EVIDENCE-BASED PRACTICE AND RESEARCH METHODOLOGY
Academic year and teacher
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- Versione italiana
- Academic year
- 2019/2020
- Teacher
- MICHELA BOZZOLAN
- Credits
- 4
- Didactic period
- Primo Semestre
Training objectives
- EVIDENCE-BASED PRACTICE
On completion of the course the student is expected to:
Knowledge: know the architecture of quantitative clinical research; -Know the principles of qualitative research in physiotherapy and rehabilitation. -Know the types of useful sources for EBP in physiotherapy.
Skills:
-formulate a clinical question (PICO)
-search for relevant literature on the main online databases related to physiotherapy.
-carry out critical appraisal (internal validity) of a clinical study or systematic review.
-evaluate external validity of a study and integrate expertise, patient values and available resources into the decision-making process (EPB 5 steps)
-integrate the results of research in physiotherapy as part of a holistic approach in accordance with ICF framework
INFORMATICS APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH
On completion of the course the student is expected to:
Knowledge: -know the main statistical parameters of descriptive statistics applied to data through Microsoft Excel
Skills: use computer software in order to create and process databases, helpful in clinical setting and research.
STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH
On completion of the course the student is expected to:
Knowledge:
-Understand the need to include uncertainty in a personalized clinical pathway. -Know concepts and basic tools of medical statistics (parametric and non-parametric) useful in the biomedical and epidemiological field, in order to reduce or quantify the areas of uncertainty.
Skills:
- choose and appropriately use the most common statistical tests in the biomedical and epidemiological filed, in order to critical evaluate and interpret the results of scientific studies for clinical decision-making. -Plan an experimental study (creating models for data collection and carrying out simple statistical processing) to adequately solve a clinical question, for example in the framework of a thesis. Prerequisites
- Preparatory courses to be passed before: none
Knowledge and skills deemed already acquired:
EVIDENCE-BASED PRACTICE:
Basic elements of statistics and computer science.
Principles for the formulation of a PICO and for online searching in databases of literature
IT APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH:
Basic knowledge of Microsoft Excel
STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH:
Basic elements of statistics and computer science.
Principles for the formulation of a PICO.
Some experience of practice variation in clinical decision-making. Course programme
- EVIDENCE-BASED PRACTICE
Structure and aims of quantitative clinical research: experimental studies (RCT,NRCT, NCT) and observational studies (cross-sectional, prospective, retrospective) and their results.
Tools for critical appraisal of studies (PEDro, QUADAS-2) and for their reporting (CONSORT and others).
Statistical and clinical significance.
Definition and interpretation of CI (confidence interval), MCID (minimally important clinical difference), MDC (minimal detectable change) in the EBP process.
Indices of diagnostic accuracy (sensitivity, specificity, LR+ and LR-, PPV and PNV), Fagan nomogram and their application in physiotherapy.
Structure, aim and methods of qualitative research in rehabilitation (phenomenological approach, grounded theory, interviews, focus groups, observation…). Mixed methods studies and their uselfulness in rehabilitation.
Aims and structure of systematic reviews (SR) and metanalysis. Critical appraisal (AMSTAR), reporting (PRISMA), and interpretation of results of SR.
-efficient strategies for online bibliographic search.
INFORMATION TECHNOLOGY APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH
Basic concepts and definition of relational database and relative application. Definition of relations between data and integrity. Making reports. Data transfer to electronic spread sheets.
Management of descriptive statistics and relative application to data through e-spreadsheets. Management of variables. Definition of frequency and calculation of distribution frequency for qualitative and quantitative data by means of Microsoft Excel. Graphic representation of data (steam-leaf) and of distribution. Measures of central tendency, position and dispersion for qualitative data.
Functions of statistical analyses in Microsoft Excel and their application to data. Relations between indices.
Analysis procedure of data: histograms/descriptive statistics in Microsoft Excel.
Practical exercises on the computer.
STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH
Introduction and methodology.
Descriptive and inferential statistics.
Study designs, parametric and non-parametric methods.
Odds Ratio, ARR, RRR
Confidence Intervals
Intra and inter-rater reliability indexes
Review of RCT and RS. Review of Clinical Guidelines and Diagnostic studies.
Outcomes, external validity.
Analysis of a study - Theory and Practice.
Practice variations. Evidence based medicine (EBM). Ethics, complexity, sustainability/transition (impact of climate change, resources peak and economical crisis on decisions), intercultural dimension (values as a founding element of clinical decisions) Didactic methods
- EVIDENCE-BASED PRACTICE:
Frontal lessons and individual or group work (critical appraisal of studies, bibliographic online search), e-learning
IT APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH:
Lectures in a computer room with PC use
STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH:
Frontal lessons and group work (critical appraisal of studies), e-learning Learning assessment procedures
- EVIDENCE-BASED PRACTICE and STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH (one exam for both the modules)
Students will receive three studies 15 days before the exam (1 clinical trial, 1 study of diagnostic accuracy, 1 systematic review). Students have to understand and critically evaluate them (using appropriate tools). Written exam with short open questions: interpretation of an abstract (max 5 points), at least 8 questions that test the correct understanding of the methods and results of the three studies, and at least 5 questions that test knowledge/skills (included in the learning objectives) but not included in the above questions. Each question can receive a maximum of 0 to 3 points (depending on the complexity of the question); the score is assigned depending on the completeness and correctness of the answer. Maximum obtainable score= 33 ; from 31 onwards a praise is attributed. A test of online literature search in PubMed, PEDro, and the Cochrane Library that can confirm the mark, or increase or decrease it up to 2 points. Duration: 2 hours to the written questions and 1 hour for the online search. Students are given the opportunity to perform an online exam simulation.
IT APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH:
Students will perform statistical analysis exercises at the PC using Microsoft Excel. For example, given a text file containing quantitative or qualitative data, you will be asked to import it into an Excel worksheet and then analyze its contents in order to obtain: conditional formatting and data filtering, subdivision into classes, absolute and relative frequency, Trend measures such as media and fashion, dispersion measures such as range and variance, graphical representations of data, stem and leaf organizations, analysis based on pivot tables and everything else seen in class. Each exercise will be associated with a maximum score that the student can get by doing it completely correctly. The final grade will be given by the sum of the scores obtained in each year, sufficiency with 18/30 points, maximum score 30/30.
THE FINAL GRADE IS A WEIGHTED AVERAGE OF THE MARKS OBTAINED IN EACH TEST. Reference texts
- EVIDENCE-BASED PRACTICE
Herbert R et al ., Evidence-based physiotherapy. Second edition EDRA 2014 (Italian version)
or
Herbert, Robert, Practical Evidence- Based Physiotherapy, 2nd Edition . Churchill Livingstone, 2011 (English version)
Slides, video presentations and articles provided by the teacher .
IT APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH
File Excel and self-learning provided by the teacher
STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH
Bibliographic and sitographic information provided by the teacher. Slides, video presentations and articles provided by the teacher.
