Research Methods Relevant to Clinical Practice

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What is NICE framework for psychological therapies?
A benchmark guide developed to aid decisions about which therapies are appropriate for which patients.
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What is the NICE framework based on?
Systematic reviews and appraisal of body of international psychotherapy research.
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What broad traditions of psychological help do NICE acknowledge (2)?
Psychodynamic therapy (including CBT) that uses structured interventions, and counselling focused on individual resources.
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What is the order of the hierarchy of evidence (best to worst) (6)?
Systematic reviews, RCTs, cohort studies, case-control studies, case series/ case reports, editorials/ expert opinion.
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Why is EBM said to have questionable philosophical underpinnings?
It assumes scientific observations can be made independent of theories/ researcher bias, as well as neglecting the sociology of science.
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Why is EBM said to have a narrow definition?
It prioritizes the value of RCTs and meta-analyses, and struggles to integrate non-statistical forms of information.
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Why might it be suggested that EBM is not 'evidence based'?
There is little evidence to suggest that the EBM way actually improves clinical care.
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Why does EBM have limited usefulness?
Rare diseases have a small evidence base, because EBM tends to focus on mean tendencies.
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What are empirically grounded interventions?
Interventions carried out by clinicians who seek to operate as scientist-practitioners.
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What is "just in time" learning?
The alternative to EBM, which shifts focus to current patient problems.
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What are the background questions of "just in time" (6)?
Who, what, when, where, why and how.
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What are the foreground questions of "just in time"? (3)?
About patient care, decisions and actions.
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What is the PICO framework?
Patient/ problem/ population, intervention, comparison (if relevant), clinical outcomes.
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What are case reports?
A detailed report of symptoms, signs, diagnosis, and treatment, usually focusing on one individual in a unusual or novel occurrence.
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What are the pros of case reports (4)?
Can be highly innovative, very useful educationally, can be persuasive, brings the individual client to the front.
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What are the cons of case reports (3)?
Limited generalisabilty, danger of author bias, not always scientifically rigorous.
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What is a case series?
When a series of cases are reported, tracking patients with a known condition, and looks at their outcomes. It is often good for developing a new intervention.
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How are case series different to case reports?
Uses more than one case, so they are more generalisable.
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What are cohort studies?
Usually longitudinal studies run on a large group using standardised measures to identify risk factors and evaluate treatment response.
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What are the pros of cohort studies (3)?
Can determine causal relationships, run on large samples so can detect subtle changes, good for discovering natural course of disease of or response to treatment.
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What are the cons of cohort studies (4)?
Lack of control weakens inferences, can't rule out confounding variables, less individual focus, expensive and time consuming.
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What are controlled trials?
When a psychotherapy is compared to no treatment, treatment as usual, medication and/ or another psychotherapy.
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What are the pros of controlled trials (3)?
Generally provides evidence, takes into account improvement or worsening of condition, minimizes bias through randomization.
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What are the cons of controlled trials (4)?
Tends to have a criteria for patients so can be exclusive, more appropriate for medical model than therapeutic, expensive and time consuming, if a treatment is favoured in RCT it can be hard to go against it.
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What are reviews?
Interpreting the results from several sources.
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What is the difference between narrative reviews and systematic reviews?
Narrative reviews have no particular criteria, systematic reviews do.
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What are the pros of reviews (1)?
Can give an accurate summary of the field.
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What are the cons of reviews (2)?
Its value depends on how well it is done, dangers of bias/ inaccurate reporting/ missing key studies.
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What are meta-analyses?
Pooling together several studies that address related hypothesis and re-analysing the data.
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What are the pros of meta-analyses (3)?
Accurate to determine if an overall treatment is effective, large sample size increases generalisibility, null findings may sometime be interpreted.
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What are the cons of meta-analyses (4)?
Subject to study selection bias, high chance of false positives, researcher allegiance bias, often failure to consider demographic variables.
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Front

What is the NICE framework based on?

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Systematic reviews and appraisal of body of international psychotherapy research.

Card 3

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What broad traditions of psychological help do NICE acknowledge (2)?

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Card 4

Front

What is the order of the hierarchy of evidence (best to worst) (6)?

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Card 5

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Why is EBM said to have questionable philosophical underpinnings?

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