Final exam

Question 1

Evidence cycle

Answer 1

Ask–acquire–appraise–apply

Question 2

Hayward’s evidence cycle

Answer 2

Adds in assess

Question 3

Making a health decision takes what into consideration

Answer 3

Patients circumstance, research evidence, clinical expertise, and patients values/preferences

Question 4

Background question components

Answer 4

Question + condition

Ex: (what causes) +(Lyme disease)

Question 5

Foreground question components

Answer 5

“PICO”

Patient +intervention+ comparison + outcome

Question 6

Diagnostic PICO

Answer 6

P: describe the patient
I: new diagnostic test
C: gold standard test
O: condition to be detected

Question 7

Prognostic PICO

Answer 7

P: describe patient
I: prognostic factor
C: no prognostic factor
O: health state

Question 8

Harm PICO

Answer 8

P: describe the patient
I: exposure
C: lack of exposure
O: health state

Question 9

What is EBCP

Answer 9

Recognize problems, asking questions, evaluating and applying evidence

Question 10

Clinical research

Answer 10

• offers direct clinical applicability
• designed to replicate authentic/functioning environments
• direct solutions to practical problems
• theory based knowledge

Question 11

Basic science research

Answer 11

• little clinical relevance
• performed in controlled lab setting
• address theoretical issues

Question 12

6 Levels of the hierarchy pyramids

Answer 12

1. (Lowest-least) in vitro research
2. Animal research
3. Case series, case studies, surveys
4. Cohort studies, case control studies
5. RCT
6. Meta analyses, systematic reviews

Question 13

Likelihood of bias

Answer 13

1. Systematic reviews
2. RCT
3. Cohort studies
4. Case studies, case series
5. (Bottom- most bias) clinical experience

Question 14

Case control studies or cohort studies

Answer 14

Start with patients who have the disease
Match them with controls
Retrospective

(+) ethnically challenging diseases, rare conditions, limited resources

Question 15

Best study to show causation

Answer 15

RCT

Question 16

Meta-analysis or systematic review

Answer 16

Combines the results of many studies

Question 17

Sensitivity

Answer 17

Probability of a positive test in someone who has the disease

“PID”

In a 4*4 it’s the top left/ total left column

Question 18

Specificity

Answer 18

Probability of a negative test in someone who doesn’t have the disease

“NIH”

In a 4*4 it’s the bottom right/ total right column

Question 19

Positive predictive value

Answer 19

Probability that a patient with a positive test really does have the disease

In a 4*4 it’s the top left/ top row

Question 20

Negative predictive value

Answer 20

The probability that a patient with a negative test really does not have the disease

In a 4*4 it’s the bottom right/bottom row

Question 21

Positive likelihood ratio

Answer 21

ratio (+in disease/ total in disease)/ (+ no disease/ total no disease)

Question 22

What are examples of exposures

Answer 22

Survey, file review, interview

Question 23

Interpretation of + likelihood ratio

Answer 23

1: test is 5 times more likely in patients w/ disease than without

Question 24

Statistical Test to use if:

Describe one group

Answer 24

Normal: mean, SD

Non-normal: median

Question 25

Statistical Test to use if: | predict value from another measured variable

Answer 25

normal: simple linear regression or non linear regression | non-normal: non parametric regression

Question 26

Where do you look for prognostic factors

Answer 26

Table 1

Question 27

How to detect similar outcome?

Answer 27

Did they use the same method to measure what you are researching

Question 28

How to find if the follow up sufficiently complete?

Answer 28

Number of starters and follow up with are equal, usually a flow chart Was there enough time to see factors

Question 29

Risk ratio, odds ratio?

Answer 29

Rr= times | Odds ratio= association

Question 30

Paired groups vs unpaired groups

Answer 30

Paired- taking data from 1 patient in two instances, grouping two points of data Unpaired- not comparing groups of data

Question 31

Normal distribution of data matches what

Answer 31

A bell curve

Question 32

T test

Answer 32

Compares two groups Can be pried or unpaired Gives t value, but look at p value

Question 33

P value

Answer 33

Significant significance if p

Question 34

Mann-Whitney

Answer 34

Difference between 2 unpaired groups | Gives u p r values

Question 35

Wilcoxon test

Answer 35

Paired groups

Question 36

ANOVA

Answer 36

Compares 3 or more groups | Report f and p value

Question 37

Pearson test

Answer 37

Test of association

Question 38

Spearman

Answer 38

Test of association | Use with non normally distributed data

Question 39

Linear regression

Answer 39

Asses relationship between 2 or more variables to see if there is a prediction

Question 40

Doe def

Answer 40

Disease oriented evidence

Question 41

Poem def

Answer 41

Patient oriented evidence that matters

Question 42

Doe examples

Answer 42

Insight into patient physiology Of interest to health provider BP, reflexes, nervoscope

Question 43

Poem examples

Answer 43

Self reported by patient Of interest to patient and clinician Pain rating, level of function, quality of life

Question 44

Outcome measure examples

Answer 44

Pain, mental status, disability measurement tool, energy, etc

Question 45

What type of question do you use to find outcome measure

Answer 45

Background question

Question 46

Clinimetric properties

Answer 46

Reliability, validity, sensitivity to change, and internal consistency Don't try to make up your own outcome measure

Question 47

Outcome measure for pain

Answer 47

Quadruple vas | NRS

Question 48

Outcome measure for spine

Answer 48

``` Oswesty Bourne neck questionnaire Neck disability index Roland Morris scale Headache disability index ```

Question 49

Outcome measure for general health

Answer 49

Health status questionnaire

Question 50

Outcome measure for upper extremity

Answer 50

Upper extremity functional index

Question 51

Outcome measure for lower extremity

Answer 51

Foot ankle outcome score Hip dysfunction and osteoarthritis outcome score Knee and osteoarthritis outcome score Lower extremity functional scale

Question 52

Outcomes for general extremity

Answer 52

Rheumatoid and arthritis outcome score

Question 53

VAS

Answer 53

10 cm line | Please make a vertical line where your pain is at

Question 54

Vertical VAS works best for who

Answer 54

Elderly

Question 55

NRS

Answer 55

Scale 1-10

Question 56

Quadruple VAS

Answer 56

Pain right now? Typical or average pain? Pain at its best? Pain at its worst?

Question 57

Pain diagrams

Answer 57

Body and you color in where the pain is

Question 58

ODI

Answer 58

``` 10 sections of daily activity 6 choices in each Scored 0-5 Add each section for overall disability Multiply by 2 for % ```

Question 59

NDI

Answer 59

Neck disability | Modified ODI by Howard Vernon

Question 60

RMQ

Answer 60

Low back disability | 24 statements

Question 61

Bournemouth

Answer 61

7 items Each on scale of 10 Take total points and divide by 70%

Question 62

Headache disability index

Answer 62

2 subscales | Emotional and functional

Question 63

UEFI or LEFI

Answer 63

20 items Scored 0-4 Total score /80 x 100=% Score gets higher with lower pain

Question 64

Foot and ankle, hip dysfunction, knee, RA

Answer 64

6 areas- symptoms, stiffness, pain, ADL, sports/recreation, quality of life Scored 0-4 Total score /168 x 100=% Needs a change of 10% for meaningful improvement

Question 65

General Health Status Questionnaire

Answer 65

8 sub-scales of general health 2 summary measures overall score 3 individual diagnostic questions

Question 66

8 sub-scales of general health

Answer 66

physical functioning, role physical, body pain, general health, vitality, social functioning, role emotional, mental health

Question 67

2 summary measures

Answer 67

Physical health and emotional health