Chapter 3- Evidence-Based Practice
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| What is the need/demand for evidence-based practice? | Patients are increasingly demanding practitioners use the most effective interventions for a faster and/or most cost-effective recovery; third-party payers are demanding that health care providers use the most cost-effective interventions
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| What is evidence-based practice? | a method if integrating the best available evidence and patients' values into the scientist-practitioner's clinical decision-making.
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| What are the first two major levels of the evidence hierarchy? | 1a. systematic reviews and meta-analyses of RCTs 1b. single RCT studies 1c. all-or-none studies 2a. systematic reviews of cohort study 2b. individual cohort study or low-quality RCT 2c. outcomes research
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| What are the last three major levels of the evidence hierarchy? | 3a. Systematic review of case-controlled study 3b. individual case-controlled study 4. case series and poor quality cohort and case-control studies 5. expert opinion without explicit critical appraisal
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| What four considerations need to be addressed to assist the S-P in formulating the patient care question? | (PICO) Patient characteristics, Intervention, Comparative intervention, and Outcomes
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| How is construct validity determined? | By how well the study controls for experimental bias and expectations
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| What 3 criteria are included in a good operation definition of the IV or DV? | 1. measurable, 2. clear, 3. complete
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| With what is internal validity concerned? | how well a study design controls factors or variables other than the intervention or IV for its influence on the study's results
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| With what is external validity concerned? | how well the study results can be generalized in its application to populations similar to those in the study, or to a setting similar to the study setting
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| What does statistical validity address? | the statistical relationship of the IVs and DVs.
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| What three aspects are emphasized when evaluating research by the EBP model? | 1. a study's validity, 2. a study's impact, 3. a study's clinical applicability
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| What are some of the limitations of evidence-based practice? | EBP emphasis on RCT studies as the 'gold standard' is misleading, not all RCTs are better than alternative designs; RCT may not be the best design for methodological reasons; RCT results are based on group averages, but pt may not be represented by avg
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