Question 1

In trying to incorporate the literature into clinical practice,what is the best way to keep up with current research?
A) Try to read it all.
B) Take 2 days off per month and do nothing but read articles.
C) Use a clinical challenge to look at the literature and incorporate published findings.
D) Attend one professional meeting per year.

Accepted Answer

It is not feasible to try to read all the current research or to take such a huge chunk of time off every month. Attending one professional meeting per year can be helpful, but it may not provide the most up-to-date information. Using a clinical challenge to look at the literature and incorporate published findings is a practical approach to staying up-to-date with the latest research while integrating new knowledge into clinical practice.

Question 2

Which of the following choices represents the highest reliability?
A) 0.83
B) 0.91
C) 0.29
D) 0.50

Accepted Answer

Reliability is a measure of how consistent and stable a measurement or test is over time. The closer the reliability coefficient is to 1, the higher the reliability of the measurement. Among the given choices, the highest reliability is represented by option B (0.91) as it is nearest to 1.

Question 3

What reliability coefficient should be used when comparing clinicians?
A) Kappa
B) Gamma
C) Delta
D) Alpha

Accepted Answer

Kappa is the correct reliability coefficient for comparing clinicians because it is specifically designed to measure agreement between two raters or judges on categorical scales, making it suitable for evaluating the consistency of clinicians' assessments or decisions.

Question 4

You and another athletic trainer share the responsibility of evaluating the star of the baseball team.In order for any follow-up evaluations to be useful and interpretable,what type of reliability must be highest?
A) Intrarater reliability
B) Interrater reliability
C) Intraexaminer reliability
D) Reliability doesn't matter.

Accepted Answer

Interrater reliability refers to the consistency of results between different raters or evaluators. In this case, having high interrater reliability is important because it ensures that both athletic trainers are evaluating the player in a consistent manner, which will make any follow-up evaluations more reliable and interpretable. Intrarater reliability (A) refers to consistency between evaluations done by the same rater, which is less relevant in this situation because there are two different athletic trainers involved. Intraexaminer reliability (C) refers to consistency between multiple evaluations done by the same examiner, which is not relevant in this situation either. Reliability (D) always matters in any scientific evaluation, so this answer is incorrect.

Question 5

Which of the following is considered the highest level of evidence?
A) Systematic review
B) Meta-analysis
C) Randomized clinical trials
D) Cohort studies

Accepted Answer

Meta-analysis is considered the highest level of evidence because it statistically combines the results of multiple studies, providing a more comprehensive and reliable conclusion.

Question 6

What is meant by a positive likelihood ratio?
A) The likelihood that a negative test will decrease the probability that the pathology is absent
B) The likelihood that a positive test will decrease the probability that the pathology is present
C) The likelihood that a positive test will enhance the probability that the pathology is present
D) The likelihood that a negative test will enhance the probability that the pathology is present

Accepted Answer

A positive likelihood ratio is the likelihood that a positive test result will enhance the probability that the pathology is present. It indicates how much the odds of the disease increase when a positive test result is obtained. A value greater than 1 suggests that the test is good at detecting the disease.

Question 7

Three clinicians (I,II,III)are working in the clinic and routinely rotate patients so they are familiar with all of their clients.Which of the following combinations of clinicians needs to work to make their skill set more reliable?
A) Interrater reliability between I and III = 0.78
B) Interrater reliability between I and II = 0.98
C) Interrater reliability between II and III = 0.83
D) Intrarater reliability of I = 0.98

Accepted Answer

Interrater reliability between I and III is the lowest (0.78), indicating that these two clinicians need to work on making their assessments more consistent with each other.

Question 8

Which of the following tests would determine with the highest sensitivity that a fracture is present?
A) X-ray
B) Magnetic resonance imaging (MRI)
C) Tap test
D) Squeeze test

Accepted Answer

X-rays are the most sensitive test for detecting fractures, as they can show even small cracks in the bone.

Question 9

The higher the prevalence of an injury,the __________ the effect on positive predictive value and the _______ the effect on negative predictive value.
A) higher; higher
B) lower; lower
C) higher; lower
D) lower; higher

Accepted Answer

When the prevalence of an injury increases, the true positive cases increase (which is good for the positive predictive value), but the false negative cases also decrease (which is bad for the negative predictive value). Therefore, the positive predictive value increases, but the negative predictive value decreases. This is consistent with Choice C.

Question 10

Which of the following is not true regarding the use of clinical decision rules,also known as clinical prediction rules?
A) They improve decision making.
B) They decrease costs.
C) They ultimately improve patient outcome.
D) They decrease the experience level of the clinician.

Accepted Answer

Clinical decision rules are designed to assist clinicians in making more accurate and evidence-based decisions, ultimately improving patient outcomes and decreasing costs by reducing unnecessary testing and treatments. However, they do not decrease the experience level of the clinician, as they are meant to supplement and guide their clinical judgment, not replace it.

Question 11

What is the best method for improving intrarater reliability?
A) Repeat the process multiple times using the same technique.
B) Repeat the process and compare it with other individuals.
C) Don't worry about it-the task will come with experience and time.
D) There is no way to improve intrarater reliability.

Accepted Answer

The best method for improving intrarater reliability is to repeat the process multiple times using the same technique. By doing so, the rater can become more familiar with the task and develop a consistent approach. Additionally, it is important to document the procedures used to ensure consistency over time.

Question 12

Which of the following terms describes when a certain number of individuals in a group sustain an injury?
A) Prevalence
B) Specificity
C) Selectivity
D) Validity

Accepted Answer

Prevalence refers to the number of individuals within a population or group that have a particular condition or disease. In this case, if a certain number of individuals in a group sustain an injury, the prevalence of injury within that group would be the appropriate term. Specificity refers to a test's ability to accurately identify individuals who do not have a particular condition or disease. Selectivity is not a commonly used term in epidemiology or public health. Validity refers to how accurately a study or measure assesses what it is intended to measure; it is not specific to injuries within a group.

Question 13

When doing a literature search on a specific topic,you find two articles that were written based on different research methods.Of the choices listed below,the ________ represents the highest level of research design,and the __________ represents the lowest level.
A) case report; cohort study
B) meta-analysis; expert opinion
C) expert opinion; meta-analysis
D) expert opinion; case report

Accepted Answer

Meta-analysis is considered the highest level of research design because it synthesizes data from multiple studies to produce more robust conclusions. Expert opinion, while valuable, is considered the lowest level because it is based on individual expertise rather than empirical evidence.

Question 14

Evidence-based practice,a foundation of best practice,is the incorporation of three elements into the decision-making process of patient care.Which of the following is not one of these elements?
A) Best available research
B) Clinical expertise
C) The overall time to achieve long-term goals
D) The needs and values of the individual patient

Accepted Answer

The overall time to achieve long-term goals is not one of the three elements of evidence-based practice. The correct elements are: best available research, clinical expertise, and the needs and values of the individual patient.

Question 15

What is the term used to identify how often a negative finding is correct?
A) Positive predictive value
B) True positive predictive value
C) Negative predictive value
D) True negative/negative value

Accepted Answer

The term used to identify how often a negative finding is correct is the negative predictive value. The negative predictive value assesses the probability that a negative test result is correct and can be calculated using the formula: true negative/(true negative + false negative). Options A and B refer to the probability that a positive finding is correct, while option D does not accurately reflect the commonly used terminology in diagnostic testing.

Question 16

Which term describes a test's ability to detect those patients who do not have the disorder being tested for?
A) Selectivity
B) Specificity
C) Reliability
D) Validity

Accepted Answer

Specificity is the term that describes a test's ability to detect those patients who do not have the disorder being tested for. It measures the true negative rate.

Question 17

Which of the following factors does not influence reliability?
A) Consistency in performing a skill
B) How the results are interpreted
C) Gender of the patient
D) Experience and training of the examiner

Accepted Answer

Gender of the patient is not a factor that influences reliability as it does not affect the consistency or accuracy of the skill being performed or the interpretation of the results. Factors such as consistency in performing a skill, how the results are interpreted, and experience and training of the examiner are all important factors that can influence reliability.

Question 18

What is the term for the ability of a protocol to produce the intended effects?
A) Likelihood ratio
B) Specificity
C) Efficacy
D) Sensitivity

Accepted Answer

Efficacy refers to the ability of a protocol or intervention to produce the intended effects under ideal or controlled conditions. It is different from effectiveness, which refers to the ability to produce intended effects in real-world settings.

Question 19

What is the term for a clinical test that incorrectly identifies a condition as present when there is no pathology?
A) True positive
B) False positive
C) True negative
D) False negative

Accepted Answer

A false positive refers to a clinical test result that indicates a condition is present when there is actually no pathology. This is in contrast to a true positive, which correctly identifies a condition that is present, a true negative, which correctly identifies the absence of a condition, and a false negative, which incorrectly indicates the absence of a condition that is actually present.

Question 20

What is the gold standard for diagnosing anterior cruciate ligament injuries?
A) Anterior drawer test
B) Lachman's test
C) MRI
D) Arthroscopy

Accepted Answer

Arthroscopy is considered the gold standard for diagnosing anterior cruciate ligament injuries because it allows direct visualization of the ligament.

Quiz 3: Evidence-Based Practice in the Diagnostic Process

In trying to incorporate the literature into clinical practice,what is the best way to keep up with current research?

Which of the following choices represents the highest reliability?

What reliability coefficient should be used when comparing clinicians?

You and another athletic trainer share the responsibility of evaluating the star of the baseball team.In order for any follow-up evaluations to be useful and interpretable,what type of reliability must be highest?

Which of the following is considered the highest level of evidence?

What is meant by a positive likelihood ratio?

Three clinicians (I,II,III) are working in the clinic and routinely rotate patients so they are familiar with all of their clients.Which of the following combinations of clinicians needs to work to make their skill set more reliable?

Which of the following tests would determine with the highest sensitivity that a fracture is present?

The higher the prevalence of an injury,the ____ the effect on positive predictive value and the _ the effect on negative predictive value.

Which of the following is not true regarding the use of clinical decision rules,also known as clinical prediction rules?

What is the best method for improving intrarater reliability?

Which of the following terms describes when a certain number of individuals in a group sustain an injury?

When doing a literature search on a specific topic,you find two articles that were written based on different research methods.Of the choices listed below,the represents the highest level of research design,and the __ represents the lowest level.

Evidence-based practice,a foundation of best practice,is the incorporation of three elements into the decision-making process of patient care.Which of the following is not one of these elements?

What is the term used to identify how often a negative finding is correct?

Which term describes a test's ability to detect those patients who do not have the disorder being tested for?

Which of the following factors does not influence reliability?

What is the term for the ability of a protocol to produce the intended effects?

What is the term for a clinical test that incorrectly identifies a condition as present when there is no pathology?

What is the gold standard for diagnosing anterior cruciate ligament injuries?