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121 Cards in this Set

  • Front
  • Back

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

clinical expertise



patient values and preferences



best research evidence



clinical circumstances and setting

what does PICO stand for?

patient, intervention, comparison, outcomes

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

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

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

tradition

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

authority

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

trial and error

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

scientific method

what are the 5 steps to research?

identify the question



design tehs tudy



methods (carry out the design)



analyze and interpret the data



communicate results (leads back to identifying the question)

describe basic vs applied research

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



applied is used to solve a clinical problem

what is the important of translation research?

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

explain experimental vs non-experimental research

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



nonexperimental uses observation of variables to describe things

describe quantatative vs qualitative research

quantitative: uses objective, numerical data



qualitative: helps you know what the data means

describe the research continuum

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

what is the difference between primary and secondary literature?

primary: the actual original research article



secondary: summary article, meta-analysis

oversee all research involving human subjects

intstituational review board (IRB)

what are the two governing bodies control IRB's

FDA, DHHS

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

A and C are human subjects

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

A and D

systematic inversigation designed to develop to contribute to generalizable knowledge

research

what is the definition of a human subject?

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



intervention or interaction with an individual


collection of private health information

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

experimental (human) ethics

what are the three basic principles of the belmont report?

human research must have:


respect for persons (autonomy)


beneficence (do good)


justice (utility)

what does it mean for a study to have autonomy?

consent process



treated as autonomous agents



diminished autonomy requires increased protectoin

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

beneficience

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

risk

what does it mean if a subject has "justice"

individual (fairness in exclusion and inclusion)



social (class burden)

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

justice

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

milgrams study

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

minimal risks

what are three reasons we use animals in reserach?

allows for use of true 'experimental design'



human safety



cant replicate complex responses that occur with intact multisystem organisms

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

experimental research

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

experimental design

what are the three essential components of experimental research?

randomization, control/intervention groups, mainpulation

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

animal research

equivalent to an IRB for animal research

institutional animal care and use committee (IACUC)

what are the three R's of the IACUC?

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

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

measurement

the property or characteristic that distinguishes among members of a group

variable

a kind of variable with any value along a continum



(distance walked, size of a wound)

continuous

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



e.g. number of exercise reps, blood type

discrete

kind of variable that has 2 possible values



e.g. answer to yes/no question

dichotomous

BMI and TEMP are examples of what kind of variable?

continuous

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

discrete

what is the hierarchy of levels of measurement?

nominal<ordinal<interval<ratio

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


examples: gender, type of arthritis.


qualitative, indentifies differences, mutually exclusive

nominal

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)

ordinal

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

ordinal

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.

interval

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

interval

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

ratio

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

raito

__ and __ levels of measurements are more sensitive to change

interval and ratio

what are three kinds of descriptive statistics

frequency distributions



measures of central tenedency



measures of variability

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

frequqncy distributions

what 3 things do frequency distributions make easier to interpret

low and high scores



which scores occurred most often



where scores cluster (shape)

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

measures of central tendency

the arithmetic average

mean

the mean can be biased by __

extreme scores

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

median, mean

the middle score

median

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

median

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

mode

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

distribution shape, application of data, level of measurement

characterize dispersion of scores in a data set

measures of variabilty

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

standard deviation and range

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

varience

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

range

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

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

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

percentile/quartiles

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

box plots

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

variance

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

small, large

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

standard devation

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

coefficient of variation

is the standard deviation divided by the mean

coefficient of variation

what is the difference between descriptive stats and inferential stats?

descrpitve: cannot infer anything beyond data sample



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

people realistically in your study

accessible population

everyone who could be in your study

estimate population

what determines critical value

alpha, decrees of freedom, 2vs1 sided test

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

probability and smapling error

what is probabilty?

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

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

should, will

what is a graphical representation of a normal distribution?

symmetrical bell curve

what are the levels of standard devation?

0-1=34.13%


1-2=13.59%


2-3=2.14%


3-on=.13%

both standard deviation and standard error are measures of __

variaiblity

degrees of freedom are based on __

sample size

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

standard deviation

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

standard error

reflects how well our sample represents the population

standard error

what two things will decrease standard error?

decreasing standard devation or increasing sample size

what does standard error equal?

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

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

confidence interval

what does confidence interval equal?

mean +/-confidence level X standard error

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

null hypothesis

the hypothesis stating that there is a difference between groups

alternative hypothesis

what are the two directions of alternative hypothesis's?

non-directional: there is a difference



directional: there is a difference and its in this way

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

P

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

small

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

large

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

level of significance

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

level of significance (alpha)

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

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

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?

two sided

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 __

the null hypothesis

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

reject

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

type 1 error

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

type 2 error

what is alpha equal to?

the probability of type 1 error

what is beta equal to?

the probabilty of type II error

what does power equal?

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

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

type 1 error

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

type II error


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.

1


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.

2

􏰈 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.

2

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

stastiical power

what 4 things affect power?

effect size, variance, alpha, sample size

what is effect size?

how big an effect does an intervention have.



how far apart are the means

how does alpha relate to power?

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



as alpha increases, beta decreases, power increases

how does variance affect power?

the lower the varaince, the more power

how does sample size effect power?

the larger your sample size, the greater the power