Evidence Based All Chapters Review

Name two key features of descriptive research studies.

a) No manipulation of the situation (data collected under natural conditions) b) Collect structured data

Describe two limitations of randomized experiments

a) Results are averages, thus don't reflect the unique of persons b) Patients in study may not be like patients seen in regular practice because of study inclusions and exclusions c) Patients not in the study may not respond like study patients (Hawthorne effect) d) It may be difficult to deliver the intervention consistently as was done under the controlled circumstances of the study.

Name and describe the three types of systematic reviews (SRs)

a. Meta-analyses is summarizing research findings uses statistical techniques to combine the results of studies from several or many studies b. Meta-synthesis combines results or findings from several or many qualitative studies c. Integrative research review is a narrative summary of past research in which the reviewer extracts findings from original studies and uses analytical reasoning to produce conclusions about the findings of a body of research.

Appraise: When you know the Level of Evidence for a study, you know a. the study was approved by the ethics committee or similar approving body, such as the IRB. b. the relative bias and rigor of the study. c. that the researchers wrote a hypothesis for the experimental study performed on an adequate sample. d. the strength and direction of any correlations found between study variables

b. The Level of Evidence tells the relative bias and rigor of the study.

Appraise: In which of the following research report sections will you most likely find information to assist in your appraisal of the research report? a. introduction/background b. methodology c. results/findings d. discussion e. conclusion

b. The methodology tells how the study is done, so you can know how reliable it is.

Ask/analyze: Which of the following items is needed to make a case for a project (background) and evaluate your intervention/comparison intervention (analysis)? a. money b. time c. permission/approval from the IRB d. data e. quality improvement committee

d. while of of these (except maybe e) are needed, to make a case, there must be proof, i.e., data

The guideline document should show a clear _____________ between ____________ and the recommendations.

linkage, evidence

Briefly, what is evidence-based practice?

the incorporation of research evidence and other forms of trustworthy clinical evidence into clinical care design

Give an example of a clinical practice guideline with a fairly narrow scope.

A guideline with a fairly narrow scope would address a single issue, not multiple issues. E.g., management of wandering in persons with dementia or Alzheimer's disease.

Name three key features of good experimental studies and describe what researchers do to achieve each.

A well-defined target population (inclusion and exclusion criteria), Adequate sample size (power analysis), Random assignment of participants to intervention and comparison groups (chance assignment and check on randomization), Control of extraneous influences and bias (study design and monitoring), Consistent delivery of interventions (intervention protocols and check on delivery), Low level of missing data (check for a pattern to missing data)

Which of the following topics would most likely use qualitative research methods? A) Attitudes toward mammography of postmenopausal women B) Predictors of success on NCLEX-RN among adult learners C) Incidence of breast cancer in African American women D) Effect of maternal diabetes on birth weight of postmature infants

A. ATTITUDES

In the results section of the research report, data that are aggregated means that A) the data are reported for the entire sample. B) the data are raw data. C) the data represent diversity in the sample. D) the data are reported for each individual.

A. Aggregate-verb-to form or group into a class or cluster.

Which of the following symbols represents the null hypothesis? A)Ho B) H1 C) Hy D) H2

A. Apparently "Ho" is a null hypothesis... I have no idea why.

One goal of the results section of the research report is to A) describe or explain the phenomenon of interest. B) make a conclusion based on the evidence. C) recommend topics for future research based on findings. D) describe the method used to choose subjects for the study.

A. Conclusion section is for conclusions (duh), recommendations are in the discussion, and method is in the method. Describing or explaining the phenomenon of interest is the only one in the results

Studies with problems in internal validity automatically will have problems with A) external validity. B) instrumentation. C) mortality. D) reliability.

A. If it is not true for the group, it will not be true for everyone either.

The statement "Man is an open system that constantly interacts with his environment" is an example of a A) theory. B) research problem. C) hypothesis. D) conceptual framework.

A. It has not been proven or disproven but there is strong evidence.

The question, "Is a criterion-referenced measurement tool a valid and reliable indicator of clinical nursing competence?" would most likely appear in which of the following sections of a research report? A) Introduction B) Methods C) Results D) Conclusions

A. It is the question

The statement "Preliminary findings underscore the need to explore ethical issues in the area of genetic counseling for families with multifactorial genetic conditions" would be an example of A) implications for future research. B) conclusions based on the data. C) results of statistical analysis. D) a summary of the findings.

A. It talked about future use for the studies

Observing and protecting the five rights of human subjects participating in a research study is the primary responsibility of which of the following: A) The researcher B) The subject C) The institutional review board D) The institutional ethics committee

A. Learned this/remember from test.

Select from the following kinds of data those that would require the use of nonparametric statistics? A) Marital status, gender, and level of education B) Weight, temperature, and pulse C) Income, PPD status, and religion D) Ethnicity, IQ, and zip code

A. None of those are continuous

Researchers must look after the rights of their human subjects. Which of the following organizations identified the five human rights in research? A) American Nurses Association B) Canadian Nurses Association C) National League for Nursing D) American Federation of Nurses

A. Remember from 215

Which of the following aspects of a study would be possible limitations on the usefulness of the results? A) The sample, the research design, the methods B) The conclusion, the discussion, the summary C) The population, the intervention, the control D) The setting, the method, the analysis

A. Sample can be too specific.

Simple random sampling differs from systematic sampling because A) subjects are selected using a table of random numbers. B) subjects volunteer for either a control or experimental group. C) subjects are selected by choosing every 10th person. D) all subjects are selected for inclusion in the study.

A. Takes the least work I guess

The larger group of persons about whom the researcher hopes to gain an understanding or knowledge refers to A) study population. B) sample. C) cohort. D) control group.

A. That is the large group that it will apply to

Which of the following is a common error found in research reports? A) Overinterpreting the results B) Including an abstract C) Writing a summary D) Drawing conclusions from results

A. The others are what are supposed to be done.

Measures of central tendency and distribution that summarize information about a variable are examples of A) univariate statistics. B) bivariate statistics. C) multivariate statistics. D) none of the above.

A. There is only one variable we are looking at.

Increasing the sample size would most likely result in A) increasing the statistical significance of the findings. B) decreasing the number of variables studied. C) increasing the use of complicated statistical procedures. D) decreasing the validity and reliability of the findings.

A. There will probably be more times that the phenomenon happens in the intervention group, so it increases the statistical significance.

In order to develop evidence-based practice, nurses must be able to: A) critically read and use research intelligently B) organize and perform clinical research C) make decisions about patient care delivery D) use an experiential base to provide care

A. They do not need to do the research themselves or anything. They just need to be able to understand research

When there is not enough information available from previous research to support a theory or to provide convincing evidence of a relationship then current researchers must realize that their study cannot A) make predictions or manipulate variables. B) rely on the literature review to define their problem. C) apply their findings to clinical situations. D) find a large enough sample to yield sufficient data.

A. You cannot make predictions without previous knowledge.

In nursing, the systematic gathering of information to gain, expand, or validate knowledge about health describes which of the following activities? A) research process B) evaluation report C) reporting evidence D) accounting for results

A."Gathering"

Give an example of two variables that are likely to have a moderate to strong negative correlation (inverse relationship).

Age and agility in people over age 65, Body weight of 20 species of carnivores and the number of them, Number of years tobacco has been grown on a plot of land (without fertilization) and soil depletion level of the soil, Number of foot and bicycle policemen in a district and the number of muggings

Give an example of two variables (from life in general) that are likely to have a moderate to strong positive correlation.

Age and weight in children ages 5-15, Weight of a car and its horsepower, Number of teenagers in a household and average daily minutes of phone usage

What would make the conclusions of an SR clinically significant?

The conclusions involve recommendations, conclusions, or findings that are sizable enough or important enough to make a difference in patients' well-being, recovery, health, experience of health care, or death.

Name three of the four features considered when a EbCPG panel evaluates a body of evidence

The consistency of the findings across studies, The quality of the individual studies, The number of studies addressing the issue, Design of the studies, The precision of the estimate of the treatment effect in the population, Number of patients studies and subgroups studied, Directness of the evidence relative to the question of interest

What is external validity?

The extent to which the findings of a study would be likely to hold up beyond the sample included in the study analysis—also called generalizability.

What is the major weakness of cohort studies?

The major concern in cohort studies is that the two groups could be different in some way other than the presence or absence of the risk factor, and that difference may produce different outcomes for the two groups.

What are systematic reviews and what purpose do they serve?

SRs are reviews of all relevant and retrievable studies about an issue or question. The goal is to identify important findings from each study and then looking across studies to identify findings supported by more than one study or the factors that produced differences. This produces a summary of what is know about the issue.

Give a one to two sentence definition of validity.

Specify an assumed population. Identify an available sample of present and/or future persons who are presumed to be members of the assumed population. Collect data from the available sample.

Give a one to two sentence definition of reliability.

Start with a list of all members of the actual population. Randomly draw a sample of pre-determined size. Conduct the study with the sample.

What does r2 indicate?

The proportion of variability in a variable that is due to its association with another variable. r2 varies between 0 and +1 but also may be expressed as a percentage.

When is cohort design used?

To study risk factors because random assignment to comparison groups is not possible.

A researcher who wanted to determine whether education, age, and gender were related to smoking cessation might use a method of statistical measurement called A) ANOVA. B) regression. C) Pearson product-moment. D) Spearman rho.

B.

Which of the following statements is true regarding the research process? A) It always progresses in a linear fashion. B) The steps of the process may overlap. C) Certain parts of the process are unnecessary. D) Both "a" and "b" are true; "c" is not true.

B. All parts are necessary, does not always progress in a linear fashion BECAUSE steps can overlap.

Which of the following statements describes the purpose of the discussion section of a research report? A) It analyzes the relationship between the variables named in the study. B) It summarizes, compares, and speculates about the results of the study. C) It verifies the results of other studies in comparison with this study. D) It creates a picture of some aspect of health reflected in the study.

B. Analyzing is in findings, it does not verify with other studies, and does not create an aspect of health. It does summarize, compare, and speculate though.

Which of the following is a potential problem with the background and literature review? A) Using articles from refereed journals B) Using articles that are more than 5 years old C) Using mostly primary sources D) Including adequate referencing for material used

B. Articles more than 5 years old can have outdated information.

The detailed plan for addressing the problem or gap in knowledge, the second step in the research process, is documented in which section of the research report? A) The literature review B) The methods section C) The introduction D) The recommendations section

B. Background then methods.

Which of the following statements best describes the research design? A) It is the type of research question being asked. B) It is the overall plan for acquiring new knowledge. C) It is an explanation of the rigor of the study. D) It represents the null hypothesis.

B. Because you answer a question

Strengths of a convenience sample are that it A) enriches the data because it includes persons with experience. B) is easy and inexpensive to acquire. C) does not allow bias to enter the sample. D) is representative of the population of interest to the study.

B. Duh.

One of the potential problems with the process of sampling occurs when subjects become unavailable to the researcher for various reasons. Subjects who individually decide not to continue their participation are said to A) become lost to follow-up. B) withdraw from the study. C) provide incomplete data. D) be excluded from the study.

B. Fact.

The conscious and intentional use of research and theory-based information to make decisions and answer clinical questions about patient care delivery is referred to as: A) research utilization review B) evidence-based practice C) systematic review options D) quality assurance review

B. It is practice because it is being used in care

When a researcher concludes that a particular result in the study is unlikely to have happened by chance alone, that finding is said to A) probably be important in future studies. B) be statistically significant in this study. C) guarantee the results will happen again. D) reflect a normal distribution of values.

B. Lower p value

The statement "Individuals have the right to nondiscriminatory selection for participation in a study" refers to which of the following rights of human subjects? A) The right to privacy B) The right to fair treatment C) The right to confidentiality D) The right to self-determination

B. Nondiscriminatory=fair treatment

The fifth step of the research process is represented by which of the following? A) The recommendation section B) The research report C) The methods section D) The literature review

B. Once the research is finished, the report can be written, the rest are part of the research.

The institutional review board addresses the subjects' right to fair treatment by reviewing the A) proposed statistical analysis methods. B) researcher's plan for recruiting subjects. C) procedures for acquiring the data of interest. D) description of compensation given to participants.

B. Only thing with subject and it should be fair

Which of the following is the most important consideration affecting the development of a detailed research plan? A) The sampling plans used in previous studies B) Subject safety and rights in this study C) Available resources and settings D) Meticulous documentation of data

B. Safety and hand washing are the nursing school equivalent of answering "Jesus" in Sunday school.

Conclusions from a research study can be powerful because they A) represent the findings of the study. B) are used to guide nursing practice. C) create evidence-based practice. D) debate the meaning of the results.

B. They suggest what to do.

The statement "Statistical analysis included factor analysis, item analysis, and cut-score" would most likely be found in which section of the research report? A) Introduction B) Methods C) Results D) Conclusions

B. They were saying the method of how they got the analysis

The term used to describe the extent to which the findings of a study are confirmed by or are applicable to a different group is A) creditability. B) transferability. C) confirmability. D) applicability.

B. Transfer is being able to apply it in more places

In which of the following information sources would a nurse be most likely to find a primary research report? A) Psychological Abstracts B) CINAHL C) The card catalog D) http:://www.altavista.com

B. We use CINAHL and it's the only one that is the full article

In nursing, the major sources of research problems are A) clients and illness. B) practice and theory. C) literature reviews and abstracts. D) integrated process.

B. You see problems in practice that need better solutions and theories that need to be explored further

Terms commonly used to describe the process of implementing the research study are A) problem, theory, hypothesis. B) measures, sample, procedures. C) themes, significant, multivariate. D) limitations, recommendations, implications.

B. measures, sample, procedures.

Creating order or organizing information about several variables in a research study is called A) univariate analysis. B) bivariate analysis. C) multivariate analysis. D) none of the above.

C. "Several"=muilt

A research study in which blood pressure, pulse rate, and temperature are the variables of interest is gathering data that are A) incremental measures. B) qualitative measures. C) physiologic measures. D) observational measures.

C. About the body

In order to openly explore the understanding and experiences of the study participants, the researcher may elect to collect data by which of the following methods? A) Questionnaires B) Triangulation C) Storytelling D) Pretesting and posttesting

C. Allows them to talk about more stuff more freely

Internal consistency reliability refers to which of the following? A) Agreement between independent data collectors B) Consistency in answers on tests C) The extent to which responses to a scale are similar D) The extent to which the responses to one measure match another

C. Assimilation.

Currently the emphasis in nursing is on: A) finding answers to clinical questions encountered every day B) understanding research language and the research process C) using research and theory as evidence for patient care decisions D) refining the art of patient care through the use of intuitive judgment

C. Being able to use recent research makes it possible to provide better care

Validity refers to the accuracy of which of the following aspects of a research study? A) Measurement B) Data collection C) Analysis D) Conclusions

C. I don't know.

The statement "Seventy-five first-time mothers stated that the nurse's ability to explain information to families of high-risk infants was the single most important factor in their recovery" would most likely be found in which section of the research report? A) Introduction B) Methods C) Results D) Conclusions

C. It tells the results of the study

When a correlation is found between variables, it tells the researcher A) the cause of the relationship. B) the strength of the relationship. C) that a relationship exists. D) that the relationship is positive.

C. No more information is given

Usually the research process follows five steps as discussed in this text: the third step of the research process would be to A) describe the knowledge gap. B) develop a sampling plan. C) implement the study. D) disseminate the findings.

C. Problem, Hypothesis, IMPLEMENTATION

Recommendations are included as part of the conclusions section of the research report to A) indicate flaws in the study. B) describe why the results are meaningless. C) describe possibilities for future studies. D) summarize specific findings from the study.

C. Recommendations are for future use

In addition to describing and explaining the results, quantitative studies also attempt to A) calculate the mean. B) identify themes in the data. C) predict future outcomes. D) increase understanding of a phenomenon.

C. Remember this from test.

The sampling approach used by qualitative researchers differs from the sampling approach used by quantitative researchers in which of the following ways? A) In quantitative research, sampling is flexible and evolves as the study develops. B) In qualitative research, the sampling strategies are established at the beginning. C) In qualitative research, sampling is driven by the data as these are collected. D) In quantitative research, sampling includes as many resources as possible.

C. Sampling is much more free in qualatative

Selected results from the research study are contained in which part of the research report? A) The conclusions B) The results C) The summary D) The introduction

C. Summaries only pick out what they want

The statement "Forty-two single women with one child between the ages of 1 month and 5 years of age who worked a minimum of 30 hours per week were randomly assigned to either the intervention or control group" would most likely describe A) the population. B) the method. C) the sample. D) the result.

C. The sample is who took part in the study

A correlational study to identify concepts and their relationships using Lazarus's theory of stress is an example of A) ethnography. B) test-retest. C) model testing. D) framework testing.

C. an application of model-based design for designing and optionally also executing artifacts to perform software testing or system testing

In a research design that seeks to predict or manipulate an outcome, which of the following designs is most appropriate? A) A cross-sectional design B) An experimental design C) A longitudinal design D) A qualitative design

C. an observational research method in which data is gathered for the same subjects repeatedly over a period of time. Longitudinal research projects can extend over years or even decades.

The beta value can be described as A) a causation. B) a result. C) an odds ratio. D) a confounding variable.

C. beta is an odds ration apparently

The extent to which a scale or instrument measures what it is supposed to measure is called A) content validity. B) criterion-related validity. C) construct validity. D) none of the above.

C. the appropriateness of inferences made on the basis of observations or measurements (often test scores), specifically whether a test measures the intended construct.

Name three skills needed by a panel developing an evidence-based clinical practice guideline.

Clinical expertise, Research expertise, Evidence-based practice expertise Information search and retrieval expertise to help locate research evidence, Group process expertise

What is the end product of an SR?

Conclusions that are important and/or found in more than one study

Analysis, the fourth step of the research process, is reflected in which section of the research report? A) The background B) The introduction C) The methods D) The conclusions

D. Analyzing must take place after the results are found, i.e., conclusion.

The statement "Individuals are autonomous and have the right to make knowledgeable, voluntary decisions" speaks to which of the following rights of human subjects? A) The right to privacy B) The right to fair treatment C) The right to confidentiality D) The right to self-determination

D. Autonomous=self

Which of the following approaches is best for a nurse seeking an answer to a clinical question related to patient care? A) using intuition to answer the question B) asking the clinical nursing supervisor C) reading a textbook about the subject D) reading current research on the topic

D. Current research will delivery the most recent information

When reading the results of a study, the researcher notes that as variable "A" increases there is a corresponding decrease in variable "B." The term used to describe this phenomenon is A) correlation coefficient. B) analysis of variance. C) standard deviation. D) covariance.

D. Inverse is covarience I guess

A low response rate can A) allow bias in subject recruitment because of an unknown factor. B) lead to overrepresentation of one segment of the population in the sample. C) cause the recruiter to be uncomfortable with either the content or the subject. D) affect the ability to generalize the results of the study to the entire population.

D. It is likely that the study will end up being only for a small population

Which of the following is a component of the conclusions section of a research report? A) the summary of key findings B) a comparison of results to those of previous studies C) speculation regarding possible interpretations D) a description of study limitations

D. It makes sure to tell what is wrong with the study. w

Financial support for research may be available from various sources. These sources include A) the government. B) individuals. C) professional organizations. D) all of the above.

D. Many people can fund SCIENCE... Including Batman for "theoretical" reasons...

Study results that allow us to make inferences must provide information about which of the following: A) Future responses or situations under the same set of circumstances B) Predictions about future health-related outcomes C) Identification of the cause of the findings of the study D) The order of events and the timing of those events

D. Must be able to know what leads up to said outcome.

Which of the following represents a visual analog scale? A) Always-often-occasionally-never B) Yes-no-maybe C) Married-divorced-widow-separated D) No stress-extreme stress

D. Only one that is a scale rather than an answer.

Which of the following is most likely to appear in the results section of a research report as a measure of the value of a correlation between two variables? A) a beta value B) a paired "t" test C) ANOVA D) Pearson's product-moment

D. Pearson's is two

The statement "The findings of this study are generalizable only to beginning clinical nurses who are baccalaureate graduates and who speak, read, and write English" would most likely be found in which section of the research report? A) Introduction B) Methods C) Results D) Conclusions

D. Post-research

A recent research study found that subjects who drank a can of beer each day had cholesterol values that were significantly lower than for subjects who did not drink beer. In clinical practice, which of the following actions would be appropriate based on this study? A) Advise all patients to drink a can of beer each day. B) Increase the sample size and repeat the study. C) Examine other factors related to the individuals. D) Take no action based on these findings at this time.

D. Risk vs benefit, not enough data to say this works.

In a quantitative study the individuals that comprise the sample are called A) participants. B) members. C) informants. D) subjects.

D. Subject are quantitative, participants are qualitative

A written form that is given to and completed by study subjects is called a/an A) document. B) instrument. C) scale. D) questionnaire.

D. They answer questions and that is the study

Research studies that have a large number of subjects who withdraw from the study for consistent reasons may have a problem with A) maintaining a sufficient number of participants. B) bias in the sampling procedures. C) recruitment of subjects for future studies. D) ability to generalize the results of the study.

D. With only a few, it is hard to get accurate data

Information about the sampling strategy and the actual sample is important in order to A) know who the individual participants in the study were. B) understand the results and conclusions found in the study. C) know how the researchers determined how the study would develop. D) understand to whom the results of the study may apply.

D. You can see the characteristics of the the subjects/participants.

The abstract of a research report is useful in helping the nurse to: A) understand the research study B) make decisions about clinical care C) recognize how the results contribute to the knowledge base D) determine if the study addresses the question of interest

D. You do not make decisions, really understand, or see how the results contribute with the abstract. You do see the general idea.

When time is not an important factor in a research design, which of the following designs would be used? A) A retrospective design B) A prospective design C) A longitudinal design D) A cross-sectional design

D. involve data collected at a defined time. They are often used to assess the prevalence of acute or chronic conditions, or to answer questions about the causes of disease or the results of intervention.

List the steps reviewers perform when conducting SRs.

Develop an Important and focused question with inclusion criteria (e.g., focus of the study, type of study, quality of study) Search for relevant studies Sifting those that meet inclusion criteria and sorting by sub-issues Extraction of information from reports Analysis of findings to reach conclusions

What broad issues are included in appraisal?

Synopsis, credibility, clinical significance, applicability

What determines the credibility of a study finding, Systematic Review (SR) conclusion, or Evidence-based Clinical Practice Guideline recommendation?

Question-design match, produced by sound methods, similar to findings from other studies

How do limits help in searching?

More precise search (fewer false hits from other usages of the word)

When looking for evidence relative to a clinical issue/problem, what type of evidence should a team developing a clinical protocol look for first? Why?

First look for EbCPGs and systematic reviews. These forms of evidence will save considerable time as they have already performed several preliminary steps to protocol development.

Name three issues that are considered when evaluating applicability.

Fit of the evidence to the setting's patients, Safety, Expected benefit, Feasibility of incorporating the change