Week 6: Evidence-Based Practice in Healthcare

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Questions and Answers

What is the primary purpose of a literature review?

  • To present original research findings
  • To gather materials from various disciplines
  • To publish the summary of a research project
  • To investigate and appraise existing work on a topic (correct)

Which type of literature review typically uses less systematic search methods?

  • Systematic review
  • Narrative review (correct)
  • Scoping review
  • Meta analysis

What is a defining characteristic of a systematic review?

  • Involves unstructured sampling of literature
  • Focuses only on peer-reviewed journal articles
  • Critically appraises relevant primary research (correct)
  • Combines results from different studies

Which of the following tasks is NOT associated with conducting a narrative literature review?

<p>Establish inclusion and exclusion criteria (A)</p> Signup and view all the answers

What does a meta-analysis aim to identify?

<p>Patterns by combining results from different studies (C)</p> Signup and view all the answers

Which of the following materials is typically NOT included in a narrative literature review?

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

In terms of search methods, what is a scoping review primarily focused on?

<p>Exploring the breadth of a research topic (D)</p> Signup and view all the answers

Choosing a broad research question for a literature review would be best exemplified by which of the following?

<p>What are the economic impacts of obesity? (A)</p> Signup and view all the answers

What is the primary goal of using evidence-based practice in healthcare?

<p>To justify clinical decisions with the best available evidence. (A)</p> Signup and view all the answers

Which factor is essential for effective engagement in evidence-based practice?

<p>Continuous reflection on practices and decisions. (B)</p> Signup and view all the answers

What is a common barrier to implementing evidence-based practice in healthcare settings?

<p>Overwhelming information from an abundance of research. (B)</p> Signup and view all the answers

How does resistance to change impact evidence-based practice?

<p>It can create a culture of stagnation, hindering new practices. (C)</p> Signup and view all the answers

In the context of evidence-based practice, what is best evidence?

<p>Conscientious use of well-conducted and applicable research. (D)</p> Signup and view all the answers

What role does patient-centeredness play in evidence-based practice?

<p>Patients are empowered to make informed decisions aligned with their values. (A)</p> Signup and view all the answers

Why is staying informed of the latest treatments important in evidence-based practice?

<p>To provide the most effective care options based on current advancements. (A)</p> Signup and view all the answers

Which strategy can help address conflicting evidence in healthcare research?

<p>Evaluating the quality and applicability of the evidence critically. (A)</p> Signup and view all the answers

Which database is an example of an online public bibliographic database?

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

What is a key aspect of breaking down research questions into concepts?

<p>Identifying synonyms for each concept (D)</p> Signup and view all the answers

What does combining search results with 'AND' generally yield?

<p>Narrower and more specific results (A)</p> Signup and view all the answers

What does the methodological screening criteria evaluate?

<p>The quality of each study being considered (B)</p> Signup and view all the answers

Which factor is NOT considered during practical screening for papers?

<p>Statistical significance (C)</p> Signup and view all the answers

What is the main benefit of conducting a literature review using multiple sources?

<p>It increases the breadth of information and perspectives (B)</p> Signup and view all the answers

Why is internal validity particularly important for certain types of studies?

<p>It is crucial for studies aiming to evaluate causal relationships (D)</p> Signup and view all the answers

What is one benefit of running searches for text keywords after searching for subject headings?

<p>It can uncover additional relevant literature (A)</p> Signup and view all the answers

What does external validity measure in a research study?

<p>The degree of generalizability of study results to other populations or circumstances (C)</p> Signup and view all the answers

Which type of research is primarily driven by solving real-world problems?

<p>Applied research (C)</p> Signup and view all the answers

Which of the following best defines a hypothesis?

<p>An unproven claim or idea requiring validation (C)</p> Signup and view all the answers

What is a key characteristic of qualitative inquiry?

<p>Utilizes observational techniques and interviews (A)</p> Signup and view all the answers

What is the primary focus of epidemiology?

<p>Study of patterns, causes, and effects of disease in populations (D)</p> Signup and view all the answers

Which type of variable is typically manipulated in an experiment?

<p>Independent variable (B)</p> Signup and view all the answers

Descriptive statistics are used to:

<p>Summarize and explain data characteristics (A)</p> Signup and view all the answers

What should a good research question do?

<p>Be answerable by empirical data and observable evidence (C)</p> Signup and view all the answers

In qualitative research, what does the term 'grounded theory' refer to?

<p>Development of theory derived from empirical data analysis (A)</p> Signup and view all the answers

What is a significant concern related to conducting interviews in research?

<p>Potential stress or trauma for participants (A)</p> Signup and view all the answers

What type of plot is used to show the spread and central tendency of data?

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

Sensitivity in medical testing refers to which of the following?

<p>The proportion of true positives among those with the disease (D)</p> Signup and view all the answers

Which of the following steps is NOT part of decision analysis in healthcare?

<p>Estimate marketing costs (B)</p> Signup and view all the answers

A major drawback of motion in head CT imaging identified by radiology staff is that it affects what?

<p>The clarity of the imaging (B)</p> Signup and view all the answers

Which two types of research design are identified in the content?

<p>Quantitative and qualitative (A)</p> Signup and view all the answers

What issue do CT manufacturers seem to be aware of regarding head motion?

<p>It affects not just imaging but also patient experience (D)</p> Signup and view all the answers

Which of the following is NOT a step mentioned in preparing a research project?

<p>Formulate a marketing strategy (B)</p> Signup and view all the answers

What is a suggested benefit of multi-channel CT technology mentioned in the context of motion?

<p>It could reduce the need for repeat scans (D)</p> Signup and view all the answers

What unique role do radiographers play in research related to CT scans?

<p>Identifying needs and advocating for solutions (C)</p> Signup and view all the answers

What is a primary advantage of Digital Breast Tomosynthesis (DBT) over traditional Digital Mammography (DM)?

<p>Improved visualization and discrimination of lesions (C)</p> Signup and view all the answers

In the context of scientific peer review, what is the purpose of eliminating errors?

<p>To ensure clarity and correctness in research (B)</p> Signup and view all the answers

What is a primary focus of research ethics regarding participant involvement?

<p>Respecting and protecting participant rights (C)</p> Signup and view all the answers

What significant potential bias reduction method is used in clinical trials?

<p>Blindness to the identity of treatments being compared (C)</p> Signup and view all the answers

What does the 3Rs principle in animal ethics stand for?

<p>Replacement, Reduction, Refinement (A)</p> Signup and view all the answers

What document established key ethical principles for conducting human research?

<p>The Nuremberg Code (A)</p> Signup and view all the answers

What is the purpose of bibliometrics in research publishing?

<p>To rank journals and analyze their influence (A)</p> Signup and view all the answers

What is a disadvantage of Digital Breast Tomosynthesis (DBT) compared to Digital Mammography (DM)?

<p>Involves a higher interpretation time (C)</p> Signup and view all the answers

Which of the following is NOT a type of research that requires ethics approval?

<p>Historical data analysis (A)</p> Signup and view all the answers

What is the main goal of informed consent in research ethics?

<p>To provide participants with clear knowledge of the study's purpose and risks (A)</p> Signup and view all the answers

What common method do journal editors rely on during the review process?

<p>Single blind referee process (D)</p> Signup and view all the answers

Which of the following describes a characteristic of qualitative research data?

<p>It is derived from interviews and focus groups (B)</p> Signup and view all the answers

Flashcards

Evidence-Based Practice (EBP)

Using the best available research and evidence to make clinical decisions and deliver patient care.

Rationale for clinical decisions

The logical and justifiable reasons for the chosen treatment or care plan.

Up-to-date vs. Best Evidence

The most recent research isn't always the best research to use when making decisions, as the reliability and applicability of the evidence matter more.

Best Evidence

Using the research deemed most relevant, well-conducted, and applicable for better clinical decision-making.

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Critical appraisal of evidence

Evaluating research carefully to determine its validity, reliability, and applicability to a particular clinical situation.

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Integrating patient values

Considering the patient's preferences, beliefs, and values when choosing treatments and care plans.

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Clinical expertise

Using your knowledge, skills, and experience to create the best approach in practice.

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Resistance to change

Senior staff not wanting to adopt new treatments or methods due to preference for traditional approaches.

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Conflicting Evidence

When different studies show opposite results, making it harder to choose the best course of action.

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Overwhelming information

Too much new research and data making it difficult to keep up and use current best practices.

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Literature Review

A systematic method for finding, evaluating, and combining existing research on a topic.

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Purpose of Literature Review

To understand existing knowledge on a topic; to build a research framework or identify research gaps.

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Narrative Review

A traditional review that may not use strict methods to find or select research.

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Scoping Review

A review that explores the scope and nature of research on a topic, using clear criteria.

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Systematic Review

A review that uses specific and explicit methods to find, choose, and analyze research to answer a specific question.

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Meta-Analysis

A review research approach that combines results from multiple studies to find patterns.

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Research Question

A clearly defined question that a literature review aims to answer.

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Inclusion Criteria

Specific conditions a study must meet to be included in a review.

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Exclusion Criteria

Specific conditions that exclude a study from inclusion in a review.

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DBT advantages over DM

Digital Breast Tomosynthesis (DBT) provides 3D images with less overlapping tissue, potentially improving cancer detection and diagnosis accuracy compared to standard Digital Mammography (DM).

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Histogram

A graph that shows the distribution of data points.

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Scatter plot

A graph that displays relationships between two variables.

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DBT current challenges

DBT faces longer interpretation times, potentially higher radiation doses (depending on breast thickness and acquisition methods), unestablished optimal clinical protocols, increased IT infrastructure needs, and limited conclusive evidence on health benefits despite higher cancer detection rates.

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Box plot

A graph that displays the spread and central tendency of a data set.

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Peer review purpose

Scientific peer review aims to improve research quality, ensure novelty, scientific soundness, and suitability for the specific journal.

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Peer review process

Typically involves two (or sometimes more) referees providing reports for the editor's evaluation, where typically the referee knows the author.

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Sensitivity

Proportion of people with a disease who test positive.

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Specificity

Proportion of people without a disease who test negative.

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Clinical trial

A type of human research designed to evaluate the effectiveness of interventions (treatments, procedures, etc).

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Ethical considerations in animal research

Research involving animals must minimize harm, promote animal welfare, and utilize alternative methods whenever possible.

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Decision Analysis

A systematic way to make decisions in healthcare, combining quantitative methods and communication.

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3Rs of animal ethics

Replacement (seeking alternative methods), Reduction (minimizing animal use), and Refinement (improving animal welfare) are crucial for ethical animal research.

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Quantitative Research

Research design that uses numerical data and statistical analysis to gain knowledge.

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Qualitative Research

Research design that explores concepts, ideas, and meanings using descriptive methods.

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Head Motion Artifacts (CT)

Blurring and ghosting in CT scans due to head movement during the scan.

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Research Question

The core issue a research project aims to answer.

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Research Hypothesis

A testable prediction about the relationship between variables.

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Reducing Hospital Length of Stay for Obese Diabetic Patients

Strategies used in NSW (New South Wales) to shorten hospital stays for obese diabetic patients experiencing complications from neuropathy.

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Research Question Influence on Results

How the phrasing and focus of a research question affect the information found through searching sources.

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Narrow Research Question

A research question focused on a specific, limited aspect of a topic, providing a clear search scope.

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Literature Review Sources

Varied sources used to gather data for literature reviews, including online bibliographic databases (e.g., Google Scholar, PubMed), specialized databases (e.g., Medline, Web of Science), and manual searches of reference lists.

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Search Term Selection

Selecting appropriate terms, using subject headings and keywords, for database searches to retrieve relevant data.

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Concept Breakdown for Search Terms

Dividing the research question into smaller, constituent concepts for the selection of appropriate search terms.

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Search Database Selection

Choosing the most suitable database for retrieving information based on the subject matter.

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Combination Search Strategy

Combining search terms through using 'AND' to narrow down search results or 'OR' to widen them, focusing on relevant connections.

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Practical Screening Criteria

Broad filtering criteria for initial identification of potentially useful studies.

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Methodological Screening Criteria

Detailed criteria for evaluating study quality and relevance for detailed evaluation.

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Internal Validity

The degree to which a study can establish a causal relationship between variables.

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External Validity

The ability to generalize study results to other populations or circumstances.

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Internal Validity

The extent to which a study accurately measures what it's supposed to measure.

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Reliability

The consistency and stability of data.

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Hypothesis

A statement that proposes a relationship but hasn't been proven.

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Basic Research

Research driven by curiosity to advance fundamental knowledge, not necessarily aimed at solving immediate problems.

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Applied Research

Research aimed at solving practical problems or improving real-world situations.

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Qualitative Research

Research that explores experiences, perceptions, and meanings through interviews, observations, and focus groups.

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Quantitative Research

Research that collects and analyzes numerical data to measure relationships between variables.

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Descriptive Statistics

Methods that summarize and describe data.

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Inferential Statistics

Methods that use sample data to make inferences about a larger population.

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Good Research Question

A research question that can be answered by collecting observable or empirical data in a reliable and testable manner.

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Validity

The accuracy and soundness of a conclusion or measurement.

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Quasi-experiment

A research approach that studies the impact of an independent variable without full control or randomization.

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Epidemiology

The study of the distribution and causes of disease in populations.

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Study Notes

Week 6: Evidence-based Practice (EBP)

  • EBP is used to provide effective care.
  • Rationale for clinical decisions is justified using the best available evidence, ensuring transparency and trust with patients.
  • Staying informed on the latest treatments and advancements is essential for providers to deliver the most effective care.
  • Patient-centered approach: present evidence-based options, empowering patients to make informed decisions aligned with their values.
  • Adherence to professional standards and regulatory standards like MRPBA is vital to maintain licensure and institutional accreditation.
  • Continuous professional development is crucial for staying current and improving practice.

Advantages of EBP

  • For Patients: Less time wasted on inappropriate care, greater consistency of care, greater value for the money, easier to justify demands for more resources.
  • For Practitioners: Competence through updated knowledge, better decision-making using critical reasoning, more confidence in practitioners, better quality of care and patient satisfaction, reducing complaints and litigation and commitment to reduce HC costs.
  • For the Organization: Enhanced delivery of care, more confidence in practitioners, less complaints and litigation, commitment to reduce HC costs, easier allocation of limited resources.

Challenges of Up-to-Date vs Best Evidence

  • Many official guidelines require healthcare to be delivered in line with the most up-to-date standards.
  • However, up-to-date may not always be the best or most reliable evidence.
  • Best evidence involves using the most relevant, well-conducted, and applicable research.

Barriers to Implementing EBP in Practice

  • Resistance to change, particularly from senior staff who may prefer traditional methods.
  • Conflicting evidence from different studies leading to confusion and uncertainty.
  • An overload of information, making it difficult to keep up with the latest developments and potentially leading to the use of outdated practices

Week 7: Literature Review

  • A systematic, explicit, and reproducible method to identify, evaluate, and synthesize existing research.
  • Purposes of literature reviews:
    • Investigate and appraise material on a specific topic.
    • Serve as a framework for a research study or thesis.
    • Raise questions and identify areas for further exploration.
  • Types of literature reviews (e.g., narrative, scoping, systematic).
  • Systematic Reviews: use systematic methods to identify, select, and critically appraise primary research, extracting and analyzing data from included studies.
  • Meta-analysis: a type of systematic review that contrasts and combines results from multiple different studies to identify patterns.

Week 8: Types of Research

  • Basic research: focused on understanding fundamental principles, potentially unrelated to real-world problems.
  • Applied research: aimed at solving practical problems.
  • Hypothesis: A statement or proposition that may not have supporting evidence but requires an argument.
  • Evidence: Crucial to research projects, used to support claims and arguments.
  • Research Question: Crucial element that needs to be clearly defined in order to direct the research, either by collecting observable evidence or empirical data.
  • Overall picture of a research project: Defining variables (independent, dependent, and influencing factors), conducting literature reviews, collecting data, testing ideas (qualitative or quantitative), and analyzing data.

Week 9: Hypotheses

  • Motion is a common problem in head CT imaging.
  • Motion compromises diagnosis and treatment.
  • Some scan types are more susceptible to motion artifacts.
  • Current remedies for motion artifacts are inadequate.
  • Repeat scans are often necessary but are not always possible.
  • Repeat scans result in increased radiation doses and discomfort.
  • CT manufacturers perceive motion as a problem in CT imaging.

Week 10: DBT and DM

  • DBT (Derivative Digital Mammographic Imaging Technology) creates volumetric 3D images using x-rays.
  • Advantages of DBT over DM (Digital Mammography):
    • Less overlapping of breast tissue in each slice compared to DM.
    • Better visualization of malignancy and discrimination between different tissue structures.
      • Potentially leading to improved cancer detection.

Week 11: Peer Review

  • Peer review is a process where experts in the field evaluate research before publication.
  • Purposes of peer review:
    • To eliminate errors.
    • To improve clarity and ensure validity of scientific claims and findings.
    • To ensure the research is scientifically sound and suitable for the journal.
  • Types of peer review:
    • Single-blind (referee knows author but author doesn't know referee).
    • Double-blind (neither referee nor author know each other's identity).
    • Open (both referee and author are aware of the identity of each other).

Week 12: Ethics in Research

  • Need for research protection of participants, researchers and animal research .
  • Quality assurance related to animal research.
  • Integrity of outcomes.
  • Conflicts of interest.
  • Ethics fundamental to conducting research, including clinical trials, epidemiological, health, and population.

Week 13: Data, Confidentiality, and Clinical Trials

  • Data Types in research : Pieces of information, focus groups, surveys, interviews, questionnaires, personal hx.
  • Confidentiality : How images are maintained and identified, risks to participants (e.g.,identifying individuals in research images, etc.)
  • Clinical Trials: Testing effects of interventions (drugs, devices, procedures) and collecting data on risks/benefits.
  • Types of clinical trials: drug trials, surgical procedures, preventive and diagnostic procedure use in research and testing.

Intellectual Property and Commercialization

  • Focus on academic honesty.

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