what does evidence based practice mean
- Refers to clinical practice that is informed by evidence about interventions, clinical practice and patient needs…
why would you want evidence based practice
- You need this evidence to be sure that you are doing good therapies
explain the limitations of statistical significance and the benefits of effect sizes as measures of clinical significance.
A statistically significant outcome indicates only that there is likely to be at least some relationship between the variables. it, does not provide information about the strength of the relationship (effect size) or whether the relationship is meaningful (clinical significance).
effect sizes tell us how large an effect is
explain which effect size measure belongs to which type of outcome.
- R family – used when both the independent and the dependent measures are ordered
- The d Family - These effect sizes are used when the independent variable is binary (dichotomous) and the dependent variable is ordered
- Measures of Risk Potency.- These effect sizes are used when both the independent and the dependent variable are binary
- odds ratio, risk ratio, relative risk reduction, risk difference, and number needed to treat (NNT)
- AUC. - the independent variable is binary but the dependent variable can be either binary or ordered
how effect sizes and measures of clinical significance can overcome the gap between research and clinical practice.
- Because they make it easier for clinicians to interpret the results of some study.
why an a priori power analysis is required in intervention research.
- To know how many subjects we should include to have a study that is poweful enough to detect an effect
explain how the power, alpha, effect size, and sample size are related to each other.
the larger the sample size the larger the power, the lower the alpha the lower the power if its not compensated wuth a large N
* Increasing sample size boosts power, making it easier to detect an effect, even if it’s small.
* Larger effect sizes make it easier to achieve higher power with a smaller sample size.
* Lowering alpha (e.g., from 0.05 to 0.01) reduces the risk of a Type I error but also decreases power, unless the sample size is increased to compensate.
* Increasing power requires either a larger sample size, a higher alpha, or a larger effect size.
In short, to maintain balance: small effects require large samples, low alpha reduces power, and power increases with larger samples or larger effects.
what are the shortcomings of RCTs
- selection criteria of clients - the criteria does not allow for comorbidity and other things that are usual in the population (low generalizabiloty, low varience)
- RCTs focus only on specific outcome - this might not capture cliens actual problems, the client wants to have ahigher quality of life not lower depression scores
2.b RCTs report effects on many outcome measures - which increases the probability of a significangt test - RCTs only focus on pre-post difference - it doesnt tell u how deos something work (mechanism)
what are the shortcomings of clinical practice
- overconfidence in clinical imoression and tailored interventions - reliance on gut feelings
- no systematic evaluation of treatments - difficult to determnine when to stop a treatmnet,
what are evidence based treatments
tratments that have demonstradef effectivenss in RCTs
what is evidence based practice
broade concept that involves integrating the best available research with clinical expertise and patient preferences
statistical significance
tells you if an observed result is likely to be real or just due to chance
clinical significance
focuses on weather t he effect has practical importance in a real world setting
