What is Evidence Flashcards
Desirable Evidence
- should be prioritized by clinician to use the best available and relevant evidence
- research is emphasized due to ability to provide objective unbiased results
Forms of Evidence
- published research articles
- clinical practice guidelines
- patient/client records
- recall or prior patient/client cases
Research Design Overview
- design options that address bias
- randomization: techniques to distribute subjects into groups
- the use of more than one group in order to make a comparison
- controlled experiments manipulation of the subjects
- measures at the patient/client level
- systematic method for collecting and analyzing information
Research Designs-Timing
- prospective: follows subjects forward over a specified period of time
- retrospective: research design that uses historical data from sources such as medical records, insurance claims, or outcomes databases
- cross-sectional: research design that collects data about a phenomenon during a single point in time or once within a defined time interval
- longitudinal: research design that looks at a phenomenon occurring over time
Types of REsearch
- quantitative: measurement of outcomes using numerical data under standardized conditions
- qualitative: attaining a deep understanding of a phenomenon through narrative description
- experimental: (categories are true and quasi) manipulate and control one or more variables; observes the results
- non-experimental: descriptive or exploratory (tries to look at relationship between variables) in nature, do not have direct control over the studied variables
Research Design-What is the Question?
-the question posed for a study guides the choices about the research design
Evidence Hierarchies
-ranking schemes in which research designs are ordered from highest to lowest in terms of bias control
-intended to facilitate the efficiency of the evidence selection process
-details vary because research designs are dictated by the question posed
-systematic reviews of high quality studies are at the top of all traditional hierarchies
most bias control: experimental designs, then quasi-experimental designs, then nonexperimental designs, then case/report anecdote are on least bias control end of continuum
From Highest to Lowest Level-Treatment Benefits
- systematic review
- randomized clinical trials
- cohort studies
- case control studies
- case-series study
- expert opinion
Low Quality vs. High Quality Evidence
- inability to find high quality evidence should not discourage EBPT but rather reaffirm that clinical judgment and expertise are valuable in determining how to use lower quality evidence in clinical decision making
- strength of evidence depends on the scale against which it is being rated
- hierarchies are tools to facilitate EBPT
- PTs must read and critically appraise the evidence before using it in clinical decisions
- best available evidence must be relevant to the clinical question asked
Introduction/Background
- provides context (i.e. clinical issues)
- summarizes current knowledge: epidemiological data
- offers rationales for current research
- states purpose of current research (research problem)
- provides framework for study
- states hypothesis
Where do research topics/questions come from?
- clinical experience
- professional literature
- clinical theory:
- organize set of relationships among concepts or constructs: concept-observable phenomenon and expressed in words; construct: non observable abstract idea defined by observable measures
- small scale theories referred to as conceptual frameworks: Nagi, ICF
Concept
- mental image of an observable phenomenon described in words
- ex: age, fatigue, pain
Construct
- non-observable abstraction created for a specific research purpose that is defined by observable measures
- ex: patient satisfaction, quality of life, motivaition
Purpose
- description of phenomena
- prediction of future behavior
- explanation of why phenomena behave the same way that they do
Conceptual Framework
- describes relationships among concepts and constructs
- biologic plausability
