3 elements of evidence based practice
- best available data
- clinical competency/experience
- preferences and specific needs of the patient
distinction between odds ratio and risk ratio
risk ratio: the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group. RR of 1 = exposure does not affect risk.
- RR under 1 risk decreases, RR over 1 risk increases
odds ratio: strength of the association between two events, A and B
- OR over 1.5 small effect; OR over 4 large effect
2 types of clinical questions
- background (general knowledge, context)
- foreground (specific, linked to clinical situations)
the more expert we become, the more we ask foreground clinical questions
pyramid of evidence in research
Systems Summaries Synopses Syntheses Studies Foundational Resources
Syntheses 1. Meta-analyses 2. Systematic Reviews Studies 1. RCTs 2. Cohort studies 3. Case-controlled studies 4. Case-studies/reports
Foundational Resources
- textbooks, narrative reviews, etc.
difference between systematic and scoping review
- scoping skips the critical analysis portion. “scope” our the terrain. systematic is higher level of evidence.
what is the PICO research question method
population intervention comparison outcome time
difference of purpose of quantitative vs qualitative studies
quantitative:
- explain and predict
- conform and validate
- test theory
qualitative
- describe and explain
- explore and interpret
- build theory
RCT is a what type of study?
cohort / case-control / cross-sectional studies are what types of studies?
experimental study
- RCTs
- controlled/uncontrolled trials; w or w/o randomization
observational studies
- cohort study
- case-control study
- cross-sectional study
difference between types of observational studies
cohort studies
- incidence studies
- observe group w/o condition
cross-sectional study
- prevalence studies
cohort study
- find cause comparing group with condition to group without
validité (validity) vs fidélité (reliability)
validité / validity:
- does the test measure what it tries to measure
fidélité / reliability:
- are the results of the test stable (intra-rater; inter-rater; test-retest; internal consistency)
sensitivity and specificity
Sensitivity measures the proportion of positives from a test that are correctly identified
- (e.g., the percentage of sick people who are correctly identified as having some illness).
Specificity measures the proportion of negatives from a test that are correctly identified
- (e.g., the percentage of healthy people who are correctly identified as not having some illness).
