How many levels are in the Level of Evidence?
5 levels
What is considered as the gold standard?
Randomized control trial (RCT)
What is Level 1?
High quality prospective cohort study with adequate power or systematic review of these studies
Ex// Large RCTS with clear cut results
What is Level 2?
Lesser quality prospective cohort, retrospective cohort study, untreated controls from an RCT, or systematic review of these studies
Ex// Small RCTS with unclear results
What is Level 3?
Case control study or systematic review of these studies
Ex// Cohort and case control studies
What is Level 4?
Case series
Ex//Historical cohort or case control studies
Ex// case series, studies with no controls
What is Level 5?
Expert opinion; case report or clinical example; evidence based on physiology, bench research or “first principles”
Ex// case series, studies with no controls
What are the three clinical tasks that OT’s use research for?
- Identifying occupations and occupational performance patterns that are familiar to and values by specific client population
- age group, risk factors
- developmental milestones (dressing, sharing) - Selecting assessments and evaluation procedures
Ex/ PHQ9 -> proven to be valid - Planning intervention
Ex/ Boston marathon (research guides effective treatments)
What clinical task is Descriptive Research Evidence associated with?
Descriptive - Identifying occupations and occupational performance patterns that are familiar to and valued by a specific client population
What clinical task is research evidence Intervention associated with?
Intervention - Planning intervention
What clinical task is research evidence Assessment associated with?
Assessment - Selecting assessments and evaluation procedures
What makes Descriptive research?
- Presentation of problem - how often and when does a particular clinical disorder or impairment cause the profile I see in my client?
- Clinical presentation - what is/are the most common symptoms, complications and challenges someone with this order experiences?
- Causes of problem (Etiology): What are the likely causes of the challenges my client is having?
- Prognosis: What is the likely clinical course and outcome for my client over time?
—> use literature to guide our responses - Comparison group: What are the roles, occupations, and abilities of a comparative population or the advantages/ disadvantages of a similar assessment tool?
What makes Assessment research?
- Evaluation of the problem: What are the most reliable and valid methods relevant to assess occupations and occupational performance i the target population?
What is Reliable?
Measure multiple times to the same person there will be the same result
What is Valid?
Measures what it intends to measure
What makes Intervention research?
- Therapy: Which of the available intervention option is likely to do more good than harm? Which of the available interventions is most likely to produce the most favorable outcomes?
- Prevention: What potential intervention could minimize this clients risk? (Ex. Hand splints)
- Client experience: What is the client’s understanding and meaning of the illness/injury? What are the client’s perceptions of his/her participation, long term occupational performance and influencing factors?
What is the first step in the research process?
Step 1: Formulating the PICO question
What does the P in PICOT stand for?
P = persons, population, patient, problem’s characteristics
What does the I in PICOT stand for?
I = intervention, assessment tool, descriptive information (increasing participation)
What does the C in PICOT stand for?
C = comparison intervention, control group, comparison assessment tool (is not always included)
What does the O in PICOT stand for?
O = outcome.
- Patterns of occupational performance (descriptive)
- Description of target population (descriptive)
- Reliable and valid methods of assessment (assessment)
- Effective interventions for increasing participation in satisfying daily life activities (intervention)
What does an Intervention Question look like?
Is 1:1 peer-mentoring more effective than weekly support group for reducing depressive symptoms in young adult males diagnosed with SCI?
What is the steps of a literature search?
Research question —> literature search —> refine research question —> literature search —> research methodology
What is Plagiarism?
Plagiarism is presenting another’s person’s words or ideas as if they were your own and not citing the source.
