Final Exam | HTHSCI 3G03 Questions &
Answers(RATED A+)
Evidence-Based Medicine - ANSWERThe conscientious, explicit, and judicious use
of current best evidence in making decisions about the care of individual patients.
Evidence-Informed Practice - ANSWERRequires integration of individual clinical
expertise and patient preferences with the best available external clinical evidence
from systematic research and consideration of available resources.
The 3 Components of Critical Appraisal - ANSWER1) Internal Validity
The ability of study results to support a cause and effect relationship between the
treatment and the observed outcome
2) External Validity
The applicability of study results to patients
3) Precision
The degree of certainty that the findings are unlikely due to chance
Peer Review - ANSWERWhen other researchers and/or clinicians, and presumably
the editor of the journal have given their opinions on the merits of the journal. They
comment usually on the study design, the relevance of the topic to the clinical
community, and sometimes the power or precision.
The Hierarchy of Evidence - ANSWER
Pragmatic vs. Explanatory - ANSWER
Therapy Questions - ANSWERAddresses issues of benefit and are the most
commonly & widely-asked type of research question.
They are used to determine the effects of interventions/treatments on certain
outcomes.
Harm Questions - ANSWERSimilar to therapy questions in that they compare the
effects of interventions on patient outcomes; only, they focus on rare harmful events.
Diagnostic Validity Questions - ANSWERFrames the question in terms of the validity
of a new diagnostic test.
This question typically compares a new diagnostic method with an established one.
Risk Questions - ANSWERAsked to determine a population's risk of developing a
target condition or disease.
,Prognosis Questions - ANSWERAsked to determine the prognosis factors that
influence the course of a specific disease.
PICOT - ANSWERPopulation
Intervention
Comparison/Control
Outcome
Timeframe
Hypothesis - ANSWER- Are the researchers still working toward proof of concept or
do they want to use their results to make conclusions that are applicable to patients?
- Are the researchers seeking to replace usual care with an intervention they believe
will work better?
- Are the researchers seeking to replace an effective intervention with one that may
be less effective because it is less costly or more easily administered?
- Are the researchers seeking to declare that one intervention is interchangeable with
another intervention?
Equality Study - ANSWER- The new treatment is no different than the control
- Relies on the p value for interpretation
Superiority Study - ANSWER- The new treatment is better than the control
- Relies on a definition of "superiority" or "better than"
Non-Inferiority Study - ANSWER- The new treatment is no worse than the control
- Relies on a definition of "non-inferiority" or "worse than"
Equivalence Study - ANSWER- The new treatment is no better nor worse than the
control (i.e., equivalent to)
- Relies on a definition of "superiority" and "non-inferiority"
Health (WHO Definition) - ANSWER"A state of complete physical, mental, and social
well-being"
- Changes in concept as circumstances and experiences change
Indirect Measurement - ANSWERProxy or Surrogate Measurement
(e.g., bone mineral density, cholesterol level, BP, functional performance)
Direct Measurement - ANSWERPatient-Important Measurement
(e.g., quality of life, incident of events)
Measurement Properties - ANSWER- Reliability
, - Validity
- Sensitivity to Change
- Responsiveness
Purpose of Measurement - ANSWERTo assess for:
- Discriminative Outcomes
- Predictive Outcomes
- Evaluative Outcomes
Discriminative Outcomes - ANSWERUsed to discriminate or differentiate between
individuals
Some examples of how they're used:
- To determine eligibility for study participation
- To classify individuals as negative or positive for disease
Predictive Outcomes - ANSWERUsed to predict future events
Examples:
- Who is likely to succeed? (e.g., MCAT Test)
- Who is likely to have a bad outcome?
Evaluative Outcomes - ANSWERUsed to assess change, and most commonly used
to measure the effectiveness of an intervention.
Examples:
- Which treatment will effect the most weight loss?
- Which treatment will heal the wound the fastest?
Surrogate Outcomes - ANSWERBelieved to proxy or predict outcomes that are
directly important to patients.
- Appropriate for smaller, explanatory, or proof-of-concept studies
- Used to make strong recommendations for practice change, research studies
should report outcomes that are directly important to patients
Examples include:
- Performance-based tests (e.g., the 6-minute walk test — a proxy for mobility)
- Physiological tests (e.g., cholesterol level — a proxy for cardiovascular events)
Patient-Important Outcomes - ANSWERDirectly important outcomes to patients.
- Appropriate for larger, pragmatic, or real-life studies
- These research studies can make strong recommendations for practice change (or
not) depending on the study findings
Examples include:
- Quality of Life
- Death
- Rehospitalization
- Stroke/Heart Attack
- Recurrence, etc.
Answers(RATED A+)
Evidence-Based Medicine - ANSWERThe conscientious, explicit, and judicious use
of current best evidence in making decisions about the care of individual patients.
Evidence-Informed Practice - ANSWERRequires integration of individual clinical
expertise and patient preferences with the best available external clinical evidence
from systematic research and consideration of available resources.
The 3 Components of Critical Appraisal - ANSWER1) Internal Validity
The ability of study results to support a cause and effect relationship between the
treatment and the observed outcome
2) External Validity
The applicability of study results to patients
3) Precision
The degree of certainty that the findings are unlikely due to chance
Peer Review - ANSWERWhen other researchers and/or clinicians, and presumably
the editor of the journal have given their opinions on the merits of the journal. They
comment usually on the study design, the relevance of the topic to the clinical
community, and sometimes the power or precision.
The Hierarchy of Evidence - ANSWER
Pragmatic vs. Explanatory - ANSWER
Therapy Questions - ANSWERAddresses issues of benefit and are the most
commonly & widely-asked type of research question.
They are used to determine the effects of interventions/treatments on certain
outcomes.
Harm Questions - ANSWERSimilar to therapy questions in that they compare the
effects of interventions on patient outcomes; only, they focus on rare harmful events.
Diagnostic Validity Questions - ANSWERFrames the question in terms of the validity
of a new diagnostic test.
This question typically compares a new diagnostic method with an established one.
Risk Questions - ANSWERAsked to determine a population's risk of developing a
target condition or disease.
,Prognosis Questions - ANSWERAsked to determine the prognosis factors that
influence the course of a specific disease.
PICOT - ANSWERPopulation
Intervention
Comparison/Control
Outcome
Timeframe
Hypothesis - ANSWER- Are the researchers still working toward proof of concept or
do they want to use their results to make conclusions that are applicable to patients?
- Are the researchers seeking to replace usual care with an intervention they believe
will work better?
- Are the researchers seeking to replace an effective intervention with one that may
be less effective because it is less costly or more easily administered?
- Are the researchers seeking to declare that one intervention is interchangeable with
another intervention?
Equality Study - ANSWER- The new treatment is no different than the control
- Relies on the p value for interpretation
Superiority Study - ANSWER- The new treatment is better than the control
- Relies on a definition of "superiority" or "better than"
Non-Inferiority Study - ANSWER- The new treatment is no worse than the control
- Relies on a definition of "non-inferiority" or "worse than"
Equivalence Study - ANSWER- The new treatment is no better nor worse than the
control (i.e., equivalent to)
- Relies on a definition of "superiority" and "non-inferiority"
Health (WHO Definition) - ANSWER"A state of complete physical, mental, and social
well-being"
- Changes in concept as circumstances and experiences change
Indirect Measurement - ANSWERProxy or Surrogate Measurement
(e.g., bone mineral density, cholesterol level, BP, functional performance)
Direct Measurement - ANSWERPatient-Important Measurement
(e.g., quality of life, incident of events)
Measurement Properties - ANSWER- Reliability
, - Validity
- Sensitivity to Change
- Responsiveness
Purpose of Measurement - ANSWERTo assess for:
- Discriminative Outcomes
- Predictive Outcomes
- Evaluative Outcomes
Discriminative Outcomes - ANSWERUsed to discriminate or differentiate between
individuals
Some examples of how they're used:
- To determine eligibility for study participation
- To classify individuals as negative or positive for disease
Predictive Outcomes - ANSWERUsed to predict future events
Examples:
- Who is likely to succeed? (e.g., MCAT Test)
- Who is likely to have a bad outcome?
Evaluative Outcomes - ANSWERUsed to assess change, and most commonly used
to measure the effectiveness of an intervention.
Examples:
- Which treatment will effect the most weight loss?
- Which treatment will heal the wound the fastest?
Surrogate Outcomes - ANSWERBelieved to proxy or predict outcomes that are
directly important to patients.
- Appropriate for smaller, explanatory, or proof-of-concept studies
- Used to make strong recommendations for practice change, research studies
should report outcomes that are directly important to patients
Examples include:
- Performance-based tests (e.g., the 6-minute walk test — a proxy for mobility)
- Physiological tests (e.g., cholesterol level — a proxy for cardiovascular events)
Patient-Important Outcomes - ANSWERDirectly important outcomes to patients.
- Appropriate for larger, pragmatic, or real-life studies
- These research studies can make strong recommendations for practice change (or
not) depending on the study findings
Examples include:
- Quality of Life
- Death
- Rehospitalization
- Stroke/Heart Attack
- Recurrence, etc.
