Clinical Inquiry Exam 1

Front 1

what are the 4 components that go into evidence based practice?

Back 1

clinical expertise

patient values and preferences

best research evidence

clinical circumstances and setting

Front 2

what does PICO stand for?

Back 2

patient, intervention, comparison, outcomes

Front 3

what are the four sources of best available evidence for EBP?

Back 3

tradition (lowest), authority, trail and error, scientific method/applicaiton of logical reasoning (highest)

Front 4

source of best available evidence for EBP that says we've always used __ at our facility and have experiences good outcomes

Back 4

tradition

Front 5

source of best available evidence for EBP that Dr. __ states that this leads to the best outcomes

Back 5

authority

Front 6

source of best available evidence for EBP that trys a lot of different measures to see if they work

Back 6

trial and error

Front 7

source of best available evidence for EBP that uses the systematic thought process of logical reasoning to answer questions and aqurie new knowledge

Back 7

scientific method

Front 8

what are the 5 steps to research?

Back 8

identify the question

design tehs tudy

methods (carry out the design)

analyze and interpret the data

communicate results (leads back to identifying the question)

Front 9

describe basic vs applied research

Back 9

basic is used to gain knowledge for its own sake (may lead to applied research questions)

applied is used to solve a clinical problem

Front 10

what is the important of translation research?

Back 10

so basic and applied science communicate as well as applied and oragnizational/health systems.

Front 11

explain experimental vs non-experimental research

Back 11

experiemental looks for cause and effect relationships (manipulates and controls variables to see effects on outcomes)

nonexperimental uses observation of variables to describe things

Front 12

describe quantatative vs qualitative research

Back 12

quantitative: uses objective, numerical data

qualitative: helps you know what the data means

Front 13

describe the research continuum

Back 13

descriptive research (describes populations) leads to exploratory research (finds relationships) which leads to experimental research (cause and effect)

Front 14

what is the difference between primary and secondary literature?

Back 14

primary: the actual original research article

secondary: summary article, meta-analysis

Front 15

oversee all research involving human subjects

Back 15

intstituational review board (IRB)

Front 16

what are the two governing bodies control IRB's

Back 16

FDA, DHHS

Front 17

Which of these are considered "human subjects"?

A: collection of data or specimins that have identifiable information that could be linked back to a specific person

B: collection of data or specimens from individuals that are no longer living

C: collection of data or specimens through interaction or intervention of living animals

Back 17

A and C are human subjects

Front 18

which of these would be considered human subject research?

A: research consisting of a clinical trial where the results would be published in teh NEJM

B: planning to hand out evaluations at the end of this session to assess the strengths and weaknesses of my presentation

C: do a research project that i will present to my psychology 101 class only

D: assess parental opinions about breastfeeding which I will present at a national conference

Back 18

A and D

Front 19

systematic inversigation designed to develop to contribute to generalizable knowledge

Back 19

research

Front 20

what is the definition of a human subject?

Back 20

a living individual about whom an investigator conducting research obtains data thorugh:

intervention or interaction with an individual

collection of private health information

Front 21

nazi experimentation, research in US prisions, and the tuskegee experiments all showed a need for __

Back 21

experimental (human) ethics

Front 22

what are the three basic principles of the belmont report?

Back 22

human research must have:

respect for persons (autonomy)

beneficence (do good)

justice (utility)

Front 23

what does it mean for a study to have autonomy?

Back 23

consent process

treated as autonomous agents

diminished autonomy requires increased protectoin

Front 24

when you gather systematic and comprehensive information about proposed research, maximize possible benefits an minimize risks

Back 24

beneficience

Front 25

the probability to harm and the severity (magnitude) or harm

Back 25

risk

Front 26

what does it mean if a subject has "justice"

Back 26

individual (fairness in exclusion and inclusion)

social (class burden)

Front 27

when you weight the risks vs the benefits of the study you are incorporating __

Back 27

justice

Front 28

what study looked at whether people would follow authority figures to the point of inflicting pain on people

Back 28

milgrams study

Front 29

the probabilty and magnitude of harm or discomfort anticipated in the reserach are not greater in and of themselves than those ordinarily encoutered in daily life or during the performance of routine physical or psychological examinations or test

Back 29

minimal risks

Front 30

what are three reasons we use animals in reserach?

Back 30

allows for use of true 'experimental design'

human safety

cant replicate complex responses that occur with intact multisystem organisms

Front 31

characterized by controlled manipulation of variables by teh reserachers

reserachers manipulate and control one or more variables and observe the resultant variation in other varables

prmary purpose is to suggest 'cause and effect' relatinships between variables

Back 31

experimental research

Front 32

considered the 'gold standard' of resreach providing the greatest degree of confidence in validity of outcome

Back 32

experimental design

Front 33

what are the three essential components of experimental research?

Back 33

randomization, control/intervention groups, mainpulation

Front 34

US public health service, USDA, OLAW, AAALAC, AVMA, and IACUC all oversee what kind of research?

Back 34

animal research

Front 35

equivalent to an IRB for animal research

Back 35

institutional animal care and use committee (IACUC)

Front 36

what are the three R's of the IACUC?

Back 36

reduction (reduce teh number of animals used in each study)

replacement (replace lab animals with non-animal models whenever possible)

refinement (refine the tests to ensure the most comfortable and humane conditions possible

Front 37

the process of assigning a number or category to a variable to represent quantities of qualities of characteristics

Back 37

measurement

Front 38

the property or characteristic that distinguishes among members of a group

Back 38

variable

Front 39

a kind of variable with any value along a continum

(distance walked, size of a wound)

Back 39

continuous

Front 40

a kind of varaible that uses whole units only, can also be discrete qualitative categoreis

e.g. number of exercise reps, blood type

Back 40

discrete

Front 41

kind of variable that has 2 possible values

e.g. answer to yes/no question

Back 41

dichotomous

Front 42

BMI and TEMP are examples of what kind of variable?

Back 42

continuous

Front 43

MMT grade, diagnosis, and HR are all examples of __ variables

Back 43

discrete

Front 44

what is the hierarchy of levels of measurement?

Back 44

nominal<ordinal<interval<ratio

Front 45

kind of level of measurement where there is no order, it is purely cartegorical.

examples: gender, type of arthritis.

qualitative, indentifies differences, mutually exclusive

Back 45

nominal

Front 46

kind of level of measurement that is cateogorical but with an order. it is qualitative and can indentify differences in direction and difference. it cannot tell the magnitude of the difference (numbers don't repreent quantities, intervals aren't necessarily equal)

Back 46

ordinal

Front 47

MMT grades, level of assistance, or stages of cancer would represent what kind of measurement?

Back 47

ordinal

Front 48

kind of level of measurement that is quantitative, has equal intervals between values, has a zero point which does not mean an absence of a variable, and can negative values.

Back 48

interval

Front 49

temperature is an example of what kind of level of measurement?

Back 49

interval

Front 50

kind of level of measurement that is quantitative, has equal intervals between values, has a difference between values that has meaning, has a true zero that means the absence of a variable, negative numbers aren't possible, and can do any mathematical operation

Back 50

ratio

Front 51

ROM measurments, HR, and time to complete activcity are all examples of what kind of level of measurement

Back 51

raito

Front 52

__ and __ levels of measurements are more sensitive to change

Back 52

interval and ratio

Front 53

what are three kinds of descriptive statistics

Back 53

frequency distributions

measures of central tenedency

measures of variability

Front 54

a table or graph of rank ordered scores taht shows the number of times each score appears in a data set

Back 54

frequqncy distributions

Front 55

what 3 things do frequency distributions make easier to interpret

Back 55

low and high scores

which scores occurred most often

where scores cluster (shape)

Front 56

a quantative summary of a group of score that reflects the 'center' of the distrubution

Back 56

measures of central tendency

Front 57

the arithmetic average

Back 57

mean

Front 58

the mean can be biased by __

Back 58

extreme scores

Front 59

if data is noramally distributed, the __ is approximately the same as the __

Back 59

median, mean

Front 60

the middle score

Back 60

median

Front 61

the __ is unaffected by extreme scores and good for ordinal data

Back 61

median

Front 62

the measure of central tendency which is the score that occurs most often, is useful for categorical data, can have multiple modes in a distrubution. it is best for ordinal data

Back 62

mode

Front 63

what three things should you consider when choosing a measure of central tendency?

Back 63

distribution shape, application of data, level of measurement

Front 64

characterize dispersion of scores in a data set

Back 64

measures of variabilty

Front 65

which measureso f variability express the same units of measuremnet as teh rest of the data?

Back 65

standard deviation and range

Front 66

__ is teh square of standard devation and is in squared units

Back 66

varience

Front 67

the difference between the lowest and highest scores. reported as single value or as low and high values, affected by extreme score, is not effective when comparing samples of differnt sizes

Back 67

range

Front 68

why is range not effective when comparing samples of different sizes?

Back 68

if you ahve a large set of data, you are more likely to find an outlier

Front 69

measure of variablity where distribution is ivded into 100 parts or 4 equal parts. this describes a single scores position relative to other socres

Back 69

percentile/quartiles

Front 70

a type of graph used to show data sets when data is skewed. the R side has teh dependetn variable, the center of teh box is teh media, teh top bar is teh 75th percentile, the bottom bar is the 25th percentile, whiskers represent 10th and 90th percentile and dots are outliers

Back 70

box plots

Front 71

affected by every score in teh distribution, able to compare variabilty of samples of different sizes, based on how different each score is from the mean

Back 71

variance

Front 72

the valueof teh variance will be __ if teh scores are similar and __ if the scors are dissimilar

Back 72

small, large

Front 73

brings variance back to original units of measurement, rather than squared units. gives the average deviation on either side of the mean

Back 73

standard devation

Front 74

given in independent units to express standard deviation as a proportion of teh mean. allows comparison of distributions with different units

Back 74

coefficient of variation

Front 75

is the standard deviation divided by the mean

Back 75

coefficient of variation

Front 76

what is the difference between descriptive stats and inferential stats?

Back 76

descrpitve: cannot infer anything beyond data sample

inferential: estimates population characteristics based on sample data (answers questions about comparisons/relationships

Front 77

people realistically in your study

Back 77

accessible population

Front 78

everyone who could be in your study

Back 78

estimate population

Front 79

what determines critical value

Back 79

alpha, decrees of freedom, 2vs1 sided test

Front 80

what are the two big keys to estimating population characteristics from our sample data?

Back 80

probability and smapling error

Front 81

what is probabilty?

Back 81

# of times an outcome can occur/total number of outcomes

Front 82

Probability is predictive of what __ happen in the long run, not what __ happen

Back 82

should, will

Front 83

what is a graphical representation of a normal distribution?

Back 83

symmetrical bell curve

Front 84

what are the levels of standard devation?

Back 84

0-1=34.13%

1-2=13.59%

2-3=2.14%

3-on=.13%

Front 85

both standard deviation and standard error are measures of __

Back 85

variaiblity

Front 86

degrees of freedom are based on __

Back 86

sample size

Front 87

an estimate of the varability of the sample (individual observations)

Back 87

standard deviation

Front 88

an estimate of the varability of the sample stastic (if repeated sampling was done)

Back 88

standard error

Front 89

reflects how well our sample represents the population

Back 89

standard error

Front 90

what two things will decrease standard error?

Back 90

decreasing standard devation or increasing sample size

Front 91

what does standard error equal?

Back 91

s(standard deviation)/square root of n (sample size)

Front 92

provides a range of values that are likely to include the true population mean

Back 92

confidence interval

Front 93

what does confidence interval equal?

Back 93

mean +/-confidence level X standard error

Front 94

the hypothesis of "no effect", means there is no difference between groups

Back 94

null hypothesis

Front 95

the hypothesis stating that there is a difference between groups

Back 95

alternative hypothesis

Front 96

what are the two directions of alternative hypothesis's?

Back 96

non-directional: there is a difference

directional: there is a difference and its in this way

Front 97

the probability of data having arsen by chance when the null is actually true

Back 97

P

Front 98

a __ P gives evidence that effect is not zero (evidence for alternative)

Back 98

small

Front 99

a __ p gives evidence that effect is zero (null)

Back 99

large

Front 100

how do you decide what is a large or small p value?

Back 100

level of significance

Front 101

compares calculated p values with alpha to make decisions during hypothesis testing. usually .05 or .01

Back 101

level of significance (alpha)

Front 102

what is the difference between a two sided nondirectional test vs a one sided directional test?

Back 102

two sided nondirectional: results can occur equally often in either direction

one sided directional: used when a real difference can only occur in one direction

Front 103

you measure blood pressure in 50 women and 50 men. you want to determine if there is a difference in BP between genders. whould you do a one sided or two sided test?

Back 103

two sided

Front 104

you measure blood pressure in 50 women and 50 men. you want to determine if there is a difference in BP between genders. the statement "there is no diffrence between BP between teh wto genders is an example of __

Back 104

the null hypothesis

Front 105

you measure blood pressure in 50 women and 50 men. you want to determine if there is a difference in BP between genders. the p=.025 and teh alpha=.01. should you reject the null hypothesis

Back 105

reject

Front 106

when the null is rejected but it is actually true, false positive.

Back 106

type 1 error

Front 107

when the null is not rejected but is false, false negative

Back 107

type 2 error

Front 108

what is alpha equal to?

Back 108

the probability of type 1 error

Front 109

what is beta equal to?

Back 109

the probabilty of type II error

Front 110

what does power equal?

Back 110

1-B, the probability of rejecting null when it is really false

Front 111

this kind of error can lead to using treatments that aren't really effective, treating populations that don't need it

Back 111

type 1 error

Front 112

this kind of error can lead to abandonment of effective treatment, not treating a population who needs it

Back 112

type II error

Front 113

type 1 error means that:

1: In reality, there is no benefit to manual therapy.

2: In reality, there is a benefit to manual therapy.

3: if they committed an error, they must not know how to conduct research.

Researchers conduct a study and conclude that the use of manual therapy is effective in reducing pain in persons with lateral epicondylitis.

􏰈 The null hypothesis is: Pain is not reduced with the use of manual therapy.

Back 113

1

Front 114

type 2 error means that:

1: In reality, there is no benefit to manual therapy.

2: In reality, there is a benefit to manual therapy. 3: The researchers still have no clue how to conduct research.

Suppose the same researchers reached a different conclusion: Manual therapy does NOT reduce pain in persons with lateral epicondylitis.

􏰈 The null hypothesis remains: Pain is not reduced with the use of manual therapy.

Back 114

2

Front 115

􏰈 Assuming α = 0.05, what if p is close to .05 but slightly higher?

Whatever difference in value that exists is likely due to chance (the difference is not real)....OR....

The test was not powerful enough to detect a difference.

Back 115

2

Front 116

The complement of a Type II error

􏰉 The more powerful a statistical test, the

less likely we are to make a Type II error and miss a significant result

􏰉 Probability of finding a significant difference when it really exists.

􏰉 Probability of rejecting Ho when it is really false

Back 116

stastiical power

Front 117

what 4 things affect power?

Back 117

effect size, variance, alpha, sample size

Front 118

what is effect size?

Back 118

how big an effect does an intervention have.

how far apart are the means

Front 119

how does alpha relate to power?

Back 119

teh larger the type I error rate and teh samller the type II error rate.

as alpha increases, beta decreases, power increases

Front 120

how does variance affect power?

Back 120

the lower the varaince, the more power

Front 121

how does sample size effect power?

Back 121

the larger your sample size, the greater the power