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Question 1
Correct
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What is the accurate formula for determining the pre-test odds?
Your Answer: Pre-test probability/ (1 - pre-test probability)
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 2
Incorrect
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What is the nature of the hypothesis that a researcher wants to test regarding the effect of a drug on a person's heart rate?
Your Answer: One-tailed null hypothesis
Correct Answer: One-tailed alternative hypothesis
Explanation:A one-tailed hypothesis indicates a specific direction of association between groups. The researcher not only declares that there will be a distinction between the groups but also defines the direction in which the difference will 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 3
Incorrect
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Through what method is data collected in the Delphi technique?
Your Answer: Focus groups
Correct Answer: Questionnaires
Explanation:The Delphi Method: A Widely Used Technique for Achieving Convergence of Opinion
The Delphi method is a well-established technique for soliciting expert opinions on real-world knowledge within specific topic areas. The process involves multiple rounds of questionnaires, with each round building on the previous one to achieve convergence of opinion among the participants. However, there are potential issues with the Delphi method, such as the time-consuming nature of the process, low response rates, and the potential for investigators to influence the opinions of the participants. Despite these challenges, the Delphi method remains a valuable tool for generating consensus among experts in various fields.
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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 4
Correct
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What is the primary benefit of conducting non-inferiority trials in the evaluation of a new medication?
Your Answer: Small sample size is required
Explanation:Study Designs for New Drugs: Options and Considerations
When launching a new drug, there are various study design options available. One common approach is a placebo-controlled trial, which can provide strong evidence but may be deemed unethical if established treatments are available. Additionally, it does not allow for a comparison with standard treatments. Therefore, statisticians must decide whether the trial aims to demonstrate superiority, equivalence, of non-inferiority to an existing treatment.
Superiority trials may seem like the obvious choice, but they require a large sample size to show a significant benefit over an existing treatment. Equivalence trials define an equivalence margin on a specified outcome, and if the confidence interval of the difference between the two drugs falls within this margin, the drugs are assumed to have a similar effect. Non-inferiority trials are similar to equivalence trials, but only the lower confidence interval needs to fall within the equivalence margin. These trials require smaller sample sizes, and once a drug has been shown to be non-inferior, larger studies may be conducted to demonstrate superiority.
It is important to note that drug companies may not necessarily aim to show superiority over an existing product. If they can demonstrate that their product is equivalent of even non-inferior, they may compete on price of convenience. Overall, the choice of study design depends on various factors, including ethical considerations, sample size, and the desired outcome.
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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 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: STARD
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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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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What is the conventional cutoff for a p-value of 0.05 and what does it mean in terms of the likelihood of detecting a difference by chance?
Your Answer: 1 in 70 times
Correct Answer: 1 in 14 times
Explanation:The probability of detecting a difference by chance is 1 in 20 times when the p-value is 0.05, which is the conventional cutoff. In this case, the answer is 1 in 14 times, which is equivalent to a p-value of 0.07.
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 7
Incorrect
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To qualify as purposive sampling, would the researcher need to specifically target participants based on certain characteristics, such as those who had received a delayed diagnosis?
Your Answer: Purposive sampling
Correct Answer: Convenience sampling
Explanation:The sampling method employed was convenience sampling, which involved recruiting participants through flyers posted in clinics. However, this approach may lead to an imbalanced sample. To be considered purposive sampling, the researcher would need to demonstrate a deliberate effort to recruit participants based on specific characteristics, such as targeting individuals who had experienced a delayed diagnosis.
Qualitative research is a method of inquiry that seeks to understand the meaning and experience dimensions of human lives and social worlds. There are different approaches to qualitative research, such as ethnography, phenomenology, and grounded theory, each with its own purpose, role of the researcher, stages of research, and method of data analysis. The most common methods used in healthcare research are interviews and focus groups. Sampling techniques include convenience sampling, purposive sampling, quota sampling, snowball sampling, and case study sampling. Sample size can be determined by data saturation, which occurs when new categories, themes, of explanations stop emerging from the data. Validity can be assessed through triangulation, respondent validation, bracketing, and reflexivity. Analytical approaches include content analysis and constant comparison.
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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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What type of data is required to compute the relative risk of odds ratio?
Your Answer: Nominal
Correct Answer: Dichotomous
Explanation:When outcomes are binary (such as dead of alive), there are various ways to report them, including proportions, percentages, risk, odds, risk ratios, odds ratios, number needed to treat, likelihood ratios, sensitivity, specificity, and pre-test and post-test probability. However, for non-binary data types, different methods of reporting are required.
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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A team of investigators aims to explore the perspectives of middle-aged physicians regarding individuals with chronic fatigue syndrome. They will conduct interviews with a random selection of physicians until no additional insights are gained of existing ones are substantially altered. What is their objective before concluding further interviews?
Your Answer: Triangulation
Correct Answer: Data saturation
Explanation:In qualitative research, data saturation refers to the point where additional data collection becomes unnecessary as the responses obtained are repetitive and do not provide any new insights. This is when the researcher has heard the same information repeatedly and there is no need to continue recruiting participants. Understanding data saturation is crucial in qualitative research.
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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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What is the most suitable significance test to examine the potential association between serum level and degree of sedation in patients who are prescribed clozapine, where sedation is measured on a scale of 1-10?
Your Answer: Student's t-test
Correct Answer: Logistic regression
Explanation:This scenario involves examining the correlation between two variables: the sedation scale (which is ordinal) and the serum clozapine level (which is a ratio scale). While the serum clozapine level can be measured using arithmetic and is considered a parametric variable, the sedation scale cannot be treated in the same way due to its non-parametric nature. Therefore, the analysis of the correlation between these two variables will need to take into account the limitations of the sedation scale as an ordinal variable.
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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A study examines the likelihood of stroke in middle-aged patients prescribed antipsychotic medication. Group A receives standard treatment, and after 5 years, 20 out of 100 patients experience a stroke. Group B receives standard treatment plus a new drug intended to decrease the risk of stroke. After 5 years, 10 out of 60 patients have a stroke. What are the chances of having a stroke while taking the new drug compared to the chances of having a stroke in those receiving standard treatment?
Your Answer: 1.25
Correct Answer: 0.8
Explanation:If the odds ratio is less than 1, it means that the likelihood of experiencing a stroke is lower for individuals who are taking the new drug compared to those who are receiving the usual treatment.
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 12
Correct
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Arrange the following research studies in the correct order based on their level of evidence.
Your Answer: Systematic review of RCTs, RCTs, cohort, case-control, cross-sectional, case-series
Explanation:While many individuals can readily remember that the systematic review is at the highest level and case-series at the lowest, it can be difficult to correctly sequence the intermediate levels.
Levels and Grades of Evidence in Evidence-Based Medicine
To evaluate the quality of evidence on a subject of question, levels of grades are used. The traditional hierarchy approach places systematic reviews of randomized control trials at the top and case-series/report at the bottom. However, this approach is overly simplistic as certain research questions cannot be answered using RCTs. To address this, the Oxford Centre for Evidence-Based Medicine introduced their 2011 Levels of Evidence system, which separates the type of study questions and gives a hierarchy for each.
The grading approach to be aware of is the GRADE system, which classifies the quality of evidence as high, moderate, low, of very low. The process begins by formulating a study question and identifying specific outcomes. Outcomes are then graded as critical of important. The evidence is then gathered and criteria are used to grade the evidence, with the type of evidence being a significant factor. Evidence can be promoted of downgraded based on certain criteria, such as limitations to study quality, inconsistency, uncertainty about directness, imprecise of sparse data, and reporting bias. The GRADE system allows for the promotion of observational studies to high-quality evidence under the right circumstances.
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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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By implementing a double-blinded randomised controlled trial to evaluate the efficacy of a new medication for Lewy Body Dementia, what type of bias can be prevented by ensuring that both the patient and doctor are blinded?
Your Answer: Confounding bias
Correct Answer: Expectation 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 14
Incorrect
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Which of the following is an inferential statistic?
Your Answer: Range
Correct Answer: Standard error
Explanation: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.
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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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How is validity assessed in qualitative research?
Your Answer: Bonferroni correction
Correct Answer: Triangulation
Explanation:To examine differences between various groups, researchers may conduct subgroup analyses by dividing participant data into subsets. These subsets may include specific demographics (e.g. gender) of study characteristics (e.g. location). Subgroup analyses can help explain inconsistent findings of provide insights into particular patient populations, interventions, of study types.
Qualitative research is a method of inquiry that seeks to understand the meaning and experience dimensions of human lives and social worlds. There are different approaches to qualitative research, such as ethnography, phenomenology, and grounded theory, each with its own purpose, role of the researcher, stages of research, and method of data analysis. The most common methods used in healthcare research are interviews and focus groups. Sampling techniques include convenience sampling, purposive sampling, quota sampling, snowball sampling, and case study sampling. Sample size can be determined by data saturation, which occurs when new categories, themes, of explanations stop emerging from the data. Validity can be assessed through triangulation, respondent validation, bracketing, and reflexivity. Analytical approaches include content analysis and constant comparison.
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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
Correct
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What is the appropriate significance test to use when analyzing the data of patients' serum cholesterol levels before and after receiving a new lipid-lowering therapy?
Your Answer: Paired t-test
Explanation:Since the serum cholesterol level is continuous data and assumed to be normally distributed, and the data is paired from the same individuals, the most suitable statistical test is the paired t-test.
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 17
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 18
Correct
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What is another name for the incidence rate?
Your Answer: Incidence density
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 19
Incorrect
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A team of investigators aimed to explore the perspectives of experienced psychologists on the use of cognitive-behavioral therapy in treating anxiety disorders. They randomly selected a group of psychologists to participate in the study.
To enhance the credibility of their results, they opted to employ two researchers with different expertise (a clinical psychologist and a social worker) to conduct interviews with the selected psychologists. Furthermore, they collected data from the psychologists not only through interviews but also by organizing focus groups.
What is the approach used in this qualitative study to improve the credibility of the findings?Your Answer: Data saturation
Correct Answer: Triangulation
Explanation:Triangulation is a technique commonly employed in research to ensure the accuracy and reliability of results. It involves using multiple methods to verify findings, also known as ‘cross examination’. This approach increases confidence in the results by demonstrating consistency across different methods. Investigator triangulation involves using researchers with diverse backgrounds, while method triangulation involves using different techniques such as interviews and focus groups. The goal of triangulation in qualitative research is to enhance the credibility and validity of the findings by addressing potential biases and limitations associated with single-method, single-observer studies.
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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
Correct
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What is the approach that targets confounding variables during the study's design phase?
Your Answer: Randomisation
Explanation:Stats Confounding
A confounding factor is a factor that can obscure the relationship between an exposure and an outcome in a study. This factor is associated with both the exposure and the disease. For example, in a study that finds a link between coffee consumption and heart disease, smoking could be a confounding factor because it is associated with both drinking coffee and heart disease. Confounding occurs when there is a non-random distribution of risk factors in the population, such as age, sex, and social class.
To control for confounding in the design stage of an experiment, researchers can use randomization, restriction, of matching. Randomization aims to produce an even distribution of potential risk factors in two populations. Restriction involves limiting the study population to a specific group to ensure similar age distributions. Matching involves finding and enrolling participants who are similar in terms of potential confounding factors.
In the analysis stage of an experiment, researchers can control for confounding by using stratification of multivariate models such as logistic regression, linear regression, of analysis of covariance (ANCOVA). Stratification involves creating categories of strata in which the confounding variable does not vary of varies minimally.
Overall, controlling for confounding is important in ensuring that the relationship between an exposure and an outcome is accurately assessed in a study.
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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 factors affect the statistical power of a study?
Your Answer: Observation bias
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 22
Incorrect
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What is the significance of the cut off of 5 on the MDQ in diagnosing depression?
Your Answer: The false positive rate
Correct Answer: The optimal threshold
Explanation:The threshold score that results in the lowest misclassification rate, achieved by minimizing both false positive and false negative rates, is known as the optimal threshold. Based on the findings of the previous study, the ideal cut off for identifying caseness on the MDQ is five, making it the optimal threshold.
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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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What statement accurately describes the process of searching a database?
Your Answer: All Medline citations include a link to the full text
Correct Answer: New references are added to PubMed more quickly than they are to MEDLINE
Explanation:PubMed receives new references faster than MEDLINE because they do not need to undergo indexing, such as adding MeSH headings and checking tags. While an increasing number of MEDLINE citations have a link to the complete article, not all of them do. Since 2010, Embased has included all MEDLINE citations in its database, but it does not have all citations from before that year.
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 24
Incorrect
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What is the proportion of values that fall within a range of 3 standard deviations from the mean in a normal distribution?
Your Answer: 97.20%
Correct Answer: 99.70%
Explanation:Standard Deviation and Standard Error of the Mean
Standard deviation (SD) and standard error of the mean (SEM) are two important statistical measures used to describe data. SD is a measure of how much the data varies, while SEM is a measure of how precisely we know the true mean of the population. The normal distribution, also known as the Gaussian distribution, is a symmetrical bell-shaped curve that describes the spread of many biological and clinical measurements.
68.3% of the data lies within 1 SD of the mean, 95.4% of the data lies within 2 SD of the mean, and 99.7% of the data lies within 3 SD of the mean. The SD is calculated by taking the square root of the variance and is expressed in the same units as the data set. A low SD indicates that data points tend to be very close to the mean.
On the other hand, SEM is an inferential statistic that quantifies the precision of the mean. It is expressed in the same units as the data and is calculated by dividing the SD of the sample mean by the square root of the sample size. The SEM gets smaller as the sample size increases, and it takes into account both the value of the SD and the sample size.
Both SD and SEM are important measures in statistical analysis, and they are used to calculate confidence intervals and test hypotheses. While SD quantifies scatter, SEM quantifies precision, and both are essential in understanding and interpreting 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 25
Incorrect
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Which of the following resources has been filtered?
Your Answer: Ovid MEDLINE
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.
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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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What type of regression is appropriate for analyzing data with dichotomous variables?
Your Answer: Logical
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 27
Incorrect
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Which of the following can be used to represent the overall number of individuals affected by a disease during a specific period?
Your Answer: Standardised prevalence
Correct Answer: Period prevalence
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 28
Correct
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A university lecturer is interested in determining if the psychology students would like more training on working with children. They know that there are 5000 psychology students and of these 60% are under the age of 25 and 40% are 25 of older. To avoid any potential age bias, they create two separate lists of students, one for those under 25 and one for those 25 of older. From these lists, they take a random sample from each list to ensure that they have an equal number of students from each age group. They then ask each selected student if they would like more training on working with children.
How would you describe the sampling strategy of this study?Your Answer: Stratified sampling
Explanation:Sampling Methods in Statistics
When collecting data from a population, it is often impractical and unnecessary to gather information from every single member. Instead, taking a sample is preferred. However, it is crucial that the sample accurately represents the population from which it is drawn. There are two main types of sampling methods: probability (random) sampling and non-probability (non-random) sampling.
Non-probability sampling methods, also known as judgement samples, are based on human choice rather than random selection. These samples are convenient and cheaper than probability sampling methods. Examples of non-probability sampling methods include voluntary sampling, convenience sampling, snowball sampling, and quota sampling.
Probability sampling methods give a more representative sample of the population than non-probability sampling. In each probability sampling technique, each population element has a known (non-zero) chance of being selected for the sample. Examples of probability sampling methods include simple random sampling, systematic sampling, cluster sampling, stratified sampling, and multistage sampling.
Simple random sampling is a sample in which every member of the population has an equal chance of being chosen. Systematic sampling involves selecting every kth member of the population. Cluster sampling involves dividing a population into separate groups (called clusters) and selecting a random sample of clusters. Stratified sampling involves dividing a population into groups (strata) and taking a random sample from each strata. Multistage sampling is a more complex method that involves several stages and combines two of more sampling methods.
Overall, probability sampling methods give a more representative sample of the population, but non-probability sampling methods are often more convenient and cheaper. It is important to choose the appropriate sampling method based on the research question and available resources.
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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 scientists embarked on a research project to determine if a new vaccine is effective in preventing a certain disease. They sought to satisfy the criteria outlined by Hill's guidelines for establishing causality.
What is the primary criterion among Hill's guidelines for establishing causality?Your Answer: Consistency
Correct Answer: Temporality
Explanation:The most crucial factor in Hill’s criteria for causation is temporality, of the temporal relationship between exposure and outcome. It is imperative that the exposure to a potential causal factor, such as factor ‘A’, always occurs before the onset of the disease. This criterion is the only absolute requirement for causation. The other criteria include the strength of the relationship, dose-response relationship, consistency, plausibility, consideration of alternative explanations, experimental evidence, specificity, and coherence.
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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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What is the name of the test that compares the variance within a group to the variance between groups?
Your Answer:
Correct Answer: ANOVA
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.
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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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