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DPT 781 Research in Physical Therapy > Research Design > Flashcards

Research Design Flashcards

1
Q

Research Design

A
  • analogous to PT plan of care
  • details re:
  • methods by which investigator will interact with subjects
  • timing of interactions
  • total length of time of study
  • type of outcomes to be measured
  • extent to which unwanted influences can be minimized
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2
Q

General Features of Research Design

A
  • approach-paradigme: qualitative or quantitative
  • study design
  • grouping of subjects
  • control components: minimize bias
  • time elements
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3
Q

True Experimental, Quasi Experimental, and Non Experimental Approaches

A
  • true: randomized, 2+ groups, manipulation
  • quasi: non-randomized, 1+ groups, manipulation
  • non: no manipulation, may only have 1 group, non-random assignment (predetermined based on naturally occurring subject characteristics), observational studies
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4
Q

Random Selection vs. Random Assignment

A

-????

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5
Q

Chart

A
  • review table 5.1 in Jewel

- know this chart

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6
Q

Quantitative Research Paradigm

A
  • assumptions: investigator and object of study are independent
  • causes and effects can be determined and differentiated
  • objectivity (value-rree)
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7
Q

Qualitative Research Paradigm

A
  • assumptions: investigator and subject are interdependent
  • impossible to distinguish between causes and effects
  • subjectivity (value-bound)
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8
Q

Design Elements: Purpose-Descriptive

A
  • to describe a variable of interest without manipulation of the subjects
  • ex: what is the functional status of patients at intervals following TKR?
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9
Q

Design Elements: Purpose-Relationship

A
  • analysis of relationships

- ex: what is the relationship between knee ROM and functional status at intervals following TKR?

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10
Q

Design Elements: Purpose-Differences

A
  • analysis of differences
  • ex: what is difference in functional status at hospital discharge between patients who receive PT twice a day and patients who receive PT once a day following TKR?
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11
Q

Variables

A
  • represent a concept
  • can have more than one value or level
  • 3 main: dependent, independent, extraneous (bias in study, factors you can’t control)
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12
Q

Independent Variable

A
  • aka factor or predictor
  • intervention studies: the presumed cause of (or influence upon) a measured effect; variable that is manipulated
  • predictive validity and prognosis studies: variable that is presumed to predict an outcome of interest
  • level: number of forms or values the independent variable takes in a study. ex treatment group: heat/exercise, manual therapy, HEP so this is 1 independent variable with 3 levels
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13
Q

Dependent Variable

A
  • outcome of interest

- variable that is hypothesized to be caused or predicted by the independent variable

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14
Q

Extraneous Variable

A
  • confounds relationship between independent and dependent variable
  • need to be anticipated and controlled for if possible
  • also those that you can’t control
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15
Q

Design Elements-Groups

A
  • between subjects design: comparison of independent groups of subjects, measures are compared between 2 or more groups (subject appears in only one level of independent variable)
  • within subjects design: repeated measures within same subjects, individual baselines measures are compared to subsequent measures
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16
Q

Design Elements-Control

A
  • bias: results that systematically deviate from truth
  • control options: subjects, equipment, environmental conditions, testing and/or training administration, data collection and recording, communication
17
Q

Design Type-Degree of Control

A
  • experimental is maximal
  • quasi is moderate
  • non is minimal
18
Q

Research Designs-Questions About Interventions

A
  • can be experimental or quasi-experimental
  • prospective
  • may be cross-sectional or longitudinal
  • efficacy: intervention produces outcome under ideal conditions
  • effectiveness: intervention produces outcome under usual clinical conditions
  • treatment must precede outcome of interest
  • randomized clinical trial: at least 2 comparison groups, random assignment, blind study, possibly double blind, large subject pool preferred
  • factorial design: number of independent variables is included-single factor (one-way, effect of 1 IV), two factor (effect of 2 IVs as well as interaction with one another), multi-factor > 2 IVs
  • single system design: not a case report, controlled manipulation of an IV, standardized, repeated measures methodology, at least two levels of IV, n=1, patient is his/her own control, conducted prospectively
19
Q

Design Options

A
  • A-B: A=baseline phase, B=treatment phase
  • does not control for concurrent influenced during treatment phase
  • A(1)-B-A(2): A(2)=withdrawal phase, can be used to assess duration of effects as well as to tease out extraneous influences, assumes effects are reversible, ethical considerations
  • can only compare adjacent time phases
20
Q

Group vs. Single-System Design Limitations

A
  • group: power-sample size, subjects comparable on DV at start, large differences between groups at finish-measurement, external validity, practicality
  • single system: ethical considerations-treatment delays, treatment withdrawal, costs of care-internal validity, external validity, statistical analysis
21
Q

Quasi-Experimental Designs-Questions About Interventions

A
  • time series design: single group, repeated measures over time, before and after experimental intervention
  • non equivalent control group design: naturally occurring groups, baseline characteristics unlikely to be equal between groups
22
Q

Research Designs for Questions About Diagnostic Tests and Clinical Measures

A
  • designs are usually non-experimental and cross-sectional
  • determine measurement validity and reliability for variable of interest and compare to the “gold standard” or “reference standard”
  • random assignment is not a priority since subject must have the condition under study
  • clear delineation and application of subject selection criteria
  • protocols to ensure consistency in all procedures
  • verification of examiner’s competence in performing test of interest
  • identification of a “gold standard” as a basis for comparison
  • masking examiners from subject grouping or test result
23
Q

Methodological Studies of Clinical Measures

A
  • development of new or modification of existing measurement instruments
  • non experimental
  • often cross-sectional but can be longitudinal if objective is to detect change over time
  • repeated administrations determine reliability
  • comparison to a superior instrument determine validity
  • control achieved by: subject selection and recruitment, protocols for development and administration of instruments, statistical adjustment to counter extraneous factors
24
Q

Research Designs for Questions About Prognostic Factors

A
  • designs assess relationship between prognostic factor and outcome
  • nonexperimental
  • control achieved through subject selection and statistical adjustment
  • causal links between prognostic factor and outcome factor CANNOT be established directly
25
Q

Cohort Designs

A
  • used for questions about prognostic factors
  • same group of subjects followed over time, additional groups can be used for comparison
  • group shares common characteristic
  • observational descriptive designs provide results to statistical analysis of relationship between prognostic factor and outcomes
  • time to ensure outcome occurs is essential
  • studies may be prospective or retrospective
  • prospective studies have more control
  • retrospective studies assure outcome has occurred
26
Q

Case-Control Designs

A
  • retrospective approach
  • subjects with outcome are compared to a control group known to be free of outcome
  • goal of study is relative frequency of exposure to the prognostic factor-risk factor identification
27
Q

Research Designs for Clinical Prediction Rules

A
  • CPR studies are non-experimental
  • intended use determine specific features
  • diagnostic CPR will have features of diagnostic test studies, as will intervention CPR have features of intervention studies
  • as CPR develops, methods to identify clinical indicators will also change to those allowing more control
28
Q

Research Designs for Outcome Research

A
  • focuses on impact of clinical practice in real world, i.e. end of results care
  • nonexperimental designs, primarily observational format with less control features
  • results reflect real-world conditions with confounding conditions
  • used as basis for assessing quality of care across settings and disciplines
  • frequently retrospective in approach, may be cross-sectional or longitudinal
  • multiple groups with differing characteristics can be used
  • self-reported outcome measures used for studies about disability, health status, satisfaction, or quality of life: operational definitions and development procedures for the measure must be considered
29
Q

Secondary Analyses

A
  • reports that study other studies
  • narrative reviews: analyze individual studies-a low level of evidence
  • systematic reviews: true research studies with defined designed features-the highest level of evidence (Cochrane Collaboration is best known source, PEDro also has PT related reviews)
  • design elements and controls:…
  • specific research question
  • inclusion and exclusion criteria for studies
  • elaborate and thorough search strategies
  • standardized review and abstracting protocols and trained reviewers
  • pre-established quality criteria to rate value of individual studies (hierarchies)
30
Q

Meta-Analysis

A
  • form of systematic reviews
  • emphasis on pooling data for additional statistical analyses
  • pooling increases sample size and statistical power of analysis
31
Q

Qualitative Studies

A
  • focus on subject’s thoughts, perceptions, opinions, beliefs, and/or attitudes
  • data reported in narrative rather than statistical format
  • data collection methods include interviews, surveys, diaries, observations, etc.
  • results focus on themes or patterns of data

DPT 781 Research in Physical Therapy (8 decks)

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