Exam one: evidence based research

components of PICO

P: population I: intervention/influence C: comparison O: outcome

results section of a research article (qualitative)

findings are often organized according to major themes, processes, or categories identified in the analysis -indicates raw data

positivism (scientific method)

gathering of empirical evidence information is numeric from formal measurement and is statistically analyzed

independent vs dependent

independent= the presumed cause dependent= presumed effect (outcome variable)

journal articles

papers often subjected to peer review

Quantitative Research

positivist tradition

sources of best research evidence

primary studies systemic review -meta-analysis (quant) -meta-synthesis (qual) -meta-aggregation (qual) -mixed studied review (both)

Title of journal article

qual: central phenomenon and group under investigation quant: key variables and the population (PICO)

the lived experience of adult victims of abuse

qualitative

level VII evidence

qualitative study/descriptive study

"Correlations among Social Support, Depression and Anxiety in Patients with Type 2 Diabetes"

quantitative

features in both positivism and constructivism

ultimate goals external evidence reliance on human cooperation ethical constraints fallibility (errors)

Evidence Hierarchy

systematic reviews randomized controlled trials cohort studies case-control studies case series, case reports editorials, expert opinion

level IIV evidence

systemic review of nonexperimental/observational studies

level VI evidence

systemic review/meta synthesis of qualitative studies

constructivist scientific method

understanding the human experience as it is lived dynamic, holistic, and individual aspects of humans flexible; in-depth; can clarify dimensions of complicated phenomenon

blinding / masking

used in some quantitative studies to prevent biases stemming from people's awareness involves concealing info from participants, data collectors, or care providers to enhance objectivity ex. placebo

content of research journal articles

*title and abstract I-introduction M-method R-results A-& D-discussion *references

Components of a Problem Statement

- Identification of the problem - Background - Scope - Consequences - Knowledge gaps - Proposed solution

clinical question

-broad enough to include central concerns -narrow enough to serve as a guide for study design

Introduction of a journal article

-description of central phenomena, concepts, or variables -study purpose, research questions, hypotheses -review of literature -theoretical/conceptual framework -study significance

The method section of a research article (qualitative)

-discuss same issues as quantitative but with different emphases -more info on the research setting and context of study -describe researchers' efforts to enhance integrity of study

results section of a research article (quantitative)

-names of statistical tests -value of statistic -statistical significance (P value)

informed consent

-participants have adequate information -subjects can comprehend -can participate/withdraw

Positivism Paradigm

-reality exists independent of human observation & should be studied and known -nature is regular and ordered -determinism

constructivist paradigm

-reality is a construction of people participating in research -reality exists within a context and is multiple and subjective -reality exists independent of human observation -knowledge is maximized when the distance between the inquirer and participants in the study is MINIMIZED (the subjects voices are crucial)

The method section of a research article (quantitative)

-research design -sampling plan -methods of measuring variables and collecting data -study procedures -analytic methods and procedures

Level II evidence

A well-designed randomized control trial

Ethical Principles

Beneficence dignity justice

statement of purpose: quantitative

Identifies key study variables Identifies possible relationships among variables Indicates the population of interest Suggests, through use of verbs, the nature of the inquiry

statement of purpose: qualitative

Identifies the central phenomenon Suggests the research tradition (e.g., grounded theory, ethnography) Indicates the group, community, or setting of interest Suggests, through use of verbs, the nature of the inquiry (e.g., to describe..., to discover..., to explore...)

primary study

In a systematic review, an original study whose findings are used as the data in the review (new data)

level III evidence

Quasi-experimental studies or nonrandomized trial

nonexperimental research

Researchers collect data without intervening or introducing treatments. -observational studies

Purpose of IRB (Institutional Review Board)

Reviews potential research projects for fairness/potential risks vs. benefits to subjects

level I evidence

Systematic reviews, meta-analyses, randomized controlled trials

p value

The probability level which forms basis for deciding if results are statistically significant (not due to chance).

Respect for human dignity

The right to self determination, the right to full disclosure -right to ask questions/not answer/drop out -right to know potential risks and benefits

meta-analysis

a procedure for statistically combining the results of many different research studies

null hypothesis

a statement or idea that can be falsified, or proved wrong

statistical significance

a statistical statement of how likely it is that an obtained result occurred by chance

concepts

abstractions of particular aspects of human behavior or characteristics (ex. pain) in quantitative studies

phenomena

abstracts in qualitative studies

abstract

brief description of major features of a study at the beginning of a journal article

vulnerable populations

cognitively impaired, pregnant, children, prisoners

Qualitative Research

constructivist tradition

bias

distortion of influence that results in an error in inference

EBP - best evidence

empirical evidence from randomized controlled trials; evidence from other scientific methods such as descriptive and qualitative research; as well as use of information from case reports, scientific principles, and expert opinion.

discussion section of a research journal

interpretation of results clinical and research implications study limitations and ramifications for the believability of the results

Theories

knit concepts into a coherent system that claim to explain some aspect of reality

EBP: Clinical Expertise

knowledge gained during training and continuing education, experiences with patient care, and interdisciplinary sharing of new knowledge

factors leading to bias

lack of participant's candor (honesty) faulty methods of data collection researchers' preconceptions participants' awareness of being studied faulty study design

which section would "the study consisted o 135 mother-infant dyads from an inner-city neighborhood" be found?

method section

beneficence

minimize harm; maximize benefits right to protection from exploitation -participants not placed at disadvantage

level VIII evidence

non-research source ex. expert opinion

level V evidence

nonexperimental/observational study

raw data

quotes directly from study participants

Evidence Hierarchy definition

ranked evidence sources in terms of their risk of bias (least biased or level 1 evidence at the top)

EBP - patient preferences

require understanding patients' circumstances, such as the resource at their disposal

research vs null hypothesis

research: states the actual prediction of a relationship Null: expresses the absence of a relationship

experimental research

researchers actively introduce an intervention or treatment most often to address therapy questions -clinical trials; test casual relationships

justice

right to fair treatment and right to privacy -confidentiality and equal distribution

empirical evidence

rooted in objective reality and gathered through the senses rather than personal belief

Conceptual definition

the abstract or theoretical meaning of a concept being studied

determinisim

the belief that phenomena are not haphazard but rather have antecedent causes -research is to understand the underlying causes and to be unbiased as possible

operational definition

the operations a researcher must perform to measure the concept and collect the desired information

EBP purpose

therapy/intervention diagnosis/assessment prognosis etiology description meaning and process