Intro Flashcards

1
Q

What is the best available research evidence, combined with clinical expertise and patient values?

A

Evidence-based Chiropractic Practice

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2
Q

EBC was started up by a group of medical educators at McMaster’s university when?

A

1980’s

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3
Q

Chiropractic interventions are difficult to investigate by what?

A

Experimental Methods

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4
Q

Because chiropractic interventions are difficult to investigate by experimental methods there are fewer chiropractic articles that use what?

A

Placebo Control Group

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5
Q

EBC is unique because chiropractors commonly utilize what?

A

Multiple Treatment Modalities

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6
Q

What are the multiple treatment modalities that chiropractors use?

A

Manipulations
Exercises
Ergonomic Advice
Physiotherapy

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7
Q

Clinical trials often utilize what?

A

One Modality (to isolate and compare it w/placebo or alternative)

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8
Q

What was limited for chiropractic research in the past which hampered progress?

A

Finances

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9
Q

What has changed as far as finances for chiropractic research?

A

Federal Funds available

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10
Q

What is clinical expertise?

A

Skills and knowledge gained by clinicians through clinical experience and practice.

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11
Q

EBC relies heavily upon the practitioners past what?

A

Clinical Experience

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12
Q

EBP is the integration of the best evidence with the past training and expertise of the clinician which results in?

A

Better patient care

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13
Q

Evidence is added to patient care to replace what

A

Outdated information

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14
Q

What are patient preferences?

A

Personal Values, Concerns, Expectations that pts have about their care.

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15
Q

The belief patients have about care that is being offered to them is known as?

A

Personal Values

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16
Q

Personal values may be related to?

A

Philosophical or Religious issues

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17
Q

What are some patient concerns?

A

Finances
Time Constraints
Office Location

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18
Q

The degree that patients accept a doctors recommendations is known as what?

A

Patient Expectations

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19
Q

Patient expectations often are wide-ranging and can have a significant impact on?

A

Clinical Results

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20
Q

Practitioners may not have enough information to answer clinical questions for what?

A

Complicated Cases

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21
Q

Practitioners need to stay current in light of an overwhelming amount of?

A

New Research

22
Q

The best practices uses the most valid clinical tools available which are established through?

A

Research

23
Q

EBP is good to determine the most effective form of?

A

Treatment

24
Q

EBP utilizes valid and reliable what?

A

Diagnostic Tests

25
Q

Insurances often pay for services when provided with an explanation grounded in credible evidence that justifies what?

A

Clinical Procedures

26
Q

Patients who present for care with unusual conditions that are unknown to the practitioners is what?

A

Patient Specific

27
Q

EBP is good for what?

A

Specific Conditions

28
Q

EBP is good to self educate by attending

A

Seminars and Conferences

29
Q

Pracititioners gather the best available evidence how?

A

On their own

30
Q

Because some elements of EBP are difficult to master make time to do what?

A

Read Journals

Search for Answers to Clinical Questions

31
Q

What are the 5 steps of EBP?

A
  1. Ask clinically relevant question
  2. Search literature to find evidence to answer question
  3. Appraise evidence for validity and applicability to clinical circumstances
  4. Apply relevant evidence to clinical situation
  5. Evaluate effectiveness in carrying out 1-4 and revise
32
Q

Clinical questions should be clinically relevant and a good question will help guide the search for?

A

Evidence toward relevant material

33
Q

What are the 2 types of questions?

A
  1. Background Q

2. Foreground Q

34
Q

Background Q are simple 2-part questions that address what?

A

Basic facts about a pt’s health problem

35
Q

Background Q don’t fully address the best what?

A

Diagnostic or Treatment options

36
Q

Foreground questions are more complex than?

A

Background Q

37
Q

Foreground Q are derived from

A

Primary Sources

Secondary Sources

38
Q

What are the elements of a good clinical question (PICO)?

A

P-patient or problem
I-intervention
C-comparison intervention
O-outcome of interest

39
Q

What is patient oriented evidence that matters (POEMs)?

A

Outcome in a study that should be something patients care about.

40
Q

What is disease oriented evidence (DOE)?

A

Studies that involve outcomes that may be of interest to researchers and practitioners, but are of little interest to patients.

41
Q

What is something that is helpful in forming a conclusion or judgement?

A

Evidence

42
Q

Evidence is found primarily in journal articles that deal with what?

A

Effectiveness and safety of treatments
Validity and reliability of diagnostic tests
Incidence and prevalence of disease in populations

43
Q

What is considered to be the gold standard for determining if a treatment is effective?

A

Systematic Reviews

RCT’s

44
Q

What are the four C’s below RCT’s on the pyramid?

A

Cohort
Case-Control
Case Studies
Case Reports

45
Q

What typically begins with case reports/series then advances to observational studies then to RCT’s?

A

Clinical Investigation

46
Q

Studies that rank higher on the hierarchy of evidence pyramid are not what?

A

Always better

47
Q

Evidence rating systems are used to rate what?

A

Quality and Class structure of evidence

Guideline formation

48
Q

The relative strength of evidence depends on what?

A

Position of hierarchy of study designs
Critical Appraisal
Study’s validity

49
Q

The degree of confidence that one may have in evidence depends on what?

A

Strength of research

How various pieces of research on that topic blend together.

50
Q

When there is little or no evidence the practitioner must decide whether or not to do what?

A

Render treatment

51
Q

Lack of evidence is not the same as?

A

Evidence of Lack