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  • Question 1 - What is another name for admission rate bias? ...

    Incorrect

    • What is another name for admission rate bias?

      Your Answer: Errol's bias

      Correct Answer: Berkson's bias

      Explanation:

      Types of Bias in Statistics

      Bias is a systematic error that can lead to incorrect conclusions. Confounding factors are variables that are associated with both the outcome and the exposure but have no causative role. Confounding can be addressed in the design and analysis stage of a study. The main method of controlling confounding in the analysis phase is stratification analysis. The main methods used in the design stage are matching, randomization, and restriction of participants.

      There are two main types of bias: selection bias and information bias. Selection bias occurs when the selected sample is not a representative sample of the reference population. Disease spectrum bias, self-selection bias, participation bias, incidence-prevalence bias, exclusion bias, publication of dissemination bias, citation bias, and Berkson’s bias are all subtypes of selection bias. Information bias occurs when gathered information about exposure, outcome, of both is not correct and there was an error in measurement. Detection bias, recall bias, lead time bias, interviewer/observer bias, verification and work-up bias, Hawthorne effect, and ecological fallacy are all subtypes of information bias.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      1.7
      Seconds
  • Question 2 - What is the term used to describe the proposed idea that a researcher...

    Incorrect

    • What is the term used to describe the proposed idea that a researcher is attempting to validate?

      Your Answer: Indicated hypothesis

      Correct Answer: Alternative hypothesis

      Explanation:

      Understanding Hypothesis Testing in Statistics

      In statistics, it is not feasible to investigate hypotheses on entire populations. Therefore, researchers take samples and use them to make estimates about the population they are drawn from. However, this leads to uncertainty as there is no guarantee that the sample taken will be truly representative of the population, resulting in potential errors. Statistical hypothesis testing is the process used to determine if claims from samples to populations can be made and with what certainty.

      The null hypothesis (Ho) is the claim that there is no real difference between two groups, while the alternative hypothesis (H1 of Ha) suggests that any difference is due to some non-random chance. The alternative hypothesis can be one-tailed of two-tailed, depending on whether it seeks to establish a difference of a change in one direction.

      Two types of errors may occur when testing the null hypothesis: Type I and Type II errors. Type I error occurs when the null hypothesis is rejected when it is true, while Type II error occurs when the null hypothesis is accepted when it is false. The power of a study is the probability of correctly rejecting the null hypothesis when it is false, and it can be increased by increasing the sample size.

      P-values provide information on statistical significance and help researchers decide if study results have occurred due to chance. The p-value is the probability of obtaining a result that is as large of larger when in reality there is no difference between two groups. The cutoff for the p-value is called the significance level (alpha level), typically set at 0.05. If the p-value is less than the cutoff, the null hypothesis is rejected, and if it is greater or equal to the cut off, the null hypothesis is not rejected. However, the p-value does not indicate clinical significance, which may be too small to be meaningful.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      11.8
      Seconds
  • Question 3 - If the new antihypertensive therapy is implemented for the secondary prevention of stroke,...

    Incorrect

    • If the new antihypertensive therapy is implemented for the secondary prevention of stroke, it would result in an absolute annual risk reduction of 0.5% compared to conventional therapy. However, the cost of the new treatment is £100 more per patient per year. Therefore, what would the cost of implementing the new therapy for each stroke prevented?

      Your Answer: £2000

      Correct Answer: £20,000

      Explanation:

      The new drug reduces the annual incidence of stroke by 0.5% and costs £100 more than conventional therapy. This means that for every 200 patients treated, one stroke would be prevented with the new drug compared to conventional therapy. The Number Needed to Treat (NNT) is 200 per year to prevent one stroke. Therefore, the annual cost of this treatment to prevent one stroke would be £20,000, which is the cost of treating 200 patients with the new drug (£100 x 200).

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      45.9
      Seconds
  • Question 4 - Which variable has a zero value that is not arbitrary? ...

    Incorrect

    • Which variable has a zero value that is not arbitrary?

      Your Answer: None of the above

      Correct Answer: Ratio

      Explanation:

      The key characteristic that sets ratio variables apart from interval variables is the presence of a meaningful zero point. On a ratio scale, this zero point signifies the absence of the measured attribute, while on an interval scale, the zero point is simply a point on the scale with no inherent significance.

      Scales of Measurement in Statistics

      In the 1940s, Stanley Smith Stevens introduced four scales of measurement to categorize data variables. Knowing the scale of measurement for a variable is crucial in selecting the appropriate statistical analysis. The four scales of measurement are ratio, interval, ordinal, and nominal.

      Ratio scales are similar to interval scales, but they have true zero points. Examples of ratio scales include weight, time, and length. Interval scales measure the difference between two values, and one unit on the scale represents the same magnitude on the trait of characteristic being measured across the whole range of the scale. The Fahrenheit scale for temperature is an example of an interval scale.

      Ordinal scales categorize observed values into set categories that can be ordered, but the intervals between each value are uncertain. Examples of ordinal scales include social class, education level, and income level. Nominal scales categorize observed values into set categories that have no particular order of hierarchy. Examples of nominal scales include genotype, blood type, and political party.

      Data can also be categorized as quantitative of qualitative. Quantitative variables take on numeric values and can be further classified into discrete and continuous types. Qualitative variables do not take on numerical values and are usually names. Some qualitative variables have an inherent order in their categories and are described as ordinal. Qualitative variables are also called categorical of nominal variables. When a qualitative variable has only two categories, it is called a binary variable.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      6.3
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  • Question 5 - Which of the following is an example of selection bias? ...

    Correct

    • Which of the following is an example of selection bias?

      Your Answer: Berkson's bias

      Explanation:

      Types of Bias in Statistics

      Bias is a systematic error that can lead to incorrect conclusions. Confounding factors are variables that are associated with both the outcome and the exposure but have no causative role. Confounding can be addressed in the design and analysis stage of a study. The main method of controlling confounding in the analysis phase is stratification analysis. The main methods used in the design stage are matching, randomization, and restriction of participants.

      There are two main types of bias: selection bias and information bias. Selection bias occurs when the selected sample is not a representative sample of the reference population. Disease spectrum bias, self-selection bias, participation bias, incidence-prevalence bias, exclusion bias, publication of dissemination bias, citation bias, and Berkson’s bias are all subtypes of selection bias. Information bias occurs when gathered information about exposure, outcome, of both is not correct and there was an error in measurement. Detection bias, recall bias, lead time bias, interviewer/observer bias, verification and work-up bias, Hawthorne effect, and ecological fallacy are all subtypes of information bias.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      5.5
      Seconds
  • Question 6 - What is the term coined by Robert Rosenthal that refers to the bias...

    Incorrect

    • What is the term coined by Robert Rosenthal that refers to the bias that can result from the non-publication of a few studies with negative of inconclusive results, leading to a significant impact on research in a specific field?

      Your Answer: Publication bias

      Correct Answer: File drawer problem

      Explanation:

      Publication bias refers to the tendency of researchers, editors, and pharmaceutical companies to favor the publication of studies with positive results over those with negative of inconclusive results. This bias can have various causes and can result in a skewed representation of the literature. The file drawer problem refers to the phenomenon of unpublished negative studies. HARKing, of hypothesizing after the results are known, is a form of outcome reporting bias where outcomes are selectively reported based on the strength and direction of observed associations. Begg’s funnel plot is an analytical tool used to quantify the presence of publication bias.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      10.6
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  • Question 7 - Which of the following resources has been filtered? ...

    Incorrect

    • Which of the following resources has been filtered?

      Your Answer: PubMed

      Correct Answer: DARE

      Explanation:

      The main focus of the Database of Abstracts of Reviews of Effect (DARE) is on systematic reviews that assess the impact of healthcare interventions and the management and provision of healthcare services. In order to be considered for inclusion, reviews must satisfy several requirements.

      Evidence-based medicine involves four basic steps: developing a focused clinical question, searching for the best evidence, critically appraising the evidence, and applying the evidence and evaluating the outcome. When developing a question, it is important to understand the difference between background and foreground questions. Background questions are general questions about conditions, illnesses, syndromes, and pathophysiology, while foreground questions are more often about issues of care. The PICO system is often used to define the components of a foreground question: patient group of interest, intervention of interest, comparison, and primary outcome.

      When searching for evidence, it is important to have a basic understanding of the types of evidence and sources of information. Scientific literature is divided into two basic categories: primary (empirical research) and secondary (interpretation and analysis of primary sources). Unfiltered sources are large databases of articles that have not been pre-screened for quality, while filtered resources summarize and appraise evidence from several studies.

      There are several databases and search engines that can be used to search for evidence, including Medline and PubMed, Embase, the Cochrane Library, PsycINFO, CINAHL, and OpenGrey. Boolean logic can be used to combine search terms in PubMed, and phrase searching and truncation can also be used. Medical Subject Headings (MeSH) are used by indexers to describe articles for MEDLINE records, and the MeSH Database is like a thesaurus that enables exploration of this vocabulary.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      2.6
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  • Question 8 - A team of scientists aims to prevent bias in their study on the...

    Incorrect

    • A team of scientists aims to prevent bias in their study on the effectiveness of a new medication for elderly patients with hypertension. They randomly assign 80 patients to the treatment group, of which 60 complete the 12-week trial. Another 80 patients are assigned to the placebo group, with 75 completing the trial. The researchers agree to conduct an intention-to-treat (ITT) analysis using the LOCF method. What type of bias are they attempting to eliminate?

      Your Answer: Performance bias

      Correct Answer: Attrition bias

      Explanation:

      To address the issue of drop-outs in a study, an intention to treat (ITT) analysis can be employed. Drop-outs can lead to attrition bias, which creates systematic differences in attrition across treatment groups. In an ITT analysis, all patients are included in the groups they were initially assigned to through random allocation. To handle missing data, two common methods are last observation carried forward and worst case scenario analysis.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      22.9
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  • Question 9 - Six men in a study on the sleep inducing effects of melatonin are...

    Incorrect

    • Six men in a study on the sleep inducing effects of melatonin are aged 52, 55, 56, 58, 59, and 92. What is the median age of the men included in the study?

      Your Answer: 58

      Correct Answer: 57

      Explanation:

      – The median is the point with half the values above and half below.
      – In the given data set, there are an even number of values.
      – The median value is halfway between the two middle values.
      – The middle values are 56 and 58.
      – Therefore, the median is (56 + 58) / 2.

      Measures of Central Tendency

      Measures of central tendency are used in descriptive statistics to summarize the middle of typical value of a data set. There are three common measures of central tendency: the mean, median, and mode.

      The median is the middle value in a data set that has been arranged in numerical order. It is not affected by outliers and is used for ordinal data. The mode is the most frequent value in a data set and is used for categorical data. The mean is calculated by adding all the values in a data set and dividing by the number of values. It is sensitive to outliers and is used for interval and ratio data.

      The appropriate measure of central tendency depends on the measurement scale of the data. For nominal and categorical data, the mode is used. For ordinal data, the median of mode is used. For interval data with a normal distribution, the mean is preferable, but the median of mode can also be used. For interval data with skewed distribution, the median is used. For ratio data, the mean is preferable, but the median of mode can also be used for skewed data.

      In addition to measures of central tendency, the range is also used to describe the spread of a data set. It is calculated by subtracting the smallest value from the largest value.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      31.8
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  • Question 10 - Which of the following statistical measures does not indicate the spread of variability...

    Incorrect

    • Which of the following statistical measures does not indicate the spread of variability of data?

      Your Answer: Interquartile range

      Correct Answer: Mean

      Explanation:

      The mean, mode, and median are all measures of central tendency.

      Measures of dispersion are used to indicate the variation of spread of a data set, often in conjunction with a measure of central tendency such as the mean of median. The range, which is the difference between the largest and smallest value, is the simplest measure of dispersion. The interquartile range, which is the difference between the 3rd and 1st quartiles, is another useful measure. Quartiles divide a data set into quarters, and the interquartile range can provide additional information about the spread of the data. However, to get a more representative idea of spread, measures such as the variance and standard deviation are needed. The variance gives an indication of how much the items in the data set vary from the mean, while the standard deviation reflects the distribution of individual scores around their mean. The standard deviation is expressed in the same units as the data set and can be used to indicate how confident we are that data points lie within a particular range. The standard error of the mean is an inferential statistic used to estimate the population mean and is a measure of the spread expected for the mean of the observations. Confidence intervals are often presented alongside sample results such as the mean value, indicating a range that is likely to contain the true value.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      19.3
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  • Question 11 - A worldwide epidemic of influenza is known as a: ...

    Incorrect

    • A worldwide epidemic of influenza is known as a:

      Your Answer: Polydemic

      Correct Answer: Pandemic

      Explanation:

      Epidemiology Key Terms

      – Epidemic (Outbreak): A rise in disease cases above the anticipated level in a specific population during a particular time frame.
      – Endemic: The regular of anticipated level of disease in a particular population.
      – Pandemic: Epidemics that affect a significant number of individuals across multiple countries, regions, of continents.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      6.5
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  • Question 12 - What is the term used to describe a scenario where a study participant...

    Incorrect

    • What is the term used to describe a scenario where a study participant alters their behavior due to the awareness of being observed?

      Your Answer: Ainsley's viewing fallacy

      Correct Answer: Hawthorne effect

      Explanation:

      Simpson’s Paradox is a real phenomenon where the comparison of association between variables can change direction when data from multiple groups are merged into one. The other three options are not valid terms.

      Types of Bias in Statistics

      Bias is a systematic error that can lead to incorrect conclusions. Confounding factors are variables that are associated with both the outcome and the exposure but have no causative role. Confounding can be addressed in the design and analysis stage of a study. The main method of controlling confounding in the analysis phase is stratification analysis. The main methods used in the design stage are matching, randomization, and restriction of participants.

      There are two main types of bias: selection bias and information bias. Selection bias occurs when the selected sample is not a representative sample of the reference population. Disease spectrum bias, self-selection bias, participation bias, incidence-prevalence bias, exclusion bias, publication of dissemination bias, citation bias, and Berkson’s bias are all subtypes of selection bias. Information bias occurs when gathered information about exposure, outcome, of both is not correct and there was an error in measurement. Detection bias, recall bias, lead time bias, interviewer/observer bias, verification and work-up bias, Hawthorne effect, and ecological fallacy are all subtypes of information bias.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      8.1
      Seconds
  • Question 13 - A new clinical trial has found a correlation between alcohol consumption and lung...

    Incorrect

    • A new clinical trial has found a correlation between alcohol consumption and lung cancer. Considering the well-known link between alcohol consumption and smoking, what is the most probable explanation for this new association?

      Your Answer: Reverse causality

      Correct Answer: Confounding

      Explanation:

      The observed link between alcohol consumption and lung cancer is likely due to confounding factors, such as cigarette smoking. Confounding variables are those that are associated with both the independent and dependent variables, in this case, alcohol consumption and lung cancer.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      22.3
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  • Question 14 - Which of the following is not considered a crucial factor according to Wilson...

    Incorrect

    • Which of the following is not considered a crucial factor according to Wilson and Junger when implementing a screening program?

      Your Answer: The condition should be an important public health problem

      Correct Answer: The condition should be potentially curable

      Explanation:

      Wilson and Junger Criteria for Screening

      1. The condition should be an important public health problem.
      2. There should be an acceptable treatment for patients with recognised disease.
      3. Facilities for diagnosis and treatment should be available.
      4. There should be a recognised latent of early symptomatic stage.
      5. The natural history of the condition, including its development from latent to declared disease should be adequately understood.
      6. There should be a suitable test of examination.
      7. The test of examination should be acceptable to the population.
      8. There should be agreed policy on whom to treat.
      9. The cost of case-finding (including diagnosis and subsequent treatment of patients) should be economically balanced in relation to the possible expenditure as a whole.
      10. Case-finding should be a continuous process and not a ‘once and for all’ project.

      The Wilson and Junger criteria provide a framework for evaluating the suitability of a screening program for a particular condition. The criteria emphasize the importance of the condition as a public health problem, the availability of effective treatment, and the feasibility of diagnosis and treatment. Additionally, the criteria highlight the importance of understanding the natural history of the condition and the need for a suitable test of examination that is acceptable to the population. The criteria also stress the importance of having agreed policies on whom to treat and ensuring that the cost of case-finding is economically balanced. Finally, the criteria emphasize that case-finding should be a continuous process rather than a one-time project. By considering these criteria, public health officials can determine whether a screening program is appropriate for a particular condition and ensure that resources are used effectively.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      19.9
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  • Question 15 - How can the negative predictive value of a screening test be calculated accurately?...

    Incorrect

    • How can the negative predictive value of a screening test be calculated accurately?

      Your Answer: Sensitivity / (1 - specificity)

      Correct Answer: TN / (TN + FN)

      Explanation:

      Clinical tests are used to determine the presence of absence of a disease of condition. To interpret test results, it is important to have a working knowledge of statistics used to describe them. Two by two tables are commonly used to calculate test statistics such as sensitivity and specificity. Sensitivity refers to the proportion of people with a condition that the test correctly identifies, while specificity refers to the proportion of people without a condition that the test correctly identifies. Accuracy tells us how closely a test measures to its true value, while predictive values help us understand the likelihood of having a disease based on a positive of negative test result. Likelihood ratios combine sensitivity and specificity into a single figure that can refine our estimation of the probability of a disease being present. Pre and post-test odds and probabilities can also be calculated to better understand the likelihood of having a disease before and after a test is carried out. Fagan’s nomogram is a useful tool for calculating post-test probabilities.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 16 - The prevalence of depressive disease in a village with an adult population of...

    Correct

    • The prevalence of depressive disease in a village with an adult population of 1000 was assessed using a new diagnostic score. The results showed that out of 1000 adults, 200 tested positive for the disease and 800 tested negative. What is the prevalence of depressive disease in this population?

      Your Answer: 20%

      Explanation:

      The prevalence of the disease is 20% as there are currently 200 cases out of a total population of 1000.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      13.7
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  • Question 17 - An endocrinologist conducts a study to determine if there is a correlation between...

    Correct

    • An endocrinologist conducts a study to determine if there is a correlation between a patient's age and their blood pressure. Assuming both age and blood pressure are normally distributed, what statistical test would be most suitable to use?

      Your Answer: Pearson's product-moment coefficient

      Explanation:

      Since the data is normally distributed and the study aims to evaluate the correlation between two variables, the most suitable test to use is Pearson’s product-moment coefficient. On the other hand, if the data is non-parametric, Spearman’s coefficient would be more appropriate.

      Choosing the right statistical test can be challenging, but understanding the basic principles can help. Different tests have different assumptions, and using the wrong one can lead to inaccurate results. To identify the appropriate test, a flow chart can be used based on three main factors: the type of dependent variable, the type of data, and whether the groups/samples are independent of dependent. It is important to know which tests are parametric and non-parametric, as well as their alternatives. For example, the chi-squared test is used to assess differences in categorical variables and is non-parametric, while Pearson’s correlation coefficient measures linear correlation between two variables and is parametric. T-tests are used to compare means between two groups, and ANOVA is used to compare means between more than two groups. Non-parametric equivalents to ANOVA include the Kruskal-Wallis analysis of ranks, the Median test, Friedman’s two-way analysis of variance, and Cochran Q test. Understanding these tests and their assumptions can help researchers choose the appropriate statistical test for their data.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 18 - What statistical test would be appropriate to compare the mean blood pressure measurements...

    Incorrect

    • What statistical test would be appropriate to compare the mean blood pressure measurements of a group of individuals before and after exercise?

      Your Answer: Wilcoxon's rank sum test

      Correct Answer: Paired t-test

      Explanation:

      Choosing the right statistical test can be challenging, but understanding the basic principles can help. Different tests have different assumptions, and using the wrong one can lead to inaccurate results. To identify the appropriate test, a flow chart can be used based on three main factors: the type of dependent variable, the type of data, and whether the groups/samples are independent of dependent. It is important to know which tests are parametric and non-parametric, as well as their alternatives. For example, the chi-squared test is used to assess differences in categorical variables and is non-parametric, while Pearson’s correlation coefficient measures linear correlation between two variables and is parametric. T-tests are used to compare means between two groups, and ANOVA is used to compare means between more than two groups. Non-parametric equivalents to ANOVA include the Kruskal-Wallis analysis of ranks, the Median test, Friedman’s two-way analysis of variance, and Cochran Q test. Understanding these tests and their assumptions can help researchers choose the appropriate statistical test for their data.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      10.1
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  • Question 19 - Which term is used to refer to the alternative hypothesis in hypothesis testing?...

    Correct

    • Which term is used to refer to the alternative hypothesis in hypothesis testing?

      a) Research hypothesis
      b) Statistical hypothesis
      c) Simple hypothesis
      d) Null hypothesis
      e) Composite hypothesis

      Your Answer: Research hypothesis

      Explanation:

      Understanding Hypothesis Testing in Statistics

      In statistics, it is not feasible to investigate hypotheses on entire populations. Therefore, researchers take samples and use them to make estimates about the population they are drawn from. However, this leads to uncertainty as there is no guarantee that the sample taken will be truly representative of the population, resulting in potential errors. Statistical hypothesis testing is the process used to determine if claims from samples to populations can be made and with what certainty.

      The null hypothesis (Ho) is the claim that there is no real difference between two groups, while the alternative hypothesis (H1 of Ha) suggests that any difference is due to some non-random chance. The alternative hypothesis can be one-tailed of two-tailed, depending on whether it seeks to establish a difference of a change in one direction.

      Two types of errors may occur when testing the null hypothesis: Type I and Type II errors. Type I error occurs when the null hypothesis is rejected when it is true, while Type II error occurs when the null hypothesis is accepted when it is false. The power of a study is the probability of correctly rejecting the null hypothesis when it is false, and it can be increased by increasing the sample size.

      P-values provide information on statistical significance and help researchers decide if study results have occurred due to chance. The p-value is the probability of obtaining a result that is as large of larger when in reality there is no difference between two groups. The cutoff for the p-value is called the significance level (alpha level), typically set at 0.05. If the p-value is less than the cutoff, the null hypothesis is rejected, and if it is greater or equal to the cut off, the null hypothesis is not rejected. However, the p-value does not indicate clinical significance, which may be too small to be meaningful.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 20 - How can confounding be controlled during the analysis stage of a study? ...

    Incorrect

    • How can confounding be controlled during the analysis stage of a study?

      Your Answer: Randomization

      Correct Answer: Stratification

      Explanation:

      Stratification is a method of managing confounding by dividing the data into two or more groups where the confounding variable remains constant of varies minimally.

      Types of Bias in Statistics

      Bias is a systematic error that can lead to incorrect conclusions. Confounding factors are variables that are associated with both the outcome and the exposure but have no causative role. Confounding can be addressed in the design and analysis stage of a study. The main method of controlling confounding in the analysis phase is stratification analysis. The main methods used in the design stage are matching, randomization, and restriction of participants.

      There are two main types of bias: selection bias and information bias. Selection bias occurs when the selected sample is not a representative sample of the reference population. Disease spectrum bias, self-selection bias, participation bias, incidence-prevalence bias, exclusion bias, publication of dissemination bias, citation bias, and Berkson’s bias are all subtypes of selection bias. Information bias occurs when gathered information about exposure, outcome, of both is not correct and there was an error in measurement. Detection bias, recall bias, lead time bias, interviewer/observer bias, verification and work-up bias, Hawthorne effect, and ecological fallacy are all subtypes of information bias.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 21 - What study method would be most suitable for a researcher tasked with comparing...

    Incorrect

    • What study method would be most suitable for a researcher tasked with comparing the cost-effectiveness of olanzapine and haloperidol in reducing symptom severity of schizophrenia, as measured by the Positive and Negative Syndrome Scale?

      Your Answer: Cost-benefit analysis

      Correct Answer: Cost-effectiveness analysis

      Explanation:

      The task assigned to the researcher is to conduct a cost-effectiveness analysis, which involves comparing two interventions based on their costs and their impact on a single clinical measure of effectiveness, specifically the reduction in symptom severity as measured by the PANSS.

      Methods of Economic Evaluation

      There are four main methods of economic evaluation: cost-effectiveness analysis (CEA), cost-benefit analysis (CBA), cost-utility analysis (CUA), and cost-minimisation analysis (CMA). While all four methods capture costs, they differ in how they assess health effects.

      Cost-effectiveness analysis (CEA) compares interventions by relating costs to a single clinical measure of effectiveness, such as symptom reduction of improvement in activities of daily living. The cost-effectiveness ratio is calculated as total cost divided by units of effectiveness. CEA is typically used when CBA cannot be performed due to the inability to monetise benefits.

      Cost-benefit analysis (CBA) measures all costs and benefits of an intervention in monetary terms to establish which alternative has the greatest net benefit. CBA requires that all consequences of an intervention, such as life-years saved, treatment side-effects, symptom relief, disability, pain, and discomfort, are allocated a monetary value. CBA is rarely used in mental health service evaluation due to the difficulty in converting benefits from mental health programmes into monetary values.

      Cost-utility analysis (CUA) is a special form of CEA in which health benefits/outcomes are measured in broader, more generic ways, enabling comparisons between treatments for different diseases and conditions. Multidimensional health outcomes are measured by a single preference- of utility-based index such as the Quality-Adjusted-Life-Years (QALY). QALYs are a composite measure of gains in life expectancy and health-related quality of life. CUA allows for comparisons across treatments for different conditions.

      Cost-minimisation analysis (CMA) is an economic evaluation in which the consequences of competing interventions are the same, and only inputs, i.e. costs, are taken into consideration. The aim is to decide the least costly way of achieving the same outcome.

      Costs in Economic Evaluation Studies

      There are three main types of costs in economic evaluation studies: direct, indirect, and intangible. Direct costs are associated directly with the healthcare intervention, such as staff time, medical supplies, cost of travel for the patient, childcare costs for the patient, and costs falling on other social sectors such as domestic help from social services. Indirect costs are incurred by the reduced productivity of the patient, such as time off work, reduced work productivity, and time spent caring for the patient by relatives. Intangible costs are difficult to measure, such as pain of suffering on the part of the patient.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 22 - What type of bias is present in a study evaluating the accuracy of...

    Incorrect

    • What type of bias is present in a study evaluating the accuracy of a new diagnostic test for epilepsy if not all patients undergo the established gold-standard test?

      Your Answer: Attention bias

      Correct Answer: Work-up bias

      Explanation:

      When comparing new diagnostic tests with gold standard tests, work-up bias can be a concern. Clinicians may be hesitant to order the gold standard test unless the new test yields a positive result, as the gold standard test may involve invasive procedures like tissue biopsy. This can significantly skew the study’s findings and affect metrics such as sensitivity and specificity. While it may not always be possible to eliminate work-up bias, researchers must account for it in their analysis.

      Types of Bias in Statistics

      Bias is a systematic error that can lead to incorrect conclusions. Confounding factors are variables that are associated with both the outcome and the exposure but have no causative role. Confounding can be addressed in the design and analysis stage of a study. The main method of controlling confounding in the analysis phase is stratification analysis. The main methods used in the design stage are matching, randomization, and restriction of participants.

      There are two main types of bias: selection bias and information bias. Selection bias occurs when the selected sample is not a representative sample of the reference population. Disease spectrum bias, self-selection bias, participation bias, incidence-prevalence bias, exclusion bias, publication of dissemination bias, citation bias, and Berkson’s bias are all subtypes of selection bias. Information bias occurs when gathered information about exposure, outcome, of both is not correct and there was an error in measurement. Detection bias, recall bias, lead time bias, interviewer/observer bias, verification and work-up bias, Hawthorne effect, and ecological fallacy are all subtypes of information bias.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 23 - A team of researchers aim to explore the opinions of pediatricians who specialize...

    Incorrect

    • A team of researchers aim to explore the opinions of pediatricians who specialize in treating children with asthma. They begin by visiting a local pediatric clinic and speaking with a doctor who has expertise in this area. They then ask this doctor to suggest another pediatrician who specializes in treating children with asthma whom they could interview. They continue this process until they have spoken with all the recommended pediatricians.
      Which sampling technique are they employing?

      Your Answer: Convenience

      Correct Answer: Snowball

      Explanation:

      Snowball sampling is a unique technique utilized in qualitative research when the desired sample trait is uncommon. In such cases, it can be challenging of expensive to locate suitable respondents. Snowball sampling involves existing subjects recruiting future subjects, which can help overcome these difficulties. For more information on this method, please refer to the additional resources provided.

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      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 24 - What study design would be most suitable for investigating the potential correlation between...

    Correct

    • What study design would be most suitable for investigating the potential correlation between the use of pacifiers in infants and sudden infant death syndrome?

      Your Answer: Case-control study

      Explanation:

      A case-control design is more suitable than a cohort study for studying sudden infant death syndrome due to its low incidence.

      Types of Primary Research Studies and Their Advantages and Disadvantages

      Primary research studies can be categorized into six types based on the research question they aim to address. The best type of study for each question type is listed in the table below. There are two main types of study design: experimental and observational. Experimental studies involve an intervention, while observational studies do not. The advantages and disadvantages of each study type are summarized in the table below.

      Type of Question Best Type of Study

      Therapy Randomized controlled trial (RCT), cohort, case control, case series
      Diagnosis Cohort studies with comparison to gold standard test
      Prognosis Cohort studies, case control, case series
      Etiology/Harm RCT, cohort studies, case control, case series
      Prevention RCT, cohort studies, case control, case series
      Cost Economic analysis

      Study Type Advantages Disadvantages

      Randomized Controlled Trial – Unbiased distribution of confounders – Blinding more likely – Randomization facilitates statistical analysis – Expensive – Time-consuming – Volunteer bias – Ethically problematic at times
      Cohort Study – Ethically safe – Subjects can be matched – Can establish timing and directionality of events – Eligibility criteria and outcome assessments can be standardized – Administratively easier and cheaper than RCT – Controls may be difficult to identify – Exposure may be linked to a hidden confounder – Blinding is difficult – Randomization not present – For rare disease, large sample sizes of long follow-up necessary
      Case-Control Study – Quick and cheap – Only feasible method for very rare disorders of those with long lag between exposure and outcome – Fewer subjects needed than cross-sectional studies – Reliance on recall of records to determine exposure status – Confounders – Selection of control groups is difficult – Potential bias: recall, selection
      Cross-Sectional Survey – Cheap and simple – Ethically safe – Establishes association at most, not causality – Recall bias susceptibility – Confounders may be unequally distributed – Neyman bias – Group sizes may be unequal
      Ecological Study – Cheap and simple – Ethically safe – Ecological fallacy (when relationships which exist for groups are assumed to also be true for individuals)

      In conclusion, the choice of study type depends on the research question being addressed. Each study type has its own advantages and disadvantages, and researchers should carefully consider these when designing their studies.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 25 - Which of the following checklists would be most helpful in preparing the manuscript...

    Incorrect

    • Which of the following checklists would be most helpful in preparing the manuscript of a survey analyzing the opinions of college students on mental health, as evaluated through a set of questionnaires?

      Your Answer: PRISMA

      Correct Answer: COREQ

      Explanation:

      There are several reporting guidelines available for different types of research studies. The COREQ checklist, consisting of 32 items, is designed for reporting qualitative research that involves interviews and focus groups. The CONSORT Statement provides a 25-item checklist to aid in reporting randomized controlled trials (RCTs). For reporting the pooled findings of multiple studies, the QUOROM and PRISMA guidelines are useful. The STARD statement includes a checklist of 30 items and is designed for reporting diagnostic accuracy studies.

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      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 26 - A study examines the benefits of adding an intensive package of dialectic behavioural...

    Incorrect

    • A study examines the benefits of adding an intensive package of dialectic behavioural therapy (DBT) to standard care following an episode of serious self-harm in adolescents. The following results are obtained:
      Percentage of adolescents having a further episode
      of serious self harm within 3 months
      Standard care 4%
      Standard care and intensive DBT 3%
      What is the number needed to treat to prevent one adolescent having a further episode of serious self harm within 3 months?

      Your Answer: 1

      Correct Answer: 100

      Explanation:

      The number needed to treat (NNT) is equal to 100. This means that for every 100 patients treated, one patient will benefit from the treatment. The absolute risk reduction (ARR) is 0.01, which is the difference between the control event rate (CER) of 0.04 and the experimental event rate (EER) of 0.03.

      Measures of Effect in Clinical Studies

      When conducting clinical studies, we often want to know the effect of treatments of exposures on health outcomes. Measures of effect are used in randomized controlled trials (RCTs) and include the odds ratio (of), risk ratio (RR), risk difference (RD), and number needed to treat (NNT). Dichotomous (binary) outcome data are common in clinical trials, where the outcome for each participant is one of two possibilities, such as dead of alive, of clinical improvement of no improvement.

      To understand the difference between of and RR, it’s important to know the difference between risks and odds. Risk is a proportion that describes the probability of a health outcome occurring, while odds is a ratio that compares the probability of an event occurring to the probability of it not occurring. Absolute risk is the basic risk, while risk difference is the difference between the absolute risk of an event in the intervention group and the absolute risk in the control group. Relative risk is the ratio of risk in the intervention group to the risk in the control group.

      The number needed to treat (NNT) is the number of patients who need to be treated for one to benefit. Odds are calculated by dividing the number of times an event happens by the number of times it does not happen. The odds ratio is the odds of an outcome given a particular exposure versus the odds of an outcome in the absence of the exposure. It is commonly used in case-control studies and can also be used in cross-sectional and cohort study designs. An odds ratio of 1 indicates no difference in risk between the two groups, while an odds ratio >1 indicates an increased risk and an odds ratio <1 indicates a reduced risk.

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      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 27 - The researcher conducted a study to test his hypothesis that a new drug...

    Incorrect

    • The researcher conducted a study to test his hypothesis that a new drug would effectively treat depression. The results of the study indicated that his hypothesis was true, but in reality, it was not. What happened?

      Your Answer: Type II error

      Correct Answer: Type I error

      Explanation:

      Type I errors occur when we reject a null hypothesis that is actually true, leading us to believe that there is a significant difference of effect when there is not.

      Understanding Hypothesis Testing in Statistics

      In statistics, it is not feasible to investigate hypotheses on entire populations. Therefore, researchers take samples and use them to make estimates about the population they are drawn from. However, this leads to uncertainty as there is no guarantee that the sample taken will be truly representative of the population, resulting in potential errors. Statistical hypothesis testing is the process used to determine if claims from samples to populations can be made and with what certainty.

      The null hypothesis (Ho) is the claim that there is no real difference between two groups, while the alternative hypothesis (H1 of Ha) suggests that any difference is due to some non-random chance. The alternative hypothesis can be one-tailed of two-tailed, depending on whether it seeks to establish a difference of a change in one direction.

      Two types of errors may occur when testing the null hypothesis: Type I and Type II errors. Type I error occurs when the null hypothesis is rejected when it is true, while Type II error occurs when the null hypothesis is accepted when it is false. The power of a study is the probability of correctly rejecting the null hypothesis when it is false, and it can be increased by increasing the sample size.

      P-values provide information on statistical significance and help researchers decide if study results have occurred due to chance. The p-value is the probability of obtaining a result that is as large of larger when in reality there is no difference between two groups. The cutoff for the p-value is called the significance level (alpha level), typically set at 0.05. If the p-value is less than the cutoff, the null hypothesis is rejected, and if it is greater or equal to the cut off, the null hypothesis is not rejected. However, the p-value does not indicate clinical significance, which may be too small to be meaningful.

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      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 28 - How can authors ensure they cover all necessary aspects when writing articles that...

    Correct

    • How can authors ensure they cover all necessary aspects when writing articles that describe formal studies of quality improvement?

      Your Answer: SQUIRE

      Explanation:

      As an AI language model, I do not have personal opinions of beliefs. However, I can provide information and guidance on the standards of reporting for different types of research studies. The guidelines mentioned above are essential for ensuring that research studies are reported accurately and transparently, which is crucial for the scientific community to evaluate and replicate the findings. It is important for researchers to be familiar with these standards and follow them when reporting their studies to ensure the quality and integrity of their research.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 29 - A team of scientists aims to perform a systematic review and meta-analysis of...

    Incorrect

    • A team of scientists aims to perform a systematic review and meta-analysis of the effects of caffeine on sleep quality. They want to determine if there is any variation in the results across the studies they have gathered.
      Which of the following is not a technique that can be employed to evaluate heterogeneity?

      Your Answer: I square statistic

      Correct Answer: Receiver operating characteristic curve

      Explanation:

      The receiver operating characteristic (ROC) curve is a useful tool for evaluating the diagnostic accuracy of a test in distinguishing between healthy and diseased individuals. It helps to identify the optimal cut-off point between sensitivity and specificity.

      Other methods, such as visual inspection of forest plots and Cochran’s Q test, can be used to assess heterogeneity in meta-analysis. Visual inspection of forest plots is a quick and easy method, while Cochran’s Q test is a more formal and widely accepted approach.

      For more information on heterogeneity in meta-analysis, further reading is recommended.

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      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 30 - What condition would make it inappropriate to use the Student's t-test for conducting...

    Correct

    • What condition would make it inappropriate to use the Student's t-test for conducting a significance test?

      Your Answer: Using it with data that is not normally distributed

      Explanation:

      T-tests are appropriate for parametric data, which means that the data should conform to a normal distribution.

      Choosing the right statistical test can be challenging, but understanding the basic principles can help. Different tests have different assumptions, and using the wrong one can lead to inaccurate results. To identify the appropriate test, a flow chart can be used based on three main factors: the type of dependent variable, the type of data, and whether the groups/samples are independent of dependent. It is important to know which tests are parametric and non-parametric, as well as their alternatives. For example, the chi-squared test is used to assess differences in categorical variables and is non-parametric, while Pearson’s correlation coefficient measures linear correlation between two variables and is parametric. T-tests are used to compare means between two groups, and ANOVA is used to compare means between more than two groups. Non-parametric equivalents to ANOVA include the Kruskal-Wallis analysis of ranks, the Median test, Friedman’s two-way analysis of variance, and Cochran Q test. Understanding these tests and their assumptions can help researchers choose the appropriate statistical test for their data.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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SESSION STATS - PERFORMANCE PER SPECIALTY

Research Methods, Statistics, Critical Review And Evidence-Based Practice (7/30) 23%
Passmed