Which statement accurately characterizes a behavioral approaches to performance measurement?

Evidence-based physical therapist practice is most accurately characterized by which of the following statements

a. Practice habits that mirror regional peers managing the same types of patients

b. Integration of evidence with patient preferences and clinical judgment

c. Adoption of practice habits taught by expert faculty in DPT programs

d. A focus on background questions that can be answered by epidemiology

Which of the following is the first step in evidence-based physical therapist practice?

a. Internet access during patient care

b. Time to search during the work-day

c. Full text article availability

d. Recognition of a gap in knowledge

Which of the following is a focus area for evidence-based physical therapist practice?

a. Accuracy of prognostic indicators

b. Effectiveness of interventions

c. Responsiveness of outcomes measures

d. All of these are correct

Which of the following statements reflects a move away from authority and tradition in practice?

a. Regular attendance at continuing education courses by the same clinical teacher.

b. Requests for consultation from expert therapist to answer clinical questions.

c. Reliance on DPT program text books to guide clinical decision making.

d. Internet search for scientific articles in response to a gap in knowledge

Which of the following is an example of confirmation bias?

a. A physical therapist believes all individuals with rheumatoid arthritis benefit from aquatic PT based on

his memory of previous patients whose symptoms improved.

b. A physical therapist designs a low-level exercise prescription because he believes his patient will be too

old to tolerate a more vigorous program.

c. A physical therapist believes all individuals with severe headaches have brain tumors because her

colleague’s patient was just told he was misdiagnosed with migraines.

d. A physical therapist applies a manual technique she learned at a continuing education course to all

patients with mid-thoracic spine pain.

All of the following are desirable design characteristics when searching for evidence

to answer a clinical question except:

a. The information includes the type of interventions about which the therapist has a question

b. The information includes subjects similar to the individual about whom the question is posed

c. The information is consistent with the contemporary physical therapist practice for patients like this one

d. The information comes from an equipment manufacturer sales piece that is not peer reviewed

Physical therapists traveling to a developing country that has a lot of industrial pollution want to know

the prevalence of asthma in children so they can anticipate the volume of patients they will see at their

pulmonary clinic. What type of clinical question are these therapists asking?

a. A background question about asthma

b. A background question about clinic staffing

c. A foreground question about asthma

d. A foreground question about clinic staffing

Authors of a study propose that disparities in access to physical therapist services are explained by a multitude of

factors depicted in this figure. Which of the following terms most accurately characterizes this figure?

Which of the following is an example of a foreground question?

a.How long will it take for the cognitive effects of a concussion to surface in a 17-year-old rugby player?

b.How do I measure a lymphedema in a 56-year-old woman following unilateral mastectomy?

c.Does a previous low back injury predispose a 45-year-old construction worker to a future injury?

d.How many physical therapists are needed to conduct a falls screening clinic at a local assisted living facility?

Which of the following is a true statement about theoretical models?

a. Researchers can prove a theory is true with one investigation

b. Theories are unable to predict future outcomes

c. Theories are simplistic characterizations of a phenomenon

d. Multiple constructs may be linked together to create a theory

Investigators propose that unweighted treadmill support training will stimulate neuroplasticity in patients with

incomplete spinal cord injury through the repetitive motion of ambulation. Which of the following most accurately

characterizes this statement?

a. It proposes a theoretical model to predict the effect of treadmill training

on neuronal organization in the spinal cord

b. It proposes a conceptual model to explain the effect of treadmill training

on neuronal organization in the spinal cord

c. It proposes a biologically plausible rationale to explain the specific

mechanism behind neuronal organization in the spinal cord

d. It proposes a null hypothesis with respect to the impact of treadmill

training on neuronal organization in the spinal cord

Which of the following statements explains why systematic reviews are highly

valued in evidence-based practice?

a. They are an efficient way for therapists to access results from multiple studies

b. They are experimental designs with a high degree of bias control in their methods

c. They focus on bench research to determine the effectiveness of interventions

d. They are case report designs that depict patient management in a realistic way

Which of the following most accurately characterizes traditional evidence hierarchies?

a. They minimize the need for a quality assessment of individual studies

b. They have the same operational definitions and number of levels

c. They may improve the efficiency of a search process for physical therapists

d. They rank physiologic studies highly because of the degree of bias control they achieve

Which of the following study designs has the fewest strategies for controlling

unwanted influence on the outcomes of interest?

a. Anecdotal reports about individual patients

b. Randomized trials in clinical settings

c. Observational studies based on large data sets

d. Quasi-experimental studies of one group of subjects

All of the following accurately characterize traditional evidence hierarchies EXCEPT:

a. They minimize the need for a quality assessment of individual studies

b. They have the same operational definitions and number of levels

c. They may improve the efficiency of a search process for physical therapists

d. They rank physiologic studies highly because of the degree of bias control they achieve

Researchers study two groups of middle-aged adults who travel long distances by plane for business on a

regular basis to determine which individuals develop deep vein thromboses and which do not. Which of the

following is the correct research design for this study?

a. Case-control

b. Cohort

c. Experimental

d. Qualitative

Physical therapists in a skilled nursing facility want to know if group exercise supervised by a PT or PTA will produce the same outcomes as

the same exercise applied in a one-on-one session with a therapist. They randomly assign individuals to the group and one-on-one sessions

and measure outcomes after six weeks. Which of the following accurately characterizes this research design?

a. It is a retrospective experimental design

b. It is a retrospective quasi-experimental design

c. It is a prospective experimental design

d. It is a prospective quasi-experimental design

Which of the following is a correct statement about the qualitative research paradigm?

a. It espouses multiple realities that are constructed through subjects’ perceptions

b. It relies on use of research design controls to isolate treatment effects

c. It only supports collection of study data in the form of numerical quantities

d. It includes designs in which researchers actively intervene with subjects

Researchers studying the effectiveness of an intervention in a cohort of teenagers with scoliosis compare their subjects’

baseline score with their final score on a self-report survey used as the outcomes measure. Which of the following

statements correctly characterizes this study design?

a. It is a between-groups comparison

b. It is a within-group comparison

c. It is an experimental design

d. It is a qualitative design

. A hypothetical study concluded that exercise improved functional outcomes more than massage in people

with neck pain. This finding is consistent with which of the following research design types?

a. A design that assesses the statistical relationship between neck pain and exercise

b. A design that describes the prevalence of neck pain in people who exercise

c. A design that tests the causes of neck pain in people who exercise

d. A design that tests the effectiveness of exercise for people with neck pain

Which of the following terms refers to the pooling of data as part of a systematic review?

a. Meta-analysis

b. Randomized trial

c. Prospective cohort

d. Case series

Authors of a study about a new clinical test to detect Achilles tendonopathy excluded individuals with

memory or cognitive impairments. Which of the following statements accurately characterizes the authors’

concerns about these individuals?

a. Test results may be influenced by their low motivation levels

b. Test results may be influenced by their inability to follow directions

c. Test results may be influenced by their low symptom levels

d. Tests results may be influenced by their limited numbers in the population

Investigators wish to study the prevalence of work place injuries in migrant farm workers. They are given

permission to make announcements about the study at a local church gathering. What form of subject

selection does this approach represent?

a. Random sampling

b. Purposive sampling

c. Convenience sampling

d. Cluster sampling

A non-probabilistic selection method that involves using a “word-of-mouth” technique to

make eligible candidates aware of a study is called:

a. Convenience sampling

b. Stratified sampling

c. Snowball sampling

d. Block sampling

The probability that a statistical test will find a significant relationship between caffeine

consumption and level of alertness in graduate students is correctly characterized by which term?

a. Statistical regression

b. Statistical power

c. Sampling error

d. Type II error

The inability of a statistical test to find a significant difference in hospital readmission rates between elders with

family support and elders without when a difference actually exists is correctly characterized by which term?

a. Regression to the mean

b. Sampling error

c. Type I error

d. Type II error

Authors of a study reported that “subjects rated their perceived global changes in pain and physical

function on a 5-point Likert scale ranging from 1 (much worse) to 5 (much better).” Which of the following

is a correct statement about this instrument?

a. This is an ordinal measure because all of the possible values are categories

b. This is an ordinal measure because the lowest possible value is a fixed zero point

c. This is an ordinal measure because the lowest possible value is not a fixed zero point

d. This is an ordinal measure because it has an infinite number of values between each score

Creators of a new self-report survey for patients with amyotrophic lateral sclerosis indicate that the

instrument is capable of distinguishing among three levels of symptom severity. What form of measurement

validity does this finding represent?

a. Concurrent validity

b. Face validity

c. Predictive validity

d. Discriminant validity

Authors of a study about outcomes of physical therapist management of plantar fasciitis report that one

of the instruments used could not detect continued improvement in five of their subjects (total n = 30).

Which of the following measurement properties does this finding reflect?

a. A floor effect

b. A ceiling effect

c. Measurement error

d. Responsiveness

An outpatient practice receives risk-adjusted outcomes reports based on surveys administered to its

patients at the start and conclusion of the episode of care. What type of variables would be used in the

risk-adjustment process?

a. Independent variables

b. Dependent variables

c. Extraneous variables

d. Predictor variables

Six physical therapists participating in a clinical study record shoulder flexion and abduction range of motion

measurements within two degrees of each other on one test subject. What does this result represent?

a. Intra-rater reliability

b. Inter-rater reliability

c. Internal consistency

d. Test-retest reliability

Authors of a study reported that “subjects improved their gait speed an average of 3.2 meters/second.” Which

of the following is a correct statement about this instrument?

a. This is a ratio level measure because all of the possible values are categories

b. This is a ratio level measure because the lowest possible value is a fixed zero point

c. This is a ratio level measure because the lowest possible value is not a fixed zero point

d. This is a ratio level measure because the distance between values is not known

Investigators want to know if a new measure of lower extremity edema obtains results consistent with a gold standard

measurement technique of the same problem. What form of measurement validity are they trying to establish?

a. Discriminant validity

b. Construct validity

c. Criterion validity

d. Predictive validity

Authors of a two-group randomized controlled trial for lateral epicondylitis reported a standardized effect

size for pain equal to .24 after the experimental treatment. Which of the following statements is a correct

interpretation of this finding?

a. The finding indicates a small treatment effect occurred for the intervention group

b. The finding indicates a small treatment effect occurred for the control group

c. The finding represents an absolute difference in final pain scores between the two groups

d. The finding represents a change score for pain in the intervention group only

All of the following are measures of variability in a data set except:

a. Interpercentile range

b. Standard deviation

c. Standard error of measurement

d. Measure of central tendency

Which of the following descriptive statistics will be shifted toward the elongated tail of a

skewed data set due to a change in its value?

a. Mean

b. Median

c. Mode

d. Frequency

Which of the following measures of central tendency is appropriate to summarize

race/ethnicity categories in a sample?

a. Mean

b. Median

c. Mode

d. Percentile

Authors of a two-group randomized controlled trial for bicipital tendonitis reported an effect size for selfreported function equal to 10 points. Which of the following statements is a correct interpretation of this

finding?

a. The finding indicates a favorable treatment effect for the intervention group

b. The finding indicates a favorable treatment effect for the control group

c. The finding represents an absolute difference in scores between the two groups

d. The finding represents an absolute change score for the intervention group only

Authors of a study about a new clinical measure designed to quantify lymphedema reported that six of their subjects

(total n = 20) had symptoms that were 50% less than the average. Which of the following is a correct statement about the

sample in this study?

a. The symptom data are positively skewed.

b. The symptom data are negatively skewed.

c. The symptom data are normally distributed.

d. The symptom data are not appropriate for analysis

Results from a study of community dwelling elderly people indicated that subjects with a higher number

of injurious falls had lower muscle strength values. Which of the following statements is correct about this

relationship if the correlation analysis is statistically significant?

a. There is a positive relationship between muscle strength and fall rate

b. There is an inverse relationship between muscle strength and fall rate

c. There is no relationship between muscle strength and fall rate

d. There is a variable relationship between muscle strength and fall rate

Authors of a non-experimental aquatic physical therapy study used a paired t-test to assess for

differences in hip abductor strength in subjects between six weeks and twelve weeks because:

a. They were making comparisons using data from two separate groups of subjects

b. They were making comparisons using data from a single group of subjects

c. They were making comparisons using data with a skewed distribution

d. They were making comparisons using data that was classified in two categories

Which of the following methods is most likely to help authors avoid a Type 1 error in a

study?

a. Randomly selecting a large number of subjects for their study

b. Verifying inter-rater reliability of personnel collecting study data

c. Keeping subjects masked to their status in the study

d. Setting a low alpha level to establish statistical significance

Which of the following design strategies enhances the quality of a systematic review?

a. Rigorous evaluation of the quality of included studies

b. Classification at the top of evidence hierarchies

c. Pooling of different types of data from individual studies

d. Exclusion of foreign-language studies

Which of the following characteristics is most likely to improve the chances of drawing a meaningful

conclusion from the cumulative evidence in a systematic review?

a. Heterogeneity of individual study findings

b. Homogeneity of individual study findings

c. A small number of well-designed studies

d. A large number of studies with different design

Which of the following design strategies reduces the chance of bias in a systematic review?

a. Pre-established inclusion and exclusion criteria for individual studies

b. Literature searches that include unpublished studies such as dissertations

c. A standardized format and process for quality assessment of included studies

d. All of these are correct

Authors of a hypothetical meta-analysis report the use of masked reviewers to assess the quality of

included studies. How does this approach influence bias in the study?

a. It increases bias because the reviewers don’t have a consistent assessment tool

b. It increases bias because the reviewers don’t know where the studies came from

c. It decreases bias because the reviewers don’t influence the conclusions drawn

d. It decreases bias because the reviewers don’t influence each other’s ratings

Authors of a hypothetical systematic review about a physical therapy intervention note that 3 of 5

individual studies suggest a positive treatment effect. However, all of the studies are poorly designed and

have small sample sizes. Which conclusion would you expect the authors to draw in this situation?

a. The authors will conclude that the evidence supports intervention use.

b. The authors will conclude that the evidence does not support intervention use.

c. The authors will conclude that the evidence is inconclusive intervention use.

d. None of the above.

Randomization of subjects to groups enhances the quality of intervention studies for which of the

following reasons?

a. Subject characteristics are more likely to be distributed evenly among the groups

b. Subject preferences are more likely to influence outcomes in the control group

c. Investigator knowledge of group assignment can be eliminated with this method

d. Investigator inexperience with the experimental protocol can be minimized

Under which of the following circumstances is an intention to treat analysis indicated?

a. When subjects in both groups are managed similarly by the investigators

b. When subjects can discern whether they are in the experimental or control groups

c. When subjects in the experimental group are masked to their outcome results

d. When subjects in the control group do not comply with the protocol for their group

Concealing subject group enrollment from research personnel enhances the quality of intervention studies for which of the following reasons?

a. Investigator inexperience with the experimental protocol can be minimized

b. Subject performance on outcome measure can be evenly distributed

c. Randomization of subjects to the study groups can be preserved

d. Subject preferences are more likely to influence control group outcomes

Which of the following design strategies reinforces the quality of a study about diagnostic tests by reducing the chance of examiner bias?

a. Masking the index test results from personnel applying the gold standard test

b. Applying the gold standard test to subjects who test negative on the index test

c. Including subjects with all severity levels of the condition of interest

d. Minimizing the time between application of the index test and the gold standard test

A hypothetical study about a diagnostic test reports the following results: LR- = 0.82, 95% C.I. = 0.54,

1.25. Which of the following statements is the correct interpretation of this finding?

a. The value for LR- indicates an increased likelihood that the condition is present

b. The value for LR- indicates an increased likelihood that the test result is negative

c. The confidence interval indicates the true value for LR- may represent a coin flip

d. The confidence interval indicates the true value for LR- is statistically significant

C

If an LR = 1.0 it represents a 50:50 chance of increasing or decreasing the probability of a diagnosis

A 95% CI that includes 1.0 in its range means that one possibility for the “true value” of the LR is a 50:50 chance

Use the information in this table to calculate the specificity of this hypothetical diagnostic test

C

Ability of the test to correctly identify (- test result) in someone

without the disorder

Patients without the disorder who test negative (TN) / All patients

without the disorder (TN+FP)

17 / 17+18 = 0.485 or 49%

Which of the following statements is the correct interpretation of the positive predictive value of this hypothetical diagnostic test?

B

(TP) / (TP+FP)

(35) / (35+22) = 0.61 or 61%

+PPV=Ability of the test to correctly determine the % of people

with the disorder from all of the people with positive test results

5. Which of the following explains why i

Which of the following explains why it is important to the quality of a study about diagnostic

tests to evaluate subjects who test negative on the index test with the gold standard test?

a. False negative results can be identified

b. False positive results can be identified

c. True negative results can be eliminated

d. True positive results can be eliminated

The confidence interval for the odds ratio in question 4 is 95% CI (0.02, 1.43). Which of the following is

the correct interpretation of this finding?

a. The true value of the odds ratio is statistically significant

b. The true value of the odds ratio is clinically meaningful

c. The true value of the odds ratio may reflect a coin flip

d. The true value of the odds ratio may be outside the 95% CI

Relative risks differ from odds ratios in which of the following ways?

a. Relative risk ratios are not different from odds ratios

b. Relative risk ratios are based on the incidence of the outcome

c. Odds ratios are based on the incidence of the outcome

d. Odds ratios cannot be used for predicting adverse events

Which of the following elements comprise a prognosis?

a. The outcomes that are possible

b. The likelihood the outcomes can be achieved

c. The timeframe for outcome achievement

d. All of these are correct

Investigators studying predictors of disparities in access to physical therapist services include the number of years that

subjects completed a formal education as a variable. What kind of prognostic factor does this variable represent?

a. A biobehavioral comorbidity

b. A demographic characteristic

c. A disease specific indicator

d. A medical comorbidity

A validated clinical prediction rule may be used to guide treatment decisions

a. True

b. False

A hypothetical study describes the derivation of a new clinical prediction rule to determine which individuals with multiple

sclerosis will respond best to physical therapy. Which of the following statements most accurately characterizes this situation?

a. Derivation of the rule is necessary after it has been validated

b. Derivation of the rule does not guarantee its validity in practice

c. Validation of the rule is unnecessary if a large enough sample size is used

d. Validation of the rule is only needed if it is applied to new populations

Which of the following statistical methods is commonly used in the process of creating a clinical prediction rule?

a. Analysis of variance to test for differences in outcomes

b. Frequencies to determine the prevalence of outcomes

c. Regression analysis to identify the most important predictive factors

d. Calculation of effect size to determine the magnitude of predictive factors

All of the following are reasons why qualitative studies may inform physical therapist practice EXCEPT?

a. Standardized self-report outcomes instruments are the primary source of data

b. Observation of subject behavior may reveal cultural influences relevant to health care

c. Interviews with subjects are useful for uncovering perceptions about disability

d. Caregivers’ lived experiences with health care may be captured in their natural contex

This statement defines which of the following qualitative research methods?

“A qualitative research design that uses analysis of experiences, interpretations, and meanings to

understand the “lived experience” of the individuals studied.”

a. Discourse analysis

b. Grounded theory

c. Ethnography

d. Phenomenology

An ethnographic qualitative research design allows investigators to examine which of the following?

a. How individuals make sense of interactions with others and/or with their setting under certain circumstances or

conditions

b. How individuals’ behaviors are shaped by the culture of a setting under certain circumstances or conditions

c. How individuals in a setting communicate with one another under certain circumstances or conditions

d. How individuals make sense of their experiences in a setting under certain circumstances or conditions

Investigators are conducting a qualitative study about physical therapist management of individuals with functional

deficits following combat related injury. They use interviews and observation to develop conceptual categories of subject

perspectives and experiences. Which qualitative research method did they use?

a. Discourse analysis

b. Patient-centered care

c. Historical analysis

d. Grounded theory

Which of the following statements describes performance measurement that has a developmental orientation?

Which type performance appraisal measures the frequency of observed behavior critical incidents?

Which of the following is true of behavioral approaches to performance measurement quizlet?

Which statement accurately characterizes behavioral approaches to performance measurement?