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Research Methodology (Using Evidence Based Medicine for Clinical Practice,…

- - - - Cochrane Library
        
        Systematic reviews and meta-analyses
        
        MeSH terms feature
      - EMBASE
      - PubMed
        
        Clinical Queries
        
        Clinical studies by categories
        
        MeSH Database
        
        Synonyms (keywords)
      - CINAHL/EBSCO
      - PEDRO
        
        Drop down menus for searching
        
        Type of therapy
        
        Body part
        
        Subdiscipline
        
        Research Method
      - PTNow
      - SportsDiscus
      - NARIC: REHABDATA
    - - AND, OR, NOT
    - - DynaMed
      - UoToDate
      - VisualDx
      - Drug info databases
        
        Lexi-comp
        
        Micromedex
        
        Natural Standard
    - - asterik, ?, $
  - - - <150 charaters
      - Use appropriate keywords
    - - Provide important information concisely
      - Structure: Intro/Background and Purpose, Methods, Results, Discussion/Conclusion
    - - Study Purpose
        
        IV and DV identifiable
        
        Population identifiable
        
        Application to PT practice
        
        Reflected in title
        
        Is the purpose stated clearly?
        
        Authors credentials
        
        Conflict of interest
        
        Authors affiliation
        
        Funding sources
      - Study Design
        
        design aligned with purpose
        
        Researchers/participants blinded
        
        Quantitative/Qualitative
        
        Describe/analyze correlation/analyze cause and effect
        
        Groups of people
        
        Single group (within subject)
        
        Greater than or equal to 2 groups (between subject)
        
        Direction of inquiry
        
        Cross-sectional
        
        Longitudinal
        
        Degree of control
        
        True Experimental
        
        Quasi-experimental
        
        Non-experimental
      - Study sample
        
        Sample size justified?
        
        Sampling process
        
        Group Division
        
        Method of allocation (random or non-random)
        
        Similarities between groups
        
        Representative of population
        
        Population described in detail
        
        Medical diagnosis
        
        Systems Review
        
        History: demographic, psychosocial and environmental
        
        Patient's desired outcomes
        
        Comorbidities explained
        
        Does it apply to your patient?
        
        Inclusion/exclusion criteria
        
        Biases
        
        Sample or selection bias
        
        Regression toward the mean
        
        Vounteer bias
        
        Measurement or detection bias
        
        intervention or performance bias
      - Research Protocol/Intervention
        
        Replicable and described in detail
        
        Frquency, intensity, time, type
        
        Reliability
        
        Chronology/missed sessions
        
        Where was study conducted? Same for all groups?
        
        Contamination
        
        Co-intervention
    - - Rationale for using test and measure
      - Levels of measurements
        
        Nominal, ordinal, interval, ratio
      - Reliability and Validity of each measure
        
        Instruments used (calibrated, reliable, valid, procedural reliability)
      - Frequency of measurement
    - - SE, MDC. MCID
      - drop-outs
      - Appropriate tables and graphs
    - - Relevant to purpose, methods, and results
      - Reproducable
      - Comparison to previosus studies
      - Identify limitations?
      - Further study needed?
      - Applicable to practice?
- - - - Prospective Retrospective
- - - - Probabilistic (Randomized
        
        Simple Random
        
        Systematic
        
        Statified
        
        Cluster
      - Non probabilistic (non-randomized)
        
        Convenience (accidental)
        
        Judgment/purposive
        
        Quota
        
        Snowball (network)
    - - Too many subjects = increase potential for risk and cost
      - Too few subjects = may fail to detect clinical important difference
      - What can effect sample size?
        
        effect size
        
        attrition
        
        sensitivity of the measures
        
        homogeneity of the population
    - - For Quantitative Studies :
        
        1) Define Population
        
        2) Determine eligibility criteria
        
        3) Select sampling method
        
        4) Determine sample size
        
        5) Determine operational plan
        
        1 more item...
    - - How to define a population
        
        target population
        
        accessible/source population
        
        sample
        
        inclusion criteria
        
        exclusion criteria
      - Definition
        
        Target population
        
        determined by sampling criteria
        
        Accessible population
        
        population available to researcher
    - - Sample: subgroup of the population
      - Sampling Frame: listing of potential subjects in accessible population
      - Sampling: procedure by which a sample of elements is selected from a population
  - - - Interviews
        
        Structured
        
        Un-structured
        
        Semi-structured
      - Open Ended Questions
      - Focus Groups
      - Observational Studies
      - Diaries, life histories, notes, letters, etc.
    - - Mail
      - Phone
      - Face to Face
      - Web/electronic
    - - Retrospective
      - Self-report
      - Observational
      - Bio-physiologic measures
  - - - primary goals
        
        create groups that are equally representative of the entire sample
      - secondary goals
        
        create groups of equal size
    - - By individual
      - By block
      - Systematic assignment
      - consecutive assignment
      - Matched assignment
  - - - chance that sample different from population
      - sample different from another even through drawn from same population
    - - due to mistake in acquisition of data
      - due to sample observation being selected improperly
      - due to selection bias
- - - - Histogram
      - Bar Chart
      - Stem and Leaf
      - Box Plot
      - Bar Charts
    - - Measure of Center
        
        Mean
        
        Mode
        
        Median
      - Spread
        
        Standard Deviation
- - - - Intra-rater reliability
      - Test-retest reliability
      - Computing comparison
        
        Standard Deviation
        
        Reliability coefficient
    - - Cronbach's Alpha
      - Split-half
    - - Inter-rater reliability
      - Cohen's Kappa
      - Intraclass Correlation Coefficient (ICC)
- - - - PICOTT
        
        Population
        
        Disease or condition
        
        Stage, severity
        
        Demographic characteristics (age, gender, ethnicity, etc)
        
        Intervention
        
        Therapeutic
        
        Diagnostic
        
        Preventative
        
        Compare
        
        Placebo
        
        No intervention
        
        What are you evaluating against the intervention?
        
        Outcomes
        
        Desired outcome to be evaluated
        
        Type of Study
        
        Type of question you are asking
        
        Diagnosis
        
        How to select or interpret diagnostic tests in order to confirm or exclude a diagnosis, based on specificity, sensitivity, likelihood ratios, expense, safety, etc.
        
        Therapy
        
        How to select treatment to offer patients that do more good than harm and that are worth the efforts and costs using them
        
        Prognosis
        
        How to estimate the patient's likely clinical course over time and anticipate likely complications of disease
        
        Etiology/Harm
        
        How to identify causes for disease
        
        Prevention
        
        How to reduce the chance of disease by identifying and modifying risk factors and how to diagnose early by screening
    - - Asked by novice
      - Address knowledge gap
      - Who, what, where, when, how, and why
  - - - Trial and error
      - Anecdotal Evidence/Experiential
- - - - Observer
      - Subject
      - Instrument
      - Environment
- - - - Cohort Design
      - Case-Control Design
      - General Features
        
        Degree of Control
        
        Moderate
        
        Minimal
        
        Maximal
        
        Time Frame
        
        Longitudinal
        
        Cross-Sectional
        
        Design Approach
        
        Experimental
        
        Quasi-experimental
        
        Non-Experimental
        
        Time Line
        
        Retrospctive
        
        Prospective
        
        Philosophical Perspective
        
        Qualitative
        
        Quantitative
      - Case-series
      - Case-report
      - Single Subject design
      - Randomized Control Trial
      - Systematic Review
      - Meta-Analysis