as causal relationships, particularly when utilizing a predictive model?

<p>Employing rigorous statistical analysis techniques combined with careful consideration of potential confounding variables. (C)</p> Signup and view all the answers

In what situation would a researcher most likely need to utilize specific research designs and/or statistical analysis techniques to establish cause-and-effect relationships?

<p>When it is unethical or not feasible to randomize participants in a clinical trial. (A)</p> Signup and view all the answers

How do researchers differentiate between studies that genuinely predict future outcomes and those that merely demonstrate correlations?

<p>By assessing whether the study design allows for the identification of expectations for the future, rather than just concurrent relationships. (B)</p> Signup and view all the answers

What is the most accurate interpretation of the statement: 'Patients who have ankle surgery can expect a more prolonged recovery than patients who do not'?

<p>The need for ankle surgery indicates a more severe initial injury, which is the primary driver of a prolonged recovery. (A)</p> Signup and view all the answers

In causal research, what is the primary aim when seeking treatment targets?

<p>To identify specific factors that, when modified, can alter the course of a condition or injury. (D)</p> Signup and view all the answers

Which study design is MOST appropriate for determining the accuracy of a new diagnostic test in a clinical setting?

<p>Cross-sectional study using a clinical sample (A)</p> Signup and view all the answers

A researcher aims to forecast the likelihood of hospital readmission within 30 days following a patient's discharge after hip replacement surgery. Which study design would be MOST appropriate for this predictive analysis?

<p>A longitudinal observational cohort study tracking patients post-discharge. (B)</p> Signup and view all the answers

When using Google Scholar and PubMed, which strategy is MOST effective for precisely targeting a specific research topic and minimizing irrelevant results?

<p>Employing quotation marks to search for exact phrases. (D)</p> Signup and view all the answers

A researcher is using PubMed to investigate the effectiveness of a novel rehabilitation program for stroke patients. What is the MOST effective way to identify articles that are clinically relevant and focused on patient care?

<p>Exploring the 'Clinical Queries' function. (A)</p> Signup and view all the answers

A physical therapist seeks to locate systematic reviews evaluating the effectiveness of different exercise protocols for patients with osteoarthritis. Which database is the MOST appropriate and efficient for this specific purpose?

<p>Cochrane Library (B)</p> Signup and view all the answers

When designing a comprehensive search strategy using the PICO framework within the Cochrane Library, what does the 'Comparison' component specifically refer to?

<p>The alternative treatment or intervention being evaluated against the primary intervention. (C)</p> Signup and view all the answers

Which action is MOST likely to reduce the occurrence of the nocebo effect when communicating with patients about their treatment?

<p>Refining language to avoid overdramatizing potential negative aspects of the treatment. (D)</p> Signup and view all the answers

What is the PRIMARY concern regarding 'reporting bias' in research?

<p>The over-representation of positive findings in published literature. (B)</p> Signup and view all the answers

In the context of evidence-based practice, how can clinicians MOST effectively leverage the placebo effect to enhance patient outcomes while maintaining ethical standards?

<p>Creating a supportive therapeutic environment and fostering positive expectations through communication. (D)</p> Signup and view all the answers

Flashcards

Descriptive Questions

Seeks to describe a situation or provide an overview using data to provide a quantitative summary.

Prediction (in research)

In research, using current information to identify expectations for the future.

Predictive Questions

Aims to learn about potential future outcomes using present information, often requiring a longitudinal study.

Causal Relationship

Determining a cause-and-effect relationship between variables.

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Causal Questions

Aims to identify treatment targets or factors that affect risk, comparing different treatment outcomes.

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Associative/Correlative Relationship

Suggesting a relationship or pattern between variables, but not necessarily direct cause-and-effect.

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Randomized Controlled Trial (RCT)

A type of research design, often considered the best for determining cause-and-effect. Participants are randomly assigned to groups.

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Google Scholar

Includes non-peer-reviewed sources.

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PubMed Search Tip

Use quotation marks to search for specific terms.

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Ankle Surgery Recovery (True Cause)

The severity of the ankle sprain, not the surgery itself, leads to longer recovery.

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PubMed - MeSH

Medical Subject Headings that help narrow down search results.

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"Casual"

Not formal. Do not confuse with causal.

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PubMed – Clinical Queries

Uses predefined filters to find clinically relevant topics or disease-specific information.

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Alternative cause-and-effect research design

Designed and implement research in a way that establish cause-and-effect relationships when RCT's are not possible (pregnancy effects)

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Establishing Cause-and-Effect

Establishing cause-and-effect relationships when RCTs is impossible through research designs and/or statistical analysis techniques

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PEDro

A physiotherapy evidence database.

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Placebo Effect Factors

Factors include confidence, beliefs, misinformation, and source of information.

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Reporting Bias

Whether researchers publish findings based on the results.

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Study Notes

  • Prediction in research is vital for identifying future expectations, distinct from mere association or correlation.
  • Prediction differs from causation; an event informs about a future outcome.
  • The severity of the injury, not the subsequent surgery, causes prolonged recovery.
  • Misinterpreting cause-and-effect can lead to incorrect conclusions.
  • Causal is meant to determine cause-and-effect.
  • Randomized controlled trials (RCTs) are often the best for determining cause-and-effect, BUT they are not the only way.
  • Specific research designs or statistical analysis can help establish cause-and-effect relationships when randomization isn't feasible or ethical.

Question Types

  • Descriptive questions aim to describe a situation, providing an overview.
  • Descriptive uses data for a quantitative summary of features.
  • Predictive questions aim to forecast the future using present information, using a longitudinal study design.
  • Causal questions aim to identify treatment targets, risk factors, or treatment outcomes, compared to alternatives.

Question Types and Study Designs

  • Descriptive questions can use cross sectional population survey to measure prevalence
  • Descriptive questions can use longitudinal population survey to measure incidence
  • Descriptive questions can use clinical notes review to conduct practice audits, case mix
  • Descriptive questions can use health systems data review to determine cost of illness –Descriptive questions can use longitudinal observational cohort to determine clinic/natural course
  • Descriptive questions can use cross-sectional study to determine diagnostic test accuracy
  • Descriptive questions can use qualitative study to determine patient experiences
  • Predictive questions can use cross-sectional population survey to build risk or prognostic models
  • Predictive questions can use longitudinal population survey to build risk or prognostic models
  • Predictive questions can use clinical notes review to build risk or prognostic models
  • Predictive questions can use health systems data review to build risk or prognostic models
  • Predictive quesitons can use longitudinal observational cohort to build risk or prognostic models
  • Predictive questions can use cross-sectional study to build risk or prognostic models
  • Predictive questions can use qualitative study to build risk or prognostic models
  • Causal questions can use randomized controlled trial, quasi-randomized controlled trial, controlled cohort study, natural experiment to measure treatment effectiveness
  • Causal questions can use longitudinal study (clinical sample), case-control study, natural experiment to identify the treatment target(s)
  • Causal questions can use mediation analyses in longitudinal studies or randomized controlled trials to identify mechanisms for treatment effect or pathological mechanisms

Google Scholar

  • Google Scholar includes sources beyond peer-reviewed articles.

PubMed

  • Use quotation marks for specificity.
  • Use "and" to separate words or phrases with the Boolean search.
  • Google Scholar helps find other relevant articles, unlike PubMed.
  • Google Scholar indicates how many studies have cited a specific study.
  • Narrow searches using timeframes.
  • Find other studies by an author by clicking on their name.

PubMed – MeSH

  • MeSH stands for medical subject headings.
  • Identify related terms to narrow searches.

PubMed – Clinical Queries

  • Uses predefined filters for clinical or disease-specific topics.
  • Designed for clinical relevance.

Searching by Date

  • Search for newest evidence, while recognizing the value of older studies.

PEDro

  • Physiotherapy Evidence Database.
  • Specific to physical therapy research.

APTA Searches

  • Utilize APTA resources to search Clinical Practice Guidelines and Clinical Summaries.
  • Search the APTA Journal.

Cochrane Searches

  • Focuses on systematic reviews.
  • Offers plain language summaries.
  • Search through Cochrane Library.
  • Includes PICOs (Population, Intervention, Comparison, Outcomes).

AHRQ Searches

  • Agency for Healthcare Research and Quality.

Placebo Effect Factors

  • Factors that may contribute to the placebo effect include confidence, beliefs, misinformation/miseducation, and source of information quality.

Nocebo Effect Factors

  • Factors that may contribute to the nocebo effect include emotions, and overdramatizing a treatment/procedure/product.
  • Physical therapists should use the placebo effect to their advantage, and prevent nocebo effects.
  • Prevention include refined language and overwhelming with positivity to deter focusing on negativity.

Reporting Bias

  • Reporting bias occurs when the decision to publish findings depends on the nature of those findings.

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Explore the difference between prediction and causation in research. Understand how to identify future outcomes and avoid misinterpreting cause-and-effect relationships. Learn about randomized controlled trials and other methods for establishing causal links.

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