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Question 1
Incorrect
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In scientific research, what variable type has traditionally been used to record the age of study participants?
Your Answer: Interval
Correct Answer: Binary
Explanation:Gender has traditionally been recorded as either male of female, creating a binary of dichotomous variable. Other categorical variables, such as eye color and ethnicity, can be grouped into two or more categories. Continuous variables, such as temperature, height, weight, and age, can be placed anywhere on a scale and have mathematical properties. Ordinal variables allow for ranking, but do not allow for direct mathematical comparisons between values.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 2
Incorrect
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What is the calculation that the nurse performed to determine the patient's average daily calorie intake over a seven day period?
Your Answer: Generalised mean
Correct Answer: Arithmetic mean
Explanation:You don’t need to concern yourself with the specifics of the various means. Simply keep in mind that the arithmetic mean is the one utilized in fundamental biostatistics.
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 3
Correct
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In a study of a new statin therapy for primary prevention of ischaemic heart disease in a diabetic population over a five year period, 1000 patients were randomly assigned to receive the new therapy and 1000 were given a placebo. The results showed that 150 patients in the placebo group had a myocardial infarction (MI) compared to 100 patients in the statin group. What is the number needed to treat (NNT) to prevent one MI in this population?
Your Answer: 20
Explanation:– Treating 1000 patients with a new statin for five years prevented 50 MIs.
– The number needed to treat (NNT) to prevent one MI is 20 (1000/50).
– NNT provides information on treatment efficacy beyond statistical significance.
– Based on these data, treating as few as 20 patients over five years may prevent an infarct.
– Cost economic data can be calculated by factoring in drug costs and costs of treating and rehabilitating a patient with an MI. -
This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 4
Correct
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What is the appropriate denominator for calculating cumulative incidence?
Your Answer: The number of disease free people at the beginning of a specified time period
Explanation:Measures of Disease Frequency: Incidence and Prevalence
Incidence and prevalence are two important measures of disease frequency. Incidence measures the speed at which new cases of a disease are emerging, while prevalence measures the burden of disease within a population. Cumulative incidence and incidence rate are two types of incidence measures, while point prevalence and period prevalence are two types of prevalence measures.
Cumulative incidence is the average risk of getting a disease over a certain period of time, while incidence rate is a measure of the speed at which new cases are emerging. Prevalence is a proportion and is a measure of the burden of disease within a population. Point prevalence measures the number of cases in a defined population at a specific point in time, while period prevalence measures the number of identified cases during a specified period of time.
It is important to note that prevalence is equal to incidence multiplied by the duration of the condition. In chronic diseases, the prevalence is much greater than the incidence. The incidence rate is stated in units of person-time, while cumulative incidence is always a proportion. When describing cumulative incidence, it is necessary to give the follow-up period over which the risk is estimated. In acute diseases, the prevalence and incidence may be similar, while for conditions such as the common cold, the incidence may be greater than the prevalence.
Incidence is a useful measure to study disease etiology and risk factors, while prevalence is useful for health resource planning. Understanding these measures of disease frequency is important for public health professionals and researchers in order to effectively monitor and address the burden of disease within populations.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 5
Incorrect
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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 hypothesisYour Answer: Composite hypothesis
Correct 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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 6
Incorrect
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Which of the following methods is most effective in eliminating of managing confounding factors?
Your Answer: Multiple regression analysis
Correct Answer: Randomisation
Explanation:The most effective way to eliminate of manage potential confounding factors is to randomize a large enough sample size. This approach addresses all potential confounders, regardless of whether they were measured in the study design. Matching involves pairing individuals who received a treatment of intervention with non-treated individuals who have similar observable characteristics. Post-hoc methods, such as stratification, regression analysis, and analysis of variance, can be used to evaluate the impact of known or suspected confounders.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 7
Incorrect
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What is the term used to describe the proposed idea that a researcher is attempting to validate?
Your Answer:
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 8
Incorrect
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A new treatment for elderly patients with hypertension is investigated. The study looks at the incidence of stroke after 1 year. The following data is obtained:
Number who had a stroke vs Number without a stroke
New drug: 40 vs 160
Placebo: 100 vs 300
What is the relative risk reduction?Your Answer:
Correct Answer: 20%
Explanation: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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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 9
Incorrect
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What factors affect the statistical power of a study?
Your Answer:
Correct Answer: Sample size
Explanation:A study that has a greater sample size is considered to have higher power, meaning it is capable of detecting a significant difference of effect that is clinically relevant.
The Importance of Power in Statistical Analysis
Power is a crucial concept in statistical analysis as it helps researchers determine the number of participants needed in a study to detect a clinically significant difference of effect. It represents the probability of correctly rejecting the null hypothesis when it is false, which means avoiding a Type II error. Power values range from 0 to 1, with 0 indicating 0% and 1 indicating 100%. A power of 0.80 is generally considered the minimum acceptable level.
Several factors influence the power of a study, including sample size, effect size, and significance level. Larger sample sizes lead to more precise parameter estimations and increase the study’s ability to detect a significant effect. Effect size, which is determined at the beginning of a study, refers to the size of the difference between two means that leads to rejecting the null hypothesis. Finally, the significance level, also known as the alpha level, represents the probability of a Type I error. By considering these factors, researchers can optimize the power of their studies and increase the likelihood of detecting meaningful effects.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 10
Incorrect
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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:
Correct 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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 11
Incorrect
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What type of regression is appropriate for analyzing data with dichotomous variables?
Your Answer:
Correct Answer: Logistic
Explanation:Logistic regression is employed when dealing with dichotomous variables, which are variables that have only two possible values, such as live/dead of head/tail.
Stats: Correlation and Regression
Correlation and regression are related but not interchangeable terms. Correlation is used to test for association between variables, while regression is used to predict values of dependent variables from independent variables. Correlation can be linear, non-linear, of non-existent, and can be strong, moderate, of weak. The strength of a linear relationship is measured by the correlation coefficient, which can be positive of negative and ranges from very weak to very strong. However, the interpretation of a correlation coefficient depends on the context and purposes. Correlation can suggest association but cannot prove of disprove causation. Linear regression, on the other hand, can be used to predict how much one variable changes when a second variable is changed. Scatter graphs are used in correlation and regression analyses to visually determine if variables are associated and to detect outliers. When constructing a scatter graph, the dependent variable is typically placed on the vertical axis and the independent variable on the horizontal axis.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 12
Incorrect
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A researcher wants to compare the mean age of two groups of participants who were randomly assigned to either a standard exercise program of a standard exercise program + new supplement. The data collected is parametric and continuous. What is the most appropriate statistical test to use?
Your Answer:
Correct Answer: Unpaired t test
Explanation:The two sample unpaired t test is utilized to examine whether the null hypothesis that the two populations related to the two random samples are equivalent is true of not. When dealing with continuous data that is believed to conform to the normal distribution, a t test is suitable, making it appropriate for comparing weight loss between two groups. In contrast, a paired t test is used when the data is dependent, meaning there is a direct correlation between the values in the two samples. This could include the same subject being measured before and after a process change of at different times.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 13
Incorrect
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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:
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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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 14
Incorrect
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For a study comparing two chemotherapy regimens for small cell lung cancer patients based on survival time, which statistical measure is most suitable for comparison?
Your Answer:
Correct Answer: Hazard ratio
Explanation:Understanding Hazard Ratio in Survival Analysis
Survival analysis is a statistical method used to analyze the time it takes for an event of interest to occur, such as death of disease progression. In this type of analysis, the hazard ratio (HR) is a commonly used measure that is similar to the relative risk but takes into account the fact that the risk of an event may change over time.
The hazard ratio is particularly useful in situations where the risk of an event is not constant over time, such as in medical research where patients may have different survival times of disease progression rates. It is a measure of the relative risk of an event occurring in one group compared to another, taking into account the time it takes for the event to occur.
For example, in a study comparing the survival rates of two groups of cancer patients, the hazard ratio would be used to compare the risk of death in one group compared to the other, taking into account the time it takes for the patients to die. A hazard ratio of 1 indicates that there is no difference in the risk of death between the two groups, while a hazard ratio greater than 1 indicates that one group has a higher risk of death than the other.
Overall, the hazard ratio is a useful tool in survival analysis that allows researchers to compare the risk of an event occurring between different groups, taking into account the time it takes for the event to occur.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 15
Incorrect
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What hierarchical language does NLM utilize to enhance search strategies and index articles?
Your Answer:
Correct Answer: MeSH
Explanation:NLM’s hierarchical vocabulary, known as MeSH (Medical Subject Heading), is utilized for the purpose of indexing articles in PubMed.
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 16
Incorrect
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How can it be determined if the study on the effectiveness of a new oral treatment for schizophrenia patients in preventing hospital admissions has yielded statistically significant results?
Your Answer:
Correct Answer:
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 17
Incorrect
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As the occurrence of a condition decreases, what increases?
Your Answer:
Correct Answer: Negative predictive value
Explanation:The prevalence of a condition has an impact on both the PPV and NPV. When the prevalence decreases, the PPV also decreases while the NPV increases.
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 18
Incorrect
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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:
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 19
Incorrect
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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:
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 20
Incorrect
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What is the meaning of the P in the PICO model used for creating a research question?
Your Answer:
Correct Answer: Population
Explanation: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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 21
Incorrect
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What database is most suitable for finding scholarly material that has not undergone official publication?
Your Answer:
Correct Answer: SIGLE
Explanation:SIGLE is a database that contains unpublished of ‘grey’ literature, while CINAHL is a database that focuses on healthcare and biomedical journal articles. The Cochrane Library is a collection of databases that includes the Cochrane Reviews, which are systematic reviews and meta-analyses of medical research. EMBASE is a pharmacological and biomedical database, and PsycINFO is a database of abstracts from psychological literature that is created by the American Psychological Association.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 22
Incorrect
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Which of the following statements accurately describes relative risk?
Your Answer:
Correct Answer: It is the usual outcome measure of cohort studies
Explanation:The relative risk is the typical measure of outcome in cohort studies. It is important to distinguish between risk and odds. For example, if 20 individuals out of 100 who take an overdose die, the risk of dying is 0.2, while the odds are 0.25 (20/80).
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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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 23
Incorrect
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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:
Correct Answer: 20%
Explanation:The prevalence of the disease is 20% as there are currently 200 cases out of a total population of 1000.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 24
Incorrect
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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:
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 25
Incorrect
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What is another name for admission rate bias?
Your Answer:
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 26
Incorrect
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Which type of variable does the measurement of temperature on the Kelvin scale represent?
Your Answer:
Correct Answer: Ratio
Explanation:The distinction between interval and ratio scales is illustrated by the fact that ratio scales have a non-arbitrary zero point and meaningful ratios between values. Celsius and Fahrenheit temperature measurements are examples of interval scales, while the Kelvin scale is a ratio scale due to its zero point representing the complete absence of heat and the meaningful ratios between its values.
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 27
Incorrect
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What is the accurate formula for determining the likelihood ratio of a negative test result?
Your Answer:
Correct Answer: (1 - sensitivity) / specificity
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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 28
Incorrect
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What condition would make it inappropriate to use the Student's t-test for conducting a significance test?
Your Answer:
Correct 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.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 29
Incorrect
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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:
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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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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Question 30
Incorrect
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Researchers have conducted a study comparing a new blood pressure medication with a standard blood pressure medication. 200 patients are divided equally between the two groups. Over the course of one year, 20 patients in the treatment group experienced a significant reduction in blood pressure, compared to 35 patients in the control group.
What is the number needed to treat (NNT)?Your Answer:
Correct Answer: 7
Explanation:The Relative Risk Reduction (RRR) is calculated by subtracting the experimental event rate (EER) from the control event rate (CER), dividing the result by the CER, and then multiplying by 100 to get a percentage. In this case, the RRR is (35-20)รท35 = 0.4285 of 42.85%.
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This question is part of the following fields:
- Research Methods, Statistics, Critical Review And Evidence-Based Practice
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