Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
PICO & Evidence Lvls
PICO & Levels of Evidence Information
| Question | Answer |
|---|---|
| Systematic Reviews of Randomized Control Test (Study) | Has internal controls, comparing many studies |
| Individual Randomized Control Test (Study) | Has internal controls, one study |
| SR & Individual RCT’s Cohort Study | Has bigger group; more generalized. May apply to your pt. |
| Outcome Study | Has a lot of people with specific outcome. Control people, measurement |
| SR of Case Control | Compares many studies of general information |
| Individual Case Study (clinical) | Gives value to the individual but not to majority population |
| Case Series | More control but not a lot |
| Expert Opinion | Value but limitations |
| Inclusion criteria | Anything the pt had that allowed them to be included in the group |
| Exclusion criteria | Anything someone in the inclusion group has that excludes them from the study |
| Subject reimbursement | Payment from participating in the study |
| Signing waivers | Pt signs so they are aware they are in a trial |
| Blinding | Can’t know any details, no Tx ,recording, or recipient bias |
| Recorder reliability | (Repeating measures) giving testers practice and training before the study |
| Research approval | From powers that be |
| Randomization | Different levels of dividing the group up so that it is random |
| Statistically sound study | Must have 30 or more people in it |
| Intention to treat (ITT) | Report the reason that any person dropped out of the trail (Proof that it wasn’t the treatment that caused the person to drop out or die before the trial ended) |
| Confounding variables (CV) | Factors that could make the study better or worse; Can’t control everything |
| Name some confounding variables | Ex. Hip replacement, Atrophy, Time of Day ** very important for stretching**, Current or past activities, Diet/meds, Arthritis, Socioeconomics, Male/female, Ages, Co-morbidities; steoporosis, diabetes, Diseases, Cooperation of patient, Family influences |
| Foreground Question (4 components): | P – Patient (everything) problem (everything) population I – Intervention (what was studied) C – Comparison (treatment or placebo) O – Outcome (SPECIFIC!!!) Return to work |
| PICO Example: | P- 55ylo, female, hemo stroke I- Retro Gait C- Standard rehab vs standard rehab + retro gait O- Increase gait skills; decrease assistance and decrease assisted device in 3 weeks |
| Places to look for Journal info: | ProQuest & medline – web sites; CINAHL – Journal directory; Cochran Database – only SR (compare pt with MANY studies); APTA – has all available for free if you are a member |
| External Validity | The truth of information gathered matches the patient you are treating (actual clinical practice) |
| Internal Controls | Things that make a study more valid; -If confounding variables are too great, we can use the study with conditions (monitor more often) - if not doing treatment, come up with what treatment you will do instead - how effects outcome |
| Evidence Based Practice (EBP) | Clinical expertise w/patient's values & best research available. Patient always decides what the best option for them is once given the choices. |
| List the levels of evidence: | 1. SR of Randomized Control Test (Study); 2. Individual Randomized Control Test (Study); 3. SR & Individual RCT’s Cohort Study; 4. Outcome Study 5. SR of Case Control; 6. Individual Case Study (clinical); 7. Case Series; 8. Expert Opinion |
| List the internal controls: | 1. Inclusion criteria; 2. Exclusion criteria; 3. Subject reimbursement; 4. Blinding; 5. Research approval; 6. Randomization |
| What is another name for Foreground Question (4 components)? | PICO |
| Ideally, these people should always be” blinded” | 1. Patients 2. Treating Clinicians 3. Data Collectors 4. Data Analysts |
| 1. Patients 2. Treating Clinicians 3. Data Collectors 4. Data Analysts Should be blinded in all SR & RCT's? | Yes, but **Not usually possible in PT** |
| True or False - If ITT is not done it can cast doubt on the study | True, if ITT is not done it can cast doubt on the study |
| How do you translate the evidence into practice? | 1. Generate evidence from research 2. Synthesize evidence 3. Develop evidence based clinical policies 4. Apply the policies |
| For EBP, what your given: patient circumstances, patient value, and the evidence...whats your best option? | Where they overlap is the best option (1. Patient circumstance 2. Patient values 3. Evidence) |
| Evidence Based Practice (EBP) | Integration of clinical expertise w/ the pt values & the best available research evidence to ensure optimal outcomes |
| Goal of EBP | Improve clinical performance through critical evaluation of the current evidence |
| In randomization, name some extraneous variables | Patient, age, race, gender, symptom duration, condition severity, comorbidities, intellectual status, motivation, & treatment expectations. |
| How can you avoid bias from the investigators in allocating to groups? | Do in this order: informed consent, enroll in trial, sealed envelope from locked file cabinet to reveal group assignment |
| True or False - It may still be possible to use the patient data set using an ITT approach | True, It may still be possible to use the patient data set using an ITT approach |
| Validity of Systematic Reviews | We must distinguish SR’s from unsystematic “literature reviews” where the authors survey published literature w/o explicit search or selection criteria |
| 4 key validity issues of SR | -Address PICO,explicit/sufficiently narrow in scope -Search for relevant studies should be detailed, exhaustive & fully revealed -Use/report explicit criteria for assessing methodologic quality -Adequate reliability btwn 2 or more assessors should be told |
| What does PICO stand for? | Patient, Intervention, Comparison, and Outcome |
| Background questions are developed to? | Enhance knowledge relative to a specific disorder |
| Reliability (intra- and inter- tester) | The extent to which an experiment, test or measuring procedure yields the same results on repeated trials |
| What is the difference between intra- and inter- tester | Intra - one person doing testing, 7%. Inter - two people doing testing, 15%. |
| Difference between internal & external validity | Internal validity - Benefit of the Tester & External validity - can NOT control |
| Identify 3 considerations of the patient and research in order to make clinical application judgement | 1. Patient circumstance 2. Patient values 3. Evidence |
Created by:
srussel
Popular Physical Therapy sets