Analytic Validation of Immunohistochemical Assays: A Comparison of Laboratory Practices Before and After Introduction of an Evidence-Based Guideline.

PubMed

Fitzgibbons, Patrick L; Goldsmith, Jeffrey D; Souers, Rhona J; Fatheree, Lisa A; Volmar, Keith E; Stuart, Lauren N; Nowak, Jan A; Astles, J Rex; Nakhleh, Raouf E

2017-09-01

- Laboratories must demonstrate analytic validity before any test can be used clinically, but studies have shown inconsistent practices in immunohistochemical assay validation. - To assess changes in immunohistochemistry analytic validation practices after publication of an evidence-based laboratory practice guideline. - A survey on current immunohistochemistry assay validation practices and on the awareness and adoption of a recently published guideline was sent to subscribers enrolled in one of 3 relevant College of American Pathologists proficiency testing programs and to additional nonsubscribing laboratories that perform immunohistochemical testing. The results were compared with an earlier survey of validation practices. - Analysis was based on responses from 1085 laboratories that perform immunohistochemical staining. Of 1057 responses, 65.4% (691) were aware of the guideline recommendations before this survey was sent and 79.9% (550 of 688) of those have already adopted some or all of the recommendations. Compared with the 2010 survey, a significant number of laboratories now have written validation procedures for both predictive and nonpredictive marker assays and specifications for the minimum numbers of cases needed for validation. There was also significant improvement in compliance with validation requirements, with 99% (100 of 102) having validated their most recently introduced predictive marker assay, compared with 74.9% (326 of 435) in 2010. The difficulty in finding validation cases for rare antigens and resource limitations were cited as the biggest challenges in implementing the guideline. - Dissemination of the 2014 evidence-based guideline validation practices had a positive impact on laboratory performance; some or all of the recommendations have been adopted by nearly 80% of respondents.

Literature evidence in open targets - a target validation platform.

PubMed

Kafkas, Şenay; Dunham, Ian; McEntyre, Johanna

2017-06-06

We present the Europe PMC literature component of Open Targets - a target validation platform that integrates various evidence to aid drug target identification and validation. The component identifies target-disease associations in documents and ranks the documents based on their confidence from the Europe PMC literature database, by using rules utilising expert-provided heuristic information. The confidence score of a given document represents how valuable the document is in the scope of target validation for a given target-disease association by taking into account the credibility of the association based on the properties of the text. The component serves the platform regularly with the up-to-date data since December, 2015. Currently, there are a total number of 1168365 distinct target-disease associations text mined from >26 million PubMed abstracts and >1.2 million Open Access full text articles. Our comparative analyses on the current available evidence data in the platform revealed that 850179 of these associations are exclusively identified by literature mining. This component helps the platform's users by providing the most relevant literature hits for a given target and disease. The text mining evidence along with the other types of evidence can be explored visually through https://www.targetvalidation.org and all the evidence data is available for download in json format from https://www.targetvalidation.org/downloads/data .

Validity evidence as a key marker of quality of technical skill assessment in OTL-HNS.

PubMed

Labbé, Mathilde; Young, Meredith; Nguyen, Lily H P

2018-01-13

Quality monitoring of assessment practices should be a priority in all residency programs. Validity evidence is one of the main hallmarks of assessment quality and should be collected to support the interpretation and use of assessment data. Our objective was to identify, synthesize, and present the validity evidence reported supporting different technical skill assessment tools in otolaryngology-head and neck surgery (OTL-HNS). We performed a secondary analysis of data generated through a systematic review of all published tools for assessing technical skills in OTL-HNS (n = 16). For each tool, we coded validity evidence according to the five types of evidence described by the American Educational Research Association's interpretation of Messick's validity framework. Descriptive statistical analyses were conducted. All 16 tools included in our analysis were supported by internal structure and relationship to variables validity evidence. Eleven articles presented evidence supporting content. Response process was discussed only in one article, and no study reported on evidence exploring consequences. We present the validity evidence reported for 16 rater-based tools that could be used for work-based assessment of OTL-HNS residents in the operating room. The articles included in our review were consistently deficient in evidence for response process and consequences. Rater-based assessment tools that support high-stakes decisions that impact the learner and programs should include several sources of validity evidence. Thus, use of any assessment should be done with careful consideration of the context-specific validity evidence supporting score interpretation, and we encourage deliberate continual assessment quality-monitoring. NA. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Truth and Evidence in Validity Theory

ERIC Educational Resources Information Center

Borsboom, Denny; Markus, Keith A.

2013-01-01

According to Kane (this issue), "the validity of a proposed interpretation or use depends on how well the evidence supports" the claims being made. Because truth and evidence are distinct, this means that the validity of a test score interpretation could be high even though the interpretation is false. As an illustration, we discuss the case of…

20 CFR 404.727 - Evidence of a deemed valid marriage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evidence of a deemed valid marriage. 404.727... DISABILITY INSURANCE (1950- ) Evidence Evidence of Age, Marriage, and Death § 404.727 Evidence of a deemed valid marriage. (a) General. A deemed valid marriage is a ceremonial marriage we consider valid even...

Measuring Decision-Making During Thyroidectomy: Validity Evidence for a Web-Based Assessment Tool.

PubMed

Madani, Amin; Gornitsky, Jordan; Watanabe, Yusuke; Benay, Cassandre; Altieri, Maria S; Pucher, Philip H; Tabah, Roger; Mitmaker, Elliot J

2018-02-01

Errors in judgment during thyroidectomy can lead to recurrent laryngeal nerve injury and other complications. Despite the strong link between patient outcomes and intraoperative decision-making, methods to evaluate these complex skills are lacking. The purpose of this study was to develop objective metrics to evaluate advanced cognitive skills during thyroidectomy and to obtain validity evidence for them. An interactive online learning platform was developed ( www.thinklikeasurgeon.com ). Trainees and surgeons from four institutions completed a 33-item assessment, developed based on a cognitive task analysis and expert Delphi consensus. Sixteen items required subjects to make annotations on still frames of thyroidectomy videos, and accuracy scores were calculated based on an algorithm derived from experts' responses ("visual concordance test," VCT). Seven items were short answer (SA), requiring users to type their answers, and scores were automatically calculated based on their similarity to a pre-populated repertoire of correct responses. Test-retest reliability, internal consistency, and correlation of scores with self-reported experience and training level (novice, intermediate, expert) were calculated. Twenty-eight subjects (10 endocrine surgeons and otolaryngologists, 18 trainees) participated. There was high test-retest reliability (intraclass correlation coefficient = 0.96; n = 10) and internal consistency (Cronbach's α = 0.93). The assessment demonstrated significant differences between novices, intermediates, and experts in total score (p < 0.01), VCT score (p < 0.01) and SA score (p < 0.01). There was high correlation between total case number and total score (ρ = 0.95, p < 0.01), between total case number and VCT score (ρ = 0.93, p < 0.01), and between total case number and SA score (ρ = 0.83, p < 0.01). This study describes the development of novel metrics and provides validity evidence for an interactive Web-based platform

Moderators and Mediators in Social Work Research: Toward a More Ecologically Valid Evidence Base for Practice

PubMed Central

Magill, Molly

2012-01-01

Summary Evidence-based practice involves the consistent and critical consumption of the social work research literature. As methodologies advance, primers to guide such efforts are often needed. In the present work, common statistical methods for testing moderation and mediation are identified, summarized, and corresponding examples, drawn from the substance abuse, domestic violence, and mental health literature, are provided. Findings While methodologically complex, analyses of these third variable effects can provide an optimal fit for the complexity involved in the provision of evidence-based social work services. While a moderator may identify the trait or state requirement for a causal relationship to occur, a mediator is concerned with the transmission of that relationship. In social work practice, these are questions of “under what conditions and for whom?” and of the “how?” of behavior change. Implications Implications include a need for greater attention to these methods among practitioners and evaluation researchers. With knowledge gained through the present review, social workers can benefit from a more ecologically valid evidence base for practice. PMID:22833701

Sicily statement on evidence-based practice

PubMed Central

Dawes, Martin; Summerskill, William; Glasziou, Paul; Cartabellotta, Antonino; Martin, Janet; Hopayian, Kevork; Porzsolt, Franz; Burls, Amanda; Osborne, James

2005-01-01

Background A variety of definitions of evidence-based practice (EBP) exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP) means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC"). Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'. PMID:15634359

The Mastery Rubric for Evidence-Based Medicine: Institutional Validation via Multidimensional Scaling.

PubMed

Tractenberg, Rochelle E; Gushta, Matthew M; Weinfeld, Jeffrey M

2016-01-01

CONSTRUCT: In this study we describe a multidimensional scaling (MDS) exercise to validate the curricular elements composing a new Mastery Rubric (MR) for a curriculum in evidence-based medicine (EBM). This MR-EBM comprises 10 elements of knowledge, skills, and abilities (KSAs) representing our institutional learning goals of career-spanning engagement with EBM. An MR also includes developmental trajectories for each KSA, beginning with medical school coursework, including residency training, and outlining the qualifications of individuals to teach and mentor in EBM. The development was not part of the validation effort, as our curriculum is focused at a single stage (undergraduate medical students). An MR comprises the desired KSAs for an entire curriculum, together with descriptions of a learner's performance and/or capabilities as they develop from novice to proficiency of the curricular target(s). The MR construct is intended to support curriculum development or refinement by capturing the KSAs that support the articulation of concrete learning goals; it also promotes assessment that demonstrates development in the target KSAs and encourages reflection and self-directed learning throughout the learner's career. Two other MRs have been published, and this is the first one specific to teaching and learning in medicine; this is also the first one created specifically to evaluate an existing curriculum. To validate the dispersion of the elements of the EBM curriculum, the nine clinical instructors in the EBM two-course curriculum completed an MDS exercise, rating the similarities of the 10 curricular elements. MDS is a mathematical approach to understanding relationships among concepts/objects when these relationships are difficult to quantify. Eliciting similarity ratings biased the responses toward the null hypothesis (that the elements are not different). MDS results suggested that the MR represents 10 different, although related, facets of the construct

Evidence based vaccinology.

PubMed

Nalin, David R

2002-02-22

Evidence based vaccinology (EBV) is the identification and use of the best evidence in making and implementing decisions during all of the stages of the life of a vaccine, including pre-licensure vaccine development and post-licensure manufacture and research, and utilization of the vaccine for disease control. Vaccines, unlike most pharmaceuticals, are in a continuous process of development both before and after licensure. Changes in biologics manufacturing technology and changes that vaccines induce in population and disease biology lead to periodic review of regimens (and sometimes dosage) based on changing immunologic data or public perceptions relevant to vaccine safety and effectiveness. EBV includes the use of evidence based medicine (EBM) both in clinical trials and in national disease containment programs. The rationale for EBV is that the highest evidentiary standards are required to maintain a rigorous scientific basis of vaccine quality control in manufacture and to ensure valid determination of vaccine efficacy, field effectiveness and safety profiles (including post-licensure safety monitoring), cost-benefit analyses, and risk:benefit ratios. EBV is increasingly based on statistically validated, clearly defined laboratory, manufacturing, clinical and epidemiological research methods and procedures, codified as good laboratory practices (GLP), good manufacturing practices (GMP), good clinical research practices (GCRP) and in clinical and public health practice (good vaccination practices, GVP). Implementation demands many data-driven decisions made by a spectrum of specialists pre- and post-licensure, and is essential to maintaining public confidence in vaccines.

20 CFR 404.725 - Evidence of a valid ceremonial marriage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evidence of a valid ceremonial marriage. 404... DISABILITY INSURANCE (1950- ) Evidence Evidence of Age, Marriage, and Death § 404.725 Evidence of a valid ceremonial marriage. (a) General. A valid ceremonial marriage is one that follows procedures set by law in...

Evidence of Construct Validity in Published Achievement Tests.

ERIC Educational Resources Information Center

Nolet, Victor; Tindal, Gerald

Valid interpretation of test scores is the shared responsibility of the test designer and the test user. Test publishers must provide evidence of the validity of the decisions their tests are intended to support, while test users are responsible for analyzing this evidence and subsequently using the test in the manner indicated by the publisher.…

Validity Evidence for the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT).

PubMed

Breimer, Gerben E; Haji, Faizal A; Cinalli, Giuseppe; Hoving, Eelco W; Drake, James M

2017-02-01

Growing demand for transparent and standardized methods for evaluating surgical competence prompted the construction of the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT). To provide validity evidence of the NEVAT by reporting on the tool's internal structure and its relationship with surgical expertise during simulation-based training. The NEVAT was used to assess performance of trainees and faculty at an international neuroendoscopy workshop. All participants performed an endoscopic third ventriculostomy (ETV) on a synthetic simulator. Participants were simultaneously scored by 2 raters using the NEVAT procedural checklist and global rating scale (GRS). Evidence of internal structure was collected by calculating interrater reliability and internal consistency of raters' scores. Evidence of relationships with other variables was collected by comparing the ETV performance of experts, experienced trainees, and novices using Jonckheere's test (evidence of construct validity). Thirteen experts, 11 experienced trainees, and 10 novices participated. The interrater reliability by the intraclass correlation coefficient for the checklist and GRS was 0.82 and 0.94, respectively. Internal consistency (Cronbach's α) for the checklist and the GRS was 0.74 and 0.97, respectively. Median scores with interquartile range on the checklist and GRS for novices, experienced trainees, and experts were 0.69 (0.58-0.86), 0.85 (0.63-0.89), and 0.85 (0.81-0.91) and 3.1 (2.5-3.8), 3.7 (2.2-4.3) and 4.6 (4.4-4.9), respectively. Jonckheere's test showed that the median checklist and GRS score increased with performer expertise ( P = .04 and .002, respectively). This study provides validity evidence for the NEVAT to support its use as a standardized method of evaluating neuroendoscopic competence during simulation-based training. Copyright © 2016 by the Congress of Neurological Surgeons

Psychometric instrumentation: reliability and validity of instruments used for clinical practice, evidence-based practice projects and research studies.

PubMed

Mayo, Ann M

2015-01-01

It is important for CNSs and other APNs to consider the reliability and validity of instruments chosen for clinical practice, evidence-based practice projects, or research studies. Psychometric testing uses specific research methods to evaluate the amount of error associated with any particular instrument. Reliability estimates explain more about how well the instrument is designed, whereas validity estimates explain more about scores that are produced by the instrument. An instrument may be architecturally sound overall (reliable), but the same instrument may not be valid. For example, if a specific group does not understand certain well-constructed items, then the instrument does not produce valid scores when used with that group. Many instrument developers may conduct reliability testing only once, yet continue validity testing in different populations over many years. All CNSs should be advocating for the use of reliable instruments that produce valid results. Clinical nurse specialists may find themselves in situations where reliability and validity estimates for some instruments that are being utilized are unknown. In such cases, CNSs should engage key stakeholders to sponsor nursing researchers to pursue this most important work.

What Counts as Validity Evidence? Examples and Prevalence in a Systematic Review of Simulation-Based Assessment

ERIC Educational Resources Information Center

Cook, David A.; Zendejas, Benjamin; Hamstra, Stanley J.; Hatala, Rose; Brydges, Ryan

2014-01-01

Ongoing transformations in health professions education underscore the need for valid and reliable assessment. The current standard for assessment validation requires evidence from five sources: content, response process, internal structure, relations with other variables, and consequences. However, researchers remain uncertain regarding the types…

Latency-Based and Psychophysiological Measures of Sexual Interest Show Convergent and Concurrent Validity.

PubMed

Ó Ciardha, Caoilte; Attard-Johnson, Janice; Bindemann, Markus

2018-04-01

Latency-based measures of sexual interest require additional evidence of validity, as do newer pupil dilation approaches. A total of 102 community men completed six latency-based measures of sexual interest. Pupillary responses were recorded during three of these tasks and in an additional task where no participant response was required. For adult stimuli, there was a high degree of intercorrelation between measures, suggesting that tasks may be measuring the same underlying construct (convergent validity). In addition to being correlated with one another, measures also predicted participants' self-reported sexual interest, demonstrating concurrent validity (i.e., the ability of a task to predict a more validated, simultaneously recorded, measure). Latency-based and pupillometric approaches also showed preliminary evidence of concurrent validity in predicting both self-reported interest in child molestation and viewing pornographic material containing children. Taken together, the study findings build on the evidence base for the validity of latency-based and pupillometric measures of sexual interest.

Policy and Validity Prospects for Performance-Based Assessment.

ERIC Educational Resources Information Center

Baker, Eva L.; And Others

1994-01-01

This article describes performance-based assessment as expounded by its proponents, comments on these conceptions, reviews evidence regarding the technical quality of performance-based assessment, and considers its validity under various policy options. (JDD)

Examining validity evidence for a simulation-based assessment tool for basic robotic surgical skills.

PubMed

Havemann, Maria Cecilie; Dalsgaard, Torur; Sørensen, Jette Led; Røssaak, Kristin; Brisling, Steffen; Mosgaard, Berit Jul; Høgdall, Claus; Bjerrum, Flemming

2018-05-14

Increasing focus on patient safety makes it important to ensure surgical competency among surgeons before operating on patients. The objective was to gather validity evidence for a virtual-reality simulator test for robotic surgical skills and evaluate its potential as a training tool. Surgeons with varying experience in robotic surgery were recruited: novices (zero procedures), intermediates (1-50), experienced (> 50). Five experienced surgeons rated five exercises on the da Vinci Skills Simulator. Participants were tested using the five exercises. Participants were invited back 3 times and completed a total of 10 attempts per exercise. The outcome was the average simulator performance score for the 5 exercises. 32 participants from 5 surgical specialties were included. 38 participants completed all 4 sessions. A moderate correlation between the average total score and robotic experience was identified for the first attempt (Spearman r = 0.58; p = 0.0004). A difference in average total score was observed between novices and intermediates [median score 61% (IQR 52-66) vs. 83% (IQR 75-91), adjusted p < 0.0001], as well as novices and experienced [median score 61% (IQR 52-66) vs. 80 (IQR 69-85), adjusted p = 0.002]. All three groups improved their performance between the 1st and 10th attempts (p < 0.00). This study describes validity evidence for a virtual-reality simulator for basic robotic surgical skills, which can be used for assessment of basic competency and as a training tool. However, more validity evidence is needed before it can be used for certification or high-stakes assessment.

Validation of an instrument to assess evidence-based practice knowledge, attitudes, access, and confidence in the dental environment.

PubMed

Hendricson, William D; Rugh, John D; Hatch, John P; Stark, Debra L; Deahl, Thomas; Wallmann, Elizabeth R

2011-02-01

This article reports the validation of an assessment instrument designed to measure the outcomes of training in evidence-based practice (EBP) in the context of dentistry. Four EBP dimensions are measured by this instrument: 1) understanding of EBP concepts, 2) attitudes about EBP, 3) evidence-accessing methods, and 4) confidence in critical appraisal. The instrument-the Knowledge, Attitudes, Access, and Confidence Evaluation (KACE)-has four scales, with a total of thirty-five items: EBP knowledge (ten items), EBP attitudes (ten), accessing evidence (nine), and confidence (six). Four elements of validity were assessed: consistency of items within the KACE scales (extent to which items within a scale measure the same dimension), discrimination (capacity to detect differences between individuals with different training or experience), responsiveness (capacity to detect the effects of education on trainees), and test-retest reliability. Internal consistency of scales was assessed by analyzing responses of second-year dental students, dental residents, and dental faculty members using Cronbach coefficient alpha, a statistical measure of reliability. Discriminative validity was assessed by comparing KACE scores for the three groups. Responsiveness was assessed by comparing pre- and post-training responses for dental students and residents. To measure test-retest reliability, the full KACE was completed twice by a class of freshman dental students seventeen days apart, and the knowledge scale was completed twice by sixteen faculty members fourteen days apart. Item-to-scale consistency ranged from 0.21 to 0.78 for knowledge, 0.57 to 0.83 for attitude, 0.70 to 0.84 for accessing evidence, and 0.87 to 0.94 for confidence. For discrimination, ANOVA and post hoc testing by the Tukey-Kramer method revealed significant score differences among students, residents, and faculty members consistent with education and experience levels. For responsiveness to training, dental students

Evidence flow graph methods for validation and verification of expert systems

NASA Technical Reports Server (NTRS)

Becker, Lee A.; Green, Peter G.; Bhatnagar, Jayant

1989-01-01

The results of an investigation into the use of evidence flow graph techniques for performing validation and verification of expert systems are given. A translator to convert horn-clause rule bases into evidence flow graphs, a simulation program, and methods of analysis were developed. These tools were then applied to a simple rule base which contained errors. It was found that the method was capable of identifying a variety of problems, for example that the order of presentation of input data or small changes in critical parameters could affect the output from a set of rules.

Evidence flow graph methods for validation and verification of expert systems

NASA Technical Reports Server (NTRS)

Becker, Lee A.; Green, Peter G.; Bhatnagar, Jayant

1988-01-01

This final report describes the results of an investigation into the use of evidence flow graph techniques for performing validation and verification of expert systems. This was approached by developing a translator to convert horn-clause rule bases into evidence flow graphs, a simulation program, and methods of analysis. These tools were then applied to a simple rule base which contained errors. It was found that the method was capable of identifying a variety of problems, for example that the order of presentation of input data or small changes in critical parameters could effect the output from a set of rules.

Synthesizing Quantitative Evidence for Evidence-based Nursing: Systematic Review.

PubMed

Oh, Eui Geum

2016-06-01

As evidence-based practice has become an important issue in healthcare settings, the educational needs for knowledge and skills for the generation and utilization of healthcare evidence are increasing. Systematic review (SR), a way of evidence generation, is a synthesis of primary scientific evidence, which summarizes the best evidence on a specific clinical question using a transparent, a priori protocol driven approach. SR methodology requires a critical appraisal of primary studies, data extraction in a reliable and repeatable way, and examination for validity of the results. SRs are considered hierarchically as the highest form of evidence as they are a systematic search, identification, and summarization of the available evidence to answer a focused clinical question with particular attention to the methodological quality of studies or the credibility of opinion and text. The purpose of this paper is to introduce an overview of the fundamental knowledge, principals and processes in SR. The focus of this paper is on SR especially for the synthesis of quantitative data from primary research studies that examines the effectiveness of healthcare interventions. To activate evidence-based nursing care in various healthcare settings, the best and available scientific evidence are essential components. This paper will include some examples to promote understandings. Copyright © 2016. Published by Elsevier B.V.

Why the Evidence-Based Paradigm in Early Childhood Education and Care Is Anything but Evident

ERIC Educational Resources Information Center

Vandenbroeck, Michel; Roets, Griet; Roose, Rudi

2012-01-01

Praxeological research is a necessary contribution to the research field in early childhood education and care, which is currently dominated by an evidence-based paradigm that tends to consider the measurement of predefined outcomes as the most valid form of research. We analyse the history of the evidence-based paradigm in the field of medicine…

Applying Kane's Validity Framework to a Simulation Based Assessment of Clinical Competence

ERIC Educational Resources Information Center

Tavares, Walter; Brydges, Ryan; Myre, Paul; Prpic, Jason; Turner, Linda; Yelle, Richard; Huiskamp, Maud

2018-01-01

Assessment of clinical competence is complex and inference based. Trustworthy and defensible assessment processes must have favourable evidence of validity, particularly where decisions are considered high stakes. We aimed to organize, collect and interpret validity evidence for a high stakes simulation based assessment strategy for certifying…

Validity of Cognitive Load Measures in Simulation-Based Training: A Systematic Review.

PubMed

Naismith, Laura M; Cavalcanti, Rodrigo B

2015-11-01

Cognitive load theory (CLT) provides a rich framework to inform instructional design. Despite the applicability of CLT to simulation-based medical training, findings from multimedia learning have not been consistently replicated in this context. This lack of transferability may be related to issues in measuring cognitive load (CL) during simulation. The authors conducted a review of CLT studies across simulation training contexts to assess the validity evidence for different CL measures. PRISMA standards were followed. For 48 studies selected from a search of MEDLINE, EMBASE, PsycInfo, CINAHL, and ERIC databases, information was extracted about study aims, methods, validity evidence of measures, and findings. Studies were categorized on the basis of findings and prevalence of validity evidence collected, and statistical comparisons between measurement types and research domains were pursued. CL during simulation training has been measured in diverse populations including medical trainees, pilots, and university students. Most studies (71%; 34) used self-report measures; others included secondary task performance, physiological indices, and observer ratings. Correlations between CL and learning varied from positive to negative. Overall validity evidence for CL measures was low (mean score 1.55/5). Studies reporting greater validity evidence were more likely to report that high CL impaired learning. The authors found evidence that inconsistent correlations between CL and learning may be related to issues of validity in CL measures. Further research would benefit from rigorous documentation of validity and from triangulating measures of CL. This can better inform CLT instructional design for simulation-based medical training.

Therapist self-report of evidence-based practices in usual care for adolescent behavior problems: factor and construct validity.

PubMed

Hogue, Aaron; Dauber, Sarah; Henderson, Craig E

2014-01-01

This study introduces a therapist-report measure of evidence-based practices for adolescent conduct and substance use problems. The Inventory of Therapy Techniques-Adolescent Behavior Problems (ITT-ABP) is a post-session measure of 27 techniques representing four approaches: cognitive-behavioral therapy (CBT), family therapy (FT), motivational interviewing (MI), and drug counseling (DC). A total of 822 protocols were collected from 32 therapists treating 71 adolescents in six usual care sites. Factor analyses identified three clinically coherent scales with strong internal consistency across the full sample: FT (8 items; α = .79), MI/CBT (8 items; α = .87), and DC (9 items, α = .90). The scales discriminated between therapists working in a family-oriented site versus other sites and showed moderate convergent validity with therapist reports of allegiance and skill in each approach. The ITT-ABP holds promise as a cost-efficient quality assurance tool for supporting high-fidelity delivery of evidence-based practices in usual care.

Developing an evidence-based practice protocol: implications for midwifery practice.

PubMed

Carr, K C

2000-01-01

Evidence-based practice is defined and its importance to midwifery practice is presented. Guidelines are provided for the development of an evidence-based practice protocol. These include: identifying the clinical question, obtaining the evidence, evaluating the validity and importance of the evidence, synthesizing the evidence and applying it to the development of a protocol or clinical algorithm, and, finally, developing an evaluation plan or measurement strategy to see if the new protocol is effective.

Competency-Based Training and Simulation: Making a "Valid" Argument.

PubMed

Noureldin, Yasser A; Lee, Jason Y; McDougall, Elspeth M; Sweet, Robert M

2018-02-01

The use of simulation as an assessment tool is much more controversial than is its utility as an educational tool. However, without valid simulation-based assessment tools, the ability to objectively assess technical skill competencies in a competency-based medical education framework will remain challenging. The current literature in urologic simulation-based training and assessment uses a definition and framework of validity that is now outdated. This is probably due to the absence of awareness rather than an absence of comprehension. The following review article provides the urologic community an updated taxonomy on validity theory as it relates to simulation-based training and assessments and translates our simulation literature to date into this framework. While the old taxonomy considered validity as distinct subcategories and focused on the simulator itself, the modern taxonomy, for which we translate the literature evidence, considers validity as a unitary construct with a focus on interpretation of simulator data/scores.

Validity of premature ejaculation diagnostic tool and its association with International Index of Erectile Function-15 in Chinese men with evidence-based-defined premature ejaculation.

PubMed

Tang, Dong-Dong; Li, Chao; Peng, Dang-Wei; Zhang, Xian-Sheng

2018-01-01

The premature ejaculation diagnostic tool (PEDT) is a brief diagnostic measure to assess premature ejaculation (PE). However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE (LPE)/acquired PE (APE) according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores (14.28 ± 3.05) and lower IIEF-15 (41.26 ± 8.20) than men without PE (PEDT: 5.32 ± 3.42, IIEF-15: 52.66 ± 6.86, P < 0.001 for both). It was suggested that a score of ≥9 indicated PE in both LPE and APE by sensitivity and specificity analyses (sensitivity: 0.875, 0.913; specificity: 0.865, 0.865, respectively). In addition, IIEF-15 were higher in men with LPE (42.64 ± 8.11) than APE (39.43 ± 7.84, P < 0.001). After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE (adjust r = -0.225, P < 0.001) and APE (adjust r = -0.378, P < 0.001). In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.

Macro- and Micro-Validation: Beyond the "Five Sources" Framework for Classifying Validation Evidence and Analysis

ERIC Educational Resources Information Center

Newton, Paul E.

2016-01-01

This paper argues that the dominant framework for conceptualizing validation evidence and analysis--the "five sources" framework from the 1999 "Standards"--is seriously limited. Its limitation raises a significant barrier to understanding the nature of comprehensive validation, and this presents a significant threat to…

Factor analysis methods and validity evidence: A systematic review of instrument development across the continuum of medical education

NASA Astrophysics Data System (ADS)

Wetzel, Angela Payne

Previous systematic reviews indicate a lack of reporting of reliability and validity evidence in subsets of the medical education literature. Psychology and general education reviews of factor analysis also indicate gaps between current and best practices; yet, a comprehensive review of exploratory factor analysis in instrument development across the continuum of medical education had not been previously identified. Therefore, the purpose for this study was critical review of instrument development articles employing exploratory factor or principal component analysis published in medical education (2006--2010) to describe and assess the reporting of methods and validity evidence based on the Standards for Educational and Psychological Testing and factor analysis best practices. Data extraction of 64 articles measuring a variety of constructs that have been published throughout the peer-reviewed medical education literature indicate significant errors in the translation of exploratory factor analysis best practices to current practice. Further, techniques for establishing validity evidence tend to derive from a limited scope of methods including reliability statistics to support internal structure and support for test content. Instruments reviewed for this study lacked supporting evidence based on relationships with other variables and response process, and evidence based on consequences of testing was not evident. Findings suggest a need for further professional development within the medical education researcher community related to (1) appropriate factor analysis methodology and reporting and (2) the importance of pursuing multiple sources of reliability and validity evidence to construct a well-supported argument for the inferences made from the instrument. Medical education researchers and educators should be cautious in adopting instruments from the literature and carefully review available evidence. Finally, editors and reviewers are encouraged to recognize

Validity and reliability of instruments aimed at measuring Evidence-Based Practice in Physical Therapy: a systematic review of the literature.

PubMed

Fernández-Domínguez, Juan Carlos; Sesé-Abad, Albert; Morales-Asencio, Jose Miguel; Oliva-Pascual-Vaca, Angel; Salinas-Bueno, Iosune; de Pedro-Gómez, Joan Ernest

2014-12-01

Our goal is to compile and analyse the characteristics - especially validity and reliability - of all the existing international tools that have been used to measure evidence-based clinical practice in physiotherapy. A systematic review conducted with data from exclusively quantitative-type studies synthesized in narrative format. An in-depth search of the literature was conducted in two phases: initial, structured, electronic search of databases and also journals with summarized evidence; followed by a residual-directed search in the bibliographical references of the main articles found in the primary search procedure. The studies included were assigned to members of the research team who acted as peer reviewers. Relevant information was extracted from each of the selected articles using a template that included the general characteristics of the instrument as well as an analysis of the quality of the validation processes carried out, by following the criteria of Terwee. Twenty-four instruments were found to comply with the review screening criteria; however, in all cases, they were found to be limited as regards the 'constructs' included. Besides, they can all be seen to be lacking as regards comprehensiveness associated to the validation process of the psychometric tests used. It seems that what constitutes a rigorously developed assessment instrument for EBP in physical therapy continues to be a challenge. © 2014 John Wiley & Sons, Ltd.

When Assessment Data Are Words: Validity Evidence for Qualitative Educational Assessments.

PubMed

Cook, David A; Kuper, Ayelet; Hatala, Rose; Ginsburg, Shiphra

2016-10-01

Quantitative scores fail to capture all important features of learner performance. This awareness has led to increased use of qualitative data when assessing health professionals. Yet the use of qualitative assessments is hampered by incomplete understanding of their role in forming judgments, and lack of consensus in how to appraise the rigor of judgments therein derived. The authors articulate the role of qualitative assessment as part of a comprehensive program of assessment, and translate the concept of validity to apply to judgments arising from qualitative assessments. They first identify standards for rigor in qualitative research, and then use two contemporary assessment validity frameworks to reorganize these standards for application to qualitative assessment.Standards for rigor in qualitative research include responsiveness, reflexivity, purposive sampling, thick description, triangulation, transparency, and transferability. These standards can be reframed using Messick's five sources of validity evidence (content, response process, internal structure, relationships with other variables, and consequences) and Kane's four inferences in validation (scoring, generalization, extrapolation, and implications). Evidence can be collected and evaluated for each evidence source or inference. The authors illustrate this approach using published research on learning portfolios.The authors advocate a "methods-neutral" approach to assessment, in which a clearly stated purpose determines the nature of and approach to data collection and analysis. Increased use of qualitative assessments will necessitate more rigorous judgments of the defensibility (validity) of inferences and decisions. Evidence should be strategically sought to inform a coherent validity argument.

Validity in work-based assessment: expanding our horizons.

PubMed

Govaerts, Marjan; van der Vleuten, Cees P M

2013-12-01

Although work-based assessments (WBA) may come closest to assessing habitual performance, their use for summative purposes is not undisputed. Most criticism of WBA stems from approaches to validity consistent with the quantitative psychometric framework. However, there is increasing research evidence that indicates that the assumptions underlying the predictive, deterministic framework of psychometrics may no longer hold. In this discussion paper we argue that meaningfulness and appropriateness of current validity evidence can be called into question and that we need alternative strategies to assessment and validity inquiry that build on current theories of learning and performance in complex and dynamic workplace settings. Drawing from research in various professional fields we outline key issues within the mechanisms of learning, competence and performance in the context of complex social environments and illustrate their relevance to WBA. In reviewing recent socio-cultural learning theory and research on performance and performance interpretations in work settings, we demonstrate that learning, competence (as inferred from performance) as well as performance interpretations are to be seen as inherently contextualised, and can only be under-stood 'in situ'. Assessment in the context of work settings may, therefore, be more usefully viewed as a socially situated interpretive act. We propose constructivist-interpretivist approaches towards WBA in order to capture and understand contextualised learning and performance in work settings. Theoretical assumptions underlying interpretivist assessment approaches call for a validity theory that provides the theoretical framework and conceptual tools to guide the validation process in the qualitative assessment inquiry. Basic principles of rigour specific to qualitative research have been established, and they can and should be used to determine validity in interpretivist assessment approaches. If used properly, these

The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria.

PubMed

Parvizi, Javad; Tan, Timothy L; Goswami, Karan; Higuera, Carlos; Della Valle, Craig; Chen, Antonia F; Shohat, Noam

2018-05-01

The introduction of the Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection (PJI) in 2011 resulted in improvements in diagnostic confidence and research collaboration. The emergence of new diagnostic tests and the lessons we have learned from the past 7 years using the MSIS definition, prompted us to develop an evidence-based and validated updated version of the criteria. This multi-institutional study of patients undergoing revision total joint arthroplasty was conducted at 3 academic centers. For the development of the new diagnostic criteria, PJI and aseptic patient cohorts were stringently defined: PJI cases were defined using only major criteria from the MSIS definition (n = 684) and aseptic cases underwent one-stage revision for a noninfective indication and did not fail within 2 years (n = 820). Serum C-reactive protein (CRP), D-dimer, erythrocyte sedimentation rate were investigated, as well as synovial white blood cell count, polymorphonuclear percentage, leukocyte esterase, alpha-defensin, and synovial CRP. Intraoperative findings included frozen section, presence of purulence, and isolation of a pathogen by culture. A stepwise approach using random forest analysis and multivariate regression was used to generate relative weights for each diagnostic marker. Preoperative and intraoperative definitions were created based on beta coefficients. The new definition was then validated on an external cohort of 222 patients with PJI who subsequently failed with reinfection and 200 aseptic patients. The performance of the new criteria was compared to the established MSIS and the prior International Consensus Meeting definitions. Two positive cultures or the presence of a sinus tract were considered as major criteria and diagnostic of PJI. The calculated weights of an elevated serum CRP (>1 mg/dL), D-dimer (>860 ng/mL), and erythrocyte sedimentation rate (>30 mm/h) were 2, 2, and 1 points, respectively. Furthermore, elevated

Construct Validity Evidence for Single-Response Items to Estimate Physical Activity Levels in Large Sample Studies

ERIC Educational Resources Information Center

Jackson, Allen W.; Morrow, James R., Jr.; Bowles, Heather R.; FitzGerald, Shannon J.; Blair, Steven N.

2007-01-01

Valid measurement of physical activity is important for studying the risks for morbidity and mortality. The purpose of this study was to examine evidence of construct validity of two similar single-response items assessing physical activity via self-report. Both items are based on the stages of change model. The sample was 687 participants (men =…

Evidence-Based Assessment of Depression in Adults

ERIC Educational Resources Information Center

Joiner, Thomas E.; Walker, Rheeda L.; Pettit, Jeremy W.; Perez, Marisol; Cukrowicz, Kelly C.

2005-01-01

From diverse perspectives, there is little doubt that depressive symptoms cohere to form a valid and distinct syndrome. Research indicates that an evidence-based assessment of depression would include (a) measures with adequate psychometric properties; (b) adequate coverage of symptoms; (c) adequate coverage of depressed mood, anhedonia, and…

Evidence-based hypnotherapy for depression.

PubMed

Alladin, Assen

2010-04-01

Cognitive hypnotherapy (CH) is a comprehensive evidence-based hypnotherapy for clinical depression. This article describes the major components of CH, which integrate hypnosis with cognitive-behavior therapy as the latter provides an effective host theory for the assimilation of empirically supported treatment techniques derived from various theoretical models of psychotherapy and psychopathology. CH meets criteria for an assimilative model of psychotherapy, which is considered to be an efficacious model of psychotherapy integration. The major components of CH for depression are described in sufficient detail to allow replication, verification, and validation of the techniques delineated. CH for depression provides a template that clinicians and investigators can utilize to study the additive effects of hypnosis in the management of other psychological or medical disorders. Evidence-based hypnotherapy and research are encouraged; such a movement is necessary if clinical hypnosis is to integrate into mainstream psychotherapy.

The Application of Evidence-Based Practice to Nonspeech Oral Motor Treatments

ERIC Educational Resources Information Center

Lass, Norman J.; Pannbacker, Mary

2008-01-01

Purpose: The purpose of this article is to help speech-language pathologists (SLPs) apply the principles of evidence-based practice (EBP) to nonspeech oral motor treatments (NSOMTs) in order to make valid, evidence-based decisions about NSOMTs and thus determine if they are viable treatment approaches for the management of communication disorders.…

The key-features approach to assess clinical decisions: validity evidence to date.

PubMed

Bordage, G; Page, G

2018-05-17

The key-features (KFs) approach to assessment was initially proposed during the First Cambridge Conference on Medical Education in 1984 as a more efficient and effective means of assessing clinical decision-making skills. Over three decades later, we conducted a comprehensive, systematic review of the validity evidence gathered since then. The evidence was compiled according to the Standards for Educational and Psychological Testing's five sources of validity evidence, namely, Content, Response process, Internal structure, Relations to other variables, and Consequences, to which we added two other types related to Cost-feasibility and Acceptability. Of the 457 publications that referred to the KFs approach between 1984 and October 2017, 164 are cited here; the remaining 293 were either redundant or the authors simply mentioned the KFs concept in relation to their work. While one set of articles reported meeting the validity standards, another set examined KFs test development choices and score interpretation. The accumulated validity evidence for the KFs approach since its inception supports the decision-making construct measured and its use to assess clinical decision-making skills at all levels of training and practice and with various types of exam formats. Recognizing that gathering validity evidence is an ongoing process, areas with limited evidence, such as item factor analyses or consequences of testing, are identified as well as new topics needing further clarification, such as the use of the KFs approach for formative assessment and its place within a program of assessment.

Clinical Evidence: a useful tool for promoting evidence-based practice?

PubMed

Formoso, Giulio; Moja, Lorenzo; Nonino, Francesco; Dri, Pietro; Addis, Antonio; Martini, Nello; Liberati, Alessandro

2003-12-23

Research has shown that many healthcare professionals have problems with guidelines as they would prefer to be given all relevant information relevant to decision-making rather than being told what they should do. This study assesses doctors' judgement of the validity, relevance, clarity and usability of the Italian translation of Clinical Evidence (CE) after its free distribution launched by the Italian Ministry of Health. Opinions elicited using a standardised questionnaire delivered either by mail or during educational or professional meetings. Twenty percent (n = 1350) doctors participated the study. Most of them found CE's content valid, useful and relevant for their clinical practice, and said CE can foster communications among clinicians, particularly among GPs and specialists. Hospital doctors (63%) more often than GPs (48%) read the detailed presentation of individual chapters. Twenty-nine percent said CE brought changes in their clinical practice. Doctors appreciated CE's nature of an evidence-based information compendium and would have not preferred a collection of practice guidelines. Overall, the pilot initiative launched by the Italian Ministry of Health seems to have been well received and to support the subsequent decision to make the Italian edition of Clinical Evidence concise available to all doctors practising in the country. Local implementation initiatives should be warranted to favour doctor's use of CE.

Adaptive Practice: Next Generation Evidence-Based Practice in Digital Environments.

PubMed

Kennedy, Margaret Ann

2016-01-01

Evidence-based practice in nursing is considered foundational to safe, competent care. To date, rigid traditional perceptions of what constitutes 'evidence' have constrained the recognition and use of practice-based evidence and the exploitation of novel forms of evidence from data rich environments. Advancements such as the conceptualization of clinical intelligence, the prevalence of increasingly sophisticated digital health information systems, and the advancement of the Big Data phenomenon have converged to generate a new contemporary context. In today's dynamic data-rich environments, clinicians have new sources of valid evidence, and need a new paradigm supporting clinical practice that is adaptive to information generated by diverse electronic sources. This opinion paper presents adaptive practice as the next generation of evidence-based practice in contemporary evidence-rich environments and provides recommendations for the next phase of evolution.

Evaluating an Instrument to Measure Mental Load and Mental Effort Considering Different Sources of Validity Evidence

ERIC Educational Resources Information Center

Krell, Moritz

2017-01-01

This study evaluates a 12-item instrument for subjective measurement of mental load (ML) and mental effort (ME) by analysing different sources of validity evidence. The findings of an expert judgement (N = 8) provide "evidence based on test content" that the formulation of the items corresponds to the meaning of ML and ME. An empirical…

Evidence-based medicine and big genomic data.

PubMed

Ioannidis, John P A; Khoury, Muin J

2018-05-01

Genomic and other related big data (Big Genomic Data, BGD for short) are ushering a new era of precision medicine. This overview discusses whether principles of evidence-based medicine hold true for BGD and how they should be operationalized in the current era. Major evidence-based medicine principles include the systematic identification, description and analysis of the validity and utility of BGD, the combination of individual clinical expertise with individual patient needs and preferences, and the focus on obtaining experimental evidence, whenever possible. BGD emphasize information of single patients with an overemphasis on N-of-1 trials to personalize treatment. However, large-scale comparative population data remain indispensable for meaningful translation of BGD personalized information. The impact of BGD on population health depends on its ability to affect large segments of the population. While several frameworks have been proposed to facilitate and standardize decision making for use of genomic tests, there are new caveats that arise from BGD that extend beyond the limitations that were applicable for more simple genetic tests. Non-evidence-based use of BGD may be harmful and result in major waste of healthcare resources. Randomized controlled trials will continue to be the strongest arbitrator for the clinical utility of genomic technologies, including BGD. Research on BGD needs to focus not only on finding robust predictive associations (clinical validity) but also more importantly on evaluating the balance of health benefits and potential harms (clinical utility), as well as implementation challenges. Appropriate features of such useful research on BGD are discussed.

20 CFR 219.31 - Evidence of a valid ceremonial marriage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evidence of a valid ceremonial marriage. 219... marriage. (a) Preferred evidence. Preferred evidence of a ceremonial marriage is— (1) A copy of the public record of the marriage, certified by the custodian of the record or by a Board employee; (2) A copy of a...

Capability beliefs regarding evidence-based practice are associated with application of EBP and research use: validation of a new measure.

PubMed

Wallin, Lars; Boström, Anne-Marie; Gustavsson, J Petter

2012-08-01

Beliefs about capabilities, or self-efficacy, is a construct originating in social cognitive psychology. Capability beliefs have been found to be positively associated with intention and healthcare practice behaviour. A measure of an individual's beliefs about his/her capability to apply the components of evidence-based practice (EBP) has potential to be useful in implementation research. To evaluate the concurrent validity and internal structure of a new scale measuring nurses' capability beliefs regarding EBP. Data were taken from a prospective longitudinal study in Sweden (the Longitudinal Analyses of Nursing Education and Entry in Worklife [LANE]). A cohort of nursing students who graduated in the autumn of 2004 that was followed up 2 years after their graduation was used (n= 1,256). Concurrent validity was tested relating different levels of capability beliefs to extent of research use and application of EBP. An item-response approach was applied in the evaluation of internal structure of the proposed scale (six items). The psychometric analyses indicated that the six items could be summed to reflect a one-dimensional scale. Nurses with the highest level of capability beliefs reported that they used research findings in clinical practice more than twice as often as those with lower levels of capability beliefs. They also participated in the implementation of evidence seven times more often. There is a need for further studies of the construct and predictive validity of the scale. It should also be validated in other groups of health professionals. Learning including mastery experiences, role modelling, social persuasion, and manageable stress could be used in undergraduate education as well as practice development to increase beliefs about capabilities which might open the way to increased application of EBP in healthcare practice. This new measure is well grounded in social cognitive theory, functions as a one-dimensional scale and possesses promising

Validity evidence for the measurement of the strength of motivation for medical school.

PubMed

Kusurkar, Rashmi; Croiset, Gerda; Kruitwagen, Cas; ten Cate, Olle

2011-05-01

The Strength of Motivation for Medical School (SMMS) questionnaire is designed to determine the strength of motivation of students particularly for medical study. This research was performed to establish the validity evidence for measuring strength of motivation for medical school. Internal structure and relations to other variables were used as the sources of validity evidence. The SMMS questionnaire was filled out by 1,494 medical students in different years of medical curriculum. The validity evidence for the internal structure was analyzed by principal components analysis with promax rotation. Validity evidence for relations to other variables was tested by comparing the SMMS scores with scores on the Academic Motivation Scale (AMS) and the exhaustion scale of Maslach Burnout Inventory-Student Survey (MBI-SS) for measuring study stress. Evidence for internal consistency was determined through the Cronbach's alpha for reliability. The analysis showed that the SMMS had a 3-factor structure. The validity in relations to other variables was established as both, the subscales and full scale scores significantly correlated positively with the intrinsic motivation scores and with the more autonomous forms of extrinsic motivation, the correlation decreasing and finally becoming negative towards the extrinsic motivation end of the spectrum. They also had significant negative correlations with amotivation scale of the AMS and exhaustion scale of MBI-SS. The Cronbach's alpha for reliability of the three subscales and full SMMS scores was 0.70, 0.67, 0.55 and 0.79. The strength of motivation for medical school has a three factor structure and acceptable validity evidence was found in our study.

The validation of forensic DNA extraction systems to utilize soil contaminated biological evidence.

PubMed

Kasu, Mohaimin; Shires, Karen

2015-07-01

The production of full DNA profiles from biological evidence found in soil has a high failure rate due largely to the inhibitory substance humic acid (HA). Abundant in various natural soils, HA co-extracts with DNA during extraction and inhibits DNA profiling by binding to the molecular components of the genotyping assay. To successfully utilize traces of soil contaminated evidence, such as that found at many murder and rape crime scenes in South Africa, a reliable HA removal extraction system would often be selected based on previous validation studies. However, for many standard forensic DNA extraction systems, peer-reviewed publications detailing the efficacy on soil evidence is either lacking or is incomplete. Consequently, these sample types are often not collected or fail to yield suitable DNA material due to the use of unsuitable methodology. The aim of this study was to validate the common forensic DNA collection and extraction systems used in South Africa, namely DNA IQ, FTA elute and Nucleosave for processing blood and saliva contaminated with HA. A forensic appropriate volume of biological evidence was spiked with HA (0, 0.5, 1.5 and 2.5 mg/ml) and processed through each extraction protocol for the evaluation of HA removal using QPCR and STR-genotyping. The DNA IQ magnetic bead system effectively removed HA from highly contaminated blood and saliva, and generated consistently acceptable STR profiles from both artificially spiked samples and crude soil samples. This system is highly recommended for use on soil-contaminated evidence over the cellulose card-based systems currently being preferentially used for DNA sample collection. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Applicability Analysis of Validation Evidence for Biomedical Computational Models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pathmanathan, Pras; Gray, Richard A.; Romero, Vicente J.

Computational modeling has the potential to revolutionize medicine the way it transformed engineering. However, despite decades of work, there has only been limited progress to successfully translate modeling research to patient care. One major difficulty which often occurs with biomedical computational models is an inability to perform validation in a setting that closely resembles how the model will be used. For example, for a biomedical model that makes in vivo clinically relevant predictions, direct validation of predictions may be impossible for ethical, technological, or financial reasons. Unavoidable limitations inherent to the validation process lead to challenges in evaluating the credibilitymore » of biomedical model predictions. Therefore, when evaluating biomedical models, it is critical to rigorously assess applicability, that is, the relevance of the computational model, and its validation evidence to the proposed context of use (COU). However, there are no well-established methods for assessing applicability. In this paper, we present a novel framework for performing applicability analysis and demonstrate its use with a medical device computational model. The framework provides a systematic, step-by-step method for breaking down the broad question of applicability into a series of focused questions, which may be addressed using supporting evidence and subject matter expertise. The framework can be used for model justification, model assessment, and validation planning. While motivated by biomedical models, it is relevant to a broad range of disciplines and underlying physics. Finally, the proposed applicability framework could help overcome some of the barriers inherent to validation of, and aid clinical implementation of, biomedical models.« less

Applicability Analysis of Validation Evidence for Biomedical Computational Models

DOE PAGES

Pathmanathan, Pras; Gray, Richard A.; Romero, Vicente J.; ...

2017-09-07

Computational modeling has the potential to revolutionize medicine the way it transformed engineering. However, despite decades of work, there has only been limited progress to successfully translate modeling research to patient care. One major difficulty which often occurs with biomedical computational models is an inability to perform validation in a setting that closely resembles how the model will be used. For example, for a biomedical model that makes in vivo clinically relevant predictions, direct validation of predictions may be impossible for ethical, technological, or financial reasons. Unavoidable limitations inherent to the validation process lead to challenges in evaluating the credibilitymore » of biomedical model predictions. Therefore, when evaluating biomedical models, it is critical to rigorously assess applicability, that is, the relevance of the computational model, and its validation evidence to the proposed context of use (COU). However, there are no well-established methods for assessing applicability. In this paper, we present a novel framework for performing applicability analysis and demonstrate its use with a medical device computational model. The framework provides a systematic, step-by-step method for breaking down the broad question of applicability into a series of focused questions, which may be addressed using supporting evidence and subject matter expertise. The framework can be used for model justification, model assessment, and validation planning. While motivated by biomedical models, it is relevant to a broad range of disciplines and underlying physics. Finally, the proposed applicability framework could help overcome some of the barriers inherent to validation of, and aid clinical implementation of, biomedical models.« less

Montreal-Toulouse Language Assessment Battery: evidence of criterion validity from patients with aphasia.

PubMed

Pagliarin, Karina Carlesso; Ortiz, Karin Zazo; Barreto, Simone dos Santos; Pimenta Parente, Maria Alice de Mattos; Nespoulous, Jean-Luc; Joanette, Yves; Fonseca, Rochele Paz

2015-10-15

The Montreal-Toulouse Language Assessment Battery - Brazilian version (MTL-BR) provides a general description of language processing and related components in adults with brain injury. The present study aimed at verifying the criterion-related validity of the Montreal-Toulouse Language Assessment Battery - Brazilian version (MTL-BR) by assessing its ability to discriminate between individuals with unilateral brain damage with and without aphasia. The investigation was carried out in a Brazilian community-based sample of 104 adults, divided into four groups: 26 participants with left hemisphere damage (LHD) with aphasia, 25 participants with right hemisphere damage (RHD), 28 with LHD non-aphasic, and 25 healthy adults. There were significant differences between patients with aphasia and the other groups on most total and subtotal scores on MTL-BR tasks. The results showed strong criterion-related validity evidence for the MTL-BR Battery, and provided important information regarding hemispheric specialization and interhemispheric cooperation. Future research is required to search for additional evidence of sensitivity, specificity and validity of the MTL-BR in samples with different types of aphasia and degrees of language impairment. Copyright © 2015 Elsevier B.V. All rights reserved.

Reliability and validity evidence of the Assessment of Language Use in Social Contexts for Adults (ALUSCA).

PubMed

Valente, Ana Rita S; Hall, Andreia; Alvelos, Helena; Leahy, Margaret; Jesus, Luis M T

2018-04-12

The appropriate use of language in context depends on the speaker's pragmatic language competencies. A coding system was used to develop a specific and adult-focused self-administered questionnaire to adults who stutter and adults who do not stutter, The Assessment of Language Use in Social Contexts for Adults, with three categories: precursors, basic exchanges, and extended literal/non-literal discourse. This paper presents the content validity, item analysis, reliability coefficients and evidences of construct validity of the instrument. Content validity analysis was based on a two-stage process: first, 11 pragmatic questionnaires were assessed to identify items that probe each pragmatic competency and to create the first version of the instrument; second, items were assessed qualitatively by an expert panel composed by adults who stutter and controls, and quantitatively and qualitatively by an expert panel composed by clinicians. A pilot study was conducted with five adults who stutter and five controls to analyse items and calculate reliability. Construct validity evidences were obtained using the hypothesized relationships method and factor analysis with 28 adults who stutter and 28 controls. Concerning content validity, the questionnaires assessed up to 13 pragmatic competencies. Qualitative and quantitative analysis revealed ambiguities in items construction. Disagreement between experts was solved through item modification. The pilot study showed that the instrument presented internal consistency and temporal stability. Significant differences between adults who stutter and controls and different response profiles revealed the instrument's underlying construct. The instrument is reliable and presented evidences of construct validity.

Evidence-based medicine for every day, everyone, and every therapeutic study.

PubMed

Govindarajan, Raghav; Narayanaswami, Pushpa

2018-04-17

The rapid growth in published medical literature makes it difficult for clinicians to keep up with advances in their fields. This may result in a cursory scan of the abstract and conclusion of a study without critically evaluating study quality. The application of evidence-based medicine (EBM) is the process of converting the abstract task of reading the literature into a practical method of using the literature to inform care in a specific clinical context while simultaneously expanding one's knowledge. EBM involves 4 steps: (1) stating the clinical problem in a defined question; (2) searching the literature for the evidence; (3) critically appraising the evidence for its validity; and (4) applying the evidence in the context of the patient's situation, preferences, and values. In this review, we use the recently published trial of thymectomy in myasthenia gravis as an example and systematically go through the steps of assessing internal validity, precision, and external validity. Muscle Nerve, 2018. © 2018 Wiley Periodicals, Inc.

Cluster analysis of novel isometric strength measures produces a valid and evidence-based classification structure for wheelchair track racing.

PubMed

Connick, Mark J; Beckman, Emma; Vanlandewijck, Yves; Malone, Laurie A; Blomqvist, Sven; Tweedy, Sean M

2017-11-25

The Para athletics wheelchair-racing classification system employs best practice to ensure that classes comprise athletes whose impairments cause a comparable degree of activity limitation. However, decision-making is largely subjective and scientific evidence which reduces this subjectivity is required. To evaluate whether isometric strength tests were valid for the purposes of classifying wheelchair racers and whether cluster analysis of the strength measures produced a valid classification structure. Thirty-two international level, male wheelchair racers from classes T51-54 completed six isometric strength tests evaluating elbow extensors, shoulder flexors, trunk flexors and forearm pronators and two wheelchair performance tests-Top-Speed (0-15 m) and Top-Speed (absolute). Strength tests significantly correlated with wheelchair performance were included in a cluster analysis and the validity of the resulting clusters was assessed. All six strength tests correlated with performance (r=0.54-0.88). Cluster analysis yielded four clusters with reasonable overall structure (mean silhouette coefficient=0.58) and large intercluster strength differences. Six athletes (19%) were allocated to clusters that did not align with their current class. While the mean wheelchair racing performance of the resulting clusters was unequivocally hierarchical, the mean performance of current classes was not, with no difference between current classes T53 and T54. Cluster analysis of isometric strength tests produced classes comprising athletes who experienced a similar degree of activity limitation. The strength tests reported can provide the basis for a new, more transparent, less subjective wheelchair racing classification system, pending replication of these findings in a larger, representative sample. This paper also provides guidance for development of evidence-based systems in other Para sports. © Article author(s) (or their employer(s) unless otherwise stated in the text of

Hopes and Cautions for Instrument-Based Evaluation of Consent Capacity: Results of a Construct Validity Study of Three Instruments

PubMed Central

Moye, Jennifer; Azar, Annin R.; Karel, Michele J.; Gurrera, Ronald J.

2016-01-01

Does instrument based evaluation of consent capacity increase the precision and validity of competency assessment or does ostensible precision provide a false sense of confidence without in fact improving validity? In this paper we critically examine the evidence for construct validity of three instruments for measuring four functional abilities important in consent capacity: understanding, appreciation, reasoning, and expressing a choice. Instrument based assessment of these abilities is compared through investigation of a multi-trait multi-method matrix in 88 older adults with mild to moderate dementia. Results find variable support for validity. There appears to be strong evidence for good hetero-method validity for the measurement of understanding, mixed evidence for validity in the measurement of reasoning, and strong evidence for poor hetero-method validity for the concepts of appreciation and expressing a choice, although the latter is likely due to extreme range restrictions. The development of empirically based tools for use in capacity evaluation should ultimately enhance the reliability and validity of assessment, yet clearly more research is needed to define and measure the constructs of decisional capacity. We would also emphasize that instrument based assessment of capacity is only one part of a comprehensive evaluation of competency which includes consideration of diagnosis, psychiatric and/or cognitive symptomatology, risk involved in the situation, and individual and cultural differences. PMID:27330455

Cultural competence, evidence-based medicine, and evidence-based practices.

PubMed

Whitley, Rob

2007-12-01

Cultural competence and evidence-based medicine are two powerful discourses that have become core components of contemporary psychiatry. Evidence-based medicine has particularly influenced psychiatry by spawning the enthusiastic creation and adoption of evidence-based practices. Despite their prominence, these paradigms have stood somewhat in isolation from each other. This Open Forum explores the relationship between these two conceptual paradigms, paying particular attention to implications for evidence-based practices. The author aims to stimulate a greater degree of mutual engagement and integration of these paradigms by examining epistemological, philosophical, and methodological overlap and discrepancy. Both paradigms can stretch and enrich each other in a positive manner. This could help achieve a situation where cultural competency becomes more evidence based and evidence-based medicine becomes more culturally competent. Such action would help bring to fruition a shared aim of both discourses-more humane, just, and effective patient-centered care.

A Confirmatory Factor Analysis of the Student Evidence-Based Practice Questionnaire (S-EBPQ) in an Australian sample.

PubMed

Beccaria, Lisa; Beccaria, Gavin; McCosker, Catherine

2018-03-01

It is crucial that nursing students develop skills and confidence in using Evidence-Based Practice principles early in their education. This should be assessed with valid tools however, to date, few measures have been developed and applied to the student population. To examine the structural validity of the Student Evidence-Based Practice Questionnaire (S-EBPQ), with an Australian online nursing student cohort. A cross-sectional study for constructing validity. Three hundred and forty-five undergraduate nursing students from an Australian regional university were recruited across two semesters. Confirmatory Factor Analysis was used to examine the structural validity. Confirmatory Factor Analysis was applied which resulted in a good fitting model, based on a revised 20-item tool. The S-EBPQ tool remains a psychometrically robust measure of evidence-based practice use, attitudes, and knowledge and skills and can be applied in an online Australian student context. The findings of this study provided further evidence of the reliability and four factor structure of the S-EBPQ. Opportunities for further refinement of the tool may result in improvements in structural validity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evidence-Based Review of Subjective Pediatric Sleep Measures

PubMed Central

Toliver-Sokol, Marisol; Palermo, Tonya M.

2011-01-01

Objective This manuscript provides an evidence-based psychometric review of parent and child-report pediatric sleep measures using criteria developed by the American Psychological Association (APA) Division 54 Evidence-Based Assessment (EBA) Task Force. Methods Twenty-one measures were reviewed: four measures of daytime sleepiness, four measures of sleep habits/hygiene, two measures assessing sleep-related attitudes/cognitions, five measures of sleep initiation/maintenance, and six multidimensional sleep measures. Results Six of the 21 measures met “well-established” evidence-based assessment criteria. An additional eight measures were rated as “approaching well-established” and seven were rated as “promising.” Conclusions Overall, the multidimensional sleep measures received the highest ratings. Strengths and weaknesses of the measures are described. Recommendations for future pediatric sleep assessment are presented including further validation of measures, use of multiple informants, and stability of sleep measures over time. PMID:21227912

Evidence-based dental practice: part I. Formulating clinical questions and searching for answers.

PubMed

Adeyemo, W L; Akinwande, J A; Bamgbose, B O

2007-01-01

Evidence-based dentistry (EBD) is an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences. Evidence-based care is now regarded as the "gold standard" in health care delivery worldwide. EBD involves tracking down the available evidence, assessing its validity and relevance, and then using the "best" evidence to inform decisions regarding care. Although, the concept of evidence-based dentistry is not new, however, anecdotal evidence suggests that the awareness of this concept among Nigerian dental practitioners is low. This first of three articles on evidence-based dental practice discusses the historical background of evidence-based medicine/evidence-based dentistry, how to formulate clear clinical questions and how to track down (search) the available evidence in the literature databases.

The predictive validity of quality of evidence grades for the stability of effect estimates was low: a meta-epidemiological study.

PubMed

Gartlehner, Gerald; Dobrescu, Andreea; Evans, Tammeka Swinson; Bann, Carla; Robinson, Karen A; Reston, James; Thaler, Kylie; Skelly, Andrea; Glechner, Anna; Peterson, Kimberly; Kien, Christina; Lohr, Kathleen N

2016-02-01

To determine the predictive validity of the U.S. Evidence-based Practice Center (EPC) approach to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Based on Cochrane reports with outcomes graded as high quality of evidence (QOE), we prepared 160 documents which represented different levels of QOE. Professional systematic reviewers dually graded the QOE. For each document, we determined whether estimates were concordant with high QOE estimates of the Cochrane reports. We compared the observed proportion of concordant estimates with the expected proportion from an international survey. To determine the predictive validity, we used the Hosmer-Lemeshow test to assess calibration and the C (concordance) index to assess discrimination. The predictive validity of the EPC approach to GRADE was limited. Estimates graded as high QOE were less likely, estimates graded as low or insufficient QOE more likely to remain stable than expected. The EPC approach to GRADE could not reliably predict the likelihood that individual bodies of evidence remain stable as new evidence becomes available. C-indices ranged between 0.56 (95% CI, 0.47 to 0.66) and 0.58 (95% CI, 0.50 to 0.67) indicating a low discriminatory ability. The limited predictive validity of the EPC approach to GRADE seems to reflect a mismatch between expected and observed changes in treatment effects as bodies of evidence advance from insufficient to high QOE. Copyright © 2016 Elsevier Inc. All rights reserved.

Construct Definition Using Cognitively Based Evidence: A Framework for Practice

ERIC Educational Resources Information Center

Ketterlin-Geller, Leanne R.; Yovanoff, Paul; Jung, EunJu; Liu, Kimy; Geller, Josh

2013-01-01

In this article, we highlight the need for a precisely defined construct in score-based validation and discuss the contribution of cognitive theories to accurately and comprehensively defining the construct. We propose a framework for integrating cognitively based theoretical and empirical evidence to specify and evaluate the construct. We apply…

[Evidence-based medicine and 'The Cochrane Collaboration'].

PubMed

Kawamura, T; Tamakoshi, A; Wakai, K; Ohno, Y

1999-06-01

In Evidence-Based Medicine (EBM), a clinical decision is based neither on pathophysiological theories nor personal experience but on the results derived from scientifically designed clinical epidemiological studies (i.e., evidence). EBM is used in various clinical applications, such as therapy, diagnosis, and prognosis prediction. The process includes (1) asking a clinical question consisting of the three elements of "patient", "exposure", and "outcome"; (2) searching for the best evidence using MEDLINE or Cochrane Library; (3) appraising critically the validity of the method and the magnitude and probability of the result; and finally (4) applying the evidence of the patient. In actual clinical practice, clinical expertise and patient preferences should be as much regarded as research evidence. 'The Cochrane Collaboration' supplies systematic reviews of clinical trials carried out all over the world to its consumers. Its fruit, 'The Cochrane Library (CD-ROM),' is a highly valuable resource. 'The Cochrane Collaboration' serves as the infrastructure for EBM. EBM, which was originally developed for the individual patient care, can also be applicable to community- or workplace-healthcare and policy making by governments. Thus, EBM is both a philosophy and a method to provide people with the most appropriate medical practice.

A Rasch-Based Validation of the Vocabulary Size Test

ERIC Educational Resources Information Center

Beglar, David

2010-01-01

The primary purpose of this study was to provide preliminary validity evidence for a 140-item form of the Vocabulary Size Test, which is designed to measure written receptive knowledge of the first 14,000 words of English. Nineteen native speakers of English and 178 native speakers of Japanese participated in the study. Analyses based on the Rasch…

Validity evidence for the Fundamentals of Laparoscopic Surgery (FLS) program as an assessment tool: a systematic review.

PubMed

Zendejas, Benjamin; Ruparel, Raaj K; Cook, David A

2016-02-01

The Fundamentals of Laparoscopic Surgery (FLS) program uses five simulation stations (peg transfer, precision cutting, loop ligation, and suturing with extracorporeal and intracorporeal knot tying) to teach and assess laparoscopic surgery skills. We sought to summarize evidence regarding the validity of scores from the FLS assessment. We systematically searched for studies evaluating the FLS as an assessment tool (last search update February 26, 2013). We classified validity evidence using the currently standard validity framework (content, response process, internal structure, relations with other variables, and consequences). From a pool of 11,628 studies, we identified 23 studies reporting validity evidence for FLS scores. Studies involved residents (n = 19), practicing physicians (n = 17), and medical students (n = 8), in specialties of general (n = 17), gynecologic (n = 4), urologic (n = 1), and veterinary (n = 1) surgery. Evidence was most common in the form of relations with other variables (n = 22, most often expert-novice differences). Only three studies reported internal structure evidence (inter-rater or inter-station reliability), two studies reported content evidence (i.e., derivation of assessment elements), and three studies reported consequences evidence (definition of pass/fail thresholds). Evidence nearly always supported the validity of FLS total scores. However, the loop ligation task lacks discriminatory ability. Validity evidence confirms expected relations with other variables and acceptable inter-rater reliability, but other validity evidence is sparse. Given the high-stakes use of this assessment (required for board eligibility), we suggest that more validity evidence is required, especially to support its content (selection of tasks and scoring rubric) and the consequences (favorable and unfavorable impact) of assessment.

A web-based library consult service for evidence-based medicine: Technical development.

PubMed

Schwartz, Alan; Millam, Gregory

2006-03-16

Incorporating evidence based medicine (EBM) into clinical practice requires clinicians to learn to efficiently gain access to clinical evidence and effectively appraise its validity. Even using current electronic systems, selecting literature-based data to solve a single patient-related problem can require more time than practicing physicians or residents can spare. Clinical librarians, as informationists, are uniquely suited to assist physicians in this endeavor. To improve support for evidence-based practice, we have developed a web-based EBM library consult service application (LCS). Librarians use the LCS system to provide full text evidence-based literature with critical appraisal in response to a clinical question asked by a remote physician. LCS uses an entirely Free/Open Source Software platform and will be released under a Free Software license. In the first year of the LCS project, the software was successfully developed and a reference implementation put into active use. Two years of evaluation of the clinical, educational, and attitudinal impact on physician-users and librarian staff are underway, and expected to lead to refinement and wide dissemination of the system. A web-based EBM library consult model may provide a useful way for informationists to assist clinicians, and is feasible to implement.

A web-based library consult service for evidence-based medicine: Technical development

PubMed Central

Schwartz, Alan; Millam, Gregory

2006-01-01

Background Incorporating evidence based medicine (EBM) into clinical practice requires clinicians to learn to efficiently gain access to clinical evidence and effectively appraise its validity. Even using current electronic systems, selecting literature-based data to solve a single patient-related problem can require more time than practicing physicians or residents can spare. Clinical librarians, as informationists, are uniquely suited to assist physicians in this endeavor. Results To improve support for evidence-based practice, we have developed a web-based EBM library consult service application (LCS). Librarians use the LCS system to provide full text evidence-based literature with critical appraisal in response to a clinical question asked by a remote physician. LCS uses an entirely Free/Open Source Software platform and will be released under a Free Software license. In the first year of the LCS project, the software was successfully developed and a reference implementation put into active use. Two years of evaluation of the clinical, educational, and attitudinal impact on physician-users and librarian staff are underway, and expected to lead to refinement and wide dissemination of the system. Conclusion A web-based EBM library consult model may provide a useful way for informationists to assist clinicians, and is feasible to implement. PMID:16542453

Evidence-based assessment in pediatric psychology: family measures.

PubMed

Alderfer, Melissa A; Fiese, Barbara H; Gold, Jeffrey I; Cutuli, J J; Holmbeck, Grayson N; Goldbeck, Lutz; Chambers, Christine T; Abad, Mona; Spetter, Dante; Patterson, Joän

2008-10-01

To provide a review of the evidence base of family measures relevant to pediatric psychology. Twenty-nine family measures were selected based upon endorsement by Division 54 listserv members, expert judgment, and literature review. Spanning observational and self-report methods, the measures fell into three broad assessment categories: Family functioning, Dyadic family relationships, and Family functioning in the context of childhood chronic health conditions. Measures were categorized as: "Well-established", "Approaching well-established", or "Promising." Nineteen measures met "well-established" criteria and the remaining ten were "approaching well-established." "Well-established" measures were documented for each of the broad assessment categories named above. Many measures deemed "well-established" in the general population are proving to be reliable and useful in pediatric samples. More evidence of the validity of family measures is needed in this context. This review should prove helpful to clinicians and researchers as they strive to make evidence-based decisions regarding family measures.

Developing the skills required for evidence-based practice.

PubMed

French, B

1998-01-01

The current health care environment requires practitioners with the skills to find and apply the best currently available evidence for effective health care, to contribute to the development of evidence-based practice protocols, and to evaluate the impact of utilizing validated research findings in practice. Current approaches to teaching research are based mainly on gaining skills by participation in the research process. Emphasis on the requirement for rigour in the process of creating new knowledge is assumed to lead to skill in the process of using research information created by others. This article reflects upon the requirements for evidence-based practice, and the degree to which current approaches to teaching research prepare practitioners who are able to find, evaluate and best use currently available research information. The potential for using the principles of systematic review as a teaching and learning strategy for research is explored, and some of the possible strengths and weakness of this approach are highlighted.

Evaluating Existing and New Validity Evidence for the Academic Motivation Scale

ERIC Educational Resources Information Center

Fairchild, Amanda J.; Horst, S. Jeanne; Finney, Sara J.; Barron, Kenneth E.

2005-01-01

The current study evaluates existing and new validity evidence for the Academic Motivation Scale (AMS; Vallerand et al., 1992). We first provide a narrative review synthesizing past research, and then conduct a validity investigation of the scores from the measure. Data analysis using a sample of 1406 American college students provided construct…

Implementing assessments of robot-assisted technical skill in urological education: a systematic review and synthesis of the validity evidence.

PubMed

Goldenberg, Mitchell G; Lee, Jason Y; Kwong, Jethro C C; Grantcharov, Teodor P; Costello, Anthony

2018-03-31

To systematically review and synthesise the validity evidence supporting intraoperative and simulation-based assessments of technical skill in urological robot-assisted surgery (RAS), and make evidence-based recommendations for the implementation of these assessments in urological training. A literature search of the Medline, PsycINFO and Embase databases was performed. Articles using technical skill and simulation-based assessments in RAS were abstracted. Only studies involving urology trainees or faculty were included in the final analysis. Multiple tools for the assessment of technical robotic skill have been published, with mixed sources of validity evidence to support their use. These evaluations have been used in both the ex vivo and in vivo settings. Performance evaluations range from global rating scales to psychometrics, and assessments are carried out through automation, expert analysts, and crowdsourcing. There have been rapid expansions in approaches to RAS technical skills assessment, both in simulated and clinical settings. Alternative approaches to assessment in RAS, such as crowdsourcing and psychometrics, remain under investigation. Evidence to support the use of these metrics in high-stakes decisions is likely insufficient at present. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

The Evidence-based Practice Attitude Scale-36 (EBPAS-36): a brief and pragmatic measure of attitudes to evidence-based practice validated in US and Norwegian samples.

PubMed

Rye, Marte; Torres, Elisa M; Friborg, Oddgeir; Skre, Ingunn; Aarons, Gregory A

2017-04-04

Short and valid instruments for measuring factors facilitating or hindering implementation efforts are called for. This article describes (1) the adaptation of a shorter version of the Evidence-based Practice Attitude Scale (EBPAS-50 items), and (2) the psychometric properties of the shortened version in both US and Norwegian data. The US participants were mental health service providers (N = 418) recruited from clinics providing mental health services in San Diego County, California. The Norwegian participants were psychologists, psychiatric nurses, and psychology students (N = 838) recruited from the Norwegian Psychological Association and the Norwegian Nurses Organization. A confirmatory factor analysis (CFA) approach was used. The reduction resulted in 36 items named EBPAS-36, and the original 12 factor model was maintained. The EBPAS-36 had acceptable model fit, as indicated by a low degree of misspecification errors in both the US (RMSEA = .045 (CI 90% .040-.049); SRMR = .05) and the Norwegian data (RMSEA = .052 (CI 90% .047-.056, SRMR = .07). Incremental model fit was fair in the US (CFI = .93, TLI = .91) and in the Norwegian samples (CFI = .91, TLI = .89). The internal consistency (Cronbach's α) in the US and the Norwegian samples were good for the total EBPAS-36 score (.79 and .86, respectively) and were ranged from adequate to excellent for the subscales (US .60-.91 and Norway .61-.92). The EBPAS-36 has adequate psychometric properties both in US and Norwegian samples, hence indicating cross-cultural validity. It is a brief, pragmatic, and more user-friendly instrument than the EBPAS-50, yet maintains a broad scope by retaining the original 12 measurement domains.

Lessons to be Learned from Evidence-based Medicine: Practice and Promise of Evidence-based Medicine and Evidence-based Education.

ERIC Educational Resources Information Center

Wolf, Fredric M.

2000-01-01

Presents statistics of deaths caused by medical errors and argues the effects of misconceptions in diagnosis and treatment. Suggests evidence-based medicine to enhance the quality of practice and minimize error rates. Presents 10 evidence-based lessons and discusses the possible benefits of evidence-based medicine to evidence-based education and…

Applying hospital evidence to paramedicine: issues of indirectness, validity and knowledge translation.

PubMed

Bigham, Blair; Welsford, Michelle

2015-05-01

The practice of emergency medicine (EM) has been intertwined with emergency medical services (EMS) for more than 40 years. In this commentary, we explore the practice of translating hospital based evidence into the prehospital setting. We will challenge both EMS and EM dogma-bringing hospital care to patients in the field is not always better. In providing examples of therapies championed in hospitals that have failed to translate into the field, we will discuss the unique prehospital environment, and why evidence from the hospital setting cannot necessarily be translated to the prehospital field. Paramedicine is maturing so that the capability now exists to conduct practice-specific research that can inform best practices. Before translation from the hospital environment is implemented, evidence must be evaluated by people with expertise in three domains: critical appraisal, EM, and EMS. Scientific evidence should be assessed for: quality and bias; directness, generalizability, and validity to the EMS population; effect size and anticipated benefit from prehospital application; feasibility (including economic evaluation, human resource availability in the mobile environment); and patient and provider safety.

Assessing Perceived Emotional Intelligence in Adolescents: New Validity Evidence of Trait Meta-Mood Scale-24

ERIC Educational Resources Information Center

Pedrosa, Ignacio; Suárez-Álvarez, Javier; Lozano, Luis M.; Muñiz, José; García-Cueto, Eduardo

2014-01-01

Adolescence is a critical period of life during which significant psychosocial adjustment occurs and in which emotional intelligence plays an essential role. This article provides validity evidence for the Trait Meta-Mood Scale-24 (TMMS-24) scores based on an item response theory (IRT) approach. A sample of 2,693 Spanish adolescents (M = 16.52…

Expanding the domains of attitudes towards evidence-based practice: the evidence based practice attitude scale-50.

PubMed

Aarons, Gregory A; Cafri, Guy; Lugo, Lindsay; Sawitzky, Angelina

2012-09-01

Mental health and social service provider attitudes toward evidence-based practice have been measured through the development and validation of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, Ment Health Serv Res 6(2):61-74, 2004). Scores on the EBPAS scales are related to provider demographic characteristics, organizational characteristics, and leadership. However, the EBPAS assesses only four domains of attitudes toward EBP. The current study expands and further identifies additional domains of attitudes towards evidence-based practice. A qualitative and quantitative mixed-methods approach was used to: (1) generate items from multiples sources (researcher, mental health program manager, clinician/therapist), (2) identify potential content domains, and (3) examine the preliminary domains and factor structure through exploratory factor analysis. Participants for item generation included the investigative team, a group of mental health program managers (n = 6), and a group of clinicians/therapists (n = 8). For quantitative analyses a sample of 422 mental health service providers from 65 outpatient programs in San Diego County completed a survey that included the new items. Eight new EBPAS factors comprised of 35 items were identified. Factor loadings were moderate to large and internal consistency reliabilities were fair to excellent. We found that the convergence of these factors with the four previously identified evidence-based practice attitude factors (15 items) was small to moderate suggesting that the newly identified factors represent distinct dimensions of mental health and social service provider attitudes toward adopting EBP. Combining the original 15 items with the 35 new items comprises the EBPAS 50-item version (EBPAS-50) that adds to our understanding of provider attitudes toward adopting EBPs. Directions for future research are discussed.

Comparison of consumer derived evidence with an omaha system evidence-based practice guideline for community dwelling older adults.

PubMed

Pruinelli, Lisiane; Fu, Helen; Monsen, Karen A; Westra, Bonnie L

2014-01-01

Consumer involvement in healthcare is critical to support continuity of care for consumers to manage their health while transitioning from one care setting to another. Validation of evidence-based practice (EBP) guideline by consumers is essential to achieving consumer health goals over time that is consistent with their needs and preferences. The purpose of this study was to compare an Omaha System EBP guideline for community dwelling older adults with consumer-derived evidence of their ongoing needs, resources, and strategies after home care discharge. All identified problems were relevant for all patients except for Neglect and Substance use. Ten additional problems were identified from the interviews, five of which affected at least 10% of the participants. Consumer derived evidence both validated and expanded EBP guidelines; thus further emphasizing the importance of consumer involvement in the delivery of home healthcare.

Developing evidence-based dentistry skills: how to interpret randomized clinical trials and systematic reviews.

PubMed

Kiriakou, Juliana; Pandis, Nikolaos; Madianos, Phoebus; Polychronopoulou, Argy

2014-10-30

Decision-making based on reliable evidence is more likely to lead to effective and efficient treatments. Evidence-based dentistry was developed, similarly to evidence-based medicine, to help clinicians apply current and valid research findings into their own clinical practice. Interpreting and appraising the literature is fundamental and involves the development of evidence-based dentistry (EBD) skills. Systematic reviews (SRs) of randomized controlled trials (RCTs) are considered to be evidence of the highest level in evaluating the effectiveness of interventions. Furthermore, the assessment of the report of a RCT, as well as a SR, can lead to an estimation of how the study was designed and conducted.

Crafting practice guidelines in the world of evidence-based medicine.

PubMed

Chung, Kevin C; Shauver, Melissa J

2009-10-01

In the era of exponential increase in the medical literature, physicians and health policy-makers are relying on well-constructed, evidence-based practice guidelines to help ensure that the care given to patients is based on valid, scientific data. The construction of practice guidelines, however, may not always adhere to accepted research protocol. In this article, the authors detail the steps required to produce effective, evidence-based practice guidelines. The seven essential steps in crafting a practice guideline are presented: (1) defining a topic, (2) selecting a work group, (3) performing a literature review, (4) writing the guideline, (5) peer review, (6) making plans for review and revision, and (7) dissemination. Given the importance of practice guidelines in supporting everyday practice, this article strives to provide a practical guide in the development of this key component of evidence-based medicine.

Validation of a short measure of effort-reward imbalance in the workplace: evidence from China.

PubMed

Li, Jian; Loerbroks, Adrian; Shang, Li; Wege, Natalia; Wahrendorf, Morten; Siegrist, Johannes

2012-01-01

Work stress is an emergent risk in occupational health in China, and its measurement is still a critical issue. The aim of this study was to examine the reliability and validity of a short version of the effort-reward imbalance (ERI) questionnaire in a sample of Chinese workers. A community-based survey was conducted in 1,916 subjects aged 30-65 years with paid employment (971 men and 945 women). Acceptable internal consistencies of the three scales, effort, reward and overcommitment, were obtained. Confirmatory factor analysis showed a good model fit of the data with the theoretical structure (goodness-of-fit index = 0.95). Evidence of criterion validity was demonstrated, as all three scales were independently associated with elevated odds ratios of both poor physical and mental health. Based on the findings of our study, this short version of the ERI questionnaire is considered to be a reliable and valid tool for measuring psychosocial work environment in Chinese working populations.

Variation, certainty, evidence, and change in dental education: employing evidence-based dentistry in dental education.

PubMed

Marinho, V C; Richards, D; Niederman, R

2001-05-01

Variation in health care, and more particularly in dental care, was recently chronicled in a Readers Digest investigative report. The conclusions of this report are consistent with sound scientific studies conducted in various areas of health care, including dental care, which demonstrate substantial variation in the care provided to patients. This variation in care parallels the certainty with which clinicians and faculty members often articulate strongly held, but very different opinions. Using a case-based dental scenario, we present systematic evidence-based methods for accessing dental health care information, evaluating this information for validity and importance, and using this information to make informed curricular and clinical decisions. We also discuss barriers inhibiting these systematic approaches to evidence-based clinical decision making and methods for effectively promoting behavior change in health care professionals.

Measuring intra-operative decision-making during laparoscopic cholecystectomy: validity evidence for a novel interactive Web-based assessment tool.

PubMed

Madani, Amin; Watanabe, Yusuke; Bilgic, Elif; Pucher, Philip H; Vassiliou, Melina C; Aggarwal, Rajesh; Fried, Gerald M; Mitmaker, Elliot J; Feldman, Liane S

2017-03-01

Errors in judgment during laparoscopic cholecystectomy can lead to bile duct injuries and other complications. Despite correlations between outcomes, expertise and advanced cognitive skills, current methods to evaluate these skills remain subjective, rater- and situation-dependent and non-systematic. The purpose of this study was to develop objective metrics using a Web-based platform and to obtain validity evidence for their assessment of decision-making during laparoscopic cholecystectomy. An interactive online learning platform was developed ( www.thinklikeasurgeon.com ). Trainees and surgeons from six institutions completed a 12-item assessment, developed based on a cognitive task analysis. Five items required subjects to draw their answer on the surgical field, and accuracy scores were calculated based on an algorithm derived from experts' responses ("visual concordance test", VCT). Test-retest reliability, internal consistency, and correlation with self-reported experience, Global Operative Assessment of Laparoscopic Skills (GOALS) score and Objective Performance Rating Scale (OPRS) score were calculated. Questionnaires were administered to evaluate the platform's usability, feasibility and educational value. Thirty-nine subjects (17 surgeons, 22 trainees) participated. There was high test-retest reliability (intraclass correlation coefficient = 0.95; n = 10) and internal consistency (Cronbach's α = 0.87). The assessment demonstrated significant differences between novices, intermediates and experts in total score (p < 0.01) and VCT score (p < 0.01). There was high correlation between total case number and total score (ρ = 0.83, p < 0.01) and between total case number and VCT (ρ = 0.82, p < 0.01), and moderate to high correlations between total score and GOALS (ρ = 0.66, p = 0.05), VCT and GOALS (ρ = 0.83, p < 0.01), total score and OPRS (ρ = 0.67, p = 0.04), and VCT and OPRS (ρ = 0.78, p = 0.01). Most subjects agreed

Extending Validity Evidence for Multidimensional Measures of Coaching Competency

ERIC Educational Resources Information Center

Myers, Nicholas D.; Wolfe, Edward W.; Maier, Kimberly S.; Feltz, Deborah L.; Reckase, Mark D.

2006-01-01

This study extended validity evidence for multidimensional measures of coaching competency derived from the Coaching Competency Scale (CCS; Myers, Feltz, Maier, Wolfe, & Reckase, 2006) by examining use of the original rating scale structure and testing how measures related to satisfaction with the head coach within teams and between teams.…

Adaptation of the ESPA29 Parental Socialization Styles Scale to the Basque language: evidence of validity.

PubMed

López-Jáuregui, Alicia; Oliden, Paula Elosua

2009-11-01

The aim of this study is to adapt the ESPA29 scale of parental socialization styles in adolescence to the Basque language. The study of its psychometric properties is based on the search for evidence of internal and external validity. The first focuses on the assessment of the dimensionality of the scale by means of exploratory factor analysis. The relationship between the dimensions of parental socialization styles and gender and age guarantee the external validity of the scale. The study of the equivalence of the adapted and original versions is based on the comparisons of the reliability coefficients and on factor congruence. The results allow us to conclude the equivalence of the two scales.

Development and validation of the Body and Appearance Self-Conscious Emotions Scale (BASES).

PubMed

Castonguay, Andrée L; Sabiston, Catherine M; Crocker, Peter R E; Mack, Diane E

2014-03-01

The purpose of these studies was to develop a psychometrically sound measure of shame, guilt, authentic pride, and hubristic pride for use in body and appearance contexts. In Study 1, 41 potential items were developed and assessed for item quality and comprehension. In Study 2, a panel of experts (N=8; M=11, SD=6.5 years of experience) reviewed the scale and items for evidence of content validity. Participants in Study 3 (n=135 males, n=300 females) completed the BASES and various body image, personality, and emotion scales. A separate sample (n=155; 35.5% male) in Study 3 completed the BASES twice using a two-week time interval. The BASES subscale scores demonstrated evidence for internal consistency, item-total correlations, concurrent, convergent, incremental, and discriminant validity, and 2-week test-retest reliability. The 4-factor solution was a good fit in confirmatory factor analysis, reflecting body-related shame, guilt, authentic and hubristic pride subscales of the BASES. The development and validation of the BASES may help advance body image and self-conscious emotion research by providing a foundation to examine the unique antecedents and outcomes of these specific emotional experiences. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evidence-based Assessment in Pediatric Psychology: Family Measures

PubMed Central

Fiese, Barbara H.; Gold, Jeffrey I.; Cutuli, J. J.; Holmbeck, Grayson N.; Goldbeck, Lutz; Chambers, Christine T.; Abad, Mona; Spetter, Dante; Patterson, Joän

2008-01-01

Objective To provide a review of the evidence base of family measures relevant to pediatric psychology. Method Twenty-nine family measures were selected based upon endorsement by Division 54 listserv members, expert judgment, and literature review. Spanning observational and self-report methods, the measures fell into three broad assessment categories: Family functioning, Dyadic family relationships, and Family functioning in the context of childhood chronic health conditions. Measures were categorized as: “Well-established”, “Approaching well-established”, or “Promising.” Results Nineteen measures met “well-established” criteria and the remaining ten were “approaching well-established.” “Well-established” measures were documented for each of the broad assessment categories named above. Conclusions Many measures deemed “well-established” in the general population are proving to be reliable and useful in pediatric samples. More evidence of the validity of family measures is needed in this context. This review should prove helpful to clinicians and researchers as they strive to make evidence-based decisions regarding family measures. PMID:17905801

Are validated outcome measures used in distal radial fractures truly valid?

PubMed Central

Nienhuis, R. W.; Bhandari, M.; Goslings, J. C.; Poolman, R. W.; Scholtes, V. A. B.

2016-01-01

Objectives Patient-reported outcome measures (PROMs) are often used to evaluate the outcome of treatment in patients with distal radial fractures. Which PROM to select is often based on assessment of measurement properties, such as validity and reliability. Measurement properties are assessed in clinimetric studies, and results are often reviewed without considering the methodological quality of these studies. Our aim was to systematically review the methodological quality of clinimetric studies that evaluated measurement properties of PROMs used in patients with distal radial fractures, and to make recommendations for the selection of PROMs based on the level of evidence of each individual measurement property. Methods A systematic literature search was performed in PubMed, EMbase, CINAHL and PsycINFO databases to identify relevant clinimetric studies. Two reviewers independently assessed the methodological quality of the studies on measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Level of evidence (strong / moderate / limited / lacking) for each measurement property per PROM was determined by combining the methodological quality and the results of the different clinimetric studies. Results In all, 19 out of 1508 identified unique studies were included, in which 12 PROMs were rated. The Patient-rated wrist evaluation (PRWE) and the Disabilities of Arm, Shoulder and Hand questionnaire (DASH) were evaluated on most measurement properties. The evidence for the PRWE is moderate that its reliability, validity (content and hypothesis testing), and responsiveness are good. The evidence is limited that its internal consistency and cross-cultural validity are good, and its measurement error is acceptable. There is no evidence for its structural and criterion validity. The evidence for the DASH is moderate that its responsiveness is good. The evidence is limited that its reliability and the

Base Flow Model Validation

NASA Technical Reports Server (NTRS)

Sinha, Neeraj; Brinckman, Kevin; Jansen, Bernard; Seiner, John

2011-01-01

A method was developed of obtaining propulsive base flow data in both hot and cold jet environments, at Mach numbers and altitude of relevance to NASA launcher designs. The base flow data was used to perform computational fluid dynamics (CFD) turbulence model assessments of base flow predictive capabilities in order to provide increased confidence in base thermal and pressure load predictions obtained from computational modeling efforts. Predictive CFD analyses were used in the design of the experiments, available propulsive models were used to reduce program costs and increase success, and a wind tunnel facility was used. The data obtained allowed assessment of CFD/turbulence models in a complex flow environment, working within a building-block procedure to validation, where cold, non-reacting test data was first used for validation, followed by more complex reacting base flow validation.

Evidence-Based Redesign of the COMLEX-USA Series.

PubMed

Gimpel, John R; Horber, Dorothy; Sandella, Jeanne M; Knebl, Janice A; Thornburg, John E

2017-04-01

To ensure that the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) reflects the evolving practice of osteopathic medicine, the National Board of Osteopathic Medical Examiners has developed new content and format specifications for an enhanced, competency-based examination program to be implemented with COMLEX-USA Level 3 in 2018. This article summarizes the evidence-based design processes that served as the foundation for blueprint development and the evidence supporting its validity. An overview is provided of the blueprint's 2 dimensions: Competency Domains and Clinical Presentations. The authors focus on the evidence that supports interpretation of test scores for the primary and intended purpose of COMLEX-USA, which is osteopathic physician licensure. Important secondary uses and the educational and catalytic effect of assessments are also described. This article concludes with the National Board of Osteopathic Medical Examiners' plans to ensure that the COMLEX-USA series remains current and meets the needs of its stakeholders-the patients who seek care from osteopathic physicians.

Persistent misunderstandings about evidence-based (sorry: informed!) policy-making.

PubMed

Bédard, Pierre-Olivier; Ouimet, Mathieu

2016-01-01

The field of research on knowledge mobilization and evidence-informed policy-making has seen enduring debates related to various fundamental assumptions such as the definition of 'evidence', the relative validity of various research methods, the actual role of evidence to inform policy-making, etc. In many cases, these discussions serve a useful purpose, but they also stem from serious disagreement on methodological and epistemological issues. This essay reviews the rationale for evidence-informed policy-making by examining some of the common claims made about the aims and practices of this perspective on public policy. Supplementing the existing justifications for evidence-based policy making, we argue in favor of a greater inclusion of research evidence in the policy process but in a structured fashion, based on methodological considerations. In this respect, we present an overview of the intricate relation between policy questions and appropriate research designs. By closely examining the relation between research questions and research designs, we claim that the usual points of disagreement are mitigated. For instance, when focusing on the variety of research designs that can answer a range of policy questions, the common critical claim about 'RCT-based policy-making' seems to lose some, if not all of its grip.

Validating a Theory-Based Survey to Evaluate Teaching Effectiveness in Higher Education

ERIC Educational Resources Information Center

Amrein-Beardsley, A.; Haladyna, T.

2012-01-01

Surveys to evaluate instructor effectiveness are commonly used in higher education. Yet the survey items included are often drawn from other surveys without reference to a theory of adult learning. The authors present the results from a validation study of such a theory-based survey. They evidence that an evaluation survey based on a theory that…

Evidence-based neurosurgery

PubMed Central

Esene, Ignatius N.; Baeesa, Saleh S.; Ammar, Ahmed

2016-01-01

Medical evidence is obtainable from approaches, which might be descriptive, analytic and integrative and ranked into levels of evidence, graded according to quality and summarized into strengths of recommendation. Sources of evidence range from expert opinions through well-randomized control trials to meta-analyses. The conscientious, explicit, and judicious use of current best evidence in making decisions related to the care of individual patients defines the concept of evidence-based neurosurgery (EBN). We reviewed reference books of clinical epidemiology, evidence-based practice and other previously related articles addressing principles of evidence-based practice in neurosurgery. Based on existing theories and models and our cumulative years of experience and expertise conducting research and promoting EBN, we have synthesized and presented a holistic overview of the concept of EBN. We have also underscored the importance of clinical research and its relationship to EBN. Useful electronic resources are provided. The concept of critical appraisal is introduced. PMID:27356649

Evidence of Concurrent Validity of SII Scores for Asian American College Students

ERIC Educational Resources Information Center

Hansen, Jo-Ida C.; Lee, W. Vanessa

2007-01-01

The validity of scores on the Strong Interest Inventory (SII) for Asian American college students has not been thoroughly investigated. This study examined the evidence of validity of the SII Occupational Scale scores for predicting college major choices of Asian American women and men and White women and men. The sample included 186 female and…

Diverse convergent evidence in the genetic analysis of complex disease: coordinating omic, informatic, and experimental evidence to better identify and validate risk factors

PubMed Central

2014-01-01

In omic research, such as genome wide association studies, researchers seek to repeat their results in other datasets to reduce false positive findings and thus provide evidence for the existence of true associations. Unfortunately this standard validation approach cannot completely eliminate false positive conclusions, and it can also mask many true associations that might otherwise advance our understanding of pathology. These issues beg the question: How can we increase the amount of knowledge gained from high throughput genetic data? To address this challenge, we present an approach that complements standard statistical validation methods by drawing attention to both potential false negative and false positive conclusions, as well as providing broad information for directing future research. The Diverse Convergent Evidence approach (DiCE) we propose integrates information from multiple sources (omics, informatics, and laboratory experiments) to estimate the strength of the available corroborating evidence supporting a given association. This process is designed to yield an evidence metric that has utility when etiologic heterogeneity, variable risk factor frequencies, and a variety of observational data imperfections might lead to false conclusions. We provide proof of principle examples in which DiCE identified strong evidence for associations that have established biological importance, when standard validation methods alone did not provide support. If used as an adjunct to standard validation methods this approach can leverage multiple distinct data types to improve genetic risk factor discovery/validation, promote effective science communication, and guide future research directions. PMID:25071867

Further Validation of the IDAS: Evidence of Convergent, Discriminant, Criterion, and Incremental Validity

ERIC Educational Resources Information Center

Watson, David; O'Hara, Michael W.; Chmielewski, Michael; McDade-Montez, Elizabeth A.; Koffel, Erin; Naragon, Kristin; Stuart, Scott

2008-01-01

The authors explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; D. Watson et al., 2007) in 2 samples (306 college students and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS; the mean convergent…

From Evidence Based Medicine to Medicine Based Evidence.

PubMed

Horwitz, Ralph I; Hayes-Conroy, Allison; Caricchio, Roberto; Singer, Burton H

2017-11-01

Evidence based medicine, using randomized controlled trials and meta-analyses as the major tools and sources of evidence about average results for heterogeneous groups of patients, developed as a reaction against poorly designed observational treatment research and physician reliance on personal experience with other patients as a guide to decision-making about a patient at hand. However, these tools do not answer the clinician's question: "Will a given therapeutic regimen help my patient at a given point in her/his clinical course?" We introduce fine-grained profiling of the patient at hand, accompanied by comparative evidence of responses from approximate matches to this patient on whom a contemplated treatment has/has not been administered. This represents medicine based evidence that is tuned to decision-making for the particular patient. Copyright © 2017 Elsevier Inc. All rights reserved.

Evidence-based dentistry.

PubMed

Chambers, David W

2010-01-01

Both panegyric and criticism of evidence-based dentistry tend to be clumsy because the concept is poorly defined. This analysis identifies several contributions to the profession that have been made under the EBD banner. Although the concept of clinicians integrating clinical epidemiology, the wisdom of their practices, and patients' values is powerful, its implementation has been distorted by a too heavy emphasis of computerized searches for research findings that meet the standards of academics. Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct. There is no systematic, high-quality evidence that EBD is effective. The metaphor of a three-legged stool (evidence, experience, values, and integration) is used as an organizing principle. "Best evidence" has become a preoccupation among EBD enthusiasts. That overlong but thinly developed leg of the stool is critiqued from the perspectives of the criteria for evidence, the difference between internal and external validity, the relationship between evidence and decision making, the ambiguous meaning of "best," and the role of reasonable doubt. The strongest leg of the stool is clinical experience. Although bias exists in all observations (including searches for evidence), there are simple procedures that can be employed in practice to increase useful and objective evidence there, and there are dangers in delegating policy regarding allowable treatments to external groups. Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests. Four potential approaches to integration are suggested, recognizing that there is virtually no literature on how the "seat" of the three-legged stool works or should work. It is likely that most dentists

[Evidence-based aspects of clinical mastitis treatment].

PubMed

Mansion-de Vries, E M; Hoedemaker, M; Krömker, V

2015-01-01

Mastitis is one of the most common and expensive diseases in dairy cattle. The decision to treat clinical mastitis is usually made without any knowledge of the etiology, and can therefore only be evidence-based to a limited extent. Evidence-based medicine relies essentially on a combination of one's own clinical competence and scientific findings. In mastitis therapy, those insights depend mostly on pathogen-specific factors. Therefore, in evidence-based therapeutic decision making the pathogen identification should serve as a basis for the consideration of scientifically validated therapeutic concepts. The present paper considers evidence-based treatment of clinical mastitis based on a literature review. The authors conclude that an anti-inflammatory treatment using an NSAID should be conducted regardless of the pathogen. However, the choice of an antibiotic therapy depends on the mastitis causative pathogen, clinical symptoms and the animal itself. In principle, a local antibiotic treatment should be chosen for mild and moderate mastitis. It should be noted, that the benefit of an antibiotic therapy for coliform infections is questionable. With knowledge concerning the pathogen, it appears entirely reasonable to refrain from an antibiotic therapy. For severe (i.   e. feverish) mastitis, a parenteral antibiotic therapy should be selected. An extension of the antibiotic therapy beyond the manufacturer's information is only reasonable for streptococcal infections. It is important to make the decision on a prolonged antibiotic therapy only with the knowledge of the mastitis-causative pathogen. In terms of the therapy of a staphylococcus or streptococcus infection, a narrow-spectrum antibiotic from the penicillin family should be adopted when selecting the active agents.

Practice-Based Evidence in Community Guide Systematic Reviews.

PubMed

Vaidya, Namita; Thota, Anilkrishna B; Proia, Krista K; Jamieson, Sara; Mercer, Shawna L; Elder, Randy W; Yoon, Paula; Kaufmann, Rachel; Zaza, Stephanie

2017-03-01

To assess the relative contributions and quality of practice-based evidence (PBE) and research-based evidence (RBE) in The Guide to Community Preventive Services (The Community Guide). We developed operational definitions for PBE and RBE in which the main distinguishing feature was whether allocation of participants to intervention and comparison conditions was under the control of researchers (RBE) or not (PBE). We conceptualized a continuum between RBE and PBE. We then categorized 3656 studies in 202 reviews completed since The Community Guide began in 1996. Fifty-four percent of studies were PBE and 46% RBE. Community-based and policy reviews had more PBE. Health care system and programmatic reviews had more RBE. The majority of both PBE and RBE studies were of high quality according to Community Guide scoring methods. The inclusion of substantial PBE in Community Guide reviews suggests that evidence of adequate rigor to inform practice is being produced. This should increase stakeholders' confidence that The Community Guide provides recommendations with real-world relevance. Limitations in some PBE studies suggest a need for strengthening practice-relevant designs and external validity reporting standards.

Improving the evidence base for better comparative effectiveness research.

PubMed

Brophy, James M

2015-09-01

The last 20 years has documented that the evidence base for informed clinical decision-making is often suboptimal. It is hoped that high-quality comparative effectiveness research may fill these knowledge gaps. Implicit in these changing paradigms is the underlying assumption that the published evidence, when available, is valid. It is posited here that this assumption is sometimes questionable. However, several recent methods that may improve the design and analysis of comparative effectiveness research have appeared and are discussed here. Examples from the cardiology literature are provided, but it is believed the highlighted principles are applicable to other branches of medicine.

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

PubMed

Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-03-01

The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

Evidence-based policy as reflexive practice. What can we learn from evidence-based medicine?

PubMed

Bal, Roland

2017-04-01

The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine - clinical trials, and the production and use of clinical guidelines - I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively. In the conclusion, I discuss the prospects of such a practice for evidence-based policy.

Appearance motives to tan and not tan: evidence for validity and reliability of a new scale.

PubMed

Cafri, Guy; Thompson, J Kevin; Roehrig, Megan; Rojas, Ariz; Sperry, Steffanie; Jacobsen, Paul B; Hillhouse, Joel

2008-04-01

Risk for skin cancer is increased by UV exposure and decreased by sun protection. Appearance reasons to tan and not tan have consistently been shown to be related to intentions and behaviors to UV exposure and protection. This study was designed to determine the factor structure of appearance motives to tan and not tan, evaluate the extent to which this factor structure is gender invariant, test for mean differences in the identified factors, and evaluate internal consistency, temporal stability, and criterion-related validity. Five-hundred eighty-nine females and 335 male college students were used to test confirmatory factor analysis models within and across gender groups, estimate latent mean differences, and use the correlation coefficient and Cronbach's alpha to further evaluate the reliability and validity of the identified factors. A measurement invariant (i.e., factor-loading invariant) model was identified with three higher-order factors: sociocultural influences to tan (lower order factors: media, friends, family, significant others), appearance reasons to tan (general, acne, body shape), and appearance reasons not to tan (skin aging, immediate skin damage). Females had significantly higher means than males on all higher-order factors. All subscales had evidence of internal consistency, temporal stability, and criterion-related validity. This study offers a framework and measurement instrument that has evidence of validity and reliability for evaluating appearance-based motives to tan and not tan.

Creation of a Tool for Assessing Knowledge in Evidence-Based Decision-Making in Practicing Health Care Providers.

PubMed

Spurr, Kathy; Dechman, Gail; Lackie, Kelly; Gilbert, Robert

2016-01-01

Evidence-based decision-making (EBDM) is the process health care providers (HCPs) use to identify and appraise potential evidence. It supports the integration of best research evidence with clinical expertise and patient values into the decision-making process for patient care. Competence in this process is essential to delivery of optimal care. There is no objective tool that assesses EBDM across HCP groups. This research aimed to develop a content valid tool to assess knowledge of the principles of evidence-based medicine and the EBDM process, for use with all HCPs. A Delphi process was used in the creation of the tool. Pilot testing established its content validity with the added benefit of evaluating HCPs' knowledge of EBDM. Descriptive statistics and multivariate mixed models were used to evaluate individual survey responses in total, as well as within each EBDM component. The tool consisted of 26 multiple-choice questions. A total of 12,884 HCPs in Nova Scotia were invited to participate in the web-based validation study, yielding 818 (6.3%) participants, 471 of whom completed all questions. The mean overall score was 68%. Knowledge in one component, integration of evidence with clinical expertise and patient preferences, was identified as needing development across all HCPs surveyed. A content valid tool for assessing HCP EBDM knowledge was created and can be used to support the development of continuing education programs to enhance EBDM competency.

Validity Evidence for Games as Assessment Environments. CRESST Report 773

ERIC Educational Resources Information Center

Delacruz, Girlie C.; Chung, Gregory K. W. K.; Baker, Eva L.

2010-01-01

This study provides empirical evidence of a highly specific use of games in education--the assessment of the learner. Linear regressions were used to examine the predictive and convergent validity of a math game as assessment of mathematical understanding. Results indicate that prior knowledge significantly predicts game performance. Results also…

The Online Student Connectedness Survey: Evidence of Initial Construct Validity

ERIC Educational Resources Information Center

Zimmerman, Tekeisha; Nimon, Kim

2017-01-01

The Online Student Connectedness Survey (OSCS) was introduced to the academic community in 2012 as an instrument designed to measure feelings of connectedness between students participating in online degree and certification programs. The purpose of this study was to examine data from the instrument for initial evidence of validity and reliability…

Rationality versus reality: the challenges of evidence-based decision making for health policy makers

PubMed Central

2010-01-01

Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the

Rationality versus reality: the challenges of evidence-based decision making for health policy makers.

PubMed

McCaughey, Deirdre; Bruning, Nealia S

2010-05-26

Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be

Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

PubMed Central

Fung, Foon Yin; Linn, Yeh Ching

2015-01-01

Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM. PMID:25949261

Evidence-based interpretation of liver biopsies.

PubMed

Crawford, James M

2006-04-01

'Evidence based medicine' is a paradigm introduced in the 1990s in which collection of clinical data in a reproducible and unbiased way is intended to guide clinical decision-making. This paradigm has been promulgated across the spectrum of medicine, but with more limited critical analysis in the realm of pathology. The 'evidence base' in support of our practices in Anatomic Pathology is a critical issue, given the key role that such diagnoses play in patient management decisions. The question is, 'On what basis are diagnostic opinions rendered in Anatomic Pathology?' The operative question becomes, 'What is the published literature that supports our anatomic pathology interpretations?' This second question was applied to the published literature in Hepatopathology, by identifying the 'citation classics' of this discipline. Specifically, the top 150 most-cited liver pathology articles were analyzed for: authorship; journal of publication; type of publication; and year of publication. Results are as follows. First, it is indeed true that the preeminent hepatopathologists of the age are the most cited authors in the 'top 150'. Second, the most cited articles in hepatopathology are not published in the pathology literature, but are instead published in much higher impact clinical journals. Third, the pathology of viral hepatitis is demonstrated to be extraordinarily well-grounded in 'evidence based medicine'. Much of the remainder of the hepatopathology literature falls into a 'narrative based' paradigm, which is the rigorous reporting of case experience without statistical clinical outcomes validation. Finally, the years of publication reflect, on the one hand, a vigorous recent literature in the pharmaceutical treatment of viral hepatitis, and on the other, a broadly distributed set of 'narrative' articles from the 1960s, 1970s, 1980s, and 1990s. In conclusion, the discipline of hepatopathology appears to be well-grounded in 'evidence based medicine' in the realm of

Ethics and Evidence-Based Medicine: Is There a Conflict?

PubMed Central

Loewy, Erich H.

2007-01-01

This article addresses the advantages, disadvantages, and traps to which evidence-based medicine (EBM) may lead and suggests that, to be ethically valid, EBM must be aimed at the patient's best interests and not at the financial interests of others. While financial considerations are by no means trivial, it is hypocritical – if not dangerous – to hide them behind words like “evidence” or “quality.” PMID:18092036

Evidence conflict measure based on OWA operator in open world

PubMed Central

Wang, Shiyu; Liu, Xiang; Zheng, Hanqing; Wei, Boya

2017-01-01

Dempster-Shafer evidence theory has been extensively used in many information fusion systems since it was proposed by Dempster and extended by Shafer. Many scholars have been conducted on conflict management of Dempster-Shafer evidence theory in past decades. However, how to determine a potent parameter to measure evidence conflict, when the given environment is in an open world, namely the frame of discernment is incomplete, is still an open issue. In this paper, a new method which combines generalized conflict coefficient, generalized evidence distance, and generalized interval correlation coefficient based on ordered weighted averaging (OWA) operator, to measure the conflict of evidence is presented. Through ordered weighted average of these three parameters, the combinatorial coefficient can still measure the conflict effectively when one or two parameters are not valid. Several numerical examples demonstrate the effectiveness of the proposed method. PMID:28542271

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

PubMed Central

Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-01-01

Background The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. Objective To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. Methods A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Results Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Conclusions Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems. PMID:26932350

A guideline for the validation of likelihood ratio methods used for forensic evidence evaluation.

PubMed

Meuwly, Didier; Ramos, Daniel; Haraksim, Rudolf

2017-07-01

This Guideline proposes a protocol for the validation of forensic evaluation methods at the source level, using the Likelihood Ratio framework as defined within the Bayes' inference model. In the context of the inference of identity of source, the Likelihood Ratio is used to evaluate the strength of the evidence for a trace specimen, e.g. a fingermark, and a reference specimen, e.g. a fingerprint, to originate from common or different sources. Some theoretical aspects of probabilities necessary for this Guideline were discussed prior to its elaboration, which started after a workshop of forensic researchers and practitioners involved in this topic. In the workshop, the following questions were addressed: "which aspects of a forensic evaluation scenario need to be validated?", "what is the role of the LR as part of a decision process?" and "how to deal with uncertainty in the LR calculation?". The questions: "what to validate?" focuses on the validation methods and criteria and "how to validate?" deals with the implementation of the validation protocol. Answers to these questions were deemed necessary with several objectives. First, concepts typical for validation standards [1], such as performance characteristics, performance metrics and validation criteria, will be adapted or applied by analogy to the LR framework. Second, a validation strategy will be defined. Third, validation methods will be described. Finally, a validation protocol and an example of validation report will be proposed, which can be applied to the forensic fields developing and validating LR methods for the evaluation of the strength of evidence at source level under the following propositions. Copyright © 2016. Published by Elsevier B.V.

Initial construct validity evidence of a virtual human application for competency assessment in breaking bad news to a cancer patient.

PubMed

Guetterman, Timothy C; Kron, Frederick W; Campbell, Toby C; Scerbo, Mark W; Zelenski, Amy B; Cleary, James F; Fetters, Michael D

2017-01-01

Despite interest in using virtual humans (VHs) for assessing health care communication, evidence of validity is limited. We evaluated the validity of a VH application, MPathic-VR, for assessing performance-based competence in breaking bad news (BBN) to a VH patient. We used a two-group quasi-experimental design, with residents participating in a 3-hour seminar on BBN. Group A (n=15) completed the VH simulation before and after the seminar, and Group B (n=12) completed the VH simulation only after the BBN seminar to avoid the possibility that testing alone affected performance. Pre- and postseminar differences for Group A were analyzed with a paired t -test, and comparisons between Groups A and B were analyzed with an independent t -test. Compared to the preseminar result, Group A's postseminar scores improved significantly, indicating that the VH program was sensitive to differences in assessing performance-based competence in BBN. Postseminar scores of Group A and Group B were not significantly different, indicating that both groups performed similarly on the VH program. Improved pre-post scores demonstrate acquisition of skills in BBN to a VH patient. Pretest sensitization did not appear to influence posttest assessment. These results provide initial construct validity evidence that the VH program is effective for assessing BBN performance-based communication competence.

Policy Claims and Problem Frames: A Cross-Case Comparison of Evidence-Based Policy in an Australian Context

ERIC Educational Resources Information Center

van Toorn, Georgia; Dowse, Leanne

2016-01-01

This paper explores the signification of evidence-based policy as a new policy-making paradigm in Australia through a cross-case comparison of the role of evidence in two key areas: child protection and illicit drug policy. Although evidence makes certain courses of action appear valid and credible, quality evidence is not necessarily the critical…

Evidence-based medicine Training: Kazakhstan experience.

PubMed

Kamalbekova, G; Kalieva, M

2015-01-01

practice. These were: failure in implementing, lack of understanding on the part of colleagues, commitment to traditional obsolete methods of treatment, discrepancy between some of the existing standards of diagnosis and treatment and principles of evidence-based medicine.To the question: «Are there any end products after listening to the seminar?» 67% of the respondents answered in affirmative. The end products were mainly marked by the publication of articles and abstracts, including international publications, and participation in the working group on the revision and development of clinical protocols. Barriers to implementation of Evidence-Based Medicine in education and practice are lack of funding to provide access to reliable sources of information, websites; outdated research methodology skills in medical education, lack of skills in critical evaluation of medical information; tradition of authoritarian relationships, use of past experience stencils; failure to comply with continuing education programs ("from training to professional development"). Knowledge of Evidence-Based Medicine, skills to perform searches for scientific data, to evaluate their validity and to transform scientific data into practical solutions are necessary for health workers in their daily activities. This culture needs to be rooted in modern medical education.

Scale of attitudes toward alcohol - Spanish version: evidences of validity and reliability 1

PubMed Central

Ramírez, Erika Gisseth León; de Vargas, Divane

2017-01-01

ABSTRACT Objective: validate the Scale of attitudes toward alcohol, alcoholism and individuals with alcohol use disorders in its Spanish version. Method: methodological study, involving 300 Colombian nurses. Adopting the classical theory, confirmatory factor analysis was applied without prior examination, based on the strong historical evidence of the factorial structure of the original scale to determine the construct validity of this Spanish version. To assess the reliability, Cronbach’s Alpha and Mc Donalid’s Omega coefficients were used. Results: the confirmatory factor analysis indicated the good fit of the scale model in a four-factor distribution, with a cut-off point at 3.2, demonstrating 66.7% of sensitivity. Conclusions: the Scale of attitudes toward alcohol, alcoholism and individuals with alcohol use disorders in Spanish presented robust psychometric qualities, affirming that the instrument possesses a solid factorial structure and reliability and is capable of precisely measuring the nurses’ atittudes towards the phenomenon proposed. PMID:28793126

Assessing Procedural Competence: Validity Considerations.

PubMed

Pugh, Debra M; Wood, Timothy J; Boulet, John R

2015-10-01

Simulation-based medical education (SBME) offers opportunities for trainees to learn how to perform procedures and to be assessed in a safe environment. However, SBME research studies often lack robust evidence to support the validity of the interpretation of the results obtained from tools used to assess trainees' skills. The purpose of this paper is to describe how a validity framework can be applied when reporting and interpreting the results of a simulation-based assessment of skills related to performing procedures. The authors discuss various sources of validity evidence because they relate to SBME. A case study is presented.

easyCBM® Reading Criterion Related Validity Evidence: Grades K-1. Technical Report #1309

ERIC Educational Resources Information Center

Lai, Cheng-Fei; Alonzo, Julie; Tindal, Gerald

2013-01-01

In this technical report, we present the results of a study to gather criterion-related evidence for Grade K-1 easyCBM® reading measures. We used correlations to examine the relation between the easyCBM® measures and other published measures with known reliability and validity evidence, including the Dynamic Indicators of Basic Early Literacy…

Application of evidence-based dentistry: from research to clinical periodontal practice.

PubMed

Kwok, Vivien; Caton, Jack G; Polson, Alan M; Hunter, Paul G

2012-06-01

Dentists need to make daily decisions regarding patient care, and these decisions should essentially be scientifically sound. Evidence-based dentistry is meant to empower clinicians to provide the most contemporary treatment. The benefits of applying the evidence-based method in clinical practice include application of the most updated treatment and stronger reasoning to justify the treatment. A vast amount of information is readily accessible with today's digital technology, and a standardized search protocol can be developed to ensure that a literature search is valid, specific and repeatable. It involves developing a preset question (population, intervention, comparison and outcome; PICO) and search protocol. It is usually used academically to perform commissioned reviews, but it can also be applied to answer simple clinical queries. The scientific evidence thus obtained can then be considered along with patient preferences and values, clinical patient circumstances and the practitioner's experience and judgment in order to make the treatment decision. This paper describes how clinicians can incorporate evidence-based methods into patient care and presents a clinical example to illustrate the process. © 2012 John Wiley & Sons A/S.

easyCBM® Reading Criterion Related Validity Evidence: Grades 2-5. Technical Report #1310

ERIC Educational Resources Information Center

Lai, Cheng-Fei; Alonzo, Julie; Tindal, Gerald

2013-01-01

In this technical report, we present the results of a study to gather criterion-related evidence for Grade 2-5 easyCBM® reading measures. We used correlations to examine the relation between the easyCBM® measures and other published measures with known reliability and validity evidence, including the Gates-MacGinitie Reading Tests and the Dynamic…

Development and Validation of a Multimedia-based Assessment of Scientific Inquiry Abilities

NASA Astrophysics Data System (ADS)

Kuo, Che-Yu; Wu, Hsin-Kai; Jen, Tsung-Hau; Hsu, Ying-Shao

2015-09-01

The potential of computer-based assessments for capturing complex learning outcomes has been discussed; however, relatively little is understood about how to leverage such potential for summative and accountability purposes. The aim of this study is to develop and validate a multimedia-based assessment of scientific inquiry abilities (MASIA) to cover a more comprehensive construct of inquiry abilities and target secondary school students in different grades while this potential is leveraged. We implemented five steps derived from the construct modeling approach to design MASIA. During the implementation, multiple sources of evidence were collected in the steps of pilot testing and Rasch modeling to support the validity of MASIA. Particularly, through the participation of 1,066 8th and 11th graders, MASIA showed satisfactory psychometric properties to discriminate students with different levels of inquiry abilities in 101 items in 29 tasks when Rasch models were applied. Additionally, the Wright map indicated that MASIA offered accurate information about students' inquiry abilities because of the comparability of the distributions of student abilities and item difficulties. The analysis results also suggested that MASIA offered precise measures of inquiry abilities when the components (questioning, experimenting, analyzing, and explaining) were regarded as a coherent construct. Finally, the increased mean difficulty thresholds of item responses along with three performance levels across all sub-abilities supported the alignment between our scoring rubrics and our inquiry framework. Together with other sources of validity in the pilot testing, the results offered evidence to support the validity of MASIA.

The Validity of Adding ECG to the Preparticipation Screening of Athletes An Evidence Based Literature Review

PubMed Central

Alattar, A; Maffulli, N

2015-01-01

Objective: To review the available evidence establishing the validity of adding electrocardiogram to the preparticipation cardiac screening in athletes. Data Sources: MEDLINE and CINAHL databases were searched. Additional references from the bibliographies of retrieved articles were also reviewed and experts in the area were contacted. Selection Criteria: Only original research articles seeking to establish the use of electrocardiography followed by second line investigations in athletes under 36 years of age were reviewed. Search Result and Quality Assessment: The initial literature search identified 226 papers. Of these, 16 original articles (all type II evidence—population-based clinical studies) met the selection criteria and directly related to the use of electrocardiography in athletes cardiac screening. The methodological qualities of included studies were assessed using the Downs and Black checklist. Conclusion: Screening with electrocardiography represents best clinical practice to prevent or reduce the risk of sudden cardiac death in athletes. It significantly improves the sensitivity of history and physical examination alone; it has reasonable specificity and excellent negative predictive value; and it is cost-effective. Future studies must be large, multicentre, multination, prospective trials powered to determine how different screening options affect the incidence of sudden cardiac death. Efforts should also be targeted toward secondary prevention of sudden cardiac death with pitch side cardiac resuscitation and the immediate use of defibrillator. PMID:25674543

Development and psychometric testing of a trans-professional evidence-based practice profile questionnaire.

PubMed

McEvoy, Maureen Patricia; Williams, Marie T; Olds, Timothy Stephen

2010-01-01

Previous survey tools operationalising knowledge, attitudes or beliefs about evidence-based practice (EBP) have shortcomings in content, psychometric properties and target audience. This study developed and psychometrically assessed a self-report trans-professional questionnaire to describe an EBP profile. Sixty-six items were collated from existing EBP questionnaires and administered to 526 academics and students from health and non-health backgrounds. Principal component factor analysis revealed the presence of five factors (Relevance, Terminology, Confidence, Practice and Sympathy). Following expert panel review and pilot testing, the 58-item final questionnaire was disseminated to 105 subjects on two occasions. Test-retest and internal reliability were quantified using intra-class correlation coefficients (ICCs) and Cronbach's alpha, convergent validity against a commonly used EBP questionnaire by Pearson's correlation coefficient and discriminative validity via analysis of variance (ANOVA) based on exposure to EBP training. The final questionnaire demonstrated acceptable internal consistency (Cronbach's alpha 0.96), test-retest reliability (ICCs range 0.77-0.94) and convergent validity (Practice 0.66, Confidence 0.80 and Sympathy 0.54). Three factors (Relevance, Terminology and Confidence) distinguished EBP exposure groups (ANOVA p < 0.001-0.004). The evidence-based practice profile (EBP(2)) questionnaire is a reliable instrument with the ability to discriminate for three factors, between respondents with differing EBP exposures.

Information systems: the key to evidence-based health practice.

PubMed Central

Rodrigues, R. J.

2000-01-01

Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

Evidence-Based Medicine: Rhinoplasty.

PubMed

Lee, Matthew K; Most, Sam P

2015-08-01

Evidence-based medicine has become increasingly prominent in the climate of modern day healthcare. The practice of evidence-based medicine involves the integration of the best available evidence with clinical experience and expertise to help guide clinical decision-making. The essential tenets of evidence-based medicine can be applied to both functional and aesthetic rhinoplasty. Current outcome measures in functional and aesthetic rhinoplasty, including objective, subjective, and clinician-reported measures, is summarized and the current data is reviewed. Copyright © 2015 Elsevier Inc. All rights reserved.

Development and initial validation of a cognitive-based work-nonwork conflict scale.

PubMed

Ezzedeen, Souha R; Swiercz, Paul M

2007-06-01

Current research related to work and life outside work specifies three types of work-nonwork conflict: time, strain, and behavior-based. Overlooked in these models is a cognitive-based type of conflict whereby individuals experience work-nonwork conflict from cognitive preoccupation with work. Four studies on six different groups (N=549) were undertaken to develop and validate an initial measure of this construct. Structural equation modeling confirmed a two-factor, nine-item scale. Hypotheses regarding cognitive-based conflict's relationship with life satisfaction, work involvement, work-nonwork conflict, and work hours were supported. The relationship with knowledge work was partially supported in that only the cognitive dimension of cognitive-based conflict was related to extent of knowledge work. Hypotheses regarding cognitive-based conflict's relationship with family demands were rejected in that the cognitive dimension correlated positively rather than negatively with number of dependent children and perceived family demands. The study provides encouraging preliminary evidence of scale validity.

Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program.

PubMed

Renfro, Mindy; Bainbridge, Donna B; Smith, Matthew Lee

2016-01-01

Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. Despite the limited number of participants ( n  = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more

Logic Brightens My Day: Evidence for Implicit Sensitivity to Logical Validity

ERIC Educational Resources Information Center

Trippas, Dries; Handley, Simon J.; Verde, Michael F.; Morsanyi, Kinga

2016-01-01

A key assumption of dual process theory is that reasoning is an explicit, effortful, deliberative process. The present study offers evidence for an implicit, possibly intuitive component of reasoning. Participants were shown sentences embedded in logically valid or invalid arguments. Participants were not asked to reason but instead rated the…

An Australian Version of the Neighborhood Environment Walkability Scale: Validity Evidence

ERIC Educational Resources Information Center

Cerin, Ester; Leslie, Eva; Owen, Neville; Bauman, Adrian

2008-01-01

This study examined validity evidence for the Australian version of the Neighborhood Environment Walkability Scale (NEWS-AU). A stratified two-stage cluster sampling design was used to recruit 2,650 adults from Adelaide (Australia). The sample was drawn from residential addresses within eight high-walkable and eight low-walkable suburbs matched…

Evidence-based financial management.

PubMed

Finkler, Steven A; Henley, Richard J; Ward, David M

2003-10-01

Like the practice of evidence-based medicine, evidence-based financial management can be used by providers to improve results. The concept provides a framework that managers and researchers can use to help direct efforts in gathering and using evidence to support management decisions in health care.

Initial construct validity evidence of a virtual human application for competency assessment in breaking bad news to a cancer patient

PubMed Central

Guetterman, Timothy C; Kron, Frederick W; Campbell, Toby C; Scerbo, Mark W; Zelenski, Amy B; Cleary, James F; Fetters, Michael D

2017-01-01

Background Despite interest in using virtual humans (VHs) for assessing health care communication, evidence of validity is limited. We evaluated the validity of a VH application, MPathic-VR, for assessing performance-based competence in breaking bad news (BBN) to a VH patient. Methods We used a two-group quasi-experimental design, with residents participating in a 3-hour seminar on BBN. Group A (n=15) completed the VH simulation before and after the seminar, and Group B (n=12) completed the VH simulation only after the BBN seminar to avoid the possibility that testing alone affected performance. Pre- and postseminar differences for Group A were analyzed with a paired t-test, and comparisons between Groups A and B were analyzed with an independent t-test. Results Compared to the preseminar result, Group A’s postseminar scores improved significantly, indicating that the VH program was sensitive to differences in assessing performance-based competence in BBN. Postseminar scores of Group A and Group B were not significantly different, indicating that both groups performed similarly on the VH program. Conclusion Improved pre–post scores demonstrate acquisition of skills in BBN to a VH patient. Pretest sensitization did not appear to influence posttest assessment. These results provide initial construct validity evidence that the VH program is effective for assessing BBN performance-based communication competence. PMID:28794664

Patient-Reported Outcome Measures for Hand and Wrist Trauma: Is There Sufficient Evidence of Reliability, Validity, and Responsiveness?

PubMed

Dacombe, Peter Jonathan; Amirfeyz, Rouin; Davis, Tim

2016-03-01

Patient-reported outcome measures (PROMs) are important tools for assessing outcomes following injuries to the hand and wrist. Many commonly used PROMs have no evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. This systematic review examines the PROMs used in the assessment of hand and wrist trauma patients, and the evidence for reliability, validity, and responsiveness of each measure in this population. A systematic review of Pubmed, Medline, and CINAHL searching for randomized controlled trials of patients with traumatic injuries to the hand and wrist was carried out to identify the PROMs. For each identified PROM, evidence of reliability, validity, and responsiveness was identified using a further systematic review of the Pubmed, Medline, CINAHL, and reverse citation trail audit procedure. The PROM used most often was the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; the Patient-Rated Wrist Evaluation (PRWE), Gartland and Werley score, Michigan Hand Outcomes score, Mayo Wrist Score, and Short Form 36 were also commonly used. Only the DASH and PRWE have evidence of reliability, validity, and responsiveness in patients with traumatic injuries to the hand and wrist; other measures either have incomplete evidence or evidence gathered in a nontraumatic population. The DASH and PRWE both have evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. Other PROMs used to assess hand and wrist trauma patients do not. This should be considered when selecting a PROM for patients with traumatic hand and wrist pathology.

Methodologic limitations of prescription opioid safety research and recommendations for improving the evidence base.

PubMed

Ranapurwala, Shabbar I; Naumann, Rebecca B; Austin, Anna E; Dasgupta, Nabarun; Marshall, Stephen W

2018-06-03

The ongoing opioid epidemic has claimed more than a quarter million Americans' lives over the past 15 years. The epidemic began with an escalation of prescription opioid deaths and has now evolved to include secondary waves of illicit heroin and fentanyl deaths, while the deaths due to prescription opioid overdoses are still increasing. In response, the Centers for Disease Control and Prevention (CDC) moved to limit opioid prescribing with the release of opioid prescribing guidelines for chronic noncancer pain in March 2016. The guidelines represent a logical and timely federal response to this growing crisis. However, CDC acknowledged that the evidence base linking opioid prescribing to opioid use disorders and overdose was grades 3 and 4. Motivated by the need to strengthen the evidence base, this review details limitations of the opioid safety studies cited in the CDC guidelines with a focus on methodological limitations related to internal and external validity. Internal validity concerns were related to poor confounding control, variable misclassification, selection bias, competing risks, and potential competing interventions. External validity concerns arose from the use of limited source populations, historical data (in a fast-changing epidemic), and issues with handling of cancer and acute pain patients' data. We provide a nonexhaustive list of 7 recommendations to address these limitations in future opioid safety studies. Strengthening the opioid safety evidence base will aid any future revisions of the CDC guidelines and enhance their prevention impact. Copyright © 2018 John Wiley & Sons, Ltd.

Validity-Supporting Evidence of the Self-Efficacy for Teaching Mathematics Instrument

ERIC Educational Resources Information Center

McGee, Jennifer R.; Wang, Chuang

2014-01-01

The purpose of this study is to provide evidence of reliability and validity of the Self-Efficacy for Teaching Mathematics Instrument (SETMI). Self-efficacy, as defined by Bandura, was the theoretical framework for the development of the instrument. The complex belief systems of mathematics teachers, as touted by Ernest provided insights into the…

A rule-based named-entity recognition method for knowledge extraction of evidence-based dietary recommendations

PubMed Central

2017-01-01

Evidence-based dietary information represented as unstructured text is a crucial information that needs to be accessed in order to help dietitians follow the new knowledge arrives daily with newly published scientific reports. Different named-entity recognition (NER) methods have been introduced previously to extract useful information from the biomedical literature. They are focused on, for example extracting gene mentions, proteins mentions, relationships between genes and proteins, chemical concepts and relationships between drugs and diseases. In this paper, we present a novel NER method, called drNER, for knowledge extraction of evidence-based dietary information. To the best of our knowledge this is the first attempt at extracting dietary concepts. DrNER is a rule-based NER that consists of two phases. The first one involves the detection and determination of the entities mention, and the second one involves the selection and extraction of the entities. We evaluate the method by using text corpora from heterogeneous sources, including text from several scientifically validated web sites and text from scientific publications. Evaluation of the method showed that drNER gives good results and can be used for knowledge extraction of evidence-based dietary recommendations. PMID:28644863

What Does It Take to Scale Up and Sustain Evidence-Based Practices?

ERIC Educational Resources Information Center

Klingner, Janette K.; Boardman, Alison G.; Mcmaster, Kristen L.

2013-01-01

This article discusses the strategic scaling up of evidence-based practices. The authors draw from the scholarly work of fellow special education researchers and from the field of learning sciences. The article defines scaling up as the process by which researchers or educators initially implement interventions on a small scale, validate them, and…

Validation of educational assessments: a primer for simulation and beyond.

PubMed

Cook, David A; Hatala, Rose

2016-01-01

Simulation plays a vital role in health professions assessment. This review provides a primer on assessment validation for educators and education researchers. We focus on simulation-based assessment of health professionals, but the principles apply broadly to other assessment approaches and topics. Validation refers to the process of collecting validity evidence to evaluate the appropriateness of the interpretations, uses, and decisions based on assessment results. Contemporary frameworks view validity as a hypothesis, and validity evidence is collected to support or refute the validity hypothesis (i.e., that the proposed interpretations and decisions are defensible). In validation, the educator or researcher defines the proposed interpretations and decisions, identifies and prioritizes the most questionable assumptions in making these interpretations and decisions (the "interpretation-use argument"), empirically tests those assumptions using existing or newly-collected evidence, and then summarizes the evidence as a coherent "validity argument." A framework proposed by Messick identifies potential evidence sources: content, response process, internal structure, relationships with other variables, and consequences. Another framework proposed by Kane identifies key inferences in generating useful interpretations: scoring, generalization, extrapolation, and implications/decision. We propose an eight-step approach to validation that applies to either framework: Define the construct and proposed interpretation, make explicit the intended decision(s), define the interpretation-use argument and prioritize needed validity evidence, identify candidate instruments and/or create/adapt a new instrument, appraise existing evidence and collect new evidence as needed, keep track of practical issues, formulate the validity argument, and make a judgment: does the evidence support the intended use? Rigorous validation first prioritizes and then empirically evaluates key

[Is evidence-based assessment fact or fiction? A bibliometric analysis of three German journals].

PubMed

Petermann, Franz; Schüssler, Gerhard; Glaesmer, Heide

2008-01-01

Despite the ongoing process for the development and dissemination of empirically supported treatments, little attention has been paid to the development of evidence-based diagnostics. The article aims at evaluating diagnostic procedures and instruments in current clinical research in terms of evidence-based assessment. Volumes 2006 and 2007 of three German psychological journals "Psychotherapeut," "Psychotherapie, Psychosomatik und Medizinische Psychologie," and "Zeitschrift für Psychiatrie, Psychologie und Psychotherapie" were screened for empirical reports and articles dealing with diagnostic issues. 93 articles were identified and evaluated. Most studies used psychometrically valid and established instruments for assessment. However, diagnostic interviews were relatively scarce, as were multimodal assessments. Measures used for outcome evaluation often lacked evidence of sensitivity to change. Clinical assessment to date does not meet criteria for evidence-based diagnostics. Implications for research and guideline development are discussed.

Procedure-specific assessment tool for flexible pharyngo-laryngoscopy: gathering validity evidence and setting pass-fail standards.

PubMed

Melchiors, Jacob; Petersen, K; Todsen, T; Bohr, A; Konge, Lars; von Buchwald, Christian

2018-06-01

The attainment of specific identifiable competencies is the primary measure of progress in the modern medical education system. The system, therefore, requires a method for accurately assessing competence to be feasible. Evidence of validity needs to be gathered before an assessment tool can be implemented in the training and assessment of physicians. This evidence of validity must according to the contemporary theory on validity be gathered from specific sources in a structured and rigorous manner. The flexible pharyngo-laryngoscopy (FPL) is central to the otorhinolaryngologist. We aim to evaluate the flexible pharyngo-laryngoscopy assessment tool (FLEXPAT) created in a previous study and to establish a pass-fail level for proficiency. Eighteen physicians with different levels of experience (novices, intermediates, and experienced) were recruited to the study. Each performed an FPL on two patients. These procedures were video recorded, blinded, and assessed by two specialists. The score was expressed as the percentage of a possible max score. Cronbach's α was used to analyze internal consistency of the data, and a generalizability analysis was performed. The scores of the three different groups were explored, and a pass-fail level was determined using the contrasting groups' standard setting method. Internal consistency was strong with a Cronbach's α of 0.86. We found a generalizability coefficient of 0.72 sufficient for moderate stakes assessment. We found a significant difference between the novice and experienced groups (p < 0.001) and strong correlation between experience and score (Pearson's r = 0.75). The pass/fail level was established at 72% of the maximum score. Applying this pass-fail level in the test population resulted in half of the intermediary group receiving a failing score. We gathered validity evidence for the FLEXPAT according to the contemporary framework as described by Messick. Our results support a claim of validity and are

The role of evidence based medicine in neurotrauma.

PubMed

Honeybul, S; Ho, K M

2015-04-01

The introduction of evidence based medicine de-emphasised clinical experience and so-called "background information" and stressed the importance of evidence gained from clinical research when making clinical decisions. For many years randomised controlled trials have been seen to be the only way to advance clinical practice, however, applying this methodology in the context of severe trauma can be problematic. In addition, it is increasingly recognised that considerable clinical experience is required in order to critically evaluate the quality of the evidence and the validity of the conclusions as presented. A contemporary example is seen when considering the role of decompressive craniectomy in the management of neurotrauma. Although there is a considerable amount of evidence available attesting to the efficacy of the procedure, considerable clinical expertise is required in order to properly interpret the results of these studies and the implications for clinical practice. Given these limitations the time may have come for a redesign of the traditional pyramid of evidence, to a model that re-emphasises the importance of "background information" such as pathophysiology and acknowledges the role of clinical experience such that the evidence can be critically evaluated in its appropriate context and the subsequent implications for clinical practice be clearly and objectively defined. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Evidence-Based Special Education in the Context of Scarce Evidence-Based Practices

ERIC Educational Resources Information Center

TEACHING Exceptional Children, 2014

2014-01-01

Evidence-based practices (EBPs) are supported as generally effective for populations of learners by bodies of high-quality and experimental research and, when aligned with stakeholder values and practical needs, should be prioritized for implementation. However, evidence-based practices are not currently available for all learner types in all…

A constructive Indian country response to the evidence-based program mandate.

PubMed

Walker, R Dale; Bigelow, Douglas A

2011-01-01

Over the last 20 years governmental mandates for preferentially funding evidence-based "model" practices and programs has become doctrine in some legislative bodies, federal agencies, and state agencies. It was assumed that what works in small sample, controlled settings would work in all community settings, substantially improving safety, effectiveness, and value-for-money. The evidence-based "model" programs mandate has imposed immutable "core components," fidelity testing, alien programming and program developers, loss of familiar programs, and resource capacity requirements upon tribes, while infringing upon their tribal sovereignty and consultation rights. Tribal response in one state (Oregon) went through three phases: shock and rejection; proposing an alternative approach using criteria of cultural appropriateness, aspiring to evaluability; and adopting logic modeling. The state heard and accepted the argument that the tribal way of knowing is different and valid. Currently, a state-authorized tribal logic model and a review panel process are used to approve tribal best practices for state funding. This constructive response to the evidence-based program mandate elevates tribal practices in the funding and regulatory world, facilitates continuing quality improvement and evaluation, while ensuring that practices and programs remain based on local community context and culture. This article provides details of a model that could well serve tribes facing evidence-based model program mandates throughout the country.

Validity evidence for procedural competency in virtual reality robotic simulation, establishing a credible pass/fail standard for the vaginal cuff closure procedure.

PubMed

Hovgaard, Lisette Hvid; Andersen, Steven Arild Wuyts; Konge, Lars; Dalsgaard, Torur; Larsen, Christian Rifbjerg

2018-03-30

The use of robotic surgery for minimally invasive procedures has increased considerably over the last decade. Robotic surgery has potential advantages compared to laparoscopic surgery but also requires new skills. Using virtual reality (VR) simulation to facilitate the acquisition of these new skills could potentially benefit training of robotic surgical skills and also be a crucial step in developing a robotic surgical training curriculum. The study's objective was to establish validity evidence for a simulation-based test for procedural competency for the vaginal cuff closure procedure that can be used in a future simulation-based, mastery learning training curriculum. Eleven novice gynaecological surgeons without prior robotic experience and 11 experienced gynaecological robotic surgeons (> 30 robotic procedures) were recruited. After familiarization with the VR simulator, participants completed the module 'Guided Vaginal Cuff Closure' six times. Validity evidence was investigated for 18 preselected simulator metrics. The internal consistency was assessed using Cronbach's alpha and a composite score was calculated based on metrics with significant discriminative ability between the two groups. Finally, a pass/fail standard was established using the contrasting groups' method. The experienced surgeons significantly outperformed the novice surgeons on 6 of the 18 metrics. The internal consistency was 0.58 (Cronbach's alpha). The experienced surgeons' mean composite score for all six repetitions were significantly better than the novice surgeons' (76.1 vs. 63.0, respectively, p < 0.001). A pass/fail standard of 75/100 was established. Four novice surgeons passed this standard (false positives) and three experienced surgeons failed (false negatives). Our study has gathered validity evidence for a simulation-based test for procedural robotic surgical competency in the vaginal cuff closure procedure and established a credible pass/fail standard for future

Criminal profiling as expert witness evidence: The implications of the profiler validity research.

PubMed

Kocsis, Richard N; Palermo, George B

The use and development of the investigative tool colloquially known as criminal profiling has steadily increased over the past five decades throughout the world. Coupled with this growth has been a diversification in the suggested range of applications for this technique. Possibly the most notable of these has been the attempted transition of the technique from a tool intended to assist police investigations into a form of expert witness evidence admissible in legal proceedings. Whilst case law in various jurisdictions has considered with mutual disinclination the evidentiary admissibility of criminal profiling, a disjunction has evolved between these judicial examinations and the scientifically vetted research testing the accuracy (i.e., validity) of the technique. This article offers an analysis of the research directly testing the validity of the criminal profiling technique and the extant legal principles considering its evidentiary admissibility. This analysis reveals that research findings concerning the validity of criminal profiling are surprisingly compatible with the extant legal principles. The overall conclusion is that a discrete form of crime behavioural analysis is supported by the profiler validity research and could be regarded as potentially admissible expert witness evidence. Finally, a number of theoretical connections are also identified concerning the skills and qualifications of individuals who may feasibly provide such expert testimony. Copyright © 2016 Elsevier Ltd. All rights reserved.

Contemporary Test Validity in Theory and Practice: A Primer for Discipline-Based Education Researchers

PubMed Central

Reeves, Todd D.; Marbach-Ad, Gili

2016-01-01

Most discipline-based education researchers (DBERs) were formally trained in the methods of scientific disciplines such as biology, chemistry, and physics, rather than social science disciplines such as psychology and education. As a result, DBERs may have never taken specific courses in the social science research methodology—either quantitative or qualitative—on which their scholarship often relies so heavily. One particular aspect of (quantitative) social science research that differs markedly from disciplines such as biology and chemistry is the instrumentation used to quantify phenomena. In response, this Research Methods essay offers a contemporary social science perspective on test validity and the validation process. The instructional piece explores the concepts of test validity, the validation process, validity evidence, and key threats to validity. The essay also includes an in-depth example of a validity argument and validation approach for a test of student argument analysis. In addition to DBERs, this essay should benefit practitioners (e.g., lab directors, faculty members) in the development, evaluation, and/or selection of instruments for their work assessing students or evaluating pedagogical innovations. PMID:26903498

Preliminary evidence for validity of the Bahasa Indonesian version of Study Process Questionnaire.

PubMed

Liem, Arief Darmanegara; Prasetya, Paulus Hidajat

2007-02-01

This study provides preliminary evidence for the validity of the Bahasa Indonesian version of the Study Process Questionnaire (BI-SPQ) from a sample of 147 psychology students (22 men and 125 women; M age = 21.8 yr., SD = 1.3). The internal consistency alpha of the BI-SPQ subscales were found to range from .46 (Surface Strategy) to .77 (Deep Strategy), with a median of .67. Principal component analysis indicated a two-factor solution, where the Deep and Achieving subscales loaded onto Factor 1 and the Surface subscales loaded on Factor 2. Students' GPAs were associated negatively with Surface Motive (r = -.24) and were associated positively with Deep and Achieving Motives (rs = .20). Further studies with larger samples involving students majoring in other disciplines are needed to provide further evidence of the validity of the BI-SPQ.

Evidence-Based Practice in Psychology

ERIC Educational Resources Information Center

American Psychologist, 2006

2006-01-01

The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes…

Toward More Evidence-Based Practice

PubMed Central

Hotelling, Barbara A.

2005-01-01

Childbirth educators are responsible for providing expectant parents with evidence-based information. In this column, the author suggests resources where educators can find evidence-based research for best practices. Additionally, the author describes techniques for childbirth educators to use in presenting research-based information in their classes. A sample of Web sites and books that offer evidence-based resources for expectant parents is provided. PMID:17273422

Voices from Test-Takers: Further Evidence for Language Assessment Validation and Use

ERIC Educational Resources Information Center

Cheng, Liying; DeLuca, Christopher

2011-01-01

Test-takers' interpretations of validity as related to test constructs and test use have been widely debated in large-scale language assessment. This study contributes further evidence to this debate by examining 59 test-takers' perspectives in writing large-scale English language tests. Participants wrote about their test-taking experiences in…

A Brazilian Portuguese Survey of School Climate: Evidence of Validity and Reliability

ERIC Educational Resources Information Center

Bear, George G.; Holst, Bruna; Lisboa, Carolina; Chen, Dandan; Yang, Chunyan; Chen, Fang Fang

2016-01-01

This study presents evidence of the validity and reliability of scores for the newly developed Brazilian Portuguese version of the Delaware School Climate Survey-Student (Brazilian DSCS-S). The sample consisted of 378 students, grades 5 through 9, attending four private and three public schools in southern Brazil. Confirmatory factor analyses…

Validation of gamma irradiator controls for quality and regulatory compliance

NASA Astrophysics Data System (ADS)

Harding, Rorry B.; Pinteric, Francis J. A.

1995-09-01

Since 1978 the U.S. Food and Drug Administration (FDA) has had both the legal authority and the Current Good Manufacturing Practice (CGMP) regulations in place to require irradiator owners who process medical devices to produce evidence of Irradiation Process Validation. One of the key components of Irradiation Process Validation is the validation of the irradiator controls. However, it is only recently that FDA audits have focused on this component of the process validation. What is Irradiator Control System Validation? What constitutes evidence of control? How do owners obtain evidence? What is the irradiator supplier's role in validation? How does the ISO 9000 Quality Standard relate to the FDA's CGMP requirement for evidence of Control System Validation? This paper presents answers to these questions based on the recent experiences of Nordion's engineering and product management staff who have worked with several US-based irradiator owners. This topic — Validation of Irradiator Controls — is a significant regulatory compliance and operations issue within the irradiator suppliers' and users' community.

Evidence-based librarianship: searching for the needed EBL evidence.

PubMed

Eldredge, J D

2000-01-01

This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

Where Is the Evidence for "Evidence-Based" Therapy?

PubMed

Shedler, Jonathan

2018-06-01

The term evidence-based therapy is a de facto code word for manualized therapy, most often brief cognitive behavior therapy and its variants. It is widely asserted that "evidence-based" therapy is scientifically proven, superior to other forms of psychotherapy, and the gold standard of care. Research findings do not support such assertions. Research on evidence-based therapies demonstrates that they are weak treatments. They have not shown superiority to other forms of psychotherapy, few patients get well, and treatment benefits do not last. Questionable research practices create a distorted picture of the actual benefits of these therapies. Copyright © 2018 Jonathan Shedler. Published by Elsevier Inc. All rights reserved.

Evidence for the construct validity of self-motivation as a correlate of exercise adherence in French older adults.

PubMed

André, Nathalie; Dishman, Rod K

2012-04-01

Exercise adherence involves a number of sociocognitive factors that influence the adoption and maintenance of regular physical activity. Among trait-like factors, self-motivation is believed to be a unique predictor of persistence during behavior change. The aim of this study was to validate the factor structure of a French version of the Self-Motivation Inventory (SMI) and to provide initial convergent and discriminant evidence for its construct validity as a correlate of exercise adherence. Four hundred seventy-one elderly were recruited and administered the SMI-10. Structural equation modeling tested the relation of SMI-10 scores with exercise adherence in a correlated network that included decisional balance and perceived quality of life. Acceptable evidence was found to support the factor validity and measurement equivalence of the French version of the SMI-10. Moreover, self-motivation was related to exercise adherence independently of decisional balance and perceived quality of life, providing initial evidence for construct validity.

Validating the Proposed Structure of the Relationships among Test Anxiety and Its Predictors Based on Control-Value Theory: Evidence for Gender-Specific Patterns

ERIC Educational Resources Information Center

Ringeisen, Tobias; Raufelder, Diana; Schnell, Kerstin; Rohrmann, Sonja

2016-01-01

Control-value theory (CVT) proposes a framework for the structure of the relationships between the various predictors of achievement-related emotions, particularly anxiety. Despite existing evidence for the role of anxiety predictors, research has not yet justified their proposed structure. Hence, the current study validated the structure of test…

Validity Evidence for the Test of Silent Reading Efficiency and Comprehension (TOSREC)

ERIC Educational Resources Information Center

Johnson, Evelyn S.; Pool, Juli L.; Carter, Deborah R.

2011-01-01

An essential component of a response to intervention (RTI) framework is a screening process that is both accurate and efficient. The purpose of this study was to analyze the validity evidence for the "Test of Silent Reading Efficiency and Comprehension" (TOSREC) to determine its potential for use within a screening process. Participants included…

Desired attributes of evidence assessments for evidence-based practices.

PubMed

Leff, H Stephen; Conley, Jeremy A

2006-11-01

In this paper we describe three approaches to assessing evidence for stakeholders interested in evidence-based practices: narrative reviews, systematic reviews (including meta-analyses), and registries. We then compare the approaches in terms of the degree to which they posses desired attributes of evidence assessments. Our review suggests that hybrid approaches that combined the best features of all three should be pursued to further the use of evidence-based practices, and that such hybrids are possible given the capacity of the World Wide Web. We conclude by stressing the need for empirical research on evidence assessments.

Evidence-based radiology: how to quickly assess the validity and strength of publications in the diagnostic radiology literature.

PubMed

Dodd, Jonathan D; MacEneaney, Peter M; Malone, Dermot E

2004-05-01

The aim of this study was to show how evidence-based medicine (EBM) techniques can be applied to the appraisal of diagnostic radiology publications. A clinical scenario is described: a gastroenterologist has questioned the diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) in a patient who may have common bile duct (CBD) stones. His opinion was based on an article on MRCP published in "Gut." The principles of EBM are described and then applied to the critical appraisal of this paper. Another paper on the same subject was obtained from the radiology literature and was also critically appraised using explicit EBM criteria. The principles for assessing the validity and strength of both studies are outlined. All statistical parameters were generated quickly using a spreadsheet in Excel format. The results of EBM assessment of both papers are presented. The calculation and application of confidence intervals (CIs) and likelihood ratios (LRs) for both studies are described. These statistical results are applied to individual patient scenarios using graphs of conditional probability (GCP). Basic EBM principles are described and additional points relevant to radiologists discussed. Online resources for EBR practice are identified. The principles of EBM and their application to radiology are discussed. It is emphasized that sensitivity and specificity are point estimates of the "true" characteristics of a test in clinical practice. A spreadsheet can be used to quickly calculate CIs, LRs and GCPs. These give the radiologist a better understanding of the meaning of diagnostic test results in any patient or population of patients.

KIPS: An Evidence-Based Tool for Assessing Parenting Strengths and Needs in Diverse Families

ERIC Educational Resources Information Center

Comfort, Marilee; Gordon, Philip R.; Naples, Denise

2011-01-01

The movement toward evidence-based practices has stimulated greater interest in assessing parenting outcomes. The purpose of these studies was to further validate the Keys to Interactive Parenting Scale (KIPS), a structured observational assessment of parenting quality, with 397 diverse families. Factor analysis demonstrated that the 12 KIPS items…

Performance of a cognitive load inventory during simulated handoffs: Evidence for validity.

PubMed

Young, John Q; Boscardin, Christy K; van Dijk, Savannah M; Abdullah, Ruqayyah; Irby, David M; Sewell, Justin L; Ten Cate, Olle; O'Sullivan, Patricia S

2016-01-01

Advancing patient safety during handoffs remains a public health priority. The application of cognitive load theory offers promise, but is currently limited by the inability to measure cognitive load types. To develop and collect validity evidence for a revised self-report inventory that measures cognitive load types during a handoff. Based on prior published work, input from experts in cognitive load theory and handoffs, and a think-aloud exercise with residents, a revised Cognitive Load Inventory for Handoffs was developed. The Cognitive Load Inventory for Handoffs has items for intrinsic, extraneous, and germane load. Students who were second- and sixth-year students recruited from a Dutch medical school participated in four simulated handoffs (two simple and two complex cases). At the end of each handoff, study participants completed the Cognitive Load Inventory for Handoffs, Paas' Cognitive Load Scale, and one global rating item for intrinsic load, extraneous load, and germane load, respectively. Factor and correlational analyses were performed to collect evidence for validity. Confirmatory factor analysis yielded a single factor that combined intrinsic and germane loads. The extraneous load items performed poorly and were removed from the model. The score from the combined intrinsic and germane load items associated, as predicted by cognitive load theory, with a commonly used measure of overall cognitive load (Pearson's r = 0.83, p < 0.001), case complexity (beta = 0.74, p < 0.001), level of experience (beta = -0.96, p < 0.001), and handoff accuracy (r = -0.34, p < 0.001). These results offer encouragement that intrinsic load during handoffs may be measured via a self-report measure. Additional work is required to develop an adequate measure of extraneous load.

Mass-casualty triage: time for an evidence-based approach.

PubMed

Jenkins, Jennifer Lee; McCarthy, Melissa L; Sauer, Lauren M; Green, Gary B; Stuart, Stephanie; Thomas, Tamara L; Hsu, Edbert B

2008-01-01

Mass-casualty triage has developed from a wartime necessity to a civilian tool to ensure that constrained medical resources are directed at achieving the greatest good for the most number of people. Several primary and secondary triage tools have been developed, including Simple Treatment and Rapid Transport (START), JumpSTART, Care Flight Triage, Triage Sieve, Sacco Triage Method, Secondary Assessment of Victim Endpoint (SAVE), and Pediatric Triage Tape. Evidence to support the use of one triage algorithm over another is limited, and the development of effective triage protocols is an important research priority. The most widely recognized mass-casualty triage algorithms in use today are not evidence-based, and no studies directly address these issues in the mass-casualty setting. Furthermore, no studies have evaluated existing mass-casualty triage algorithms regarding ease of use, reliability, and validity when biological, chemical, or radiological agents are introduced. Currently, the lack of a standardized mass-casualty triage system that is well validated, reliable, and uniformly accepted, remains an important gap. Future research directed at triage is recognized as a necessity, and the development of a practical, universal, triage algorithm that incorporates requirements for decontamination or special precautions for infectious agents would facilitate a more organized mass-casualty medical response.

Evidence-based dentistry: a clinician's perspective.

PubMed

Bauer, Janet; Spackman, Sue; Chiappelli, Francesco; Prolo, Paolo; Stevenson, Richard

2006-07-01

Evidence-based dentistry is a discipline that provides best, explicit-based evidence to dentists and their patients in shared decision-making. Currently, dentists are being trained and directed to adopt the role of translational researchers in developing evidence-based dental practices. Practically, evidence-based dentistry is not usable in its current mode for the provision of labor-intensive services that characterize current dental practice. The purpose of this article is to introduce a model of evidence-based dental practice. This model conceptualizes a team approach in explaining problems and solutions to change current dental practice. These changes constitute an evidence-based dental practice that involves the electronic chart, centralized database, knowledge management software, and personnel in optimizing effective oral health care to dental patients.

Evidence-Based Language Practice

ERIC Educational Resources Information Center

Pollock, Eric J.

2005-01-01

The purpose of this paper was to examine evidence-based procedures in medicine and to demonstrate that the same protocols can be used in English language instruction. In the evidence-based methodology, studies are divided into those that address specific language problems. Integrated studies are presented as a systematic overview, meta-analysis,…

Evidence-Based Parenting Interventions to Promote Secure Attachment

PubMed Central

Wright, Barry; Edginton, Elizabeth

2016-01-01

Various interventions are used in clinical practice to address insecure or disorganized attachment patterns and attachment disorders. The most common of these are parenting interventions, but not all have a robust empirical evidence base. We undertook a systematic review of randomized trials comparing a parenting intervention with a control, where these used a validated attachment instrument, in order to evaluate the clinical and cost-effectiveness of interventions aiming to improve attachment in children with severe attachment problems (mean age <13 years). This article aims to inform clinicians about the parenting interventions included in our systematic review that were clinically effective in promoting secure attachment. For completeness, we also briefly discuss other interventions without randomized controlled trial evidence, identified in Patient Public Involvement workshops and expert groups at the point our review was completed as being used or recommended. We outline the key implications of our findings for clinical practice and future research. PMID:27583298

Why evidence-based medicine failed in patient care and medicine-based evidence will succeed.

PubMed

Horwitz, Ralph I; Singer, Burton H

2017-04-01

Evidence-based medicine (EBM) has succeeded in strengthening the evidence base for population medicine. Where EBM has failed is in answering the practicing doctor's question of what a likely outcome would be when a given treatment is administered to a particular patient with her own distinctive biological and biographical (life experience) profile. We propose Medicine-based evidence (MBE), based on the profiles of individual patients, as the evidence base for individualized or personalized medicine. MBE will build an archive of patient profiles using data from all study types and data sources, and will include both clinical and socio-behavioral information. The clinician seeking guidance for the management of an individual patient will start with the patient's longitudinal profile and find approximate matches in the archive that describes how similar patients responded to a contemplated treatment and alternative treatments. Copyright © 2017 Elsevier Inc. All rights reserved.

The behavioral regulation in sport questionnaire (BRSQ): instrument development and initial validity evidence.

PubMed

Lonsdale, Chris; Hodge, Ken; Rose, Elaine A

2008-06-01

The purpose of the four studies described in this article was to develop and test a new measure of competitive sport participants' intrinsic motivation, extrinsic motivation, and amotivation (self-determination theory; Deci & Ryan, 1985). The items for the new measure, named the Behavioral Regulation in Sport Questionnaire (BRSQ), were constructed using interviews, expert review, and pilot testing. Analyses supported the internal consistency, test-retest reliability, and factorial validity of the BRSQ scores. Nomological validity evidence was also supportive, as BRSQ subscale scores were correlated in the expected pattern with scores derived from measures of motivational consequences. When directly compared with scores derived from the Sport Motivation Scale (SMS; Pelletier, Fortier, Vallerand, Tuson, & Blais, 1995) and a revised version of that questionnaire (SMS-6; Mallett, Kawabata, Newcombe, Otero-Forero, & Jackson, 2007), BRSQ scores demonstrated equal or superior reliability and factorial validity as well as better nomological validity.

Evidence-based Assessment in Pediatric Psychology: Measures of Psychosocial Adjustment and Psychopathology

PubMed Central

Thill, Azure Welborn; Bachanas, Pamela; Garber, Judy; Miller, Karen Bearman; Abad, Mona; Bruno, Elizabeth Franks; Carter, Jocelyn Smith; David-Ferdon, Corinne; Jandasek, Barbara; Mennuti-Washburn, Jean E.; O’Mahar, Kerry; Zukerman, Jill

2008-01-01

Objective To provide an evidence-based review of measures of psychosocial adjustment and psychopathology, with a specific focus on their use in the field of pediatric psychology. Methods As part of a larger survey of pediatric psychologists from the Society of Pediatric Psychology e-mail listserv (American Psychological Association, APA, Division 54), 37 measures were selected for this psychometric review. Measures that qualified for the review fell into one of the following three categories: (a) internalizing or externalizing rating scales, (b) broad-band rating scales, and (c) self-related rating scales. Results Psychometric characteristics (i.e., three types of reliability, two types of validity) were strong for the majority of measures reviewed, with 34 of the 37 measures meeting “well-established” evidence-based assessment (EBA) criteria. Strengths and weaknesses of existing measures were noted. Conclusions Recommendations for future work in this area of assessment are presented, including suggestions that more fine-grained EBA criteria be developed and that evidence-based “profiles” be devised for each measure. PMID:17728305

Reliability and Validity of Assessing User Satisfaction With Web-Based Health Interventions.

PubMed

Boß, Leif; Lehr, Dirk; Reis, Dorota; Vis, Christiaan; Riper, Heleen; Berking, Matthias; Ebert, David Daniel

2016-08-31

The perspective of users should be taken into account in the evaluation of Web-based health interventions. Assessing the users' satisfaction with the intervention they receive could enhance the evidence for the intervention effects. Thus, there is a need for valid and reliable measures to assess satisfaction with Web-based health interventions. The objective of this study was to analyze the reliability, factorial structure, and construct validity of the Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I). The psychometric quality of the CSQ-I was analyzed in user samples from 2 separate randomized controlled trials evaluating Web-based health interventions, one from a depression prevention intervention (sample 1, N=174) and the other from a stress management intervention (sample 2, N=111). At first, the underlying measurement model of the CSQ-I was analyzed to determine the internal consistency. The factorial structure of the scale and the measurement invariance across groups were tested by multigroup confirmatory factor analyses. Additionally, the construct validity of the scale was examined by comparing satisfaction scores with the primary clinical outcome. Multigroup confirmatory analyses on the scale yielded a one-factorial structure with a good fit (root-mean-square error of approximation =.09, comparative fit index =.96, standardized root-mean-square residual =.05) that showed partial strong invariance across the 2 samples. The scale showed very good reliability, indicated by McDonald omegas of .95 in sample 1 and .93 in sample 2. Significant correlations with change in depressive symptoms (r=-.35, P<.001) and perceived stress (r=-.48, P<.001) demonstrated the construct validity of the scale. The proven internal consistency, factorial structure, and construct validity of the CSQ-I indicate a good overall psychometric quality of the measure to assess the user's general satisfaction with Web-based interventions for depression and

Evidence-Based Psychotherapy: Advantages and Challenges.

PubMed

Cook, Sarah C; Schwartz, Ann C; Kaslow, Nadine J

2017-07-01

Evidence-based psychotherapies have been shown to be efficacious and cost-effective for a wide range of psychiatric conditions. Psychiatric disorders are prevalent worldwide and associated with high rates of disease burden, as well as elevated rates of co-occurrence with medical disorders, which has led to an increased focus on the need for evidence-based psychotherapies. This chapter focuses on the current state of evidence-based psychotherapy. The strengths and challenges of evidence-based psychotherapy are discussed, as well as misperceptions regarding the approach that may discourage and limit its use. In addition, we review various factors associated with the optimal implementation and application of evidence-based psychotherapies. Lastly, suggestions are provided on ways to advance the evidence-based psychotherapy movement to become truly integrated into practice.

Trainees' Perceptions of Feedback: Validity Evidence for Two FEEDME (Feedback in Medical Education) Instruments.

PubMed

Bing-You, Robert; Ramesh, Saradha; Hayes, Victoria; Varaklis, Kalli; Ward, Denham; Blanco, Maria

2018-01-01

Construct: Medical educators consider feedback a core component of the educational process. Effective feedback allows learners to acquire new skills, knowledge, and attitudes. Learners' perceptions of feedback are an important aspect to assess with valid methods in order to improve the feedback skills of educators and the feedback culture. Although guidelines for delivering effective feedback have existed for several decades, medical students and residents often indicate that they receive little feedback. A recent scoping review on feedback in medical education did not reveal any validity evidence on instruments to assess learner's perceptions of feedback. The purpose of our study was to gather validity evidence on two novel FEEDME (Feedback in Medical Education) instruments to assess medical students' and residents' perceptions of the feedback that they receive. After the authors developed an initial instrument with 54 items, cognitive interviews with medical students and residents suggested that 2 separate instruments were needed, one focused on the feedback culture (FEEDME-Culture) and the other on the provider of feedback (FEEDME-Provider). A Delphi study with 17 medical education experts and faculty members assessed content validity. The response process was explored involving 31 medical students and residents at 2 academic institutions. Exploratory factor analysis and reliability analyses were performed on completed instruments. Two Delphi consultation rounds refined the wording of items and eliminated several items. Learners found both instruments easy and quick to answer; it took them less than 5 minutes to complete. Learners preferred an electronic format of the instruments over paper. Factor analysis revealed a two- and three-factor solution for the FEEDME-Culture and FEEDME-Provider instruments, respectively. Cronbach's alpha was greater than 0.80 for all factors. Items on both instruments were moderately to highly correlated (range, r = .3-.7). Our

Evidence-based management - healthcare manager viewpoints.

PubMed

Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

2018-06-11

Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

Evidence-based information needs of public health workers: a systematized review.

PubMed

Barr-Walker, Jill

2017-01-01

This study assessed public health workers' evidence-based information needs, based on a review of the literature using a systematic search strategy. This study is based on a thesis project conducted as part of the author's master's in public health coursework and is considered a systematized review. Four databases were searched for English-language articles published between 2005 and 2015: PubMed, Web of Science, Library Literature & Information Science Index, and Library, Information Science & Technology Abstracts (LISTA). Studies were excluded if there was no primary data collection, the population in the study was not identified as public health workers, "information" was not defined according to specific criteria, or evidence-based information and public health workers were not the major focus. Studies included in the final analysis underwent data extraction, critical appraisal using CASP and STROBE checklists, and thematic analysis. Thirty-three research studies were identified in the search, including twenty-one using quantitative methods and twelve using qualitative methods. Critical appraisal revealed many potential biases, particularly in the validity of research. Thematic analysis revealed five common themes: (1) definition of information needs, (2) current information-seeking behavior and use, (3) definition of evidence-based information, (4) barriers to information needs, and (5) public health-specific issues. Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers' information needs.

Montreal Battery of Evaluation of Amusia: Validity evidence and norms for adolescents in Belo Horizonte, Minas Gerais, Brazil

PubMed Central

Nunes-Silva, Marília; Haase, Vitor Geraldi

2012-01-01

The Montreal Battery of Evaluation of Amusia (MBEA) is a battery of tests that assesses six music processing components: scale, contour, interval, rhythm, metric, and music memory. The present study sought to verify the psychometric characteristics of the MBEA in a sample of 150 adolescents aged 14-18 years in the city of Belo Horizonte, Minas Gerais, Brazil, and to develop specific norms for this population. We used statistical procedures that explored the dimensional structure of the MBEA and its items, evaluating their adequacy from empirical data, verifying their reliability, and providing evidence of validity. The results for the difficult levels for each test indicated a trend toward higher scores, corroborating previous studies. From the analysis of the criterion groups, almost all of the items were considered discriminatory. The global score of the MBEA was shown to be valid and reliable (rK-R20=0.896) for assessing the musical ability of normal teenagers. Based on the analysis of the items, we proposed a short version of the MBEA. Further studies with larger samples and amusic individuals are necessary to provide evidence of the validity of the MBEA in the Brazilian milieu. The present study brings to the Brazilian context a tool for diagnosing deficits in musical skills and will serve as a basis for comparisons with single case studies and studies of populations with specific neuropsychological syndromes. PMID:29213804

Evidence-based ethics? On evidence-based practice and the "empirical turn" from normative bioethics

PubMed Central

Goldenberg, Maya J

2005-01-01

Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for

Historical perspectives on evidence-based nursing.

PubMed

Beyea, Suzanne C; Slattery, Mary Jo

2013-04-01

The authors of this article offer a review and historical perspective on research utilization and evidence-based practice in nursing. They present the evolution of research utilization to the more contemporary framework of evidence-based nursing practice. The authors address the role of qualitative research in the context of evidence-based practice. Finally, some approaches and resources for learning more about the fundamentals of evidence-based healthcare are provided.

Evidence-based practice of periodontics.

PubMed

Cobb, Charles M; MacNeill, Simon R; Satheesh, Keerthana

2010-01-01

Evidence-based practice involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever-changing and involves uncertainties and probabilities. The specialty of periodontics has abundant high-level evidence upon which treatment decisions can be determined. This paper offers a brief commentary and overview of the available evidence commonly used in the private practice of periodontics.

Staff views on supporting evidence based practice for children with ASD.

PubMed

Trembath, David; Sulek, Rhylee; Paynter, Jessica; Simpson, Kate; Keen, Deb

2017-11-22

A variety of empirically supported interventions are available for children with autism spectrum disorder (ASD), but previous research suggests that their selection and use within an evidence-based practice (EBP) framework in clinical settings is challenging. To date, research has primarily focused on identifying individual, organisational, and contextual barriers to EBP rather than identifying collaborative solutions to these barriers through consultation with staff. The aim of our study was to explore staff views on supporting EBP in their work with children with ASD. We conducted five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim and analysed using thematic analysis. Two central themes, comprising six categories, emerged to account for the participants' views. Initiative and Effort accounted for the range of creative strategies staff had developed to support their engagement in EBP. They also expressed the need for A Better Way involving organisational-wide support such as this engagement, including peer-to-peer mentoring. The findings suggest that an organisational-wide model to support engagement in EBP, with peer-to-peer mentoring at its foundation, may provide a desirable, ecologically valid, and acceptable model. Implications for Rehabilitation Clinicians and educators recognise the importance of evidence-based practice. Efforts to support evidence-based practice have focused mostly on access to research evidence. Clinicians and educators in this study were developing their own strategies based on intuition. They identified a need for organisation-wide approaches to supporting evidence-based practice. Peer-to-peer mentoring appears to be an acceptable and viable strategy.

Federal Public Health Workforce Development: An Evidence-Based Approach for Defining Competencies.

PubMed

Mumford, Karen; Young, Andrea C; Nawaz, Saira

2016-01-01

This study reports the use of exploratory factor analysis to describe essential skills and knowledge for an important segment of the domestic public health workforce-Centers for Disease Control and Prevention (CDC) project officers-using an evidence-based approach to competency development and validation. A multicomponent survey was conducted. Exploratory factor analysis was used to examine the underlying domains and relationships between competency domains and key behaviors. The Cronbach α coefficient determined the reliability of the overall scale and identified factors. All domestic (US state, tribe, local, and territorial) grantees who received funding from the CDC during fiscal year 2011 to implement nonresearch prevention or intervention programs were invited to participate in a Web-based questionnaire. A total of 34 key behaviors representing knowledge, skills, and abilities, grouped in 7 domains-communication, grant administration and management, public health applied science and knowledge, program planning and development, program management, program monitoring and improvement, and organizational consultation-were examined. There were 795 responses (58% response rate). A total of 6 factors were identified with loadings of 0.40 or more for all 34 behavioral items. The Cronbach α coefficient was 0.95 overall and ranged between 0.73 and 0.91 for the factors. This study provides empirical evidence for the construct validity of 6 competencies and 34 key behaviors important for CDC project officers and serves as an important first step to evidence-driven workforce development efforts in public health.

Evidence and Evidence-Based Practices: Are We There Yet?

ERIC Educational Resources Information Center

Schalock, Robert L.; Gomez, Laura E.; Verdugo, Miguel A.; Claes, Claudia

2017-01-01

The purpose of this article is to move the field of intellectual and closely related developmental disabilities (IDD) towards a better understanding of evidence and evidence-based practices. To that end, we discuss (a) different perspectives on and levels of evidence, (b) commonly used evidence-gathering strategies, (c) standards to evaluate…

Towards evidence-based medical education in Saudi medical schools.

PubMed

AlFaris, Eiad; Abdulgader, Abdelgalil; Alkhenizan, Abdullah

2006-01-01

(EBME) [corrected] is an attitude of mind that entails the creation of a culture in which teachers think critically about what they are doing, look at the best evidence available and on this basis, make decisions about their teaching practice, and subsequently, undertake the necessary revision and change. More medical schools have opened in Saudi Arabia in the last few years than have existed over the last three decades. Currently, the education of health professionals is based on assumption and traditions and rarely on research findings. Medical teaching has evolved from being opinion-based to evidence-based and the art of teaching is rapidly becoming the 'science' of teaching. The need for evidence in our teaching and medical education practices is as important as it is in assessing a new therapy. This approach to education is not only associated with better results in terms of better learning, from the side of the students (the consumers), but also has a wider impact on patient care and the community. Moreover, in this age of accountability, litigations and quality assurance, the need for BEME becomes greater. Some suggestions to implement BEME in Saudi Arabia have been put forward and these are the training of medical education professionals in the use the existing information systems, and disseminating information through the creation of a BEME journal (secondary publication) that publishes a critically appraised summary of medical education articles that are both valid and of immediate clinical use.

Evidence-based algorithm for heparin dosing before cardiopulmonary bypass. Part 1: Development of the algorithm.

PubMed

McKinney, Mark C; Riley, Jeffrey B

2007-12-01

The incidence of heparin resistance during adult cardiac surgery with cardiopulmonary bypass has been reported at 15%-20%. The consistent use of a clinical decision-making algorithm may increase the consistency of patient care and likely reduce the total required heparin dose and other problems associated with heparin dosing. After a directed survey of practicing perfusionists regarding treatment of heparin resistance and a literature search for high-level evidence regarding the diagnosis and treatment of heparin resistance, an evidence-based decision-making algorithm was constructed. The face validity of the algorithm decisive steps and logic was confirmed by a second survey of practicing perfusionists. The algorithm begins with review of the patient history to identify predictors for heparin resistance. The definition for heparin resistance contained in the algorithm is an activated clotting time < 450 seconds with > 450 IU/kg heparin loading dose. Based on the literature, the treatment for heparin resistance used in the algorithm is anti-thrombin III supplement. The algorithm seems to be valid and is supported by high-level evidence and clinician opinion. The next step is a human randomized clinical trial to test the clinical procedure guideline algorithm vs. current standard clinical practice.

Validity Evidence for a Serious Game to Assess Performance on Critical Pediatric Emergency Medicine Scenarios.

PubMed

Gerard, James M; Scalzo, Anthony J; Borgman, Matthew A; Watson, Christopher M; Byrnes, Chelsie E; Chang, Todd P; Auerbach, Marc; Kessler, David O; Feldman, Brian L; Payne, Brian S; Nibras, Sohail; Chokshi, Riti K; Lopreiato, Joseph O

2018-06-01

We developed a first-person serious game, PediatricSim, to teach and assess performances on seven critical pediatric scenarios (anaphylaxis, bronchiolitis, diabetic ketoacidosis, respiratory failure, seizure, septic shock, and supraventricular tachycardia). In the game, players are placed in the role of a code leader and direct patient management by selecting from various assessment and treatment options. The objective of this study was to obtain supportive validity evidence for the PediatricSim game scores. Game content was developed by 11 subject matter experts and followed the American Heart Association's 2011 Pediatric Advanced Life Support Provider Manual and other authoritative references. Sixty subjects with three different levels of experience were enrolled to play the game. Before game play, subjects completed a 40-item written pretest of knowledge. Game scores were compared between subject groups using scoring rubrics developed for the scenarios. Validity evidence was established and interpreted according to Messick's framework. Content validity was supported by a game development process that involved expert experience, focused literature review, and pilot testing. Subjects rated the game favorably for engagement, realism, and educational value. Interrater agreement on game scoring was excellent (intraclass correlation coefficient = 0.91, 95% confidence interval = 0.89-0.9). Game scores were higher for attendings followed by residents then medical students (Pc < 0.01) with large effect sizes (1.6-4.4) for each comparison. There was a very strong, positive correlation between game and written test scores (r = 0.84, P < 0.01). These findings contribute validity evidence for PediatricSim game scores to assess knowledge of pediatric emergency medicine resuscitation.

Peer-teaching of evidence-based medicine.

PubMed

Rees, Eliot; Sinha, Yashashwi; Chitnis, Abhishek; Archer, James; Fotheringham, Victoria; Renwick, Stephen

2014-07-01

Many medical schools teach the principles of evidence-based medicine (EBM) as part of their undergraduate curriculum. Medical students perceive that EBM is valuable to their undergraduate and postgraduate career. Students may experience barriers to applying EBM principles, especially when searching for evidence or identifying high-quality resources. The UK National Institute for Health and Care Excellence (NICE) Evidence Search is a service that enables access to authoritative clinical and non-clinical evidence and best practice through a web-based portal. Evidence-based medicine workshops were organised and delivered by fourth-year medical students, having first received training from NICE to become NICE student champions. The workshops covered the basic principles of EBM and focused on retrieving EBM resources for study through the NICE Evidence Search portal. The scheme was evaluated using a pre-workshop survey and an 8-12 week post-workshop survey. Self-reported confidence in searching for evidence-based resources increased from 29 per cent before the workshop to 87 per cent after the workshop. Only 1 per cent of students rated evidence-based resources as their first preference pre-workshop, compared with 31 per cent post-workshop. The results show that although many students were aware of evidence-based resources, they tended not to use them as their preferred resource. Despite appreciating the value of evidence-based resources, few students were confident in accessing and using such resources for pre-clinical study. A peer-taught workshop in EBM improved students' confidence with, and use of, evidence-based resources. © 2014 John Wiley & Sons Ltd.

Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence-based definition of premature ejaculation. Part I--validity of DSM-IV-TR.

PubMed

Waldinger, Marcel D; Schweitzer, Dave H

2006-07-01

In former days, information obtained from randomized well-controlled clinical trials and epidemiological studies on premature ejaculation (PE) was not available, thereby hampering the efforts of the consecutive DSM Work Groups on Sexual Disorders to formulate an evidence-based definition of PE. The current DSM-IV-TR definition of PE is still nonevidence based. In addition, the requirement that persistent self-perceived PE, distress, and interpersonal difficulties, in absence of a quantified ejaculation time, are necessary to establish the diagnosis remains disputable. To investigate the validity and reliability of DSM and ICD diagnosis of premature ejaculation. The historical development of DSM and ICD classification of mental disorders is critically reviewed, and two studies using the DSM-IV-TR definition of PE is critically reanalyzed. Reanalysis of two studies using the DSM-IV-TR definition of PE has shown that DSM-diagnosed PE can be accompanied by long intravaginal ejaculation latency time (IELT) values. The reanalysis revealed a low positive predictive value for the DSM-IV-TR definition when used as a diagnostic test. A similar situation pertains to the American Urological Association (AUA) definition of PE, which is practically a copy of the DSM-IV-TR definition. It should be emphasized that any evidence-based definition of PE needs objectively collected patient-reported outcome (PRO) data from epidemiological studies, as well as reproducible quantifications of the IELT.

Expert consensus v. evidence-based approaches in the revision of the DSM.

PubMed

Kendler, K S; Solomon, M

2016-08-01

The development of DSM-III through DSM-5 has relied heavily on expert consensus. In this essay, we provide an historical and critical perspective on this process. Over the last 40 years, medicine has struggled to find appropriate methods for summarizing research results and making clinical recommendations. When such recommendations are issued by authorized organizations, they can have widespread influence (i.e. DSM-III and its successors). In the 1970s, expert consensus conferences, led by the NIH, reviewed research about controversial medical issues and successfully disseminated results. However, these consensus conferences struggled with aggregating the complex available evidence. In the 1990s, the rise of evidence-based medicine cast doubt on the reliability of expert consensus. Since then, medicine has increasingly relied on systematic reviews, as developed by the evidence-based medicine movement, and advocated for their early incorporation in expert consensus efforts. With the partial exception of DSM-IV, such systematic evidence-based reviews have not been consistently integrated into the development of the DSMs, leaving their development out of step with the larger medical field. Like the recommendations made for the NIH consensus conferences, we argue that the DSM process should be modified to require systematic evidence-based reviews before Work Groups make their assessments. Our suggestions - which would require leadership and additional resources to set standards for appropriate evidence hierarchies, carry out systematic reviews, and upgrade the group process - should improve the objectivity of the DSM, increase the validity of its results, and improve the reception of any changes in nosology.

On-the-Job Evidence-Based Medicine Training for Clinician-Scientists of the Next Generation.

PubMed

Leung, Elaine Yl; Malick, Sadia M; Khan, Khalid S

2013-08-01

Clinical scientists are at the unique interface between laboratory science and frontline clinical practice for supporting clinical partnerships for evidence-based practice. In an era of molecular diagnostics and personalised medicine, evidence-based laboratory practice (EBLP) is also crucial in aiding clinical scientists to keep up-to-date with this expanding knowledge base. However, there are recognised barriers to the implementation of EBLP and its training. The aim of this review is to provide a practical summary of potential strategies for training clinician-scientists of the next generation. Current evidence suggests that clinically integrated evidence-based medicine (EBM) training is effective. Tailored e-learning EBM packages and evidence-based journal clubs have been shown to improve knowledge and skills of EBM. Moreover, e-learning is no longer restricted to computer-assisted learning packages. For example, social media platforms such as Twitter have been used to complement existing journal clubs and provide additional post-publication appraisal information for journals. In addition, the delivery of an EBLP curriculum has influence on its success. Although e-learning of EBM skills is effective, having EBM trained teachers available locally promotes the implementation of EBM training. Training courses, such as Training the Trainers, are now available to help trainers identify and make use of EBM training opportunities in clinical practice. On the other hand, peer-assisted learning and trainee-led support networks can strengthen self-directed learning of EBM and research participation among clinical scientists in training. Finally, we emphasise the need to evaluate any EBLP training programme using validated assessment tools to help identify the most crucial ingredients of effective EBLP training. In summary, we recommend on-the-job training of EBM with additional focus on overcoming barriers to its implementation. In addition, future studies evaluating the

On-the-Job Evidence-Based Medicine Training for Clinician-Scientists of the Next Generation

PubMed Central

Leung, Elaine YL; Malick, Sadia M; Khan, Khalid S

2013-01-01

Clinical scientists are at the unique interface between laboratory science and frontline clinical practice for supporting clinical partnerships for evidence-based practice. In an era of molecular diagnostics and personalised medicine, evidence-based laboratory practice (EBLP) is also crucial in aiding clinical scientists to keep up-to-date with this expanding knowledge base. However, there are recognised barriers to the implementation of EBLP and its training. The aim of this review is to provide a practical summary of potential strategies for training clinician-scientists of the next generation. Current evidence suggests that clinically integrated evidence-based medicine (EBM) training is effective. Tailored e-learning EBM packages and evidence-based journal clubs have been shown to improve knowledge and skills of EBM. Moreover, e-learning is no longer restricted to computer-assisted learning packages. For example, social media platforms such as Twitter have been used to complement existing journal clubs and provide additional post-publication appraisal information for journals. In addition, the delivery of an EBLP curriculum has influence on its success. Although e-learning of EBM skills is effective, having EBM trained teachers available locally promotes the implementation of EBM training. Training courses, such as Training the Trainers, are now available to help trainers identify and make use of EBM training opportunities in clinical practice. On the other hand, peer-assisted learning and trainee-led support networks can strengthen self-directed learning of EBM and research participation among clinical scientists in training. Finally, we emphasise the need to evaluate any EBLP training programme using validated assessment tools to help identify the most crucial ingredients of effective EBLP training. In summary, we recommend on-the-job training of EBM with additional focus on overcoming barriers to its implementation. In addition, future studies evaluating the

Consistency between direct and indirect trial evidence: is direct evidence always more reliable?

PubMed

Madan, Jason; Stevenson, Matt D; Cooper, Katy L; Ades, A E; Whyte, Sophie; Akehurst, Ron

2011-01-01

To present a case study involving the reduction in incidence of febrile neutropenia (FN) after chemotherapy with granulocyte colony-stimulating factors (G-CSFs), illustrating difficulties that may arise when following the common preference for direct evidence over indirect evidence. Evidence of the efficacy of treatments was identified from two previous systematic reviews. We used Bayesian evidence synthesis to estimate relative treatment effects based on direct evidence, indirect evidence, and both pooled together. We checked for inconsistency between direct and indirect evidence and explored the role of one specific trial using cross-validation. A subsequent review identified further studies not available at the time of the original analysis. We repeated the analyses on the enlarged evidence base. We found substantial inconsistency in the original evidence base. The median odds ratio of FN for primary pegfilgrastim versus no primary G-CSF was 0.06 (95% credible interval: 0.02-0.19) based on direct evidence, but 0.27 (95% credible interval: 0.13-0.53) based on indirect evidence (P value for consistency hypothesis 0.027). The additional trials were consistent with the earlier indirect, rather than the direct, evidence, and there was no inconsistency between direct and indirect estimates in the updated evidence. The earlier inconsistency was due to one trial comparing primary pegfilgrastim with no primary G-CSF. Predictive cross-validation showed that this study was inconsistent with the evidence as a whole and with other trials making this comparison. Both the Cochrane Handbook and the NICE Methods Guide express a preference for direct evidence. A more robust strategy, which is in line with the accepted principles of evidence synthesis, would be to combine all relevant and appropriate information, whether direct or indirect. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Validity and power of association testing in family-based sampling designs: evidence for and against the common wisdom.

PubMed

Knight, Stacey; Camp, Nicola J

2011-04-01

Current common wisdom posits that association analyses using family-based designs have inflated type 1 error rates (if relationships are ignored) and independent controls are more powerful than familial controls. We explore these suppositions. We show theoretically that family-based designs can have deflated type-error rates. Through simulation, we examine the validity and power of family designs for several scenarios: cases from randomly or selectively ascertained pedigrees; and familial or independent controls. Family structures considered are as follows: sibships, nuclear families, moderate-sized and extended pedigrees. Three methods were considered with the χ(2) test for trend: variance correction (VC), weighted (weights assigned to account for genetic similarity), and naïve (ignoring relatedness) as well as the Modified Quasi-likelihood Score (MQLS) test. Selectively ascertained pedigrees had similar levels of disease enrichment; random ascertainment had no such restriction. Data for 1,000 cases and 1,000 controls were created under the null and alternate models. The VC and MQLS methods were always valid. The naïve method was anti-conservative if independent controls were used and valid or conservative in designs with familial controls. The weighted association method was generally valid for independent controls, and was conservative for familial controls. With regard to power, independent controls were more powerful for small-to-moderate selectively ascertained pedigrees, but familial and independent controls were equivalent in the extended pedigrees and familial controls were consistently more powerful for all randomly ascertained pedigrees. These results suggest a more complex situation than previously assumed, which has important implications for study design and analysis. © 2011 Wiley-Liss, Inc.

Internal Factor Structure and Convergent Validity Evidence: The Self-Report Version of Self-Regulation Strategy Inventory

ERIC Educational Resources Information Center

Cleary, Timothy J.; Dembitzer, Leah; Kettler, Ryan J.

2015-01-01

Using a sample of 348 middle school students, we gathered evidence regarding the internal consistency of scores, as well as the internal factor structure and convergent validity evidence for inferences from a self-report questionnaire called the Self-Regulation Strategy Inventory-Self Report. Confirmatory factor analysis revealed that the fit…

Recent advances in evidence-based psychiatry.

PubMed

Geddes, J; Carney, S

2001-06-01

There is increasing interest in the potential contribution of evidence-based medicine to clinical decision making in psychiatry. In this article, we describe some of the recent advances in evidence-based psychiatry and outline future challenges. Narrative review. The successful introduction of evidence-based practice into psychiatry requires the acquisition of new skills by clinicians. It is also important that policy statements that aim to be evidence-based, such as clinical practice guidelines, use rigorous methods to synthesize the primary evidence and do not overlook its limitations. One result of the systematic reviewing of evidence is the identification of important residual clinical uncertainties. Primary research can then be focused on these questions. For questions regarding therapy in psychiatry, it will be necessary to undertake some large, simple randomized trials. Making the best available evidence readily accessible in a clinical setting, however, remains a significant challenge. Collaboration between clinicians, researchers, policy-makers, and those involved in information technology is required to optimize the contribution of evidence-based medicine in psychiatry.

Situating Standard Setting within Argument-Based Validity

ERIC Educational Resources Information Center

Papageorgiou, Spiros; Tannenbaum, Richard J.

2016-01-01

Although there has been substantial work on argument-based approaches to validation as well as standard-setting methodologies, it might not always be clear how standard setting fits into argument-based validity. The purpose of this article is to address this lack in the literature, with a specific focus on topics related to argument-based…

Validity Evidence for the Measurement of the Strength of Motivation for Medical School

ERIC Educational Resources Information Center

Kusurkar, Rashmi; Croiset, Gerda; Kruitwagen, Cas; ten Cate, Olle

2011-01-01

The Strength of Motivation for Medical School (SMMS) questionnaire is designed to determine the strength of motivation of students particularly for medical study. This research was performed to establish the validity evidence for measuring strength of motivation for medical school. Internal structure and relations to other variables were used as…

Evidence-based medicine: medical librarians providing evidence at the point of care.

PubMed

Yaeger, Lauren H; Kelly, Betsy

2014-01-01

Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. .. by best available external clinical evidence we mean clinically relevant research.' Health care reform authorized by the Affordable Care Act is based on the belief that evidence-based practice (EBP) generates cost savings due to the delivery of more effective care.2 Medical librarians, skilled in identifying appropriate resources and working with multiple complex interfaces, can support clinicians' efforts to practice evidence based medicine by providing time and expertise in articulating the clinical question and identifying the best evidence.

Evidence-Based Cancer Imaging

PubMed Central

Khorasani, Ramin

2017-01-01

With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients. PMID:28096722

Evidence based practice readiness: A concept analysis.

PubMed

Schaefer, Jessica D; Welton, John M

2018-01-15

To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.

[Validation of a Japanese version of the Experience in Close Relationship- Relationship Structure].

PubMed

Komura, Kentaro; Murakami, Tatsuya; Toda, Koji

2016-08-01

The purpose of this study was to translate the Experience of Close Relationship-Relationship Structure (ECRRS) and evaluate its validity. In study 1 (N = 982), evidence based internal structure (factor structure, internal consistency, and correlation among sub-scales) and evidence based relations to other variables (depression, reassurance seeking and self-esteem) were confirmed. In study 2 (N = 563), evidence based on internal structure was reconfirmed, and evidence based relations to other variables (IWMS, RQ, and ECR-GO) were confirmed. In study 3 (N = 342), evidence based internal structure (test-retest reliability) was confirmed. Based on these results, we concluded that ECR-RS was valid for measuring adult attachment style.

Validity and clinical utility of the DSM-5 severity specifier for bulimia nervosa: results from a multisite sample of patients who received evidence-based treatment.

PubMed

Dakanalis, Antonios; Bartoli, Francesco; Caslini, Manuela; Crocamo, Cristina; Zanetti, Maria Assunta; Riva, Giuseppe; Clerici, Massimo; Carrà, Giuseppe

2017-12-01

A new "severity specifier" for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (IWCBs), was added to the DSM-5 as a means of documenting heterogeneity and variability in the severity of the disorder. Yet, evidence for its validity in clinical populations, including prognostic significance for treatment outcome, is currently lacking. Existing data from 281 treatment-seeking patients with DSM-5 BN, who received the best available treatment for their disorder (manual-based cognitive behavioural therapy; CBT) in an outpatient setting, were re-analysed to examine whether these patients subgrouped based on the DSM-5 severity levels would show meaningful and consistent differences on (a) a range of clinical variables assessed at pre-treatment and (b) post-treatment abstinence from IWCBs. Results highlight that the mild, moderate, severe, and extreme severity groups were statistically distinguishable on 22 variables assessed at pre-treatment regarding eating disorder pathological features, maintenance factors of BN, associated (current) and lifetime psychopathology, social maladjustment and illness-specific functional impairment, and abstinence outcome. Mood intolerance, a maintenance factor of BN but external to eating disorder pathological features (typically addressed within CBT), emerged as the primary clinical variable distinguishing the severity groups showing a differential treatment response. Overall, the findings speak to the concurrent and predictive validity of the new DSM-5 severity criterion for BN and are important because a common benchmark informing patients, clinicians, and researchers about severity of the disorder and allowing severity fluctuation and patient's progress to be tracked does not exist so far. Implications for future research are outlined.

Evidence-based periodontal therapy: An overview

PubMed Central

Vijayalakshmi, R.; Anitha, V.; Ramakrishnan, T.; Sudhakar, Uma

2008-01-01

Dentists need to make clinical decisions based on limited scientific evidence. In clinical practice, a clinician must weigh a myriad of evidences every day. The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Periodontology has a rich background of research and scholarship. Therefore, efficient use of this wealth of research data needs to be a part of periodontal practice. Evidence-based periodontology aims to facilitate such an approach and it offers a bridge from science to clinical practice. The clinician must integrate the evidence with patient preference, scientific knowledge, and personal experience. Most important, it allows us to care for our patients. Therefore, evidence-based periodontology is a tool to support decision-making and integrating the best evidence available with clinical practice. PMID:20142947

Novel Strength Test Battery to Permit Evidence-Based Paralympic Classification

PubMed Central

Beckman, Emma M.; Newcombe, Peter; Vanlandewijck, Yves; Connick, Mark J.; Tweedy, Sean M.

2014-01-01

Abstract Ordinal-scale strength assessment methods currently used in Paralympic athletics classification prevent the development of evidence-based classification systems. This study evaluated a battery of 7, ratio-scale, isometric tests with the aim of facilitating the development of evidence-based methods of classification. This study aimed to report sex-specific normal performance ranges, evaluate test–retest reliability, and evaluate the relationship between the measures and body mass. Body mass and strength measures were obtained from 118 participants—63 males and 55 females—ages 23.2 years ± 3.7 (mean ± SD). Seventeen participants completed the battery twice to evaluate test–retest reliability. The body mass–strength relationship was evaluated using Pearson correlations and allometric exponents. Conventional patterns of force production were observed. Reliability was acceptable (mean intraclass correlation = 0.85). Eight measures had moderate significant correlations with body size (r = 0.30–61). Allometric exponents were higher in males than in females (mean 0.99 vs 0.30). Results indicate that this comprehensive and parsimonious battery is an important methodological advance because it has psychometric properties critical for the development of evidence-based classification. Measures were interrelated with body size, indicating further research is required to determine whether raw measures require normalization in order to be validly applied in classification. PMID:25068950

Understanding evidence-based diagnosis.

PubMed

Kohn, Michael A

2014-01-01

The real meaning of the word "diagnosis" is naming the disease that is causing a patient's illness. The cognitive process of assigning this name is a mysterious combination of pattern recognition and the hypothetico-deductive approach that is only remotely related to the mathematical process of using test results to update the probability of a disease. What I refer to as "evidence-based diagnosis" is really evidence-based use of medical tests to guide treatment decisions. Understanding how to use test results to update the probability of disease can help us interpret test results more rationally. Also, evidence-based diagnosis reminds us to consider the costs and risks of testing and the dangers of over-diagnosis and over-treatment, in addition to the costs and risks of missing serious disease.

The Prosocial and Antisocial Behaviour in Sport Scale: further evidence for construct validity and reliability.

PubMed

Kavussanu, Maria; Stanger, Nicholas; Boardley, Ian D

2013-01-01

The purpose of this research was to provide further evidence for the construct validity (i.e., convergent, concurrent, and discriminant validity) of the Prosocial and Antisocial Behaviour in Sport Scale (PABSS), an instrument that has four subscales measuring prosocial and antisocial behaviour toward teammates and opponents. We also investigated test-retest reliability and stability of the PABSS. We conducted three studies using athletes from a variety of team sports. In Study 1, participants (N = 129) completed the PABSS and measures of physical and verbal aggression, hostility, anger, moral identity, and empathy; a sub-sample (n = 111) also completed the PABSS one week later. In Study 2, in addition to the PABSS, participants (N = 89) completed measures of competitive aggressiveness and anger, moral attitudes, moral disengagement, goal orientation, and anxiety. In Study 3, participants (N = 307) completed the PABSS and a measure of social goals. Across the three studies, the four subscales evidenced the hypothesised relationships with a number of variables. Correlations were large between the two antisocial behaviours and small between the two prosocial behaviours. Overall, the findings supported the convergent, concurrent, and discriminant validity of the scale, provided evidence for its test-retest reliability and stability, and suggest that the instrument is a valid and reliable measure of prosocial and antisocial behaviour in sport.

Communication of Evidence-Based Medicine

DTIC Science & Technology

2004-06-01

Communication between physician and patient is very important to allow the patient to make a well-informed health care decision. Evidence - based medicine is...patient’s understanding of information, specifically evidence - based medicine , provided by a physician.

Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis.

PubMed

Kjeken, Ingvild

2011-12-01

The aims of this study were to develop recommendations for occupational therapy assessment and design of hand exercise programmes in patients with hand osteoarthritis. An expert group followed a Delphi procedure to reach consensus for up to 10 recommendations for assessment and exercises, respectively. Thereafter, an evidence-based approach was used to identify and appraise research evidence supporting each recommendation, before the recommendations were validated by the expert group. The process resulted in 10 recommendations for assessment and eight for design of exercise programmes. The literature search revealed that there is a paucity of clinical trials to guide recommendations for hand osteoarthritis, and the evidence for the majority of the recommendations was based on expert opinions. Also, even if a systematic review demonstrates some evidence for the efficacy of strength training exercises in hand OA, the evidence for any specific exercise is limited to expert opinions. A first set of recommendations for assessment and exercise in hand osteoarthritis has been developed. For many of the recommendations there is a paucity of research evidence. High-quality studies are therefore needed to establish a high level of evidence concerning functional assessment and the effect of hand exercises in hand osteoarthritis.

Measuring Students' Motivation: Validity Evidence for the MUSIC Model of Academic Motivation Inventory

ERIC Educational Resources Information Center

Jones, Brett D.; Skaggs, Gary

2016-01-01

This study provides validity evidence for the MUSIC Model of Academic Motivation Inventory (MUSIC Inventory; Jones, 2012), which measures college students' beliefs related to the five components of the MUSIC Model of Motivation (MUSIC model; Jones, 2009). The MUSIC model is a conceptual framework for five categories of teaching strategies (i.e.,…

[Clinical applicability of evidence-based orthopedics--a cross-sectional study of the quality of orthopedic evidence].

PubMed

Vavken, P; Culen, G; Dorotka, R

2008-01-01

The demand to routinely apply evidence-based methods in orthopedic surgery increases steadily. In order to do so, however, the validity and reliability of the "evidence" has to be scrutinized. The object of this study was to assess the quality of the most recent orthopedic evidence and to determine variables that have an influence on quality. All 2006 controlled trials from orthopedic journals with high impact factors were analysed in a cross-sectional study. A score based on the CONSORT statement was used to assess study quality. Selected variables were tested for their influence on the quality of the study. Two independent blinded observers reviewed 126 studies. The overall quality was moderate to high. The most neglected parameters were power analysis, intention-to-treat, and concealment. The participation of a methodologically trained investigator increases study quality significantly. There was no difference in study quality irrespective of whether or not there was statistically significant result. Using our quality score we were able show fairly good results for recent orthopedic studies. The most frequently neglected issues in orthopedic research are blinding, power analysis, and intention-to-treat. This may distort the results of clinical investigations considerably and, especially, lack of concealment causes false-positive findings. Our data show furthermore that participation of a methodologist significantly increases quality of the study and consequently strengthens the reliability of results.

Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government.

PubMed

Kelly, M P; Atkins, L; Littleford, C; Leng, G; Michie, S

2017-12-01

In 2013, many public health functions transferred from the National Health Service to local government in England. From 2006 NICE had produced public health guidelines based on the principles of evidence-based medicine. This study explores how the guidelines were received in the new environment in local government and related issues raised relating to the use of evidence in local authoritites. In depth, interviews with 31 elected members and officers, including Directors of Public Health, from four very different local government organizations ('local authorities'). Participants reported that (i) there were tensions between evidence-based, and political decision-making; (ii) there were differences in views about what constituted 'good' evidence and (iii) that organizational life is an important mediator in the way evidence is used. Democratic political decision-making does not necessarily naturally align with decision-making based on evidence from the international scientific literature, and local knowledge and local evidence are very important in the ways that public health decisions are made. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health.

From evidence based bioethics to evidence based social policies.

PubMed

Bonneux, Luc

2007-01-01

In this issue, Norwegian authors demonstrate that causes of early expulsion out the workforce are rooted in childhood. They reconstruct individual biographies in administrative databases linked by an unique national identification number, looking forward 15 years in early adulthood and looking back 20 years till birth with close to negligible loss to follow up. Evidence based bioethics suggest that it is better to live in a country that allows reconstructing biographies in administrative databases then in countries that forbid access by restrictive legislation based on privacy considerations. The benefits of gained knowledge from existing and accessible information are tangible, particularly for the weak and the poor, while the harms of theoretical privacy invasion have not yet materialised. The study shows once again that disadvantage runs in families. Low parental education, parental disability and unstable marital unions predict early disability pensions and premature expulsion out gainful employment. The effect of low parental education is mediated by low education of the index person. However, in a feast of descriptive studies of socio-economic causes of ill health we still face a famine of evaluative intervention studies. An evidence based social policy should be based on effective interventions that are able to break the vicious circles of disability handed down from generation to generation.

Evidence-based librarianship: an overview.

PubMed

Eldredge, J D

2000-10-01

To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors.

Do evidence-based active-engagement courses reduce the gender gap in introductory physics?

NASA Astrophysics Data System (ADS)

Karim, Nafis I.; Maries, Alexandru; Singh, Chandralekha

2018-03-01

Prior research suggests that using evidence-based pedagogies can not only improve learning for all students, it can also reduce the gender gap. We describe the impact of physics education research-based pedagogical techniques in flipped and active-engagement non-flipped courses on the gender gap observed with validated conceptual surveys. We compare male and female students’ performance in courses which make significant use of evidence-based active-engagement (EBAE) strategies with courses that primarily use lecture-based (LB) instruction. All courses had large enrolment and often had more than 100 students. The analysis of data for validated conceptual surveys presented here includes data from two-semester sequences of algebra-based and calculus-based introductory physics courses. The conceptual surveys used to assess student learning in the first and second semester courses were the force concept inventory and the conceptual survey of electricity and magnetism, respectively. In the research discussed here, the performance of male and female students in EBAE courses at a particular level is compared with LB courses in two situations: (I) the same instructor taught two courses, one of which was an EBAE course and the other an LB course, while the homework, recitations and final exams were kept the same; (II) student performance in all of the EBAE courses taught by different instructors was averaged and compared with LB courses of the same type also averaged over different instructors. In all cases, on conceptual surveys we find that students in courses which make significant use of active-engagement strategies, on average, outperformed students in courses of the same type using primarily lecture-based instruction even though there was no statistically significant difference on the pre-test before instruction. However, the gender gap persisted even in courses using EBAE methods. We also discuss correlations between the performance of male and female students on

Evidence-Based Psychological Assessment.

PubMed

Bornstein, Robert F

2017-01-01

In recent years there has been increasing emphasis on evidence-based practice in psychology (EBPP), and as is true in most health care professions, the primary focus of EBPP has been on treatment. Comparatively little attention has been devoted to applying the principles of EBPP to psychological assessment, despite the fact that assessment plays a central role in myriad domains of empirical and applied psychology (e.g., research, forensics, behavioral health, risk management, diagnosis and classification in mental health settings, documentation of neuropsychological impairment and recovery, personnel selection and placement in organizational contexts). This article outlines the central elements of evidence-based psychological assessment (EBPA), using the American Psychological Association's tripartite definition of EBPP as integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. After discussing strategies for conceptualizing and operationalizing evidence-based testing and evidence-based assessment, 6 core skills and 3 meta-skills that underlie proficiency in psychological assessment are described. The integration of patient characteristics, culture, and preferences is discussed in terms of the complex interaction of patient and assessor identities and values throughout the assessment process. A preliminary framework for implementing EBPA is offered, and avenues for continued refinement and growth are described.

miRTarBase update 2018: a resource for experimentally validated microRNA-target interactions.

PubMed

Chou, Chih-Hung; Shrestha, Sirjana; Yang, Chi-Dung; Chang, Nai-Wen; Lin, Yu-Ling; Liao, Kuang-Wen; Huang, Wei-Chi; Sun, Ting-Hsuan; Tu, Siang-Jyun; Lee, Wei-Hsiang; Chiew, Men-Yee; Tai, Chun-San; Wei, Ting-Yen; Tsai, Tzi-Ren; Huang, Hsin-Tzu; Wang, Chung-Yu; Wu, Hsin-Yi; Ho, Shu-Yi; Chen, Pin-Rong; Chuang, Cheng-Hsun; Hsieh, Pei-Jung; Wu, Yi-Shin; Chen, Wen-Liang; Li, Meng-Ju; Wu, Yu-Chun; Huang, Xin-Yi; Ng, Fung Ling; Buddhakosai, Waradee; Huang, Pei-Chun; Lan, Kuan-Chun; Huang, Chia-Yen; Weng, Shun-Long; Cheng, Yeong-Nan; Liang, Chao; Hsu, Wen-Lian; Huang, Hsien-Da

2018-01-04

MicroRNAs (miRNAs) are small non-coding RNAs of ∼ 22 nucleotides that are involved in negative regulation of mRNA at the post-transcriptional level. Previously, we developed miRTarBase which provides information about experimentally validated miRNA-target interactions (MTIs). Here, we describe an updated database containing 422 517 curated MTIs from 4076 miRNAs and 23 054 target genes collected from over 8500 articles. The number of MTIs curated by strong evidence has increased ∼1.4-fold since the last update in 2016. In this updated version, target sites validated by reporter assay that are available in the literature can be downloaded. The target site sequence can extract new features for analysis via a machine learning approach which can help to evaluate the performance of miRNA-target prediction tools. Furthermore, different ways of browsing enhance user browsing specific MTIs. With these improvements, miRTarBase serves as more comprehensively annotated, experimentally validated miRNA-target interactions databases in the field of miRNA related research. miRTarBase is available at http://miRTarBase.mbc.nctu.edu.tw/. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

[Validity evidence of the Health-Related Quality of Life for Drug Abusers Test based on the Biaxial Model of Addiction].

PubMed

Lozano, Oscar M; Rojas, Antonio J; Pérez, Cristino; González-Sáiz, Francisco; Ballesta, Rosario; Izaskun, Bilbao

2008-05-01

The aim of this work is to show evidence of the validity of the Health-Related Quality of Life for Drug Abusers Test (HRQoLDA Test). This test was developed to measure specific HRQoL for drugs abusers, within the theoretical addiction framework of the biaxial model. The sample comprised 138 patients diagnosed with opiate drug dependence. In this study, the following constructs and variables of the biaxial model were measured: severity of dependence, physical health status, psychological adjustment and substance consumption. Results indicate that the HRQoLDA Test scores are related to dependency and consumption-related problems. Multiple regression analysis reveals that HRQoL can be predicted from drug dependence, physical health status and psychological adjustment. These results contribute empirical evidence of the theoretical relationships established between HRQoL and the biaxial model, and they support the interpretation of the HRQoLDA Test to measure HRQoL in drug abusers, thus providing a test to measure this specific construct in this population.

Evidence-Based Practice for Outpatient Clinical Teams

ERIC Educational Resources Information Center

Hamilton, John D.

2006-01-01

This column focuses on evidence-based practice (EBP) within multidisciplinary outpatient settings, but first provides some definitions. Besides EBP (Burns and Hoagwood, 2005; Guyatt and Rennie, 2002), there are also evidence-based medicine (EBM; March et al., 2005), evidence-based service (EBS; Chorpita et al., 2002), and evidence-based treatment…

Identifying and Evaluating External Validity Evidence for Passing Scores

ERIC Educational Resources Information Center

Davis-Becker, Susan L.; Buckendahl, Chad W.

2013-01-01

A critical component of the standard setting process is collecting evidence to evaluate the recommended cut scores and their use for making decisions and classifying students based on test performance. Kane (1994, 2001) proposed a framework by which practitioners can identify and evaluate evidence of the results of the standard setting from (1)…

Construct Validity Evidence for Bracken School Readiness Assessment, Third Edition, Spanish Form Scores

ERIC Educational Resources Information Center

Ortiz, Arlene; Clinton, Amanda; Schaefer, Barbara A.

2015-01-01

Convergent and discriminant validity evidence was examined for scores on the Spanish Record Form of the Bracken School Readiness Assessment, Third Edition (BSRA-3). Participants included a sample of 68 Hispanic, Spanish-speaking children ages 4 to 5 years enrolled in preschool programs in Puerto Rico. Scores obtained from the BSRA-3 Spanish Record…

Validity evidence of non-technical skills assessment instruments in simulated anaesthesia crisis management.

PubMed

Jirativanont, T; Raksamani, K; Aroonpruksakul, N; Apidechakul, P; Suraseranivongse, S

2017-07-01

We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisis management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents. The study included 70 participants, composed of 24 PGY-1, 24 PGY-2 and 22 PGY-3 residents. Both instruments differentiated the non-technical skills of PGY-1 from PGY-3 residents ( P <0.05). Inter-rater agreement was measured using the intraclass correlation coefficient (ICC). For the ANTS instrument, the intraclass correlation coefficients for task management, team-working, situation awareness and decision-making were 0.79, 0.34, 0.81 and 0.70, respectively. For the Ottawa GRS, the intraclass correlation coefficients for overall performance, leadership, problem-solving, situation awareness, resource utilisation and communication skills were 0.86, 0.83, 0.84, 0.87, 0.80 and 0.86, respectively. The Cronbach's alpha for internal consistency of the ANTS instrument was 0.93, and was 0.96 for the Ottawa GRS. There was a high correlation between the ANTS and Ottawa GRS. The raters reported the ease of use of the Ottawa GRS compared to the ANTS. We found sufficient evidence of validity in the ANTS instrument and the Ottawa GRS for the evaluation of non-technical skills in a simulated anaesthesia setting, but the Ottawa GRS was more practical and had higher reliability.

An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

PubMed

Fitch, Dale

2014-01-01

This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

Face and construct validity of a computer-based virtual reality simulator for ERCP.

PubMed

Bittner, James G; Mellinger, John D; Imam, Toufic; Schade, Robert R; Macfadyen, Bruce V

2010-02-01

Currently, little evidence supports computer-based simulation for ERCP training. To determine face and construct validity of a computer-based simulator for ERCP and assess its perceived utility as a training tool. Novice and expert endoscopists completed 2 simulated ERCP cases by using the GI Mentor II. Virtual Education and Surgical Simulation Laboratory, Medical College of Georgia. Outcomes included times to complete the procedure, reach the papilla, and use fluoroscopy; attempts to cannulate the papilla, pancreatic duct, and common bile duct; and number of contrast injections and complications. Subjects assessed simulator graphics, procedural accuracy, difficulty, haptics, overall realism, and training potential. Only when performance data from cases A and B were combined did the GI Mentor II differentiate novices and experts based on times to complete the procedure, reach the papilla, and use fluoroscopy. Across skill levels, overall opinions were similar regarding graphics (moderately realistic), accuracy (similar to clinical ERCP), difficulty (similar to clinical ERCP), overall realism (moderately realistic), and haptics. Most participants (92%) claimed that the simulator has definite training potential or should be required for training. Small sample size, single institution. The GI Mentor II demonstrated construct validity for ERCP based on select metrics. Most subjects thought that the simulated graphics, procedural accuracy, and overall realism exhibit face validity. Subjects deemed it a useful training tool. Study repetition involving more participants and cases may help confirm results and establish the simulator's ability to differentiate skill levels based on ERCP-specific metrics.

Direct Observation of Clinical Skills Feedback Scale: Development and Validity Evidence.

PubMed

Halman, Samantha; Dudek, Nancy; Wood, Timothy; Pugh, Debra; Touchie, Claire; McAleer, Sean; Humphrey-Murto, Susan

2016-01-01

Construct: This article describes the development and validity evidence behind a new rating scale to assess feedback quality in the clinical workplace. Competency-based medical education has mandated a shift to learner-centeredness, authentic observation, and frequent formative assessments with a focus on the delivery of effective feedback. Because feedback has been shown to be of variable quality and effectiveness, an assessment of feedback quality in the workplace is important to ensure we are providing trainees with optimal learning opportunities. The purposes of this project were to develop a rating scale for the quality of verbal feedback in the workplace (the Direct Observation of Clinical Skills Feedback Scale [DOCS-FBS]) and to gather validity evidence for its use. Two panels of experts (local and national) took part in a nominal group technique to identify features of high-quality feedback. Through multiple iterations and review, 9 features were developed into the DOCS-FBS. Four rater types (residents n = 21, medical students n = 8, faculty n = 12, and educators n = 12) used the DOCS-FBS to rate videotaped feedback encounters of variable quality. The psychometric properties of the scale were determined using a generalizability analysis. Participants also completed a survey to gather data on a 5-point Likert scale to inform the ease of use, clarity, knowledge acquisition, and acceptability of the scale. Mean video ratings ranged from 1.38 to 2.96 out of 3 and followed the intended pattern suggesting that the tool allowed raters to distinguish between examples of higher and lower quality feedback. There were no significant differences between rater type (range = 2.36-2.49), suggesting that all groups of raters used the tool in the same way. The generalizability coefficients for the scale ranged from 0.97 to 0.99. Item-total correlations were all above 0.80, suggesting some redundancy in items. Participants found the scale easy to use (M = 4.31/5) and clear

Reliability and Validity of Assessing User Satisfaction With Web-Based Health Interventions

PubMed Central

Lehr, Dirk; Reis, Dorota; Vis, Christiaan; Riper, Heleen; Berking, Matthias; Ebert, David Daniel

2016-01-01

Background The perspective of users should be taken into account in the evaluation of Web-based health interventions. Assessing the users’ satisfaction with the intervention they receive could enhance the evidence for the intervention effects. Thus, there is a need for valid and reliable measures to assess satisfaction with Web-based health interventions. Objective The objective of this study was to analyze the reliability, factorial structure, and construct validity of the Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I). Methods The psychometric quality of the CSQ-I was analyzed in user samples from 2 separate randomized controlled trials evaluating Web-based health interventions, one from a depression prevention intervention (sample 1, N=174) and the other from a stress management intervention (sample 2, N=111). At first, the underlying measurement model of the CSQ-I was analyzed to determine the internal consistency. The factorial structure of the scale and the measurement invariance across groups were tested by multigroup confirmatory factor analyses. Additionally, the construct validity of the scale was examined by comparing satisfaction scores with the primary clinical outcome. Results Multigroup confirmatory analyses on the scale yielded a one-factorial structure with a good fit (root-mean-square error of approximation =.09, comparative fit index =.96, standardized root-mean-square residual =.05) that showed partial strong invariance across the 2 samples. The scale showed very good reliability, indicated by McDonald omegas of .95 in sample 1 and .93 in sample 2. Significant correlations with change in depressive symptoms (r=−.35, P<.001) and perceived stress (r=−.48, P<.001) demonstrated the construct validity of the scale. Conclusions The proven internal consistency, factorial structure, and construct validity of the CSQ-I indicate a good overall psychometric quality of the measure to assess the user’s general

The Evidence-Based Manifesto for School Librarians

ERIC Educational Resources Information Center

Todd, Ross

2008-01-01

School Library Journal's 2007 Leadership Summit, "Where's the Evidence? Understanding the Impact of School Libraries," focused on the topic of evidence-based practice. Evidence-based school librarianship is a systematic approach that engages research-derived evidence, school librarian-observed evidence, and user-reported evidence in the processes…

A motor speech assessment for children with severe speech disorders: reliability and validity evidence.

PubMed

Strand, Edythe A; McCauley, Rebecca J; Weigand, Stephen D; Stoeckel, Ruth E; Baas, Becky S

2013-04-01

In this article, the authors report reliability and validity evidence for the Dynamic Evaluation of Motor Speech Skill (DEMSS), a new test that uses dynamic assessment to aid in the differential diagnosis of childhood apraxia of speech (CAS). Participants were 81 children between 36 and 79 months of age who were referred to the Mayo Clinic for diagnosis of speech sound disorders. Children were given the DEMSS and a standard speech and language test battery as part of routine evaluations. Subsequently, intrajudge, interjudge, and test-retest reliability were evaluated for a subset of participants. Construct validity was explored for all 81 participants through the use of agglomerative cluster analysis, sensitivity measures, and likelihood ratios. The mean percentage of agreement for 171 judgments was 89% for test-retest reliability, 89% for intrajudge reliability, and 91% for interjudge reliability. Agglomerative hierarchical cluster analysis showed that total DEMSS scores largely differentiated clusters of children with CAS vs. mild CAS vs. other speech disorders. Positive and negative likelihood ratios and measures of sensitivity and specificity suggested that the DEMSS does not overdiagnose CAS but sometimes fails to identify children with CAS. The value of the DEMSS in differential diagnosis of severe speech impairments was supported on the basis of evidence of reliability and validity.

Evidence-based librarianship: an overview

PubMed Central

Eldredge, Jonathan D.

2000-01-01

Objective: To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Method: Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. Results: First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Conclusions: Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors. PMID:11055296

The Importance of Multi-Group Validity Evidence in Gifted and Talented Identification and Research

ERIC Educational Resources Information Center

Peters, Scott J.

2011-01-01

Practitioners and researchers often review the validity evidence of an instrument before using it for student assessment or in the practice of diagnosing or identifying children with exceptionalities. However, few test manuals present data on instrument measurement equivalence/ invariance or differential item functioning. This information is…

I Spy with My Little Eye: Jurors' Detection of Internal Validity Threats in Expert Evidence

PubMed Central

McAuliff, Bradley D.; Duckworth, Tejah D.

2010-01-01

This experiment examined whether jury-eligible community members (N = 223) were able to detect internally invalid psychological science presented at trial. Participants read a simulated child sexual abuse case in which the defense expert described a study he had conducted on witness memory and suggestibility. We varied the study's internal validity (valid, missing control group, confound, and experimenter bias) and publication status (published, unpublished). Expert evidence quality ratings were higher for the valid versus missing control group version only. Publication increased ratings of defendant guilt when the study was missing a control group. Variations in internal validity did not influence perceptions of child victim credibility or police interview quality. Participants' limited detection of internal validity threats underscores the need to examine the effectiveness of traditional legal safeguards against junk science in court and improve the scientific reasoning ability of lay people and legal professionals. PMID:20162342

Value-based medicine: evidence-based medicine and beyond.

PubMed

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay

2003-09-01

Value-based medicine is the practice of medicine emphasizing the value received from an intervention. Value is measured by objectively quantifying: 1) the improvement in quality of life and/or 2) the improvement in length of life conferred by an intervention. Evidence-based medicine often measures the improvement gained in length of life, but generally ignores the importance of quality of life improvement or loss. Value-based medicine incorporates the best features of evidence-based medicine and takes evidence-based data to a higher level by incorporating the quality of life perceptions of patients with a disease in concerning the value of an intervention. Inherent in value-based medicine are the costs associated with an intervention. The resources expended for the value gained in value-based medicine is measured with cost-utility analysis in terms of the US dollars/QALY (money spent per quality-adjusted life-year gained). A review of the current status and the likely future of value-based medicine is addressed herein.

Validation of a scenario-based assessment of critical thinking using an externally validated tool.

PubMed

Buur, Jennifer L; Schmidt, Peggy; Smylie, Dean; Irizarry, Kris; Crocker, Carlos; Tyler, John; Barr, Margaret

2012-01-01

With medical education transitioning from knowledge-based curricula to competency-based curricula, critical thinking skills have emerged as a major competency. While there are validated external instruments for assessing critical thinking, many educators have created their own custom assessments of critical thinking. However, the face validity of these assessments has not been challenged. The purpose of this study was to compare results from a custom assessment of critical thinking with the results from a validated external instrument of critical thinking. Students from the College of Veterinary Medicine at Western University of Health Sciences were administered a custom assessment of critical thinking (ACT) examination and the externally validated instrument, California Critical Thinking Skills Test (CCTST), in the spring of 2011. Total scores and sub-scores from each exam were analyzed for significant correlations using Pearson correlation coefficients. Significant correlations between ACT Blooms 2 and deductive reasoning and total ACT score and deductive reasoning were demonstrated with correlation coefficients of 0.24 and 0.22, respectively. No other statistically significant correlations were found. The lack of significant correlation between the two examinations illustrates the need in medical education to externally validate internal custom assessments. Ultimately, the development and validation of custom assessments of non-knowledge-based competencies will produce higher quality medical professionals.

Convergent validity evidence for the Pain and Discomfort Scale (PADS) for pain assessment among adults with intellectual disability

PubMed Central

Shinde, Satomi K.; Danov, Stacy; Chen, Chin-Chih; Clary, Jamie; Harper, Vicki; Bodfish, James W.; Symons, Frank J.

2014-01-01

Objectives The main aim of the study was to generate initial convergent validity evidence for the Pain and Discomfort Scale (PADS) for use with non-verbal adults with intellectual disabilities (ID). Methods Forty-four adults with intellectual disability (mean age = 46, 52 % male) were evaluated using a standardized sham-controlled and blinded sensory testing protocol, from which FACS and PADS scores were tested for (1) sensitivity to an array of calibrated sensory stimuli, (2) specificity (active vs. sham trials), and (3) concordance. Results The primary findings were that participants were reliably coded using both FACS and PADS approaches as being reactive to the sensory stimuli (FACS: F[2, 86] = 4.71, P < .05, PADS: F[2, 86] = 21.49, P < .05) (sensitivity evidence), not reactive during the sham stimulus trials (FACS: F[1, 43]= 3.77, p = .06, PADS: F[1, 43] = 5.87, p = .02) (specificity evidence), and there were significant (r = .41 – .51, p < .01) correlations between PADS and FACS (convergent validity evidence). Discussion FACS is an objective coding platform for facial expression. It requires intensive training and resources for scoring. As such it may be limited for clinical application. PADS was designed for clinical application. PADS scores were comparable to FACS scores under controlled evaluation conditions providing partial convergent validity evidence for its use. PMID:24135902

Construct Validation in Counseling Psychology Research

ERIC Educational Resources Information Center

Hoyt, William T.; Warbasse, Rosalia E.; Chu, Erica Y.

2006-01-01

Counseling psychology researchers devote little attention to theory-based measurement validation, as evidenced by cursory mention of validity issues in the method and discussion sections of published research reports. Especially, many researchers appear unaware of the limitations of correlations between pairs of self-report measures as evidence of…

Challenging evidence-based decision-making: a hypothetical case study about return to work.

PubMed

Aas, Randi W; Alexanderson, Kristina

2012-03-01

A hypothetical case study about return to work was used to explore the process of translating research into practice. The method involved constructing a case study derived from the characteristics of a typical, sick-listed employee with non-specific low back pain in Norway. Next, the five-step evidence-based process, including the Patient, Intervention, Co-Interventions and Outcome framework (PICO), was applied to the case study. An inductive analysis produced 10 technical and more fundamental challenges to incorporate research into intervention decisions for an individual with comorbidity. A more dynamic, interactive approach to the evidence-based practice process is proposed. It is recommended that this plus the 10 challenges are validated with real life cases, as the hypothetical case study may not be replicable. Copyright © 2011 John Wiley & Sons, Ltd.

Reviving Cochrane's contribution to evidence-based medicine: bridging the gap between evidence of efficacy and evidence of effectiveness and cost-effectiveness.

PubMed

James, Jack E

2017-09-01

Throughout the quarter century since the advent of evidence-based medicine (EBM), medical research has prioritized 'efficacy' (i.e. internal validity) using randomized controlled trials. EBM has consistently neglected 'effectiveness' and 'cost-effectiveness', identified in the pioneering work of Archie Cochrane as essential for establishing the external (i.e. clinical) validity of health care interventions. Neither Cochrane nor other early pioneers appear to have foreseen the extent to which EBM would be appropriated by the pharmaceutical and medical devices industries, which are responsible for extensive biases in clinical research due to selective reporting, exaggeration of benefits, minimization of risks, and misrepresentation of data. The promise of EBM to effect transformational change in health care will remain unfulfilled until (i) studies of effectiveness and cost-effectiveness are pursued with some of the same fervour that previously succeeded in elevating the status of the randomized controlled trial, and (ii) ways are found to defeat threats to scientific integrity posed by commercial conflicts of interest. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

Limitations in conduct and reporting of cochrane reviews rarely inhibit the determination of the validity of evidence for clinical decision-making.

PubMed

Alper, Brian S; Fedorowicz, Zbys; van Zuuren, Esther J

2015-08-01

To determine how often clinical conclusions derived from Cochrane Reviews have uncertain validity due to review conduct and reporting deficiencies. We evaluated 5142 clinical conclusions in DynaMed (an evidence-based point-of-care clinical reference) based on 4743 Cochrane Reviews. Clinical conclusions with level 2 evidence due to shortcomings in the review's conduct or reporting (rather than deficiencies in the underlying evidence) were confirmed by a DynaMed editor and two Cochrane Review authors. Thirty-one Cochrane Reviews (0.65%) had confirmed deficiencies in conduct and reporting as the reason for classifying 37 assessed clinical conclusions (0.72%) as level 2 evidence. In all cases, it was not feasible for the assessors to specify a clear criticism of the studies included in the reviews. The deficiencies were specific to not accounting for dropouts (2) or inadequate assessment and reporting of allocation concealment (11), other specific trial quality criteria (14), or all trial quality criteria (4). Cochrane Reviews provide high-quality assessment and synthesis of evidence, with fewer than 1% of Cochrane Reviews having limitations which hinder the summary of best current evidence for clinical decision-making. We expect this will further decrease following recent Cochrane quality initiatives. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Validity of CBCL-derived PTSD and dissociation scales: further evidence in a sample of neglected children and adolescents.

PubMed

Milot, Tristan; Plamondon, André; Ethier, Louise S; Lemelin, Jean-Pascal; St-Laurent, Diane; Rousseau, Michel

2013-05-01

There is growing evidence that child neglect is an important risk factor for posttraumatic stress disorder (PTSD) and dissociation. Considering that the Child Behavior Checklist (CBCL) is a widely used measure, the possibility of using validated CBCL-derived trauma symptoms scales could be particularly useful to better understand how trauma symptoms develop among neglected children and adolescents. This study examined the factor structure of three CBCL-derived measures of PTSD and dissociation (namely, PTSD scale, Dissociation scale, and PTSD/Dissociation scale) in a sample of 239 neglected children and adolescents aged 6 to 18 years using the latest version of CBCL (CBCL 6-18). Evidence of convergent validity of these scales was also examined for participants aged 12 and under using two well-validated measures of PTSD and Dissociation: the Trauma Symptoms Checklist for Young Children and the Child Dissociation Checklist. Findings suggest that CBCL-derived measures of trauma symptoms, especially PTSD and Dissociations scales, may be of heuristic value in the study of trauma symptomatology in neglected samples. Factor structure and evidence of convergent validity were supported for these two scales. Results also provide further support to the well-established assumption that PTSD and dissociation are two related but different constructs.

How to understand and conduct evidence-based medicine.

PubMed

Kang, Hyun

2016-10-01

Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions regarding the care of individual patients. This concept has gained popularity recently, and its applications have been steadily expanding. Nowadays, the term "evidence-based" is used in numerous situations and conditions, such as evidence-based medicine, evidence-based practice, evidence-based health care, evidence-based social work, evidence-based policy, and evidence-based education. However, many anesthesiologists and their colleagues have not previously been accustomed to utilizing EBM, and they have experienced difficulty in understanding and applying the techniques of EBM to their practice. In this article, the author discusses the brief history, definition, methods, and limitations of EBM. As EBM also involves making use of the best available information to answer questions in clinical practice, the author emphasizes the process of performing evidence-based medicine: generate the clinical question, find the best evidence, perform critical appraisal, apply the evidence, and then evaluate. Levels of evidence and strength of recommendation were also explained. The author expects that this article may be of assistance to readers in understanding, conducting, and evaluating EBM.

20 CFR 220.14 - Weighing of evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... capacity evaluation is based upon functional objective tests with high validity and reliability; (2) The... consists of objective findings of exams that have poor reliability or validity; (7) The evidence consists...

Accumulation of Content Validation Evidence for the Critical Thinking Self-Assessment Scale.

PubMed

Nair, Girija Gopinathan; Hellsten, Laurie-Ann M; Stamler, Lynnette Leeseberg

2017-04-01

Critical thinking skills (CTS) are essential for nurses; assessing students' acquisition of these skills is a mandate of nursing curricula. This study aimed to develop a self-assessment instrument of critical thinking skills (Critical Thinking Self-Assessment Scale [CTSAS]) for students' self-monitoring. An initial pool of 196 items across 6 core cognitive skills and 16 subskills were generated using the American Philosophical Association definition of CTS. Experts' content review of the items and their ratings provided evidence of content relevance using the item-level content validity index (I-CVI) and Aiken's content validity coefficient (VIk). 115 items were retained (range of I-CVI values = .70 to .94 and range of VIk values = .69-.95; significant at p< .05). The CTSAS is the first CTS instrument designed specifically for self-assessment purposes.

Beliefs and implementation of evidence-based practice among community health nurses: A cross-sectional descriptive study.

PubMed

Pereira, Filipa; Pellaux, Victoria; Verloo, Henk

2018-03-08

To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n = 100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk et al. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n = 100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8 weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by

Corroborating evidence-based medicine.

PubMed

Mebius, Alexander

2014-12-01

Proponents of evidence-based medicine (EBM) have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. © 2014 John Wiley & Sons, Ltd.

Evidence-based clinical practice, [corrected] evidence-based medicine and the Cochrane collaboration.

PubMed

Gambrill, E

1999-03-01

Encouraging professionals in training and later to consider practice-related research findings when making important clinical decisions is an on-going concern. Evidenced-Based Medicine (EBM) and the Cochrane Collaboration (CC) provide a source of tools and ideas for doing so, as well as a roster of colleagues who share this interest. Evidenced-based medicine involves integrating clinical expertise with the best available external evidence from systematic research as well as considering the values and expectations of patients/clients. Advantage can be taken of educational formats developed in EBM, such as problem-based learning and critical-appraisal workshops in which participants learn how to ask key answerable questions related to important clinical practice questions (e.g., regarding effectiveness, accuracy of assessment measures, prediction, prevention, and quality of clinical practice guidelines) and to access and critically appraise related research. The Cochrane Collaboration is a world-wide network of centers that prepare, maintain, and disseminate high-quality systematic reviews on the efficacy of healthcare. These databases allow access to evidence related to clinical practice decisions. Forging reciprocal working relationships with those involved in EBM reciprocal and the CC should contribute to the pursuit of shared goals such as basing clinical decisions on the best-available evidence and involving clients as informed consumers.

Validating the cross-cultural factor structure and invariance property of the Insomnia Severity Index: evidence based on ordinal EFA and CFA.

PubMed

Chen, Po-Yi; Yang, Chien-Ming; Morin, Charles M

2015-05-01

The purpose of this study is to examine the factor structure of the Insomnia Severity Index (ISI) across samples recruited from different countries. We tried to identify the most appropriate factor model for the ISI and further examined the measurement invariance property of the ISI across samples from different countries. Our analyses included one data set collected from a Taiwanese sample and two data sets obtained from samples in Hong Kong and Canada. The data set collected in Taiwan was analyzed with ordinal exploratory factor analysis (EFA) to obtain the appropriate factor model for the ISI. After that, we conducted a series of confirmatory factor analyses (CFAs), which is a special case of the structural equation model (SEM) that concerns the parameters in the measurement model, to the statistics collected in Canada and Hong Kong. The purposes of these CFA were to cross-validate the result obtained from EFA and further examine the cross-cultural measurement invariance of the ISI. The three-factor model outperforms other models in terms of global fit indices in Taiwan's population. Its external validity is also supported by confirmatory factor analyses. Furthermore, the measurement invariance analyses show that the strong invariance property between the samples from different cultures holds, providing evidence that the ISI results obtained in different cultures are comparable. The factorial validity of the ISI is stable in different populations. More importantly, its invariance property across cultures suggests that the ISI is a valid measure of the insomnia severity construct across countries. Copyright © 2014 Elsevier B.V. All rights reserved.

Evidence of validity of the Stress-Producing Life Events (SPLE) instrument.

PubMed

Rizzini, Marta; Santos, Alcione Miranda Dos; Silva, Antônio Augusto Moura da

2018-01-01

OBJECTIVE Evaluate the construct validity of a list of eight Stressful Life Events in pregnant women. METHODS A cross-sectional study was conducted with 1,446 pregnant women in São Luís, MA, and 1,364 pregnant women in Ribeirão Preto, SP (BRISA cohort), from February 2010 to June 2011. In the exploratory factorial analysis, the promax oblique rotation was used and for the calculation of the internal consistency, we used the compound reliability. The construct validity was determined by means of the confirmatory factorial analysis with the method of estimation of weighted least squares adjusted by the mean and variance. RESULTS The model with the best fit in the exploratory analysis was the one that retained three factors with a cumulative variance of 61.1%. The one-factor model did not obtain a good fit in both samples in the confirmatory analysis. The three-factor model called Stress-Producing Life Events presented a good fit (RMSEA < 0.05; CFI/TLI > 0.90) for both samples. CONCLUSIONS The Stress-Producing Life Events constitute a second order construct with three dimensions related to health, personal and financial aspects and violence. This study found evidence that confirms the construct validity of a list of stressor events, entitled Stress-Producing Life Events Inventory.

Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

PubMed

Cairney, Paul; Oliver, Kathryn

2017-04-26

There is extensive health and public health literature on the 'evidence-policy gap', exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy.We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda - should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise 'evidence-based' policymaking above other factors? The latter includes governance principles such the 'co-production' of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence.We conclude that successful engagement in 'evidence-based policymaking' requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions

Understanding Evidence-Based Public Health Policy

PubMed Central

Chriqui, Jamie F.; Stamatakis, Katherine A.

2009-01-01

Public health policy has a profound impact on health status. Missing from the literature is a clear articulation of the definition of evidence-based policy and approaches to move the field forward. Policy-relevant evidence includes both quantitative (e.g., epidemiological) and qualitative information (e.g., narrative accounts). We describe 3 key domains of evidence-based policy: (1) process, to understand approaches to enhance the likelihood of policy adoption; (2) content, to identify specific policy elements that are likely to be effective; and (3) outcomes, to document the potential impact of policy. Actions to further evidence-based policy include preparing and communicating data more effectively, using existing analytic tools more effectively, conducting policy surveillance, and tracking outcomes with different types of evidence. PMID:19608941

Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter.

PubMed

Alnemer, Khalid A; Alhuzaim, Waleed M; Alnemer, Ahmed A; Alharbi, Bader B; Bawazir, Abdulrahman S; Barayyan, Omar R; Balaraj, Faisal K

2015-10-29

Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions. The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets. All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board-certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated. A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2%) tweets as false and 305 (48.8%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80%) tweets by government institutes, 124 of 201 (61.7%) tweets by physicians, and 42 of 101 (41.6%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1%) from nonofficial health institutes and dietician accounts (59/101, 58.4%) were false. Tweets by the physicians were more likely to be rated "true" compared to other groups (P<.001). Approximately half of the medical tweets

Diet Assessment Methods in the Nurses' Health Studies and Contribution to Evidence-Based Nutritional Policies and Guidelines

PubMed Central

Satija, Ambika; Rimm, Eric B.; Spiegelman, Donna; Sampson, Laura; Rosner, Bernard; Camargo, Carlos A.; Stampfer, Meir; Willett, Walter C.

2016-01-01

Objectives. To review the contribution of the Nurses’ Health Studies (NHSs) to diet assessment methods and evidence-based nutritional policies and guidelines. Methods. We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results. Through periodic assessment of diet by validated dietary questionnaires over 40 years, the NHSs have identified dietary determinants of diseases such as breast and other cancers; obesity; type 2 diabetes; cardiovascular, respiratory, and eye diseases; and neurodegenerative and mental health disorders. Nutritional biomarkers were assessed using blood, urine, and toenail samples. Robust findings, from the NHSs, together with evidence from other large cohorts and randomized dietary intervention trials, have contributed to the evidence base for developing dietary guidelines and nutritional policies to reduce intakes of trans fat, saturated fat, sugar-sweetened beverages, red and processed meats, and refined carbohydrates while promoting higher intake of healthy fats and carbohydrates and overall healthful dietary patterns. Conclusions. The long-term, periodically collected dietary data in the NHSs, with documented reliability and validity, have contributed extensively to our understanding of the dietary determinants of various diseases, informing dietary guidelines and shaping nutritional policy. PMID:27459459

Evidence-based Practice for Mere Mortals

PubMed Central

Sim, Ida; Sanders, Gillian D; McDonald, Kathryn M

2002-01-01

The poor translation of evidence into practice is a well-known problem. Hopes are high that information technology can help make evidence-based practice feasible for mere mortal physicians. In this paper, we draw upon the methods and perspectives of clinical practice, medical informatics, and health services research to analyze the gap between evidence and action, and to argue that computing systems for bridging this gap should incorporate both informatics and health services research expertise. We discuss 2 illustrative systems—trial banks and a web-based system to develop and disseminate evidence-based guidelines (alchemist)— and conclude with a research and training agenda. PMID:11972727

Development of an evidence-based training program for laparoscopic hysterectomy on a virtual reality simulator.

PubMed

Crochet, Patrice; Aggarwal, Rajesh; Knight, Sophie; Berdah, Stéphane; Boubli, Léon; Agostini, Aubert

2017-06-01

Substantial evidence in the scientific literature supports the use of simulation for surgical education. However, curricula lack for complex laparoscopic procedures in gynecology. The objective was to evaluate the validity of a program that reproduces key specific components of a laparoscopic hysterectomy (LH) procedure until colpotomy on a virtual reality (VR) simulator and to develop an evidence-based and stepwise training curriculum. This prospective cohort study was conducted in a Marseille teaching hospital. Forty participants were enrolled and were divided into experienced (senior surgeons who had performed more than 100 LH; n = 8), intermediate (surgical trainees who had performed 2-10 LH; n = 8) and inexperienced (n = 24) groups. Baselines were assessed on a validated basic task. Participants were tested for the LH procedure on a high-fidelity VR simulator. Validity evidence was proposed as the ability to differentiate between the three levels of experience. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on experienced surgeons' performances. Outcome measures were simulator-derived metrics and Objective Structured Assessment of Technical Skills (OSATS) scores. Quantitative analysis found significant inter-group differences between experienced intermediate and inexperienced groups for time (1369, 2385 and 3370 s; p < 0.001), number of movements (2033, 3195 and 4056; p = 0.001), path length (3390, 4526 and 5749 cm; p = 0.002), idle time (357, 654 and 747 s; p = 0.001), respect for tissue (24, 40 and 84; p = 0.01) and number of bladder injuries (0.13, 0 and 4.27; p < 0.001). Learning curves plateaued at the 2nd to 6th repetition. Further qualitative analysis found significant inter-group OSATS score differences at first repetition (22, 15 and 8, respectively; p < 0.001) and second repetition (25.5, 19.5 and 14; p < 0.001). The VR program for LH accrued validity evidence and

Validity Evidence in Scale Development: The Application of Cross Validation and Classification-Sequencing Validation

ERIC Educational Resources Information Center

Acar, Tu¨lin

2014-01-01

In literature, it has been observed that many enhanced criteria are limited by factor analysis techniques. Besides examinations of statistical structure and/or psychological structure, such validity studies as cross validation and classification-sequencing studies should be performed frequently. The purpose of this study is to examine cross…

Faculty Training in Evidence-Based Medicine: Improving Evidence Acquisition and Critical Appraisal

ERIC Educational Resources Information Center

Nicholson, Laura J.; Warde, Carole M.; Boker, John R.

2007-01-01

Introduction: Evidence-based medicine (EBM) integrates published clinical evidence with patient values and clinical expertise, the output of which is informed medical decision making. Key skills for evidence-based practice include acquisition and appraisal of clinical information. Faculty clinicians often lack expertise in these skills and are…

Interpreting Variance Components as Evidence for Reliability and Validity.

ERIC Educational Resources Information Center

Kane, Michael T.

The reliability and validity of measurement is analyzed by a sampling model based on generalizability theory. A model for the relationship between a measurement procedure and an attribute is developed from an analysis of how measurements are used and interpreted in science. The model provides a basis for analyzing the concept of an error of…

Methodology for testing and validating knowledge bases

NASA Technical Reports Server (NTRS)

Krishnamurthy, C.; Padalkar, S.; Sztipanovits, J.; Purves, B. R.

1987-01-01

A test and validation toolset developed for artificial intelligence programs is described. The basic premises of this method are: (1) knowledge bases have a strongly declarative character and represent mostly structural information about different domains, (2) the conditions for integrity, consistency, and correctness can be transformed into structural properties of knowledge bases, and (3) structural information and structural properties can be uniformly represented by graphs and checked by graph algorithms. The interactive test and validation environment have been implemented on a SUN workstation.

Using an evidence-based approach to measure outcomes in clinical practice.

PubMed

MacDermid, Joy C; Grewal, Ruby; MacIntyre, Norma J

2009-02-01

Evaluation of the outcome of evidence-based practice decisions in individual patients or patient groups is step five in the evidence-based practice approach. Outcome measures are any measures that reflect patient status. Status or outcome measures can be used to detect change over time (eg, treatment effects), to discriminate among clinical groups, or to predict future outcomes (eg, return to work). A variety of reliable and valid physical impairment and disability measures are available to assess treatment outcomes in hand surgery and therapy. Evidence from research studies that includes normative data, standard error of measurement, or comparative scores for important clinical subgroups can be used to set treatment goals, monitor recovery, and compare individual patient outcomes to those reported in the literature. Clinicians tend to rely on impairment measures, such as radiographic measures, grip strength, and range of motion, although self-report measures are known to be equally reliable and more related to global effects, such as return-to-work. The process of selecting and implementing outcome measures is crucial. This process works best when team members are involved and willing to trial new measures. In this way, the team can develop customized outcome assessment procedures that meet their needs for assessing individual patients and providing data for program evaluation.

Web-based questionnaires to assess perinatal outcome proved to be valid.

PubMed

van Gelder, Marleen M H J; Vorstenbosch, Saskia; Derks, Lineke; Te Winkel, Bernke; van Puijenbroek, Eugène P; Roeleveld, Nel

2017-10-01

The objective of this study was to validate a Web-based questionnaire completed by the mother to assess perinatal outcome used in a prospective cohort study. For 882 women with an estimated date of delivery between February 2012 and February 2015 who participated in the PRegnancy and Infant DEvelopment (PRIDE) Study, we compared data on pregnancy outcome, including mode of delivery, plurality, gestational age, birth weight and length, head circumference, birth defects, and infant sex, from Web-based questionnaires administered to the mothers 2 months after delivery with data from obstetric records. For continuous variables, we calculated intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs), whereas sensitivity and specificity were determined for categorical variables. We observed only very small differences between the two methods of data collection for gestational age (ICC, 0.91; 95% CI, 0.90-0.92), birth weight (ICC, 0.96; 95% CI, 0.95-0.96), birth length (ICC, 0.90; 95% CI, 0.87-0.92), and head circumference (ICC, 0.88; 95% CI, 0.80-0.93). Agreement between the Web-based questionnaire and obstetric records was high as well, with sensitivity ranging between 0.86 (termination of pregnancy) and 1.00 (four outcomes) and specificity between 0.96 (term birth) and 1.00 (nine outcomes). Our study provides evidence that Web-based questionnaires could be considered as a valid complementary or alternative method of data collection. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of Evidence-Based Practice between Physicians and Nurses: A National Survey of Regional Hospitals in Taiwan

ERIC Educational Resources Information Center

Chiu, Ya-Wen; Weng, Yi-Hao; Lo, Heng-Lien; Hsu, Chih-Cheng; Shih, Ya-Hui; Kuo, Ken N.

2010-01-01

Introduction: Although evidence-based practice (EBP) has been widely investigated, few studies compare physicians and nurses on performance. Methods: A structured questionnaire survey was used to investigate EBP among physicians and nurses in 61 regional hospitals of Taiwan. Valid postal questionnaires were collected from 605 physicians and 551…

Evidence-based practice.

PubMed Central

McKibbon, K A

1998-01-01

Evidence-based practice (EBP) is spreading in popularity in many health care disciplines. One of its main features is the reliance on the partnership among hard scientific evidence, clinical expertise, and individual patient needs and choices. Librarians play an important role in the spread of EBP because of the importance of identifying and retrieving appropriate literature from various sources for use in making health care decisions. This article gives an overview of how to search for therapy, diagnosis, etiology, and prognosis both for original studies and secondary publications such as systematic reviews, meta-analyses, and clinical practice guidelines. Understanding how this research is done, how it is indexed, and how to retrieve the clinical evidence are an important set of skills that librarians can provide for clinicians interested in EBP. PMID:9681176

Implementing Evidence-Based Social Work Practice

ERIC Educational Resources Information Center

Mullen, Edward J.; Bledsoe, Sarah E.; Bellamy, Jennifer L.

2008-01-01

Recently, social work has been influenced by new forms of practice that hold promise for bringing practice and research together to strengthen the scientific knowledge base supporting social work intervention. The most recent new practice framework is evidence-based practice. However, although evidence-based practice has many qualities that might…

Evidence-based practice guidelines in OHS: are they agree-able?

PubMed

Hulshof, Carel; Hoenen, John

2007-01-01

The purpose of this study was to evaluate the acceptance, validity, reliability and feasibility of the AGREE (Appraisal of Guidelines and REsearch and Evaluation) instrument to assess the quality of evidence-based practice guidelines for occupational physicians. In total, 6 practice guidelines of the Netherlands Society of Occupational Medicine (NVAB) were appraised by 20 occupational health professionals and experts in guideline development or implementation. Although appraisers often disagreed on individual item scores, the internal consistency and interrater reliability for most domains was sufficient. The AGREE criteria were in general considered relevant and no major suggestions for additional items for use in the context of occupational health were brought up. The domain scores for the individual guidelines show a wide variety: 'applicability' had on average the lowest mean score (53%) while 'scope and purpose' had the highest one (87%). Low scores indicate where improvements are possible and necessary, e.g. by providing more information about the development. Key experts in occupational health report that AGREE is a relevant and easy to use instrument to evaluate quality aspects and the included criteria provide a good framework to develop or update evidence-based practice guidelines in the field of occupational health.

Building validation tools for knowledge-based systems

NASA Technical Reports Server (NTRS)

Stachowitz, R. A.; Chang, C. L.; Stock, T. S.; Combs, J. B.

1987-01-01

The Expert Systems Validation Associate (EVA), a validation system under development at the Lockheed Artificial Intelligence Center for more than a year, provides a wide range of validation tools to check the correctness, consistency and completeness of a knowledge-based system. A declarative meta-language (higher-order language), is used to create a generic version of EVA to validate applications written in arbitrary expert system shells. The architecture and functionality of EVA are presented. The functionality includes Structure Check, Logic Check, Extended Structure Check (using semantic information), Extended Logic Check, Semantic Check, Omission Check, Rule Refinement, Control Check, Test Case Generation, Error Localization, and Behavior Verification.

Evidence-Based Practice: Management of Vertigo

PubMed Central

Nguyen-Huynh, Anh T.

2012-01-01

Synopsis The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented. PMID:22980676

Risks, Outcomes, and Evidence-Based Interventions for Girls in the US Juvenile Justice System.

PubMed

Leve, Leslie D; Chamberlain, Patricia; Kim, Hyoun K

2015-09-01

The proportion of the juvenile justice population that comprises females is increasing, yet few evidence-based models have been evaluated and implemented with girls in the juvenile justice system. Although much is known about the risk and protective factors for girls who participate in serious delinquency, significant gaps in the research base hamper the development and implementation of theoretically based intervention approaches. In this review, we first summarize the extant empirical work about the predictors and sequelae of juvenile justice involvement for girls. Identified risk and protective factors that correspond to girls' involvement in the juvenile justice system have been shown to largely parallel those of boys, although exposure rates and magnitudes of association sometimes differ by sex. Second, we summarize findings from empirically validated, evidence-based interventions for juvenile justice-involved youths that have been tested with girls. The interventions include Functional Family Therapy, Multisystemic Therapy, Multidimensional Family Therapy, and Treatment Foster Care Oregon (formerly known as Multidimensional Treatment Foster Care). We conclude that existing evidence-based practices appear to be effective for girls. However, few studies have been sufficiently designed to permit conclusions about whether sex-specific interventions would yield any better outcomes for girls than would interventions that already exist for both sexes and that have a strong base of evidence to support them. Third, we propose recommendations for feasible, cost-efficient next steps to advance the research and intervention agendas for this under-researched and underserved population of highly vulnerable youths.

[From evidence-based medicine to value-based medicine].

PubMed

Zhang, Shao-dan; Liang, Yuan-bo; Li, Si-zhen

2006-11-01

Evidence base medicine (EBM) is based on objective evidence, which provides best available knowledge for physicians to scientifically make medical and therapeutic decisions for the care of all individual patients in order to improve the effectiveness of treatment and to prolong the life of patients. EBM has made a significant progress in clinical practice. But medical therapies cannot always bring a better life quality and clinically, patients' preference should be always taken into account. Value-based medicine medicine (VBM) is the practice of medicine that emphasizes the value received from an intervention. It takes evidence-based data to a higher level by combining the parameters of patient-perceived value with the cost of an intervention. The fundamental instrument of VBM is cost-utility analysis. VBM will provide a better practice model to evaluate the therapeutic package and cost effectiveness for individual and general health care.

Educating change agents: a qualitative descriptive study of graduates of a Master's program in evidence-based practice.

PubMed

Hole, Grete Oline; Brenna, Sissel Johansson; Graverholt, Birgitte; Ciliska, Donna; Nortvedt, Monica Wammen

2016-02-25

Health care professionals are expected to build decisions upon evidence. This implies decisions based on the best available, current, valid and relevant evidence, informed by clinical expertise and patient values. A multi-professional master's program in evidence-based practice was developed and offered. The aims of this study were to explore how students in this program viewed their ability to apply evidence-based practice and their perceptions of what constitute necessary conditions to implement evidence-based practice in health care organizations, one year after graduation. A qualitative descriptive design was chosen to examine the graduates' experiences. All students in the first two cohorts of the program were invited to participate. Six focus-group interviews, with a total of 21 participants, and a telephone interview of one participant were conducted. The data was analyzed thematically, using the themes from the interview guide as the starting point. The graduates reported that an overall necessary condition for evidence-based practice to occur is the existence of a "readiness for change" both at an individual level and at the organizational level. They described that they gained personal knowledge and skills to be "change-agents" with "self-efficacy, "analytic competence" and "tools" to implement evidence based practice in clinical care. An organizational culture of a "learning organization" was also required, where leaders have an "awareness of evidence- based practice", and see the need for creating "evidence-based networks". One year after graduation the participants saw themselves as "change agents" prepared to improve clinical care within a learning organization. The results of this study provides useful information for facilitating the implementation of EBP both from educational and health care organizational perspectives.

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

PubMed

Sands, Natisha; Elsom, Stephen; Keppich-Arnold, Sandra; Henderson, Kathryn; King, Peter; Bourke-Finn, Karen; Brunning, Debra

2016-02-01

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage. © 2015 Australian College of Mental Health Nurses Inc.

A Motor Speech Assessment for Children with Severe Speech Disorders: Reliability and Validity Evidence

ERIC Educational Resources Information Center

Strand, Edythe A.; McCauley, Rebecca J.; Weigand, Stephen D.; Stoeckel, Ruth E.; Baas, Becky S.

2013-01-01

Purpose: In this article, the authors report reliability and validity evidence for the Dynamic Evaluation of Motor Speech Skill (DEMSS), a new test that uses dynamic assessment to aid in the differential diagnosis of childhood apraxia of speech (CAS). Method: Participants were 81 children between 36 and 79 months of age who were referred to the…

Contemporary Test Validity in Theory and Practice: A Primer for Discipline-Based Education Researchers.

PubMed

Reeves, Todd D; Marbach-Ad, Gili

2016-01-01

Most discipline-based education researchers (DBERs) were formally trained in the methods of scientific disciplines such as biology, chemistry, and physics, rather than social science disciplines such as psychology and education. As a result, DBERs may have never taken specific courses in the social science research methodology--either quantitative or qualitative--on which their scholarship often relies so heavily. One particular aspect of (quantitative) social science research that differs markedly from disciplines such as biology and chemistry is the instrumentation used to quantify phenomena. In response, this Research Methods essay offers a contemporary social science perspective on test validity and the validation process. The instructional piece explores the concepts of test validity, the validation process, validity evidence, and key threats to validity. The essay also includes an in-depth example of a validity argument and validation approach for a test of student argument analysis. In addition to DBERs, this essay should benefit practitioners (e.g., lab directors, faculty members) in the development, evaluation, and/or selection of instruments for their work assessing students or evaluating pedagogical innovations. © 2016 T. D. Reeves and G. Marbach-Ad. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Validity evidence for the adaptation of the State Mindfulness Scale for Physical Activity (SMS-PA) in Spanish youth.

PubMed

Ullrich-French, Sarah; González Hernández, Juan; Hidalgo Montesinos, María D

2017-02-01

Mindfulness is an increasingly popular construct with promise in enhancing multiple positive health outcomes. Physical activity is an important behavior for enhancing overall health, but no Spanish language scale exists to test how mindfulness during physical activity may facilitate physical activity motivation or behavior. This study examined the validity of a Spanish adaption of a new scale, the State Mindfulness Scale for Physical Activity, to assess mindfulness during a specific experience of physical activity. Spanish youths (N = 502) completed a cross-sectional survey of state mindfulness during physical activity and physical activity motivation regulations based on Self-Determination Theory. A high-order model fit the data well and supports the use of one general state mindfulness factor or the use of separate subscales of mindfulness of mental (e.g., thoughts, emotions) and body (physical movement, muscles) aspects of the experience. Internal consistency reliability was good for the general scale and both sub-scales. The pattern of correlations with motivation regulations provides further support for construct validity with significant and positive correlations with self-determined forms of motivation and significant and negative correlations with external regulation and amotivation. Initial validity evidence is promising for the use of the adapted measure.

Evidence of Convergent and Discriminant Validity of Child, Teacher, and Peer Reports of Teacher-Student Support

PubMed Central

Li, Yan; Hughes, Jan N.; Kwok, Oi-man; Hsu, Hsien-Yuan

2012-01-01

This study investigated the construct validity of measures of teacher-student support in a sample of 709 ethnically diverse second and third grade academically at-risk students. Confirmatory factor analysis investigated the convergent and discriminant validities of teacher, child, and peer reports of teacher-student support and child conduct problems. Results supported the convergent and discriminant validity of scores on the measures. Peer reports accounted for the largest proportion of trait variance and non-significant method variance. Child reports accounted for the smallest proportion of trait variance and the largest method variance. A model with two latent factors provided a better fit to the data than a model with one factor, providing further evidence of the discriminant validity of measures of teacher-student support. Implications for research, policy, and practice are discussed. PMID:21767024

Evidence-based medicine: a commentary on common criticisms

PubMed Central

Straus, Sharon E.; McAlister, Finlay A.

2000-01-01

Discussions about evidence-based medicine engender both negative and positive reactions from clinicians and academics. Ways to achieve evidence-based practice are reviewed here and the most common criticisms described. The latter can be classified as ”limitations universal to the practice of medicine,” ”limitations unique to evidence-based medicine” and ”misperceptions of evidence-based medicine.” Potential solutions to the true limitations of evidence-based medicine are discussed and areas for future work highlighted. PMID:11033714

An evidence-based virtual reality training program for novice laparoscopic surgeons.

PubMed

Aggarwal, Rajesh; Grantcharov, Teodor P; Eriksen, Jens R; Blirup, Dorthe; Kristiansen, Viggo B; Funch-Jensen, Peter; Darzi, Ara

2006-08-01

To develop an evidence-based virtual reality laparoscopic training curriculum for novice laparoscopic surgeons to achieve a proficient level of skill prior to participating in live cases. Technical skills for laparoscopic surgery must be acquired within a competency-based curriculum that begins in the surgical skills laboratory. Implementation of this program necessitates the definition of the validity, learning curves and proficiency criteria on the training tool. The study recruited 40 surgeons, classified into experienced (performed >100 laparoscopic cholecystectomies) or novice groups (<10 laparoscopic cholecystectomies). Ten novices and 10 experienced surgeons were tested on basic tasks, and 11 novices and 9 experienced surgeons on a procedural module for dissection of Calot triangle. Performance of the 2 groups was assessed using time, error, and economy of movement parameters. All basic tasks demonstrated construct validity (Mann-Whitney U test, P < 0.05), and learning curves for novices plateaued at a median of 7 repetitions (Friedman's test, P < 0.05). Expert surgeons demonstrated a learning rate at a median of 2 repetitions (P < 0.05). Performance on the dissection module demonstrated significant differences between experts and novices (P < 0.002); learning curves for novice subjects plateaued at the fourth repetition (P < 0.05). Expert benchmark criteria were defined for validated parameters on each task. A competency-based training curriculum for novice laparoscopic surgeons has been defined. This can serve to ensure that junior trainees have acquired prerequisite levels of skill prior to entering the operating room, and put them directly into practice.

Automatic evidence quality prediction to support evidence-based decision making.

PubMed

Sarker, Abeed; Mollá, Diego; Paris, Cécile

2015-06-01

Evidence-based medicine practice requires practitioners to obtain the best available medical evidence, and appraise the quality of the evidence when making clinical decisions. Primarily due to the plethora of electronically available data from the medical literature, the manual appraisal of the quality of evidence is a time-consuming process. We present a fully automatic approach for predicting the quality of medical evidence in order to aid practitioners at point-of-care. Our approach extracts relevant information from medical article abstracts and utilises data from a specialised corpus to apply supervised machine learning for the prediction of the quality grades. Following an in-depth analysis of the usefulness of features (e.g., publication types of articles), they are extracted from the text via rule-based approaches and from the meta-data associated with the articles, and then applied in the supervised classification model. We propose the use of a highly scalable and portable approach using a sequence of high precision classifiers, and introduce a simple evaluation metric called average error distance (AED) that simplifies the comparison of systems. We also perform elaborate human evaluations to compare the performance of our system against human judgments. We test and evaluate our approaches on a publicly available, specialised, annotated corpus containing 1132 evidence-based recommendations. Our rule-based approach performs exceptionally well at the automatic extraction of publication types of articles, with F-scores of up to 0.99 for high-quality publication types. For evidence quality classification, our approach obtains an accuracy of 63.84% and an AED of 0.271. The human evaluations show that the performance of our system, in terms of AED and accuracy, is comparable to the performance of humans on the same data. The experiments suggest that our structured text classification framework achieves evaluation results comparable to those of human performance

Sensitivity-Uncertainty Based Nuclear Criticality Safety Validation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Forrest B.

2016-09-20

These are slides from a seminar given to the University of Mexico Nuclear Engineering Department. Whisper is a statistical analysis package developed to support nuclear criticality safety validation. It uses the sensitivity profile data for an application as computed by MCNP6 along with covariance files for the nuclear data to determine a baseline upper-subcritical-limit for the application. Whisper and its associated benchmark files are developed and maintained as part of MCNP6, and will be distributed with all future releases of MCNP6. Although sensitivity-uncertainty methods for NCS validation have been under development for 20 years, continuous-energy Monte Carlo codes such asmore » MCNP could not determine the required adjoint-weighted tallies for sensitivity profiles. The recent introduction of the iterated fission probability method into MCNP led to the rapid development of sensitivity analysis capabilities for MCNP6 and the development of Whisper. Sensitivity-uncertainty based methods represent the future for NCS validation – making full use of today’s computer power to codify past approaches based largely on expert judgment. Validation results are defensible, auditable, and repeatable as needed with different assumptions and process models. The new methods can supplement, support, and extend traditional validation approaches.« less

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

PubMed Central

Teschke, Rolf; Wolff, Albrecht; Frenzel, Christian; Eickhoff, Axel; Schulze, Johannes

2015-01-01

Herbal traditional Chinese medicine (TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providing effective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in PubMed and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn’s disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmatic modern medicine by bridging the

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders.

PubMed

Teschke, Rolf; Wolff, Albrecht; Frenzel, Christian; Eickhoff, Axel; Schulze, Johannes

2015-04-21

Herbal traditional Chinese medicine (TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providing effective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in PubMed and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmatic modern medicine by bridging the gap

Evidence-Based Practice Guidelines and School Nursing

ERIC Educational Resources Information Center

Adams, Susan; McCarthy, Ann Marie

2007-01-01

The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

Visualization studies on evidence-based medicine domain knowledge (series 3): visualization for dissemination of evidence based medicine information.

PubMed

Shen, Jiantong; Yao, Leye; Li, Youping; Clarke, Mike; Gan, Qi; Li, Yifei; Fan, Yi; Gou, Yongchao; Wang, Li

2011-05-01

To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor

Refining knowledge, attitude and practice of evidence-based medicine (EBM) among pharmacy students for professional challenges.

PubMed

Abu-Gharbieh, Eman; Khalidi, Doaa Al; Baig, Mirza R; Khan, Saeed A

2015-04-01

Practicing evidence based medicine (EBM) is a professional need for the future clinical pharmacist in UAE and around the world. An attempt was made to evaluate pharmacy student's knowledge, attitude and proficiency in the practice of EBM. A within-subject study design with pre and post survey and skill test were conducted using case based practice of EBM through a validated questionnaire. The results were tabulated and there was a statistically significant increase in pharmacy students' perceived ability to go through steps of EBM, namely: formulating PICO questions (95.3%), searching for evidence (97%), appraising the evidence (81%), understanding statistics (78.1%), and applying evidence at point of care (81.2%). In this study, workshops and (Problem Based Learning) PBLs were used as a module of EBM teaching and practices, which has been shown to be an effective educational method in terms of improving students' skills, knowledge and attitude toward EBM. Incorporating hands on experience, PBLs will become an impetus for developing EBM skills and critical appraisal of research evidence alongside routine clinical practice. This integration would constitute the cornerstone in lifting EBM in UAE up to the needed standards and would enable pharmacy students to become efficient pharmacists that rely on evidence in their health practice.

Information literacy for evidence-based practice in perianesthesia nurses: readiness for evidence-based practice.

PubMed

Ross, Jacqueline

2010-04-01

Information literacy, the recognition of information required, and the development of skills for locating, evaluating, and effectively using relevant evidence is needed for evidence-based practice (EBP). The purpose of this study was to examine perianesthesia nurses' perception of searching skills and access to evidence sources. The design was a descriptive, exploratory survey. The sample consisted of ASPAN members (n = 64) and nonmembers (n = 64). The Information Literacy for Evidence-Based Nursing Practice instrument was used. Findings were that ASPAN members read more journal articles, were more proficient with computers, and used Cumulative Index to Nursing and Allied Health Literature (CINAHL) more frequently than nonmembers. The three top barriers to use of research were: lack of understanding of organization or structure of electronic databases, lack of skills to critique and/or synthesize the literature, and difficulty in accessing research materials. In conclusion, education is needed for critiquing literature and understanding electronic databases and research articles to promote EBP in perianesthesia areas. Copyright 2010. Published by Elsevier Inc.

Validity and usability of a professional association's web-based knowledge translation portal: American Physical Therapy Association's PTNow.org.

PubMed

Deutsch, Judith E; Romney, Wendy; Reynolds, Jan; Manal, Tara Jo

2015-10-08

PTNow.org is an evidence-based, on-line portal created by a professional membership association to promote use of evidence in practice and to help decrease unwarranted variation in practice. The site contains synthesis documents designed to promote efficient clinical reasoning. These documents were written and peer-reviewed by teams of content experts and master clinicians. The purpose of this paper is to report on the content and construct validity as well as usability of the site. Physical therapist participants used clinical summaries (available in 3 formats--as a full summary with hyperlinks, "quick takes" with hyperlinks, and a portable two-page version) on the PTNow.org site to answer knowledge acquisition and clinical reasoning questions related to four patient scenarios. They also responded to questions about ease of use related to website navigation and about format and completeness of information using a 1-5 Likert scale. Responses were coded to reflect how participants used the site and then were summarized descriptively. Preferences for clinical summary format were analyzed using an analysis of variance (ANOVA) and a Dunnett T3 post hoc analysis. Seventeen participants completed the study. Clinical relevance and completeness ratings by experienced clinicians, which were used as the measure of content validity, ranged from 3.1 to 4.6 on a 5 point scale. Construct validity based on the information on the PTNow.org site was supported for knowledge acquisition questions 66 % of the time and for clinical reasoning questions 40 % of the time. Usability ratings for the full clinical summary were 4.6 (1.2); for the quick takes, 3.5 (.98); and for the portable clinical summary, 4.0 (.45). Participants preferred the full clinical summary over the other two formats (F = 5.908, P = 0.007). One hundred percent of the participants stated that they would recommend the PTNow site to their colleagues. Prelimary evidence supported both content validity and

Assessing child and adolescent pragmatic language competencies: toward evidence-based assessments.

PubMed

Russell, Robert L; Grizzle, Kenneth L

2008-06-01

Using language appropriately and effectively in social contexts requires pragmatic language competencies (PLCs). Increasingly, deficits in PLCs are linked to child and adolescent disorders, including autism spectrum, externalizing, and internalizing disorders. As the role of PLCs expands in diagnosis and treatment of developmental psychopathology, psychologists and educators will need to appraise and select clinical and research PLC instruments for use in assessments and/or studies. To assist in this appraisal, 24 PLC instruments, containing 1,082 items, are assessed by addressing four questions: (1) Can PLC domains targeted by assessment items be reliably identified?, (2) What are the core PLC domains that emerge across the 24 instruments?, (3) Do PLC questionnaires and tests assess similar PLC domains?, and (4) Do the instruments achieve content, structural, diagnostic, and ecological validity? Results indicate that test and questionnaire items can be reliably categorized into PLC domains, that PLC domains featured in questionnaires and tests significantly differ, and that PLC instruments need empirical confirmation of their dimensional structure, content validity across all developmental age bands, and ecological validity. Progress in building a better evidence base for PLC assessments should be a priority in future research.

Formalizing Evidence Type Definitions for Drug-Drug Interaction Studies to Improve Evidence Base Curation.

PubMed

Utecht, Joseph; Brochhausen, Mathias; Judkins, John; Schneider, Jodi; Boyce, Richard D

2017-01-01

In this research we aim to demonstrate that an ontology-based system can categorize potential drug-drug interaction (PDDI) evidence items into complex types based on a small set of simple questions. Such a method could increase the transparency and reliability of PDDI evidence evaluation, while also reducing the variations in content and seriousness ratings present in PDDI knowledge bases. We extended the DIDEO ontology with 44 formal evidence type definitions. We then manually annotated the evidence types of 30 evidence items. We tested an RDF/OWL representation of answers to a small number of simple questions about each of these 30 evidence items and showed that automatic inference can determine the detailed evidence types based on this small number of simpler questions. These results show proof-of-concept for a decision support infrastructure that frees the evidence evaluator from mastering relatively complex written evidence type definitions.

Development and Validation of a Primary Care-Based Family Health History and Decision Support Program (MeTree)

PubMed Central

Orlando, Lori A.; Buchanan, Adam H.; Hahn, Susan E.; Christianson, Carol A.; Powell, Karen P.; Skinner, Celette Sugg; Chesnut, Blair; Blach, Colette; Due, Barbara; Ginsburg, Geoffrey S.; Henrich, Vincent C.

2016-01-01

INTRODUCTION Family health history is a strong predictor of disease risk. To reduce the morbidity and mortality of many chronic diseases, risk-stratified evidence-based guidelines strongly encourage the collection and synthesis of family health history to guide selection of primary prevention strategies. However, the collection and synthesis of such information is not well integrated into clinical practice. To address barriers to collection and use of family health histories, the Genomedical Connection developed and validated MeTree, a Web-based, patient-facing family health history collection and clinical decision support tool. MeTree is designed for integration into primary care practices as part of the genomic medicine model for primary care. METHODS We describe the guiding principles, operational characteristics, algorithm development, and coding used to develop MeTree. Validation was performed through stakeholder cognitive interviewing, a genetic counseling pilot program, and clinical practice pilot programs in 2 community-based primary care clinics. RESULTS Stakeholder feedback resulted in changes to MeTree’s interface and changes to the phrasing of clinical decision support documents. The pilot studies resulted in the identification and correction of coding errors and the reformatting of clinical decision support documents. MeTree’s strengths in comparison with other tools are its seamless integration into clinical practice and its provision of action-oriented recommendations guided by providers’ needs. LIMITATIONS The tool was validated in a small cohort. CONCLUSION MeTree can be integrated into primary care practices to help providers collect and synthesize family health history information from patients with the goal of improving adherence to risk-stratified evidence-based guidelines. PMID:24044145

Competency-based assessment in surgeon-performed head and neck ultrasonography: A validity study.

PubMed

Todsen, Tobias; Melchiors, Jacob; Charabi, Birgitte; Henriksen, Birthe; Ringsted, Charlotte; Konge, Lars; von Buchwald, Christian

2018-06-01

Head and neck ultrasonography (HNUS) increasingly is used as a point-of-care diagnostic tool by otolaryngologists. However, ultrasonography (US) is a very operator-dependent image modality. Hence, this study aimed to explore the diagnostic accuracy of surgeon-performed HNUS and to establish validity evidence for an objective structured assessment of ultrasound skills (OSAUS) used for competency-based assessment. A prospective experimental study. Six otolaryngologists and 11 US novices were included in a standardized test setup for which they had to perform focused HNUS of eight patients suspected for different head and neck lesions. Their diagnostic accuracy was calculated based on the US reports, and two blinded raters assessed the video-recorded US performance using the OSAUS scale. The otolaryngologists obtained a high diagnostic accuracy on 88% (range 63%-100%) compared to the US novices on 38% (range 0-63%); P < 0.001. The OSAUS score demonstrated good inter-case reliability (0.85) and inter-rater reliability (0.76), and significant discrimination between otolaryngologist and US novices; P < 0.001. A strong correlation between the OSAUS score and the diagnostic accuracy was found (Spearman's ρ, 0.85; P < P 0.001), and a pass/fail score was established at 2.8. Strong validity evidence supported the use of the OSAUS scale to assess HNUS competence with good reliability, significant discrimination between US competence levels, and a strong correlation of assessment score to diagnostic accuracy. An OSAUS pass/fail score was established and could be used for competence-based assessment in surgeon-performed HNUS. NA. Laryngoscope, 128:1346-1352, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Evidence-Based Dentistry in Everyday Practice.

PubMed

Gudray, Kiran; Walmsley, Anthony Damien

2016-12-01

This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.

Introducing a Chair-Side Novel Approach to Reach Evidence-based Periodontal Information in the Daily Periodontal Practice

PubMed Central

Dannan, Aous

2009-01-01

Background Evidence-based healthcare is not an easier approach to patient management, but should provide both clinicians and patients with greater confidence and trust in their mutual relationship. The intellectual embrace of evidence-based methods, coupled with clinical expertise and consideration of the patients individual uniqueness and requirements, is needed for all periodontal therapists if optimum care is the goal. One important element of evidence-based decision making in periodontology is the systematic review. Systematic reviews usually provide the periodontist with the highest level of evidence which should be taken into consideration when constructing any treatment plan in the dental clinic. However, reaching systematic reviews might be a time-consuming procedure that needs further personal skills. Methods In this paper, a chair-side novel approach to facilitate the incorporation of systematic reviews into daily periodontal practice is presented. It is based on three simple tools, namely, a list of suitable periodontics-related key words, a data bank of all up-to-date published systematic reviews in periodontology, and hand-made paper sheets to match the key words with their related systematic review statements. Results and Conclusions A primary validation of this method indicated the simplicity in learning and application. Keywords Chair-side; Evidence-based medicine; Periodontology; Systematic review PMID:22461868

In the teeth of the evidence: the curious case of evidence-based medicine.

PubMed

Davidoff, F

1999-03-01

For a very long time, evidence from research has contributed to clinical decision making. Over the past 50 years, however, the nature of clinical research evidence has drastically changed compared with previous eras: its standards are higher, the tools for assembling and analyzing it are more powerful, and the context in which it is used is less authoritarian. The consequence has been a shift in both the concept and the practice of clinical decision making known as evidence-based medicine. Evidence-based decisions, by definition, use the strongest available evidence, are often more quantitatively informed than decisions made in the traditional fashion; and sometimes run counter to expert opinion. The techniques of evidence-based medicine are also helpful in resolving conflicting opinions. Evidence-based medicine did not simply appear in vacuo; its roots extend back at least as far as the great French Encyclopedia of the 18th century, and the subsequent work of Pierre Louis in Paris in the early 19th century. The power of the evidence-based approach has been enhanced in recent years by the development of the techniques of systematic review and meta-analysis. While this approach has its critics, we would all want the best available evidence used in making decisions about our care if we got sick. It is only fair that the patients under our care receive nothing less.

Are the available apathy measures reliable and valid? A review of the psychometric evidence

PubMed Central

Clarke, Diana E.; Ko, Jean Y.; Kuhl, Emily A.; van Reekum, Robert; Salvador, Rocio; Marin, Robert S.

2014-01-01

Objective Apathy is highly prevalent among neuropsychiatric populations and is associated with greater morbidity and worse functional outcomes. Despite this, it remains understudied and poorly understood, primarily due to lack of consensus definition and clear diagnostic criteria for apathy. Without a gold standard for defining and measuring apathy, the availability of empirically sound measures is imperative. This paper provides a psychometric review of the most commonly used apathy measures and provides recommendations for use and further research. Methods Pertinent literature databases were searched to identify all available assessment tools for apathy in adults aged 18 and older. Evidence of the reliability and validity of the scales were examined. Alternate variations of scales (e.g., non-English versions) were also evaluated if the validating articles were written in English. Results Fifteen apathy scales or subscales were examined. The most psychometrically robust measures for assessing apathy across any disease population appear to be the Apathy Evaluation Scale and the apathy subscale of the Neuropsychiatric Inventory based on the criteria set in this review. For assessment in specific populations, the Dementia Apathy Interview and Rating for patients with Alzheimer’s dementia, the Positive and Negative Symptom Scale for schizophrenia populations, and the Frontal System Behavior Scale for patients with fronto-temporal deficits are reliable and valid measures. Conclusion Clinicians and researchers have numerous apathy scales for use in broad and disease-specific neuropsychiatric populations. Our understanding of apathy would be advanced by research that helps build a consensus as to the definition and diagnosis of apathy, and further refine the psychometric properties of all apathy assessment tools. PMID:21193104

Determining registered nurses' readiness for evidence-based practice.

PubMed

Thiel, Linda; Ghosh, Yashowanto

2008-01-01

As health care systems worldwide move toward instituting evidence-based practice (EBP), its implementation can be challenging. Conducting a baseline assessment to determine nurses' readiness for EBP presents opportunities to plan strategies before implementation. Although a growing body of research literature is focused on implementing EBP, little attention has been paid to assessing nurses' readiness for EBP. The purpose of this study was to assess registered nurses' readiness for EBP in a moderate-sized acute care hospital in the Midwestern United States before implementation of a hospital-wide nursing EBP initiative. A descriptive cross-sectional survey design was used; 121 registered nurses completed the survey. The participants (n= 121) completed the 64-item Nurses' Readiness for Evidence-Based Practice Survey that allowed measurement of information needs, knowledge and skills, culture, and attitudes. Data were analyzed using descriptive statistics and a post hoc analysis. The majority (72.5%) of respondents indicated that when they needed information, they consulted colleagues and peers rather than using journals and books; 24% of nurses surveyed used the health database, Cumulative Index to Nursing & Allied Health Literature (CINAHL). The respondents perceived their EBP knowledge level as moderate. Cultural EBP scores were moderate, with unit scores being higher than organizational scores. The nurses' attitudes toward EBP were positive. The post hoc analysis showed many significant correlations. Nurses have access to technological resources and perceive that they have the ability to engage in basic information gathering but not in higher level evidence gathering. The elements important to EBP such as a workplace culture and positive attitudes are present and can be built upon. A "site-specific" baseline assessment provides direction in planning EBP initiatives. The Nurses' Readiness for EBP Survey is a streamlined tool with established reliability and

Evidence-based surgery: barriers, solutions, and the role of evidence synthesis.

PubMed

Garas, George; Ibrahim, Amel; Ashrafian, Hutan; Ahmed, Kamran; Patel, Vanash; Okabayashi, Koji; Skapinakis, Petros; Darzi, Ara; Athanasiou, Thanos

2012-08-01

Surgery is a rapidly evolving field, making the rigorous testing of emerging innovations vital. However, most surgical research fails to employ randomized controlled trials (RCTs) and has particularly been based on low-quality study designs. Subsequently, the analysis of data through meta-analysis and evidence synthesis is particularly difficult. Through a systematic review of the literature, this article explores the barriers to achieving a strong evidence base in surgery and offers potential solutions to overcome the barriers. Many barriers exist to evidence-based surgical research. They include enabling factors, such as funding, time, infrastructure, patient preference, ethical issues, and additionally barriers associated with specific attributes related to researchers, methodologies, or interventions. Novel evidence synthesis techniques in surgery are discussed, including graphics synthesis, treatment networks, and network meta-analyses that help overcome many of the limitations associated with existing techniques. They offer the opportunity to assess gaps and quantitatively present inconsistencies within the existing evidence of RCTs. Poorly or inadequately performed RCTs and meta-analyses can give rise to incorrect results and thus fail to inform clinical practice or revise policy. The above barriers can be overcome by providing academic leadership and good organizational support to ensure that adequate personnel, resources, and funding are allocated to the researcher. Training in research methodology and data interpretation can ensure that trials are conducted correctly and evidence is adequately synthesized and disseminated. The ultimate goal of overcoming the barriers to evidence-based surgery includes the improved quality of patient care in addition to enhanced patient outcomes.

From Opinion-Based to Evidence-Based Social Work: The Swedish Case

ERIC Educational Resources Information Center

Sundell, Knut; Soydan, Haluk; Tengvald, Karin; Anttila, Sten

2010-01-01

This article presents an account of Sweden's Institute for Evidence-Based Social Work Practice (IMS), located in Stockholm, Sweden. The article places IMS in the context of making Swedish social care services less opinion-based and more evidence-based. The institute is an example of how policy-driven processes promote the use of evidence-based…

When Does Evidence-Based Policy Turn into Policy-Based Evidence? Configurations, Contexts and Mechanisms

ERIC Educational Resources Information Center

Strassheim, Holger; Kettunen, Pekka

2014-01-01

Many studies on evidence-based policy are still clinging to a linear model. Instead, we propose to understand expertise and evidence as "socially embedded" in authority relations and cultural contexts. Policy-relevant facts are the result of an intensive and complex struggle for political and epistemic authority. This is especially true…

'We hold these truths to be self-evident': deconstructing 'evidence-based' medical practice.

PubMed

Devisch, Ignaas; Murray, Stuart J

2009-12-01

Rationale, aims and objectives Evidence-based medicine (EBM) claims to be based on 'evidence', rather than 'intuition'. However, EBM's fundamental distinction between quantitative 'evidence' and qualitative 'intuition' is not self-evident. The meaning of 'evidence' is unclear and no studies of quality exist to demonstrate the superiority of EBM in health care settings. This paper argues that, despite itself, EBM holds out only the illusion of conclusive scientific rigour for clinical decision making, and that EBM ultimately is unable to fulfil its own structural criteria for 'evidence'. Methods Our deconstructive analysis of EBM draws on the work of the French philosopher, Jacques Derrida. Deconstruction works in the name of justice to lay bare, to expose what has been hidden from view. In plain language, we deconstruct EBM's paradigm of 'evidence', the randomized controlled trial (RCT), to demonstrate that there cannot be incontrovertible evidence for EBM as such. We argue that EBM therefore 'auto-deconstructs' its own paradigm, and that medical practitioners, policymakers and patients alike ought to be aware of this failure within EBM itself. Results EBM's strict distinction between admissible evidence (based on RCTs) and other supposedly inadmissible evidence is not itself based on evidence, but rather, on intuition. In other words, according to EBM's own logic, there can be no 'evidentiary' basis for its distinction between admissible and inadmissible evidence. Ultimately, to uphold this fundamental distinction, EBM must seek recourse in (bio)political ideology and an epistemology akin to faith.

Nutrition screening tools: an analysis of the evidence.

PubMed

Skipper, Annalynn; Ferguson, Maree; Thompson, Kyle; Castellanos, Victoria H; Porcari, Judy

2012-05-01

In response to questions about tools for nutrition screening, an evidence analysis project was developed to identify the most valid and reliable nutrition screening tools for use in acute care and hospital-based ambulatory care settings. An oversight group defined nutrition screening and literature search criteria. A trained analyst conducted structured searches of the literature for studies of nutrition screening tools according to predetermined criteria. Eleven nutrition screening tools designed to detect undernutrition in patients in acute care and hospital-based ambulatory care were identified. Trained analysts evaluated articles for quality using criteria specified by the American Dietetic Association's Evidence Analysis Library. Members of the oversight group assigned quality grades to the tools based on the quality of the supporting evidence, including reliability and validity data. One tool, the NRS-2002, received a grade I, and 4 tools-the Simple Two-Part Tool, the Mini-Nutritional Assessment-Short Form (MNA-SF), the Malnutrition Screening Tool (MST), and Malnutrition Universal Screening Tool (MUST)-received a grade II. The MST was the only tool shown to be both valid and reliable for identifying undernutrition in the settings studied. Thus, validated nutrition screening tools that are simple and easy to use are available for application in acute care and hospital-based ambulatory care settings.

MotiveValidator: interactive web-based validation of ligand and residue structure in biomolecular complexes.

PubMed

Vařeková, Radka Svobodová; Jaiswal, Deepti; Sehnal, David; Ionescu, Crina-Maria; Geidl, Stanislav; Pravda, Lukáš; Horský, Vladimír; Wimmerová, Michaela; Koča, Jaroslav

2014-07-01

Structure validation has become a major issue in the structural biology community, and an essential step is checking the ligand structure. This paper introduces MotiveValidator, a web-based application for the validation of ligands and residues in PDB or PDBx/mmCIF format files provided by the user. Specifically, MotiveValidator is able to evaluate in a straightforward manner whether the ligand or residue being studied has a correct annotation (3-letter code), i.e. if it has the same topology and stereochemistry as the model ligand or residue with this annotation. If not, MotiveValidator explicitly describes the differences. MotiveValidator offers a user-friendly, interactive and platform-independent environment for validating structures obtained by any type of experiment. The results of the validation are presented in both tabular and graphical form, facilitating their interpretation. MotiveValidator can process thousands of ligands or residues in a single validation run that takes no more than a few minutes. MotiveValidator can be used for testing single structures, or the analysis of large sets of ligands or fragments prepared for binding site analysis, docking or virtual screening. MotiveValidator is freely available via the Internet at http://ncbr.muni.cz/MotiveValidator. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

[Evidence-based Chinese medicine：theory and practice].

PubMed

Zhang, Jun-Hua; Li, You-Ping; Zhang, Bo-Li

2018-01-01

The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine. The basic concept of evidence-based Chinese medicine: EBCM is an applied discipline, following the theory and methodology of evidence-based medicine, to collect, evaluate, produce, transform the evidence of effectiveness, safety and economy of TCM, to reveal the feature and regular pattern of TCM taking effect, and to guide the development of clinical guidelines, clinical pathways and health decisions. The effects and achievements of EBCM development: secondary studies mainly based on systematic review/Meta-analysis were extensively carried out; clinical efficacy studies mainly relying on randomized controlled trials grew rapidly; clinical safety evaluations based on real world study have been conducted; methodological researches mainly focused on study quality control deepened gradually; internationalization researches mainly on report specifications have got some breakthroughs; standardization researches based on treatment specification were strengthened gradually; the research team and talents with the characteristics of inter-disciplinary have been steadily increased. A number of high-quality research findings have been published at international well-known journals; the clinical efficacy and safety evidence of TCM has been increased; the level of clinical rational use of TCM has been improved; a large number of Chinese patent medicines with big market have been cultured. The

Adapting HIV prevention evidence-based interventions in practice settings: an interview study

PubMed Central

2009-01-01

Background Evidence-based interventions that are being delivered in real-world settings are adapted to enhance the external validity of these interventions. The purpose of this study was to examine multiple intervention adaptations made during pre-implementation, implementation, maintenance, and evolution phases of human immunodeficiency virus HIV prevention technology transfer. We examined two important categories of adaptations -- modifications to key characteristics, such as activities or delivery methods of interventions and reinvention of the interventions including addition and deletion of core elements. Methods Study participants were thirty-four community-based organization staff who were implementing evidence-based interventions in Los Angeles, California. Participants were interviewed twice and interviews were professionally transcribed. Transcriptions were coded by two coders with good inter-rater reliability (kappa coefficient = 0.73). Sixty-two open-ended codes for adaptation activities, which were linked to 229 transcript segments, were categorized as modifications of key characteristics or reinvention. Results Participants described activities considered modifications to key characteristics and reinvention of evidence-based interventions during pre-implementation, implementation, and maintenance phases. None of the participants reported accessing technical assistance or guidance when reinventing their interventions. Staff executed many of the recommended steps for sound adaptation of these interventions for new populations and settings. Conclusion Staff reported modifying and reinventing interventions when translating HIV prevention programs into practice. Targeted technical assistance for formative evaluation should be focused on the pre-implementation phase during which frequent modifications occur. Continuous or repeated measurements of fidelity are recommended. Increased technical assistance and guidance are needed to ensure that reinventions are

Current Evidence Regarding Diagnostic Imaging Methods for Pediatric Lumbar Spondylolysis: A Report From the Scoliosis Research Society Evidence-Based Medicine Committee.

PubMed

Ledonio, Charles G T; Burton, Douglas C; Crawford, Charles H; Bess, Robert Shay; Buchowski, Jacob M; Hu, Serena S; Lonner, Baron S H; Polly, David W; Smith, Justin S; Sanders, James O

2017-03-01

Spondylolysis is common among the pediatric population, yet no formal systematic literature review regarding diagnostic imaging has been performed. The Scoliosis Research Society (SRS) requested an assessment of the current state of peer reviewed evidence regarding pediatric spondylolysis. Literature was searched professionally and citations retrieved. Abstracts were reviewed and analyzed by the SRS Evidence-Based Medicine Committee. Level I studies were considered to provide Good Evidence for the clinical question. Level II or III studies were considered Fair Evidence. Level IV studies were considered Poor Evidence. From 947 abstracts, 383 full texts reviewed. Best available evidence for the questions of diagnostic methods was provided by 27 studies: no Level I sensitivity/specificity studies, five Level II and two Level III evidence, and 19 Level IV evidence. Pain with hyperextension in athletes is the most widely reported finding in history and physical examination. Plain radiography is considered a first-line diagnostic test for suspected spondylolysis, but validation evidence is lacking. There is consistent Level II and III evidence that pars defects are detected by advanced imaging in 32% to 44% of adolescents with spondylolysis based on history and physical. Level III evidence that single-photon emission computed tomography (SPECT) is superior to planar bone scan and plain radiographs but limited by high rates of false-positive and false-negative results and by high radiation dose. Computed tomography (CT) is considered the gold standard and most accurate modality for detecting the bony defect and assessment of osseous healing but exposes the pediatric patient to ionizing radiation. Magnetic resonance imaging (MRI) is reported to be as accurate as CT and useful in detecting early stress reactions of the pars without a fracture. Plain radiographs are widely used as screening tools for pediatric spondylolysis. CT scan is considered the gold standard but

Evidence-based Medicine in Pediatric Orthopaedics: Evidence-based Practice Committee Summary of Levels of Evidence, Clinical Practice Guidelines, Appropriate Use Criteria, and Best Practice Guidelines.

PubMed

Gandhi, Jigar S; Shea, Kevin G; Sponseller, Paul D; Brighton, Brian K; Ganley, Theodore J

2018-04-30

The concept of evidence-based medicine has evolved over the past 2 decades, and has become a cornerstone to clinical decision-making in virtually every aspect of medicine. With a commitment to providing its members with high-quality evidence-based guidelines, the American Academy of Orthopaedic Surgeons has instituted concerted efforts since 2006 to develop clinical practice guidelines (CPGs) and appropriate use criteria (AUCs) for certain orthopaedic conditions. Many of these CPGs and AUCs detail the management of pediatric orthopaedic conditions. By the same token, members of the Pediatric Orthopaedic Society of North America (POSNA) Evidence Based Practice Committee have been publishing succinct evaluations of randomized controlled trials in pediatric orthopaedic surgery to create an evidence-based repository for quick reference to available high-level evidence as well as resource to identify gaps in the current research and identify opportunities for future investigation. In instances where higher-level evidence needed to develop CPGs is not available to address a critically important clinical question, consensus recommendations from experts in the field have been obtained to develop best practice guidelines (BPGs). The purpose of this review is to provide readers with a deeper understanding of the key principles of evidence-based medicine and methodologies used for the development of CPGs, AUCs, and BPGs.

Evidence - based medicine/practice in sports physical therapy.

PubMed

Manske, Robert C; Lehecka, B J

2012-10-01

A push for the use of evidence-based medicine and evidence-based practice patterns has permeated most health care disciplines. The use of evidence-based practice in sports physical therapy may improve health care quality, reduce medical errors, help balance known benefits and risks, challenge views based on beliefs rather than evidence, and help to integrate patient preferences into decision-making. In this era of health care utilization sports physical therapists are expected to integrate clinical experience with conscientious, explicit, and judicious use of research evidence in order to make clearly informed decisions in order to help maximize and optimize patient well-being. One of the more common reasons for not using evidence in clinical practice is the perceived lack of skills and knowledge when searching for or appraising research. This clinical commentary was developed to educate the readership on what constitutes evidence-based practice, and strategies used to seek evidence in the daily clinical practice of sports physical therapy.

[Evidence-based medicine - the current self-reflection of an individualised approach to medicine as an action science].

PubMed

Behrens, Johann

2010-01-01

Evidence-based Medicine (EbM) is the ongoing self-reflection of an individualised approach to medicine in terms of a science that originates from and focuses on clinical decision-making (pragmatic science="Handlungswissenschaft"). EbM is particularly suitable for self-reflecting individualised medicine on the basis of decision-oriented pragmatic science because it consistently distinguishes between external evidence (i.e., other subjects' experience gained through "qualitative" and "quantitative" scientific methods) and internal evidence, i.e., the individual user's, or patient's, own experience manifesting and developing in the individual contact between therapist and patient. Therefore, internal evidence is completely different from the individual clinical experience, expertise, and conviction which therapists contribute to the encounter with clients. A deeper understanding of internal evidence as a result of this encounter has emerged only in the past 15 years. However, it is an integral part of the logic of evidence-based professional decision-making. Scientifically justified beneficial and effective treatment in the individual case cannot be deduced from external evidence but can only be gathered from internal evidence for which the best external evidence available has been utilised. In the past 15 years nursing science has not only carved out the decision-oriented scientific core of evidence-based practice but has also tried to increase the validity of studies on external evidence by employing a combination of 'qualitative' social science studies and clinical epidemiological methods. Copyright © 2010. Published by Elsevier GmbH.

Protocols for pressure ulcer prevention: are they evidence-based?

PubMed

Chaves, Lidice M; Grypdonck, Mieke H F; Defloor, Tom

2010-03-01

This study is a report of a study to determine the quality of protocols for pressure ulcer prevention in home care in the Netherlands. If pressure ulcer prevention protocols are evidence-based and practitioners use them correctly in practice, this will result a reduction in pressure ulcers. Very little is known about the evidence-based content and quality of the pressure ulcer prevention protocols. In 2008, current pressure ulcer prevention protocols from 24 home-care agencies in the Netherlands were evaluated. A checklist developed and validated by two pressure ulcer prevention experts was used to assess the quality of the protocols, and weighted and unweighted quality scores were computed and analysed using descriptive statistics. The 24 pressure ulcer prevention protocols had a mean weighted quality score of 63.38 points out of a maximum of 100 (sd 5). The importance of observing the skin at the pressure points at least once a day was emphasized in 75% of the protocols. Only 42% correctly warned against the use of materials that were 'less effective or that could potentially cause harm'. Pressure ulcer prevention commands a reasonable amount of attention in home care, but the incidence of pressure ulcers and lack of a consistent, standardized document for use in actual practice indicate a need for systematic implementation of national pressure ulcer prevention standards in the Netherlands to ensure adherence to the established protocols.

Assessing and Treating Pain in Hospices: Current State of Evidence-Based Practices

PubMed Central

Herr, Keela; Titler, Marita; Fine, Perry; Sanders, Sara; Cavanaugh, Joe; Swegle, John; Forcucci, Chris; Tang, Xiongwen

2010-01-01

The aim of this article is to report on current provider evidence-based assessment and treatment practices for older adults with cancer in community-based hospice settings. Using the Cancer Pain Practices Index (CPPI), a tool developed by the researchers to measure evidence-based pain management practices, patients received an average of 32% of the those key evidence-based practices (EBPs) that were applicable to their situation. When examining individual practices, the majority of patients had their pain assessed at admission using a valid pain scale (69.7%) and had primary components of a comprehensive assessment completed at admission (52.7%); most patients with admission reports of pain had an order for pain medication (83.5%). However, data revealed a number of practice gaps including: additional components of a comprehensive assessment completed within 48 hours of admission (0%); review of the Pain Treatment Plan at each reassessment (35.7%); reassessment of moderate or greater pain (5.3%); consecutive pain reports of 5 or greater followed by pain medication increases (15.8%); monitoring of analgesic- induced side effects (19.3%); initiation of a bowel regimen for patients with an opioid order (32.3%); and documentation of both non-pharmacological therapies (22.5%) and written pain management plans (0.6%). Findings highlight positive EBPs and areas for improving the translation of EBPs into practice. Data suggest that cancer pain is not being documented as consistently assessed, reassessed or treated in a manner consistent with current EBP recommendations for older adults with cancer in community-based hospices. PMID:20471542

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings.

PubMed

Bergström, Anna; Skeen, Sarah; Duc, Duong M; Blandon, Elmer Zelaya; Estabrooks, Carole; Gustavsson, Petter; Hoa, Dinh Thi Phuong; Källestål, Carina; Målqvist, Mats; Nga, Nguyen Thu; Persson, Lars-Åke; Pervin, Jesmin; Peterson, Stefan; Rahman, Anisur; Selling, Katarina; Squires, Janet E; Tomlinson, Mark; Waiswa, Peter; Wallin, Lars

2015-08-15

The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow

Evidence-Based Clearinghouses in Social Work

ERIC Educational Resources Information Center

Soydan, Haluk; Mullen, Edward J.; Alexandra, Laine; Rehnman, Jenny; Li, You-Ping

2010-01-01

Objectives: The purpose of this article is to describe several evidence-based clearinghouses focused on social work and related intervention outcomes, placing them in the context of how such clearinghouses can contribute to research dissemination to foster effective, evidence-based practice. Method: The study employed an analysis of data provided…

Hierarchy of evidence: a simple system for orthopaedic research?

PubMed

Pemberton, Julia; Kraeva, Juliana; Bhandari, Mohit

2007-01-01

To be able to make a sound recommendation for a treatment based on the best available evidence, it is necessary to follow specific steps in acquiring literature, appraising the study design and quality, and assessing the results. Evidence-based medicine is founded on the concepts of using best evidence, levels of evidence, and grades of recommendation, and aims to provide clinicians with standardized rules to help them appraise the validity of published research. A number of systems have been developed to categorize research studies into consistent levels of evidence. These systems are based primarily on consensus expert opinion, and have not been validated to any extent. The use of different systems does not allow for effective communication between users; there is a lack of accord even between users of the same system. The GRADE working group has devised a new rating system that attempts to address deficiencies seen within other systems.

[Evidence-based management of medical disposable materials].

PubMed

Yang, Hai

2009-03-01

Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient.

Query-oriented evidence extraction to support evidence-based medicine practice.

PubMed

Sarker, Abeed; Mollá, Diego; Paris, Cecile

2016-02-01

Evidence-based medicine practice requires medical practitioners to rely on the best available evidence, in addition to their expertise, when making clinical decisions. The medical domain boasts a large amount of published medical research data, indexed in various medical databases such as MEDLINE. As the size of this data grows, practitioners increasingly face the problem of information overload, and past research has established the time-associated obstacles faced by evidence-based medicine practitioners. In this paper, we focus on the problem of automatic text summarisation to help practitioners quickly find query-focused information from relevant documents. We utilise an annotated corpus that is specialised for the task of evidence-based summarisation of text. In contrast to past summarisation approaches, which mostly rely on surface level features to identify salient pieces of texts that form the summaries, our approach focuses on the use of corpus-based statistics, and domain-specific lexical knowledge for the identification of summary contents. We also apply a target-sentence-specific summarisation technique that reduces the problem of underfitting that persists in generic summarisation models. In automatic evaluations run over a large number of annotated summaries, our extractive summarisation technique statistically outperforms various baseline and benchmark summarisation models with a percentile rank of 96.8%. A manual evaluation shows that our extractive summarisation approach is capable of selecting content with high recall and precision, and may thus be used to generate bottom-line answers to practitioners' queries. Our research shows that the incorporation of specialised data and domain-specific knowledge can significantly improve text summarisation performance in the medical domain. Due to the vast amounts of medical text available, and the high growth of this form of data, we suspect that such summarisation techniques will address the time

The Consistencies and Vagaries of the Washington State Inventory of Evidence-Based Practice: The Definition of "Evidence-Based" in a Policy Context.

PubMed

Walker, Sarah Cusworth; Lyon, Aaron R; Aos, Steve; Trupin, Eric W

2017-01-01

As states increasingly establish the importance of evidence-based practice through policy and funding mandates, the definition of evidence-based practice can have a significant impact on investment decisions. Not meeting established criteria can mean a loss of funding for established programs and the implementation disruption of programs without a strong research base. Whether the definition of "evidence-based" is influenced by these high stakes contexts is an interesting question that can inform the larger field about the value and utility of evidence-based practice lists/inventories for disseminating knowledge. In this paper we review the development of the Washington State Inventory of Evidence-Based, Research-Based and Promising Practices as a case study for the process of defining evidence-based practice in a policy context. As part of this study we also present a comparison of other well-known evidence-based practice inventories and examine consistencies and differences in the process of identifying and developing program ratings.

Single-Case Design Research: Building the Evidence-Base in the Field of Education of Deaf and Hard of Hearing Students.

PubMed

Cannon, Joanna E; Guardino, Caroline; Antia, Shirin D; Luckner, John L

2016-01-01

The field of education of deaf and hard of hearing (DHH) students has a paucity of evidence-based practices (EBPs) to guide instruction. The authors discussed how the research methodology of single-case design (SCD) can be used to build EBPs through direct and systematic replication of studies. An overview of SCD research methods is presented, including an explanation of how internal and external validity issues are addressed, and why SCD is appropriate for intervention research with DHH children. The authors then examine the SCD research in the field according to quality indicators (QIs; at the individual level and as a body of evidence) to determine the existing evidence base. Finally, future replication areas are recommended to fill the gaps in SCD research with students who are DHH in order to add to the evidence base in the field.

Evidence synthesis and its role in evidence-based health care.

PubMed

Pearson, Alan

2014-12-01

The central role of evidence synthesis (or the systematic review of evidence) in evidence-based health care is often poorly understood. There are numerous examples in the literature of poorly conceived and/or executed systematic reviews and of a lack of awareness of the international standards developed by the international leaders in systematic reviews. The Cochrane Collaboration has played a critical global role in developing and refining systematic review methods in relation to evidence of effects and of diagnostic accuracy. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessing impact of physical activity-based youth development programs: validation of the Life Skills Transfer Survey (LSTS).

PubMed

Weiss, Maureen R; Bolter, Nicole D; Kipp, Lindsay E

2014-09-01

A signature characteristic of positive youth development (PYD) programs is the opportunity to develop life skills, such as social, behavioral, and moral competencies, that can be generalized to domains beyond the immediate activity. Although context-specific instruments are available to assess developmental outcomes, a measure of life skills transfer would enable evaluation of PYD programs in successfully teaching skills that youth report using in other domains. The purpose of our studies was to develop and validate a measure of perceived life skills transfer, based on data collected with The First Tee, a physical activity-based PYD program. In 3 studies, we conducted a series of steps to provide content and construct validity and internal consistency reliability for the Life Skills Transfer Survey (LSTS), a measure of perceived life skills transfer. Study 1 provided content validity for the LSTS that included 8 life skills and 50 items. Study 2 revealed construct validity (structural validity) through a confirmatory factor analysis and convergent validity by correlating scores on the LSTS with scores on an assessment tool that measures a related construct. Study 3 offered additional construct validity by reassessing youth 1 year later and showing that scores during both time periods were invariant in factor pattern, loadings, and variances and covariances. Studies 2 and 3 demonstrated internal consistency reliability of the LSTS. RESULTS from 3 studies provide evidence of content and construct validity and internal consistency reliability for the LSTS, which can be used in evaluation research with youth development programs.

Evidence-Based Practice: Separating Science From Pseudoscience

PubMed Central

Lee, Catherine M; Hunsley, John

2015-01-01

Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. PMID:26720821

Evidence-Based Practice: Separating Science From Pseudoscience.

PubMed

Lee, Catherine M; Hunsley, John

2015-12-01

Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills.

The Process of Adoption of Evidence-based Tobacco Use Prevention Programs in California Schools

PubMed Central

Little, Melissa A.; Pokhrel, Pallav; Sussman, Steve; Rohrbach, Louise Ann

2014-01-01

Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community- and organizational variables on the adoption of prevention programs via school administrators’ beliefs and the organization’s receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts’ use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools. PMID:24398826

Developing an evidence-based Guide to Community Preventive Services--methods. The Task Force on Community Preventive Services.

PubMed

Briss, P A; Zaza, S; Pappaioanou, M; Fielding, J; Wright-De Agüero, L; Truman, B I; Hopkins, D P; Mullen, P D; Thompson, R S; Woolf, S H; Carande-Kulis, V G; Anderson, L; Hinman, A R; McQueen, D V; Teutsch, S M; Harris, J R

2000-01-01

evidence-based approach to identify and recommend effective interventions directed at specific public health goals may reduce errors in how information is collected and interpreted, identify important gaps in current knowledge thus guiding further research, and enhance the Guide users' ability to assess whether recommendations are valid and prudent from their own perspectives. Over time, all of these advantages could help to increase agreement regarding appropriate community health strategies and help to increase their implementation.

"La Clave Profesional": Validation of a Vocational Guidance Instrument

ERIC Educational Resources Information Center

Mudarra, Maria J.; Lázaro Martínez, Ángel

2014-01-01

Introduction: The current study demonstrates empirical and cultural validity of "La Clave Profesional" (Spanish adaptation of Career Key, Jones's test based Holland's RIASEC model). The process of providing validity evidence also includes a reflection on personal and career development and examines the relationahsips between RIASEC…

Evidence Based Medicine – New Approaches and Challenges

PubMed Central

Masic, Izet; Miokovic, Milan; Muhamedagic, Belma

2008-01-01

CONFLICT OF INTEREST: NONE DECLARED Evidence based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information. It is a movement which aims to increase the use of high quality clinical research in clinical decision making. EBM requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning in which caring for one’s own patients creates the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues. It is not “cookbook” with recipes, but its good application brings cost-effective and better health care. The key difference between evidence-based medicine and traditional medicine is not that EBM considers the evidence while the latter does not. Both take evidence into account; however, EBM demands better evidence than has traditionally been used. One of the greatest achievements of evidence-based medicine has been the development of systematic reviews and meta-analyses, methods by which researchers identify multiple studies on a topic, separate the best ones and then critically analyze them to come up with a summary of the best available evidence. The EBM-oriented clinicians of tomorrow have three tasks: a) to use evidence summaries in clinical practice; b) to help develop and update selected systematic reviews or evidence-based guidelines in their area of expertise; and c) to enrol patients in studies of treatment, diagnosis and prognosis on which medical practice is based. PMID:24109156

Specialized Community-Based Care: An Evidence-Based Analysis

PubMed Central

2012-01-01

Background Specialized community-based care (SCBC) refers to services that manage chronic illness through formalized links between primary and specialized care. Objectives The objectives of this evidence-based analysis (EBA) were as follows: to summarize the literature on SCBC, also known as intermediate care to synthesize the evidence from previous Medical Advisory Secretariat (now Health Quality Ontario) EBAs on SCBC for heart failure, diabetes, chronic obstructive pulmonary disease (COPD), and chronic wounds to examine the role of SCBC in family practice Results Part 1: Systematic Review of Intermediate Care Seven systematic reviews on intermediate care since 2008 were identified. The literature base is complex and difficult to define. There is evidence to suggest that intermediate care is effective in improving outcomes; however, the effective interventions are still uncertain. Part 2: Synthesis of Evidence in Intermediate Care Mortality • Heart failure Significant reduction in patients receiving SCBC • COPD Nonsignificant reduction in patients receiving SCBC Hospitalization • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Emergency Department Visits • Heart failure Nonsignificant reduction in patients receiving SCBC • COPD Significant reduction in patients receiving SCBC Disease-Specific Patient Outcomes • COPD Nonsignificant improvement in lung function in patients receiving SCBC • Diabetes Significant reduction in hemoglobin A1c (HbA1c) and systolic blood pressure in patients receiving SCBC • Chronic wounds Significant increase in the proportion of healed wounds in patients receiving SCBC Quality of Life • Heart failure Trend toward improvement in patients receiving SCBC • COPD Significant improvement in patients receiving SCBC Part 3: Intermediate Care in Family Practice—Evidence-Based Analysis Five randomized controlled trials were identified comparing SCBC

Training of Lay Health Educators to Implement an Evidence-Based Behavioral Weight Loss Intervention in Rural Senior Centers

ERIC Educational Resources Information Center

Krukowski, Rebecca A.; Lensing, Shelly; Love, ShaRhonda; Prewitt, T. Elaine; Adams, Becky; Cornell, Carol E.; Felix, Holly C.; West, Delia

2013-01-01

Purpose of the Study: Lay health educators (LHEs) offer great promise for facilitating the translation of evidence-based health promotion programs to underserved areas; yet, there is little guidance on how to train LHEs to implement these programs, particularly in the crucial area of empirically validated obesity interventions. Design and Methods:…

Hardiness scales in Iranian managers: evidence of incremental validity in relationships with the five factor model and with organizational and psychological adjustment.

PubMed

Ghorbani, Nima; Watson, P J

2005-06-01

This study examined the incremental validity of Hardiness scales in a sample of Iranian managers. Along with measures of the Five Factor Model and of Organizational and Psychological Adjustment, Hardiness scales were administered to 159 male managers (M age = 39.9, SD = 7.5) who had worked in their organizations for 7.9 yr. (SD=5.4). Hardiness predicted greater Job Satisfaction, higher Organization-based Self-esteem, and perceptions of the work environment as being less stressful and constraining. Hardiness also correlated positively with Assertiveness, Emotional Stability, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness and negatively with Depression, Anxiety, Perceived Stress, Chance External Control, and a Powerful Others External Control. Evidence of incremental validity was obtained when the Hardiness scales supplemented the Five Factor Model in predicting organizational and psychological adjustment. These data documented the incremental validity of the Hardiness scales in a non-Western sample and thus confirmed once again that Hardiness has a relevance that extends beyond the culture in which it was developed.

Evidence-based Assessment of Adherence to Medical Treatments in Pediatric Psychology

PubMed Central

Modi, Avani C.; Lemanek, Kathleen L.; Ievers-Landis, Carolyn E.; Rapoff, Michael A.

2008-01-01

Objectives Adherence to medical regimens for children and adolescents with chronic conditions is generally below 50% and is considered the single, greatest cause of treatment failure. As the prevalence of chronic illnesses in pediatric populations increases and awareness of the negative consequences of poor adherence become clearer, the need for reliable and valid measures of adherence has grown. Methods This review evaluated empirical evidence for 18 measures utilizing three assessment methods: (a) self-report or structured interviews, (b) daily diary methods, and (c) electronic monitors. Results Ten measures met the “well-established” evidence-based (EBA) criteria. Conclusions Several recommendations for improving adherence assessment were made. In particular, consideration should be given to the use of innovative technologies that provide a window into the “real time” behaviors of patients and families. Providing written treatment plans, identifying barriers to good adherence, and examining racial and ethnic differences in attitudes, beliefs and behaviors affecting adherence were strongly recommended. PMID:17846042

Evidence-Based Medicine in the Education of Psychiatrists

ERIC Educational Resources Information Center

Srihari, Vinod

2008-01-01

Objective: Evidence-based medicine has an important place in the teaching and practice of psychiatry. Attempts to teach evidence-based medicine skills can be weakened by conceptual confusions feeding a false polarization between traditional clinical skills and evidence-based medicine. Methods: The author develops a broader conception of clinical…

Evaluating the Content Validity of Multistage-Adaptive Tests

ERIC Educational Resources Information Center

Crotts, Katrina; Sireci, Stephen G.; Zenisky, April

2012-01-01

Validity evidence based on test content is important for educational tests to demonstrate the degree to which they fulfill their purposes. Most content validity studies involve subject matter experts (SMEs) who rate items that comprise a test form. In computerized-adaptive testing, examinees take different sets of items and test "forms"…

In Defense of an Instrument-Based Approach to Validity

ERIC Educational Resources Information Center

Hood, S. Brian

2012-01-01

Paul E. Newton argues in favor of a conception of validity, viz, "the consensus definition of validity," according to which the extension of the predicate "is valid" is a subset of "assessment-based decision-making procedure[s], which [are] underwritten by an argument that the assessment procedure can be used to measure the attribute entailed by…

Introduction: evidence-based action in humanitarian crises.

PubMed

Dijkzeul, Dennis; Hilhorst, Dorothea; Walker, Peter

2013-07-01

This introductory paper sets the stage for this special issue of Disasters on evidence-based action in humanitarian crises. It reviews definition(s) of evidence and it examines the different disciplinary and methodological approaches to collecting and analysing evidence. In humanitarian action, the need for evidence-based approaches sometimes is viewed in tension with a principled approach, often unnecessarily. Choosing appropriate research methods depends on the objectives of the researcher, in particular whether the research focuses on the intervention and/or the context and the length and complexity of the causal chains involved. The paper concludes by defining some trends in evidence-based approaches in crises: the move away from inputs and outputs of humanitarian action towards outcomes and impacts; the shift towards a higher degree of partnerships in research, and the participation of users and target groups; and the acceptance of a broad array of approaches to establish evidence. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Evidence-Based Nonpharmacological Practices to Address Behavioral and Psychological Symptoms of Dementia.

PubMed

Scales, Kezia; Zimmerman, Sheryl; Miller, Stephanie J

2018-01-18

To draw from systematic and other literature reviews to identify, describe, and critique nonpharmacological practices to address behavioral and psychological symptoms of dementia (BPSDs) and provide evidence-based recommendations for dementia care especially useful for potential adopters. A search of systematic and other literature reviews published from January 2010 through January 2017. Nonpharmacological practices were summarized to describe the overall conceptual basis related to effectiveness, the practice itself, and the size and main conclusions of the evidence base. Each practice was also critically reviewed to determine acceptability, harmful effects, elements of effectiveness, and level of investment required, based on time needed for training/implementation, specialized care provider requirements, and equipment/capital requirements. Nonpharmacological practices to address BPSDs include sensory practices (aromatherapy, massage, multi-sensory stimulation, bright light therapy), psychosocial practices (validation therapy, reminiscence therapy, music therapy, pet therapy, meaningful activities), and structured care protocols (bathing, mouth care). Most practices are acceptable, have no harmful effects, and require minimal to moderate investment. Nonpharmacological practices are person-centered, and their selection can be informed by considering the cause and meaning of the individual's behavioral and psychological symptoms. Family caregivers and paid care providers can implement evidence-based practices in home or residential care settings, although some practices require the development of more specific protocols if they are to become widely used in an efficacious manner. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Anomalous Sentences Repetition Test: Replication and Validation Study.

ERIC Educational Resources Information Center

Weeks, David J.

1986-01-01

Presents a brief clinical test, derived from earlier neuropsychological instruments, with evidence for its reliability, interscorer agreement, and validity. The latter is based upon correlations with both CAT scan measures of cortical atrophy and ventricular enlargement, as well as correlations with seven other previously validated cognitive…

Social marketing: should it be used to promote evidence-based health information?

PubMed

Formoso, Giulio; Marata, Anna Maria; Magrini, Nicola

2007-02-01

The implementation of public health knowledge is a complex process; researchers focus on organizational barriers but generally give little attention to the format and validity of relevant information. Primary and secondary papers and practice guidelines should represent valid and relevant sources of knowledge for clinicians and others involved in public health. However, this information is usually targeted at researchers rather than practitioners; it is often not completely intelligible, does not explain what it really adds to existing knowledge or which clinical/organizational context to place it in, and often lacks 'appeal' for those who are less informed. Moreover, this information is sometimes founded on biased research, shaped by sponsors to give scientific plausibility to market-driven messages. A "social marketing" approach can help public health researchers make evidence-based information clear and appealing. The validity and relevance of this information can be explained to target readers in light of their own knowledge levels and in terms of how this information could help their practice. In this paper we analyse the barriers to knowledge transfer that are often inherent in the format of the information, and propose a more user-friendly, enriched and non-research-article format.

OWL-based reasoning methods for validating archetypes.

PubMed

Menárguez-Tortosa, Marcos; Fernández-Breis, Jesualdo Tomás

2013-04-01

Some modern Electronic Healthcare Record (EHR) architectures and standards are based on the dual model-based architecture, which defines two conceptual levels: reference model and archetype model. Such architectures represent EHR domain knowledge by means of archetypes, which are considered by many researchers to play a fundamental role for the achievement of semantic interoperability in healthcare. Consequently, formal methods for validating archetypes are necessary. In recent years, there has been an increasing interest in exploring how semantic web technologies in general, and ontologies in particular, can facilitate the representation and management of archetypes, including binding to terminologies, but no solution based on such technologies has been provided to date to validate archetypes. Our approach represents archetypes by means of OWL ontologies. This permits to combine the two levels of the dual model-based architecture in one modeling framework which can also integrate terminologies available in OWL format. The validation method consists of reasoning on those ontologies to find modeling errors in archetypes: incorrect restrictions over the reference model, non-conformant archetype specializations and inconsistent terminological bindings. The archetypes available in the repositories supported by the openEHR Foundation and the NHS Connecting for Health Program, which are the two largest publicly available ones, have been analyzed with our validation method. For such purpose, we have implemented a software tool called Archeck. Our results show that around 1/5 of archetype specializations contain modeling errors, the most common mistakes being related to coded terms and terminological bindings. The analysis of each repository reveals that different patterns of errors are found in both repositories. This result reinforces the need for making serious efforts in improving archetype design processes. Copyright © 2012 Elsevier Inc. All rights reserved.

[The forgotten capitulation of evidence-based medicine].

PubMed

Schoemaker, Casper G; Smulders, Yvo M

2015-01-01

In 1992, the Canadian physician Gordon Guyatt wrote an article that is generally regarded as the starting point of evidence-based medicine (EBM). He described the ideas behind the McMaster residency programme for 'evidence-based practitioners', founded by David Sackett. Eight years later, in 2000, Guyatt concluded that this programme was too ambitious. In a new publication he described most doctors as 'evidence-users'. This editorial marks the transition from an individual to a collective form of EBM, emphasizing the use of evidence-based guidelines. The starting point of this collective form of EBM is not the well-known 1992 paper, but the forgotten editorial in 2000, which was described by Guyatt's colleagues as the capitulation of EBM.

Evidence-based dentistry: fundamentals for the dentist.

PubMed

Bauer, Janet; Chiappelli, Francesco; Spackman, Sue; Prolo, Paolo; Stevenson, Richard

2006-06-01

This article explains the fundamentals of evidence-based dentistry for the dentist. Evidence-based dentistry is a discipline whose primary participant is the translational researcher. Recent developments have emphasized the importance of this discipline (clinical and translational research) for improving health care. The process of evidence-based dentistry is the reciprocation of new and existing evidence between dentists and quantitative and qualitative researchers, facilitated by the translational researcher. The product of this reciprocation is the clinical practice guideline, or best evidence, that provides the patient options in choosing treatments or services. These options are quantified and qualified by decision, utility, and cost data. Using shared decision-making, the dentist and patient arrive at a mutual understanding of which option best meets an acceptable and preferred treatment course that is cost effective. This option becomes the clinical decision.

An Adaptation of the Original Fresno Test to Measure Evidence-Based Practice Competence in Pediatric Bedside Nurses.

PubMed

Laibhen-Parkes, Natasha; Kimble, Laura P; Melnyk, Bernadette Mazurek; Sudia, Tanya; Codone, Susan

2018-06-01

Instruments used to assess evidence-based practice (EBP) competence in nurses have been subjective, unreliable, or invalid. The Fresno test was identified as the only instrument to measure all the steps of EBP with supportive reliability and validity data. However, the items and psychometric properties of the original Fresno test are only relevant to measure EBP with medical residents. Therefore, the purpose of this paper is to describe the development of the adapted Fresno test for pediatric nurses, and provide preliminary validity and reliability data for its use with Bachelor of Science in Nursing-prepared pediatric bedside nurses. General adaptations were made to the original instrument's case studies, item content, wording, and format to meet the needs of a pediatric nursing sample. The scoring rubric was also modified to complement changes made to the instrument. Content and face validity, and intrarater reliability of the adapted Fresno test were assessed during a mixed-methods pilot study conducted from October to December 2013 with 29 Bachelor of Science in Nursing-prepared pediatric nurses. Validity data provided evidence for good content and face validity. Intrarater reliability estimates were high. The adapted Fresno test presented here appears to be a valid and reliable assessment of EBP competence in Bachelor of Science in Nursing-prepared pediatric nurses. However, further testing of this instrument is warranted using a larger sample of pediatric nurses in diverse settings. This instrument can be a starting point for evaluating the impact of EBP competence on patient outcomes. © 2018 Sigma Theta Tau International.

[Is "evidence-based medicine" followed by "confidence-based medicine"?].

PubMed

Porzsolt, Franz; Fangerau, Heiner

2010-08-01

In an appeal concerning accusations of defamation, the England and Wales Court of Appeal Decisions determined that evidence-based statements are to be judged as opinions and not statements of fact. Since the authors consider it probable that this legal judgment will exert influence on physicians' decisions about the provision of health care services, they have compiled the implications of the judgment and discuss its consequences. The own analyses and considerations lead to the conclusion that confidence-based medicine follows evidence-based medicine. This extension is necessary because evidence-based medicine has not been able to generate the required trust. Therefore, it will be demanded to underpin the existing concept with additional data. These data will be necessary because it is no longer sufficient to convince scientists with data which are obtained under ideal conditions, but to convince critical members of society with additional data which have been obtained under everyday conditions.

Development and testing of a DVT risk assessment tool: providing evidence of validity and reliability.

PubMed

McCaffrey, Ruth; Bishop, Mary; Adonis-Rizzo, Marie; Williamson, Ellen; McPherson, Melanie; Cruikshank, Alice; Carrier, Vicki Jo; Sands, Simone; Pigano, Diane; Girard, Patricia; Lauzon, Cathy

2007-01-01

Hospital-acquired deep vein thrombosis (DVT) and pulmonary embolisms (PE) are preventable problems that can increase mortality. Early assessment and recognition of risk as well as initiating appropriate prevention measures can prevent DVT or PE. The purpose of this research project was to develop a DVT risk assessment tool and test the tool for validity and reliability. Three phases were undertaken in developing and testing the JFK Medical Center DVT risk assessment tool. Investigation and clarification of risk and predisposing factors for DVT were identified from the literature, expert nursing knowledge, and medical staff input. Second, item development and weighting were undertaken. Third, parametric testing for content validity measured the differences in mean assessment tool scores between a group of patients who developed DVT in the hospital and a demographically similar group who did not develop DVT. Interrater reliability was measured by having three different nurses score each patient and compare the differences in scores among the three. The DVT group had significantly higher scores on the JFK DVT assessment scale than did those who did not experience DVT. Interrater reliability showed a strong correlation among the scores of the three nurses (.98). Providing a valid and reliable tool for measuring the risk for DVT or PE in hospitalized patients will enable nurses to intervene early in patients at risk. Basing DVT risk assessment on the evidence provided in this study will assist nurses in becoming more confident in recognizing the necessity for interventions in hospitalized patients and decreasing risk. Nurses can now evaluate patients at risk for DVT or PE using the JFK Medial Center's risk assessment tool.

An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration.

PubMed

Ulbricht, Catherine; Basch, Ethan; Cheung, Lisa; Goldberg, Harley; Hammerness, Paul; Isaac, Richard; Khalsa, Karta Purkh Singh; Romm, Aviva; Rychlik, Idalia; Varghese, Minney; Weissner, Wendy; Windsor, Regina C; Wortley, Jayme

2014-03-01

An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

Development and Validation of a Novel Evidence-Based Lupus Multivariable Outcome Score for Clinical Trials.

PubMed

Abrahamowicz, Michal; Esdaile, John M; Ramsey-Goldman, Rosalind; Simon, Lee S; Strand, Vibeke; Lipsky, Peter E

2018-04-12

Trials of new SLE treatments are hampered by the lack of effective outcome measures. To address this, we developed a new Lupus Multivariable Lupus Outcome Score (LuMOS). The LuMOS formula was developed by analyzing raw data of two pivotal trials: BLISS-52 and BLISS-76, the basis for approval of belimumab (Bel). Using data from BLISS-76 as the learning dataset, we optimized discrimination between outcomes for patients treated with 10mg/kg Bel versus placebo over the first 52 weeks of follow-up using multivariable logistic regression analyses. Performance of LuMOS was assessed using an independent validation dataset from the BLISS-52 trial. The LuMOS model incorporated reduction in SELENA-SLEDAI ≥4 points, increase in C4, decrease in anti-dsDNA titer, and changes in BILAG organ system manifestations: no worsening in renal and improvements in mucocutaneous components. Decreases in prednisone doses and increases in C3 had very minor impacts on total LuMOS. In all analyses of BLISS-76 and BLISS-52 RCTs, mean LuMOS were significantly higher (p < 0.0001) for Bel 10mg and Bel 1mg treatment groups than placebo. LuMOS also found significant differences between active treatment and placebo when SRI did not, as for Bel 1mg in BLISS-76. The Effect Sizes were significantly much higher with LuMOS compared with SLE Response Index(SRI-4). The evidenced-based LuMOS developed with data from BLISS-76 and validated with data from BLISS-52 exhibits superior capacity to discriminate responders from nonresponders compared to the SRI-4. Use of LuMOS may improve the efficiency and power of analyses in future lupus trials. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Science and Pseudoscience in Medicine: Evidence-Based vs. Evidence-Biased Medicine.

PubMed

Jakovljević, Miro; Ostojić, Ljerka

2016-12-01

The concept of evidence-based medicine (EBM), as the highest standard of health care, came into existence in 1990s to promote a systematic approach to helping clinicians in their practice to be guided by the best available scientific evidence. However, there has been an increasing number of warning reports that in modern research, misrepresented, false and unuseful findings may be the majority or even the vast majority of published research claims In spite of the huge scientific progress, pseudoscience and associated evidence biased medicine represent a serious threat to the concept of the EBM. Effective education in medicine, proper research motivation, sound systems and creative thinking and culture of scientific dialogue may significantly contribute to better science and evidence-based medicine. The seven key words of good science, research and publishing are: integrity, motivation, capacity, understanding, knowledge, experience, and creativity.

E-Learning and Evidence Based Practice in Schools

ERIC Educational Resources Information Center

Quong, Terrence

2016-01-01

JCTIC has used open source software to develop a unique school online environment that has made evidence based practice viable in their school. In this paper the proposition is made that eLearning enables evidence based practice which in turn leads to improved student outcomes. Much has been written about evidence based practice in schools, but…

Reconciling evidence-based medicine and patient-centred care: defining evidence-based inputs to patient-centred decisions.

PubMed

Weaver, Robert R

2015-12-01

Evidence-based and patient-centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards 'cookbook' medicine undermine the view of patients as unique particulars, and diminish what might be considered patient-centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence-based and person-centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients' uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner-patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence-based and patient-centred approaches. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Risks, Outcomes, and Evidence-based Interventions for Girls in the U.S. Juvenile Justice System

PubMed Central

Leve, Leslie D.; Chamberlain, Patricia; Kim, Hyoun K.

2015-01-01

The proportion of the juvenile justice population that is comprised of females is increasing, yet few evidence-based models have been evaluated and implemented with girls in the juvenile justice system. Although much is known about the risk and protective factors for girls who participate in serious delinquency, significant gaps in the research base hamper the development and implementation of theoretically based intervention approaches. In this review, we first summarize the extant empirical work about the predictors and sequelae of juvenile justice involvement for girls. Identified risk and protective factors that correspond to girls’ involvement in the juvenile justice system have been shown to largely parallel those of boys, although exposure rates and magnitudes of association sometimes differ by sex. Second, we summarize findings from empirically validated, evidence-based interventions for juvenile justice–involved youths that have been tested with girls. The interventions include Functional Family Therapy, Multisystemic Therapy, Multidimensional Family Therapy, and Treatment Foster Care Oregon (formerly known as Multidimensional Treatment Foster Care). We conclude that existing evidence-based practices appear to be effective for girls. However, few studies have been sufficiently designed to permit conclusions about whether sex-specific interventions would yield any better outcomes for girls than would interventions that already exist for both sexes and that have a strong base of evidence to support them. Third, we propose recommendations for feasible, cost-efficient next steps to advance the research and intervention agendas for this under-researched, under-served population of highly vulnerable youths. PMID:26119215

[Approaches, knowledge and capabilities of nurses and physicians regarding evidence-based clinical practice in the Imbadura province (Ecuador)].

PubMed

Molina Mula, Jesús; Muñoz Navarro, Paulina; Vaca Auz, Janeth; Cabascango Cabascango, Carmita; Cabascango Cabascango, Katty

2015-01-01

The research raises the need to increase understanding of organizational and personal factors that influence the attitude and aptitude of each professional, with respect to evidence-based clinical practice. The aim of this study is to describe the transfer of knowledge into clinical practice in hospital units in Imbabura (Ecuador) identifying the obstacles to implementing evidence-based clinical practice validated questionnaire EBPQ-19. A cross-sectional observational study was conducted in hospitals of the Ministry of Public Health of Imbabura of Ecuador took place, including a total of 281 nurses and physicians. Nurses and physicians showed positive attitudes toward evidence-based clinical practice (EBCP) and their use to support clinical decision-making. This research evidences perceptions of professionals on strategies for knowledge transfer and obstacles to carry it out. Significant differences between the perception of the use of EBCP strategies between nurses and physicians are observed. Physicians consider they use them frequently, while nurses acknowledge using them less (chi-square: 105.254, P=.018). In conclusion, we can say that these factors should be considered as necessary to improve the quality of care that is provided to users based on the best available evidence. It is necessary to start developing change interventions in this regard to remedy the current situation of clinical practice based not on evidence, but rather on experience only. Experimental studies demonstrating the effectiveness of strategies to eliminate barriers to scientific evidence-based clinical practice should be conducted. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

The Utrecht questionnaire (U-CEP) measuring knowledge on clinical epidemiology proved to be valid.

PubMed

Kortekaas, Marlous F; Bartelink, Marie-Louise E L; de Groot, Esther; Korving, Helen; de Wit, Niek J; Grobbee, Diederick E; Hoes, Arno W

2017-02-01

Knowledge on clinical epidemiology is crucial to practice evidence-based medicine. We describe the development and validation of the Utrecht questionnaire on knowledge on Clinical epidemiology for Evidence-based Practice (U-CEP); an assessment tool to be used in the training of clinicians. The U-CEP was developed in two formats: two sets of 25 questions and a combined set of 50. The validation was performed among postgraduate general practice (GP) trainees, hospital trainees, GP supervisors, and experts. Internal consistency, internal reliability (item-total correlation), item discrimination index, item difficulty, content validity, construct validity, responsiveness, test-retest reliability, and feasibility were assessed. The questionnaire was externally validated. Internal consistency was good with a Cronbach alpha of 0.8. The median item-total correlation and mean item discrimination index were satisfactory. Both sets were perceived as relevant to clinical practice. Construct validity was good. Both sets were responsive but failed on test-retest reliability. One set took 24 minutes and the other 33 minutes to complete, on average. External GP trainees had comparable results. The U-CEP is a valid questionnaire to assess knowledge on clinical epidemiology, which is a prerequisite for practicing evidence-based medicine in daily clinical practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Original research in pathology: judgment, or evidence-based medicine?

PubMed

Crawford, James M

2007-02-01

Pathology is both a medical specialty and an investigative scientific discipline, concerned with understanding the essential nature of human disease. Ultimately, pathology is accountable as well, as measured by the accuracy of our diagnoses and the resultant patient care outcomes. As such, we must consider the evidence base underlying our practices. Within the realm of Laboratory Medicine, extensive attention has been given to testing accuracy and precision. Critical examination of the evidence base supporting the clinical use of specific laboratory tests or technologies is a separate endeavor, to which specific attention must be given. In the case of anatomic pathology and more specifically surgical pathology, the expertise required to render a diagnosis is derived foremost from experience, both personal and literature-based. In the first instance, knowledge of the linkage between one's own diagnoses and individual patient outcomes is required, to validate the role of one's own interpretations in the clinical course of patients. Experience comes from seeing this linkage first hand, from which hopefully comes wisdom and, ultimately, good clinical judgment. In the second instance, reading the literature and learning from experts is required. Only a minority of the relevant literature is published in pathology journals to which one may subscribe. A substantial portion of major papers relevant to the practice of anatomic pathology are published in collateral clinical specialty journals devoted to specific disease areas or organs. Active effort is therefore required to seek out the literature beyond the domain of pathology journals. In examining the published literature, the essential question then becomes: Does the practice of anatomic pathology fulfill the tenets of 'evidence-based medicine' (EBM)? If the pinnacle of EBM is 'systematic review of randomized clinical trials, with or without meta-analysis', then anatomic pathology falls far short. Our published

Assessing the Culture of Residency Using the C - Change Resident Survey: Validity Evidence in 34 U.S. Residency Programs.

PubMed

Pololi, Linda H; Evans, Arthur T; Civian, Janet T; Shea, Sandy; Brennan, Robert T

2017-07-01

A practical instrument is needed to reliably measure the clinical learning environment and professionalism for residents. To develop and present evidence of validity of an instrument to assess the culture of residency programs and the clinical learning environment. During 2014-2015, we surveyed residents using the C - Change Resident Survey to assess residents' perceptions of the culture in their programs. Residents in all years of training in 34 programs in internal medicine, pediatrics, and general surgery in 14 geographically diverse public and private academic health systems. The C - Change Resident Survey assessed residents' perceptions of 13 dimensions of the culture: Vitality, Self-Efficacy, Institutional Support, Relationships/Inclusion, Values Alignment, Ethical/Moral Distress, Respect, Mentoring, Work-Life Integration, Gender Equity, Racial/Ethnic Minority Equity, and self-assessed Competencies. We measured the internal reliability of each of the 13 dimensions and evaluated response process, content validity, and construct-related evidence validity by assessing relationships predicted by our conceptual model and prior research. We also assessed whether the measurements were sensitive to differences in specialty and across institutions. A total of 1708 residents completed the survey [internal medicine: n = 956, pediatrics: n = 411, general surgery: n = 311 (51% women; 16% underrepresented in medicine minority)], with a response rate of 70% (range across programs, 51-87%). Internal consistency of each dimension was high (Cronbach α: 0.73-0.90). The instrument was able to detect significant differences in the learning environment across programs and sites. Evidence of validity was supported by a good response process and the demonstration of several relationships predicted by our conceptual model. The C - Change Resident Survey assesses the clinical learning environment for residents, and we encourage further study of validity in different

Model-based verification and validation of the SMAP uplink processes

NASA Astrophysics Data System (ADS)

Khan, M. O.; Dubos, G. F.; Tirona, J.; Standley, S.

Model-Based Systems Engineering (MBSE) is being used increasingly within the spacecraft design community because of its benefits when compared to document-based approaches. As the complexity of projects expands dramatically with continually increasing computational power and technology infusion, the time and effort needed for verification and validation (V& V) increases geometrically. Using simulation to perform design validation with system-level models earlier in the life cycle stands to bridge the gap between design of the system (based on system-level requirements) and verifying those requirements/validating the system as a whole. This case study stands as an example of how a project can validate a system-level design earlier in the project life cycle than traditional V& V processes by using simulation on a system model. Specifically, this paper describes how simulation was added to a system model of the Soil Moisture Active-Passive (SMAP) mission's uplink process. Also discussed are the advantages and disadvantages of the methods employed and the lessons learned; which are intended to benefit future model-based and simulation-based development efforts.

Factorial Invariance and Convergent Validity of the Group-Based Medical Mistrust Scale across Gender and Ethnoracial Identity.

PubMed

Wheldon, Christopher W; Kolar, Stephanie K; Hernandez, Natalie D; Daley, Ellen M

2017-01-01

The objective of this study was to assess the factorial invariance and convergent validity of the Group-Based Medical Mistrust Scale (GBMMS) across gender (male and female) and ethnoracial identity (Latino and Black). Minority students (N = 686) attending a southeastern university were surveyed in the fall of 2011. Psychometric analysis of the GBMMS was performed. A three-factor solution fit the data after the omission of two problematic items. This revised version of the GBMMS exhibited sufficient configural, metric, and scalar invariance. Convergence of the GBMMS with conceptually related measures provided further evidence of validity; however, there was variation across ethnoracial identity. The GBMMS has viable psychometric properties across gender and ethnoracial identity in Black and Latino populations.

Evidence-Based School Behavior Assessment of Externalizing Behavior in Young Children.

PubMed

Bagner, Daniel M; Boggs, Stephen R; Eyberg, Sheila M

2010-02-01

This study examined the psychometric properties of the Revised Edition of the School Observation Coding System (REDSOCS). Participants were 68 children ages 3 to 6 who completed parent-child interaction therapy for Oppositional Defiant Disorder as part of a larger efficacy trial. Interobserver reliability on REDSOCS categories was moderate to high, with percent agreement ranging from 47% to 90% (M = 67%) and Cohen's kappa coefficients ranging from .69 to .95 (M = .82). Convergent validity of the REDSOCS categories was supported by significant correlations with the Intensity Scale of the Sutter-Eyberg Student Behavior Inventory-Revised and related subscales of the Conners' Teacher Rating Scale-Revised: Long Version (CTRS-R: L). Divergent validity was indicated by nonsignificant correlations between REDSOCS categories and scales on the CTRS-R: L expected not to relate to disruptive classroom behavior. Treatment sensitivity was demonstrated for two of the three primary REDSOCS categories by significant pre to posttreatment changes. This study provides psychometric support for the designation of REDSOCS as an evidence-based assessment procedure for young children.

Evidence-Based School Behavior Assessment of Externalizing Behavior in Young Children

PubMed Central

Bagner, Daniel M.; Boggs, Stephen R.; Eyberg, Sheila M.

2011-01-01

This study examined the psychometric properties of the Revised Edition of the School Observation Coding System (REDSOCS). Participants were 68 children ages 3 to 6 who completed parent-child interaction therapy for Oppositional Defiant Disorder as part of a larger efficacy trial. Interobserver reliability on REDSOCS categories was moderate to high, with percent agreement ranging from 47% to 90% (M = 67%) and Cohen’s kappa coefficients ranging from .69 to .95 (M = .82). Convergent validity of the REDSOCS categories was supported by significant correlations with the Intensity Scale of the Sutter-Eyberg Student Behavior Inventory-Revised and related subscales of the Conners’ Teacher Rating Scale-Revised: Long Version (CTRS-R: L). Divergent validity was indicated by nonsignificant correlations between REDSOCS categories and scales on the CTRS-R: L expected not to relate to disruptive classroom behavior. Treatment sensitivity was demonstrated for two of the three primary REDSOCS categories by significant pre to posttreatment changes. This study provides psychometric support for the designation of REDSOCS as an evidence-based assessment procedure for young children. PMID:21687781

Toward Evidence-Based Transport of Evidence-Based Treatments: MST as an Example

ERIC Educational Resources Information Center

Schoenwald, Sonja K.

2008-01-01

This article describes the journey toward evidence-based transport and implementation in usual care settings of Multisystemic Therapy (MST) for youth with drug abuse and behavioral problems (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998). Research and experience informing the design of the MST transport strategy, progress in…

Disruptive Innovations for Designing and Diffusing Evidence-based Interventions

PubMed Central

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chorpita, Bruce F.

2013-01-01

The numbers of evidence-based interventions (EBIs) have been growing exponentially, both therapeutic and prevention programs. Yet, EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically re-examine our scientific conventions and norms. Innovation may be spurred by re-examining the biomedical model for validating EBIs and the compartmentalization of EBIs as disease-specific, institutionally-based, counseling programs. The model of Disruptive Innovations suggests that we re-engineer EBIs based on their most robust features in order to reach more people in less time and at lower cost. Four new research agendas will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. PMID:22545596

Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

PubMed

Park, Yoon Soo; Hyderi, Abbas; Heine, Nancy; May, Win; Nevins, Andrew; Lee, Ming; Bordage, Georges; Yudkowsky, Rachel

2017-11-01

To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs). Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring. Data included scores from standardized patient encounters for history taking, physical examination, and PNs. Descriptive statistics were used to examine scores from the different assessment components. Generalizability studies (G-studies) using variance components were conducted to estimate reliability for composite scores. Validity evidence was collected for response process (rater perception), internal structure (variance components, reliability), relations to other variables (interassessment correlations), and consequences (composite score). Student performance varied by case and task. In the PNs, justification of differential diagnosis was the most discriminating task. G-studies showed that schools accounted for less than 1% of total variance; however, for the PNs, there were differences in scores for varying cases and tasks across schools, indicating a school effect. Composite score reliability was maximized when the PN was weighted between 30% and 40%. Raters preferred using case-specific scoring guidelines with clear point-scoring systems. This multisite study presents validity evidence for PN scores based on scoring rubric and case-specific scoring guidelines that offer rigor and feedback for learners. Variability in PN scores across participating sites may signal different approaches to teaching clinical reasoning among medical schools.

Queer challenges to evidence-based practice.

PubMed

Zeeman, Laetitia; Aranda, Kay; Grant, Alec

2014-06-01

This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge. © 2013 John Wiley

[Forensic evidence-based medicine in computer communication networks].

PubMed

Qiu, Yun-Liang; Peng, Ming-Qi

2013-12-01

As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people's legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks.

A prototype for evidence-based pharmaceutical opinions to promote physician-pharmacist communication around deprescribing

PubMed Central

Tannenbaum, Cara

2018-01-01

Context: Interprofessional communication is an effective mechanism for reducing inappropriate prescriptions among older adults. Physicians’ views about which elements are essential for pharmacists to include in an evidence-based pharmaceutical opinion for deprescribing remain unknown. Objective: To develop a prototype for an evidence-based pharmaceutical opinion that promotes physician-pharmacist communication around deprescribing. Methods: A standardized template for an evidence-based pharmaceutical opinion was developed with input from a convenience sample of 32 primary care physicians and 61 primary care pharmacists, recruited from conferences and community settings in Montreal, Canada. Participants were asked to comment on the need for clarifying treatment goals, including personalized patient data and biomarkers, highlighting evidence about drug harms, listing the credibility and source of the recommendations, providing therapeutic alternatives and formalizing official documentation of decision making. The content and format of the prototype underwent revision by community physicians and pharmacists until consensus was reached on a final recommended template. Results: The majority of physicians (84%-97%) requested that the source of the deprescribing recommendations be cited, that alternative management options be provided and that the information be tailored to the patient. Sixteen percent of physicians expressed concern about the information in the opinions being too dense. Pharmacists also questioned the length of the opinion and asked that additional space be provided for the physician’s response. A statement was added making the opinion a valid prescription upon receipt of a signature from physicians. Compared to a nonstandardized opinion, the majority of pharmacists believed the template was easier to use, more evidence based, more time efficient and more likely to lead to deprescribing. Conclusion: Physicians and pharmacists endorsed a standardized

SDG and qualitative trend based model multiple scale validation

NASA Astrophysics Data System (ADS)

Gao, Dong; Xu, Xin; Yin, Jianjin; Zhang, Hongyu; Zhang, Beike

2017-09-01

Verification, Validation and Accreditation (VV&A) is key technology of simulation and modelling. For the traditional model validation methods, the completeness is weak; it is carried out in one scale; it depends on human experience. The SDG (Signed Directed Graph) and qualitative trend based multiple scale validation is proposed. First the SDG model is built and qualitative trends are added to the model. And then complete testing scenarios are produced by positive inference. The multiple scale validation is carried out by comparing the testing scenarios with outputs of simulation model in different scales. Finally, the effectiveness is proved by carrying out validation for a reactor model.

The gender identity/gender dysphoria questionnaire for adolescents and adults: further validity evidence.

PubMed

Singh, Devita; Deogracias, Joseph J; Johnson, Laurel L; Bradley, Susan J; Kibblewhite, Sarah J; Owen-Anderson, Allison; Peterson-Badali, Michele; Meyer-Bahlburg, Heino F L; Zucker, Kenneth J

2010-01-01

This study aimed to provide further validity evidence for the dimensional measurement of gender identity and gender dysphoria in both adolescents and adults. Adolescents and adults with gender identity disorder (GID) were compared to clinical control (CC) adolescents and adults on the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA), a 27-item scale originally developed by Deogracias et al. (2007). In Study 1, adolescents with GID (n = 44) were compared to CC adolescents (n = 98); and in Study 2, adults with GID (n = 41) were compared to CC adults (n = 94). In both studies, clients with GID self-reported significantly more gender dysphoria than did the CCs, with excellent sensitivity and specificity rates. In both studies, degree of self-reported gender dysphoria was significantly correlated with recall of cross-gender behavior in childhood-a test of convergent validity. The research and clinical utility of the GIDYQ-AA is discussed, including directions for further research in distinct clinical populations.

Sleep disturbances as an evidence-based suicide risk factor.

PubMed

Bernert, Rebecca A; Kim, Joanne S; Iwata, Naomi G; Perlis, Michael L

2015-03-01

Increasing research indicates that sleep disturbances may confer increased risk for suicidal behaviors, including suicidal ideation, suicide attempts, and death by suicide. Despite increased investigation, a number of methodological problems present important limitations to the validity and generalizability of findings in this area, which warrant additional focus. To evaluate and delineate sleep disturbances as an evidence-based suicide risk factor, a systematic review of the extant literature was conducted with methodological considerations as a central focus. The following methodologic criteria were required for inclusion: the report (1) evaluated an index of sleep disturbance; (2) examined an outcome measure for suicidal behavior; (3) adjusted for presence of a depression diagnosis or depression severity, as a covariate; and (4) represented an original investigation as opposed to a chart review. Reports meeting inclusion criteria were further classified and reviewed according to: study design and timeframe; sample type and size; sleep disturbance, suicide risk, and depression covariate assessment measure(s); and presence of positive versus negative findings. Based on keyword search, the following search engines were used: PubMed and PsycINFO. Search criteria generated N = 82 articles representing original investigations focused on sleep disturbances and suicide outcomes. Of these, N = 18 met inclusion criteria for review based on systematic analysis. Of the reports identified, N = 18 evaluated insomnia or poor sleep quality symptoms, whereas N = 8 assessed nightmares in association with suicide risk. Despite considerable differences in study designs, samples, and assessment techniques, the comparison of such reports indicates preliminary, converging evidence for sleep disturbances as an empirical risk factor for suicidal behaviors, while highlighting important, future directions for increased investigation.

From evidence-based medicine to genomic medicine

PubMed Central

2007-01-01

The concept of ‘evidence-based medicine’ dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal ‘evidence’ in approving any form of health care provision. Essentially ‘evidence-based medicine’ aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients. It is in fact the ‘personalised medicine’ in practice. Since the completion of the human genome project and the rapid accumulation of huge amount of data, scientists and physicians alike are excited on the prospect of ‘personalised health care’ based on individual’s genotype and phenotype. The first decade of the new millennium now witnesses the transition from ‘evidence-based medicine’ to the ‘genomic medicine’. The practice of medicine, including health promotion and prevention of disease, stands now at a wide-open road as the scientific and medical community embraces itself with the rapidly expanding and revolutionising field of genomic medicine. This article reviews the rapid transformation of modern medicine from the ‘evidence-based medicine’ to ‘genomic medicine’. PMID:18923934

Evidence-based health promotion: applying it in practice.

PubMed

Wong, M L

2002-09-01

In health promotion, we should use interventions established by evidence to be effective in improving the health of the community. This paper reviews the concepts, evaluation and use of evidence in health promotion. A literature search of evidence-based health promotion and evaluation of health promotion was conducted using Medline, Social Science Citation Index (SSCI), PsycLIT and evidence-based web sites on health promotion, health education and community preventive services. Recent issues of key journals on health promotion, health education and public health were also hand-searched. The concept of evidence in health promotion interventions is complex due to its multidimensional nature. Evidence of effectiveness in health promotion is assessed by combining quantitative data on effect change in outcome measures and qualitative data on process evaluation of health promotion activities. Limitations to the use of randomised trials in community-based health promotion interventions include ethical and logistic problems in maintaining randomisation of subjects over long periods, absence of experimental conditions in the real-world setting, contamination of control subjects and the multidimensional nature of health promotion interventions. Randomised controlled trials should be used to evaluate the effectiveness of most health education and behavioural interventions in clinical settings. When such trials are not feasible as in community-based health promotion interventions, quasi-experimental designs provide strong evidence. Multiple methods are needed to assess evidence of effectiveness of health promotion programmes. Appropriate practice of evidence-based health promotion requires consideration of quality of available evidence, local values and prevailing resources.

Barriers and Enablers to Evidence-Based Practices

ERIC Educational Resources Information Center

Foster, Robyn

2014-01-01

The importance of educational practices based on evidence is well-supported in the literature, however barriers to their implementation in classrooms still exist. This paper examines the phenomenon of evidence-based practice in education highlighting enablers and barriers to their implementation with particular reference to RTLB practice.

Social Skills Questionnaire for Argentinean College Students (SSQ-U) Development and Validation.

PubMed

Morán, Valeria E; Olaz, Fabián O; Del Prette, Zilda A P

2015-11-27

In this paper we present a new instrument called Social Skills Questionnaire for Argentinean College Students (SSQ-U). Based on the adapted version of the Social Skills Inventory - Del Prette (SSI-Del Prette) (Olaz, Medrano, Greco, & Del Prette, 2009), we wrote new items for the scale, and carried out psychometric analysis to assess the validity and reliability of the instrument. In the first study, we collected evidence based on test content through expert judges who evaluated the quality and the relevance of the items. In the second and third studies, we provided validity evidence based on the internal structure of the instrument using exploratory (n = 1067) and confirmatory (n = 661) factor analysis. Results suggested a five-factor structure consistent with the dimensions of social skills, as proposed by Kelly (2002). The fit indexes corresponding to the obtained model were adequate, and composite reliability coefficients of each factor were excellent (above .75). Finally, in the fourth study, we provided evidence of convergent and discriminant validity. The obtained results allow us to conclude that the SSQ-U is the first valid and reliable instrument for measuring social skills in Argentinean college students.

Challenges Facing Evidence-Based Prevention: Incorporating an Abductive Theory of Method.

PubMed

Mason, W Alex; Cogua-Lopez, Jasney; Fleming, Charles B; Scheier, Lawrence M

2018-06-01

Current systems used to determine whether prevention programs are "evidence-based" rely on the logic of deductive reasoning. This reliance has fostered implementation of strategies with explicitly stated evaluation criteria used to gauge program validity and suitability for dissemination. Frequently, investigators resort to the randomized controlled trial (RCT) combined with null hypothesis significance testing (NHST) as a means to rule out competing hypotheses and determine whether an intervention works. The RCT design has achieved success across numerous disciplines but is not without limitations. We outline several issues that question allegiance to the RCT, NHST, and the hypothetico-deductive method of scientific inquiry. We also discuss three challenges to the status of program evaluation including reproducibility, generalizability, and credibility of findings. As an alternative, we posit that extending current program evaluation criteria with principles drawn from an abductive theory of method (ATOM) can strengthen our ability to address these challenges and advance studies of drug prevention. Abductive reasoning involves working from observed phenomena to the generation of alternative explanations for the phenomena and comparing the alternatives to select the best possible explanation. We conclude that an ATOM can help increase the influence and impact of evidence-based prevention for population benefit.

Evidence-based prosthodontics: fundamental considerations, limitations, and guidelines.

PubMed

Bidra, Avinash S

2014-01-01

Evidence-based dentistry is rapidly emerging to become an integral part of patient care, dental education, and research. Prosthodontics is a unique dental specialty that encompasses art, philosophy, and science and includes reversible and irreversible treatments. It not only affords good applicability of many principles of evidence-based dentistry but also poses numerous limitations. This article describes the epidemiologic background, fundamental considerations, scrutiny of levels of evidence, limitations, guidelines, and future perspectives of evidence-based prosthodontics. Understanding these principles can aid clinicians in appropriate appraisal of the prosthodontics literature and use the best available evidence for making confident clinical decisions and optimizing patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

Reliability and Validity Evidence of Multiple Balance Assessments in Athletes With a Concussion

PubMed Central

Murray, Nicholas; Salvatore, Anthony; Powell, Douglas; Reed-Jones, Rebecca

2014-01-01

Context: An estimated 300 000 sport-related concussion injuries occur in the United States annually. Approximately 30% of individuals with concussions experience balance disturbances. Common methods of balance assessment include the Clinical Test of Sensory Organization and Balance (CTSIB), the Sensory Organization Test (SOT), the Balance Error Scoring System (BESS), and the Romberg test; however, the National Collegiate Athletic Association recommended the Wii Fit as an alternative measure of balance in athletes with a concussion. A central concern regarding the implementation of the Wii Fit is whether it is reliable and valid for measuring balance disturbance in athletes with concussion. Objective: To examine the reliability and validity evidence for the CTSIB, SOT, BESS, Romberg test, and Wii Fit for detecting balance disturbance in athletes with a concussion. Data Sources: Literature considered for review included publications with reliability and validity data for the assessments of balance (CTSIB, SOT, BESS, Romberg test, and Wii Fit) from PubMed, PsycINFO, and CINAHL. Data Extraction: We identified 63 relevant articles for consideration in the review. Of the 63 articles, 28 were considered appropriate for inclusion and 35 were excluded. Data Synthesis: No current reliability or validity information supports the use of the CTSIB, SOT, Romberg test, or Wii Fit for balance assessment in athletes with a concussion. The BESS demonstrated moderate to high reliability (interclass correlation coefficient = 0.87) and low to moderate validity (sensitivity = 34%, specificity = 87%). However, the Romberg test and Wii Fit have been shown to be reliable tools in the assessment of balance in Parkinson patients. Conclusions: The BESS can evaluate balance problems after a concussion. However, it lacks the ability to detect balance problems after the third day of recovery. Further investigation is needed to establish the use of the CTSIB, SOT, Romberg test, and Wii Fit for

Bi-national cross-validation of an evidence-based conduct problem prevention model.

PubMed

Porta, Carolyn M; Bloomquist, Michael L; Garcia-Huidobro, Diego; Gutiérrez, Rafael; Vega, Leticia; Balch, Rosita; Yu, Xiaohui; Cooper, Daniel K

2018-04-01

To (a) explore the preferences of Mexican parents and Spanish-speaking professionals working with migrant Latino families in Minnesota regarding the Mexican-adapted brief model versus the original conduct problems intervention and (b) identifying the potential challenges, and preferred solutions, to implementation of a conduct problems preventive intervention. The core practice elements of a conduct problems prevention program originating in the United States were adapted for prevention efforts in Mexico. Three focus groups were conducted in the United States, with Latino parents (n = 24; 2 focus groups) and professionals serving Latino families (n = 9; 1 focus group), to compare and discuss the Mexican-adapted model and the original conduct problems prevention program. Thematic analysis was conducted on the verbatim focus group transcripts in the original language spoken. Participants preferred the Mexican-adapted model. The following key areas were identified for cultural adaptation when delivering a conduct problems prevention program with Latino families: recruitment/enrollment strategies, program delivery format, and program content (i.e., child skills training, parent skills training, child-parent activities, and child-parent support). For both models, strengths, concerns, barriers, and strategies for overcoming concerns and barriers were identified. We summarize recommendations offered by participants to strengthen the effective implementation of a conduct problems prevention model with Latino families in the United States. This project demonstrates the strength in binational collaboration to critically examine cultural adaptations of evidence-based prevention programs that could be useful to diverse communities, families, and youth in other settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

[Basic assessment of needs for training in evidence-based medicine in Slovakia].

PubMed

Bacharova, L; Hlavacka, S; Rusnakova, V

2001-01-01

The health care reform in Slovakia produces a desire for greater responsibility for and control of strategic decisions and to be better able to evaluate international knowledge and experience in the specific national social and professional contexts. Evidence based medicine (EBM) provides an increasingly organised and accessible database of international knowledge in health and health care, capable of informing decisions at the macro and micro levels. The aim of this pilot study was to assess education, training and other capacity building needs in EBM and evidence based health care. This study was primarily qualitative and based on a triangular approach, which included: (1) The analysis of the situation in pre- and postgraduate education in Slovakia aiming to the estimation of needs in EBM and critical appraisal skills training; (2) The analysis of questionnaires distributed in a sample of 50 medical doctors and university educated public health workers undergoing a postgraduate training; (3) The discussion in focused groups. The findings and analysis uncovered a gap in knowledge and experience of EBM approaches, particularly of searching for evidence, utilising information technology, of undertaking critical appraisals of the validity and quality of external evidence and of knowledge of English. On the other hand the findings revealed a high access to information including the Internet access at the workplace, an increasing awareness of the need for up-date information, a demand for training and potential opportunities for action. The effective implementation introduction of EBM approach would require changes in broader political, cultural and behavioural contexts, including changes in pre- and postgraduate systems of professional and managerial education, changes in professional and managerial attitudes and changes in emphasis in skills and capacity building and improvements in knowledge management systems at the national level.

Evidence-Based Practice Beliefs and Implementation in Doctor of Nursing Practice Students.

PubMed

Singleton, Joanne K

2017-10-01

Doctors of Nursing Practice focus on leadership in evidence-based practice (EBP). EBP is influenced by one's beliefs in and implementation of EBP. Little is known to date about the EBP beliefs and implementation of Doctor of Nursing Practice students and outcomes of Doctor of Nursing Practice education. Guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBPB) and Implementation (EBPI) tools were used to assess the impact of EBP as a program pillar, curricular thread, and content area on EBPB and EBPI of Doctor of Nursing Practice-Family Nurse Practitioner students. Five cohorts who completed the same curriculum were studied. Fifty-four of the 89 students across the five cohorts began and completed the study. Paired t-test for group effects showed statistical significance from pre- to post-measure in students overall EBPB, t = 4.4 (52), p < .001, and EBPI, t = 8.4 (52), p < .001. A large effect size of .75 standard deviation (SD) gain above the mean for EBPB, and a very large effect size of 1 SD gain above the mean for EBPI were observed. Repeated measures ANOVA showed that all cohorts made gains across the curriculum. Effect sizes for EBPB ranged from .25 to 1 SD above the mean, and .75 to 1.5 for EBPI. DNP students who are educated to be EBP leaders must have a curriculum that supports them in the knowledge and skill-set needed to translate evidence into practice. The ARCC Model can guide faculty in EBP curriculum development. EBPB and EBPI are valid and reliable measures to assess for gains across a curriculum. Through educational outcomes, educators can assess desired student outcomes for EBP across a curriculum and can build an evidence base for ongoing curriculum development. © 2017 Sigma Theta Tau International.

CDMBE: A Case Description Model Based on Evidence

PubMed Central

Zhu, Jianlin; Yang, Xiaoping; Zhou, Jing

2015-01-01

By combining the advantages of argument map and Bayesian network, a case description model based on evidence (CDMBE), which is suitable to continental law system, is proposed to describe the criminal cases. The logic of the model adopts the credibility logical reason and gets evidence-based reasoning quantitatively based on evidences. In order to consist with practical inference rules, five types of relationship and a set of rules are defined to calculate the credibility of assumptions based on the credibility and supportability of the related evidences. Experiments show that the model can get users' ideas into a figure and the results calculated from CDMBE are in line with those from Bayesian model. PMID:26421006

Evidence-based management of recurrent miscarriages

PubMed Central

Jeve, Yadava B.; Davies, William

2014-01-01

Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase) using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based. PMID:25395740

Development of, and initial validity evidence for, the referee self-efficacy scale: a multistudy report.

PubMed

Myers, Nicholas D; Feltz, Deborah L; Guillén, Félix; Dithurbide, Lori

2012-12-01

The purpose of this multistudy report was to develop, and then to provide initial validity evidence for measures derived from, the Referee Self-Efficacy Scale. Data were collected from referees (N = 1609) in the United States (n = 978) and Spain (n = 631). In Study 1 (n = 512), a single-group exploratory structural equation model provided evidence for four factors: game knowledge, decision making, pressure, and communication. In Study 2 (n = 1153), multiple-group confirmatory factor analytic models provided evidence for partial factorial invariance by country, level of competition, team gender, and sport refereed. In Study 3 (n = 456), potential sources of referee self-efficacy information combined to account for a moderate or large amount of variance in each dimension of referee self-efficacy with years of referee experience, highest level refereed, physical/mental preparation, and environmental comfort, each exerting at least two statistically significant direct effects.

Organisational support for evidence-based practice: occupational therapists perceptions.

PubMed

Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth

2016-02-01

Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.

The Predictive Validity of Measures of Teacher Candidate Programs and Performance: Toward an Evidence-Based Approach to Teacher Preparation

ERIC Educational Resources Information Center

Henry, Gary T.; Campbell, Shanyce L.; Thompson, Charles L.; Patriarca, Linda A.; Luterbach, Kenneth J.; Lys, Diana B.; Covington, Vivian Martin

2013-01-01

Calls for evidence-based reform of teacher preparation programs (TPPs) suggest the question: Do the current indicators of progress and performance used by TPPs predict effectiveness of their graduates when they become teachers? In this study, the indicators of progress and performance used by one program are examined for their ability to predict…

School Psychology: A Public Health Framework: I. From Evidence-Based Practices to Evidence-Based Policies.

ERIC Educational Resources Information Center

Hoagwood, Kimberly; Johnson, Jacqueline

2003-01-01

Describes current perspectives on evidence-based practices in psychology, medicine, and education; discusses challenges in the implementation and dissemination of research-based findings into schools; describes differences between current models of organizational behavior as studied in children's mental health services and in education; and…

Factors influencing evidence-based practice in prosthetics and orthotics.

PubMed

Andrysek, Jan; Christensen, James; Dupuis, Annie

2011-03-01

The importance of evidence-based practice is being recognized across a broad range of healthcare disciplines as a means for improving patient outcomes and also efficiently managing healthcare resources. The objective of this work was to obtain information from clinicians about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Cross sectional survey. An internet survey was developed and distributed to 300 prosthetists and orthotists currently practicing in Canada. A principal component factor analysis of the survey results revealed ten primary factors affecting evidence-based practice. These include time constraints, workload and system demands, limited relevant evidence from research, and gaps in skills and knowledge required to perform evidence-based practice. Clinicians value research as a means of improving clinical practice, but they are faced with a number of practical barriers in performing evidence-based practice. This study provides empirical data about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Such data are essential in order to inform those involved in improving existing clinical practices, including educators, professional organizations, and governing bodies.

Striving for evidence-based practice innovations through a hybrid model journal club: A pilot study.

PubMed

Wilson, Marian; Ice, Suzanna; Nakashima, Cathy Y; Cox, Lynn Annette; Morse, Elizabeth C; Philip, Ginu; Vuong, Ellen

2015-05-01

The purpose of this study was to pilot a "hybrid" style journal club and determine whether measurable effects could be detected over 8-weeks' time on evidence-based practice ability, desire, behaviors, use, and barriers. Journal clubs have been suggested as a method to increase nurses' confidence with using research evidence to guide practice. However, it is yet unknown how nurse educators can best implement effective programs for clinicians with varying schedules, education levels, and research skills. Thirty-six participants from one large urban United States hospital (72% registered nurses) were invited to access bi-weekly interdisciplinary journal club activities. Nurse educators created curriculum focused on clinical problem solving that was offered via in-person sessions or a social media site. A pretest-posttest no control group design was used to measure impacts of those engaged in journal club activities. Data were collected using a combination of validated evidence-based practice instruments and program participation records. A two-tailed paired t test showed significant increases over 8weeks' time in evidence-based practice use (p=.002) and behaviors (p=.007). Slight preference for in-person sessions was reported, although greater participation was reflected in online activities. Mean satisfaction ratings were high; however, attrition rates suggest that more is needed to maximize clinician engagement. A hybrid method using online and in-person sessions was feasible and adaptive for varying learning styles and work schedules. Positive changes in measurements were detected among journal club participants. Instruments were identified that may be useful for trialing similar programs intended to increase evidence-based practice self-efficacy, use, behaviors, and ability. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evidence-based pathology: umbilical cord coiling.

PubMed

Khong, T Y

2010-12-01

The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.

Evidence-based guidelines: Improving AGREEment on consistence evaluation

PubMed Central

Vincenzi, Bruno; Napolitano, Andrea; Santini, Daniele; Maiello, Evaristo; Torri, Valter; Tonini, Giuseppe

2012-01-01

Modern clinical practice relies on evidence-based medicine (EBM) and evidence-based guidelines (EBGs). The critical evaluation of EBGs value is therefore an essential step to further improve clinical practice. In our opinion, correlating levels of evidence and grades of recommendation can be an easy tool to quickly display internal consistence of EBGs. PMID:26909252

Model-Based Method for Sensor Validation

NASA Technical Reports Server (NTRS)

Vatan, Farrokh

2012-01-01

Fault detection, diagnosis, and prognosis are essential tasks in the operation of autonomous spacecraft, instruments, and in situ platforms. One of NASA s key mission requirements is robust state estimation. Sensing, using a wide range of sensors and sensor fusion approaches, plays a central role in robust state estimation, and there is a need to diagnose sensor failure as well as component failure. Sensor validation can be considered to be part of the larger effort of improving reliability and safety. The standard methods for solving the sensor validation problem are based on probabilistic analysis of the system, from which the method based on Bayesian networks is most popular. Therefore, these methods can only predict the most probable faulty sensors, which are subject to the initial probabilities defined for the failures. The method developed in this work is based on a model-based approach and provides the faulty sensors (if any), which can be logically inferred from the model of the system and the sensor readings (observations). The method is also more suitable for the systems when it is hard, or even impossible, to find the probability functions of the system. The method starts by a new mathematical description of the problem and develops a very efficient and systematic algorithm for its solution. The method builds on the concepts of analytical redundant relations (ARRs).

A practical approach to evidence-based dentistry: How to search for evidence to inform clinical decisions.

PubMed

Brignardello-Petersen, Romina; Carrasco-Labra, Alonso; Booth, H Austin; Glick, Michael; Guyatt, Gordon H; Azarpazhooh, Amir; Agoritsas, Thomas

2014-12-01

Knowing how to search for evidence that can inform clinical decisions is a fundamental skill for the practice of evidence-based dentistry. There are many available types of evidence-based resources, characterized by their degrees of coverage of preappraised or summarized evidence at varying levels of processing, from primary studies to systematic reviews and clinical guidelines. The practice of evidence-based dentistry requires familiarity with these resources. In this article, the authors describe the process of searching for evidence: defining the question, identifying the question's nature and main components, and selecting the study design that best addresses the question.

Evidence-Based Treatment and Stuttering--Historical Perspective

ERIC Educational Resources Information Center

Prins, David; Ingham, Roger J.

2009-01-01

Purpose: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. Method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking…

The Development and Validation of the Age-Based Rejection Sensitivity Questionnaire

ERIC Educational Resources Information Center

Kang, Sonia K.; Chasteen, Alison L.

2009-01-01

Purpose: There is much evidence suggesting that older adults are often negatively affected by aging stereotypes; however, no method to identify individual differences in vulnerability to these effects has yet been developed. The purpose of this study was to develop a reliable and valid questionnaire to measure individual differences in the…

Evidence-Based Practices and Autism

ERIC Educational Resources Information Center

Mesibov, Gary B.; Shea, Victoria

2011-01-01

Interventions for autism are increasing being held to standards such as "evidence-based practice" in psychology and "scientifically-based research" in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special…

Evidence-Based and Values-Based Practices for People with Severe Disabilities

ERIC Educational Resources Information Center

Singer, George H. S.; Agran, Martin; Spooner, Fred

2017-01-01

This article discusses the relationship between evidence-based practices (EBPs) and values in research and practice pertaining to people with severe disabilities. The importance of basing educational and habilitation practices on substantial scientific evidence for practical, moral, and legal reasons is acknowledged given the prevalence of…

20 CFR 220.14 - Weighing of evidence.

Code of Federal Regulations, 2013 CFR

2013-04-01

... capacity evaluation is based upon functional objective tests with high validity and reliability; (2) The... exam findings which is indicative of exaggerated or potential malingering response; (6) The evidence...

20 CFR 220.14 - Weighing of evidence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... capacity evaluation is based upon functional objective tests with high validity and reliability; (2) The... exam findings which is indicative of exaggerated or potential malingering response; (6) The evidence...

20 CFR 220.14 - Weighing of evidence.

Code of Federal Regulations, 2014 CFR

2014-04-01

... capacity evaluation is based upon functional objective tests with high validity and reliability; (2) The... exam findings which is indicative of exaggerated or potential malingering response; (6) The evidence...

20 CFR 220.14 - Weighing of evidence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... capacity evaluation is based upon functional objective tests with high validity and reliability; (2) The... exam findings which is indicative of exaggerated or potential malingering response; (6) The evidence...

Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial

PubMed Central

2007-01-01

Background At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine. Methods This was a randomised controlled trial involving six postgraduate education centres in the West Midlands, U.K. Fifty five newly qualified foundation year one doctors (U.S internship equivalent) were randomised to either computer based sessions or an equivalent lecture in EBM and systematic reviews. The change from pre to post-intervention score was measured using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). Results Both groups were similar at baseline. Participants' improvement in knowledge in the computer based group was equivalent to the lecture based group (gain in score: 2.1 [S.D = 2.0] versus 1.9 [S.D = 2.4]; ANCOVA p = 0.078). Attitudinal gains were similar in both groups. Conclusion On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic reviews. PMID:17659076

Validation of the Female Sexual Function Index (FSFI) for web-based administration.

PubMed

Crisp, Catrina C; Fellner, Angela N; Pauls, Rachel N

2015-02-01

Web-based questionnaires are becoming increasingly valuable for clinical research. The Female Sexual Function Index (FSFI) is the gold standard for evaluating female sexual function; yet, it has not been validated in this format. We sought to validate the Female Sexual Function Index (FSFI) for web-based administration. Subjects enrolled in a web-based research survey of sexual function from the general population were invited to participate in this validation study. The first 151 respondents were included. Validation participants completed the web-based version of the FSFI followed by a mailed paper-based version. Demographic data were collected for all subjects. Scores were compared using the paired t test and the intraclass correlation coefficient. One hundred fifty-one subjects completed both web- and paper-based versions of the FSFI. Those subjects participating in the validation study did not differ in demographics or FSFI scores from the remaining subjects in the general population study. Total web-based and paper-based FSFI scores were not significantly different (mean 20.31 and 20.29 respectively, p = 0.931). The six domains or subscales of the FSFI were similar when comparing web and paper scores. Finally, intraclass correlation analysis revealed a high degree of correlation between total and subscale scores, r = 0.848-0.943, p < 0.001. Web-based administration of the FSFI is a valid alternative to the paper-based version.

[Evidence-based medicine: a critical analysis of the concept of evidence in medicine].

PubMed

Federspil, G; Vettor, R

2001-06-01

There is currently a lively debate involving scholars from diverse cultural background on the subject of evidence-based medicine. In order to set out the grounds of discussion this paper deals with the problem of "evidence", both the concept and meaning of this term. After a brief history of the idea of "evidence" from antiquity to the present day, it will be underlined how modern day thinking recognizes the existence of two types of "evidence": rational evidence supported first by René Descartes, and perceptible evidence, defended by Francis Bacon. In contemporary epistemology the idea of "evidence" has been conceived above all as perceptible and is closely linked to the idea of fact. The concept of "scientific fact" will therefore be analyzed and will reveal how in science, contrary to prevailing opinion, "pure facts" practically do not exist and how the "facts" which scientists talk about in their research are always "facts depending on theory". Subsequently the capacity of "facts" to prove scientific hypothesis will be examined. In the light of more recent epistemological reflection the thesis will be maintained according to which facts are not capable of definitively proving the truth of a theory. Such reflection leads to the conclusion that in medicine "evidence" is always dependent on the theoretical and practical context in which researchers work. In the final part of the paper the epistemological presumptions and ambitions of evidence-based medicine will be examined. This analysis concludes that the epistemology on which evidence-based medicine relies upon does not grasp the true complexity of the scientific methodology and can weaken in doctors the beneficial stimulus that is doubt.

Computer aided manual validation of mass spectrometry-based proteomic data.

PubMed

Curran, Timothy G; Bryson, Bryan D; Reigelhaupt, Michael; Johnson, Hannah; White, Forest M

2013-06-15

Advances in mass spectrometry-based proteomic technologies have increased the speed of analysis and the depth provided by a single analysis. Computational tools to evaluate the accuracy of peptide identifications from these high-throughput analyses have not kept pace with technological advances; currently the most common quality evaluation methods are based on statistical analysis of the likelihood of false positive identifications in large-scale data sets. While helpful, these calculations do not consider the accuracy of each identification, thus creating a precarious situation for biologists relying on the data to inform experimental design. Manual validation is the gold standard approach to confirm accuracy of database identifications, but is extremely time-intensive. To palliate the increasing time required to manually validate large proteomic datasets, we provide computer aided manual validation software (CAMV) to expedite the process. Relevant spectra are collected, catalogued, and pre-labeled, allowing users to efficiently judge the quality of each identification and summarize applicable quantitative information. CAMV significantly reduces the burden associated with manual validation and will hopefully encourage broader adoption of manual validation in mass spectrometry-based proteomics. Copyright © 2013 Elsevier Inc. All rights reserved.

Validation of an Innovative Satellite-Based UV Dosimeter

NASA Astrophysics Data System (ADS)

Morelli, Marco; Masini, Andrea; Simeone, Emilio; Khazova, Marina

2016-08-01

We present an innovative satellite-based UV (ultraviolet) radiation dosimeter with a mobile app interface that has been validated by exploiting both ground-based measurements and an in-vivo assessment of the erythemal effects on some volunteers having a controlled exposure to solar radiation.Both validations showed that the satellite-based UV dosimeter has a good accuracy and reliability needed for health-related applications.The app with this satellite-based UV dosimeter also includes other related functionalities such as the provision of safe sun exposure time updated in real-time and end exposure visual/sound alert. This app will be launched on the global market by siHealth Ltd in May 2016 under the name of "HappySun" and available both for Android and for iOS devices (more info on http://www.happysun.co.uk).Extensive R&D activities are on-going for further improvement of the satellite-based UV dosimeter's accuracy.

Montreal Accord on Patient-Reported Outcomes (PROs) use series-Paper 7: modern perspectives of measurement validation emphasize justification of inferences based on patient reported outcome scores.

PubMed

Sawatzky, Richard; Chan, Eric K H; Zumbo, Bruno D; Ahmed, Sara; Bartlett, Susan J; Bingham, Clifton O; Gardner, William; Jutai, Jeffrey; Kuspinar, Ayse; Sajobi, Tolulope; Lix, Lisa M

2017-09-01

Obtaining the patient's view about the outcome of care is an essential component of patient-centered care. Many patient-reported outcome (PRO) instruments for different purposes have been developed since the 1960s. Measurement validation is fundamental in the development, evaluation, and use of PRO instruments. This paper provides a review of modern perspectives of measurement validation in relation to the followings three questions as applied to PROs: (1) What evidence is needed to warrant comparisons between groups and individuals? (2) What evidence is needed to warrant comparisons over time? and (3) What are the value implications, including personal and societal consequences, of using PRO scores? Measurement validation is an ongoing process that involves the accumulation of evidence regarding the justification of inferences, actions, and decisions based on measurement scores. These include inferences pertaining to comparisons between groups and comparisons over time as well as consideration of value implications of using PRO scores. Personal and societal consequences must be examined as part of a comprehensive approach to measurement validation. The answers to these three questions are fundamental to the the validity of different types of inferences, actions, and decisions made on PRO scores in health research, health care administration, and clinical practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Evidence-based healthcare in developing countries.

PubMed

Pearson, Alan; Jordan, Zoe

2010-06-01

Developing countries have limited resources, so it is particularly important to invest in healthcare that works. The case for evidence-based practice has long been made in the West. However, poor access to information makes this endeavour near impossible for health professionals working with vulnerable communities in low-income economies. This paper provides a call to action to create an evidence base for health professionals in developing countries and identify appropriate strategies for the dissemination of this information in realistic and meaningful ways.

Yaruss, Coleman, and Hammer (2006): an exemplar of non-evidence-based practice in stuttering treatment.

PubMed

Ingham, Roger J

2007-07-01

This letter is a response to a recent report by J. S. Yaruss, C. Coleman, and D. Hammer (2006) that described a treatment program for preschool children who stutter. Problems with the Yaruss et al. study fall into four domains: (a) failure to provide clinicians with replicable procedures, (b) failure to collect valid and reliable speech performance data, (c) failure to control for predictable improvement in children who have been stuttering for less than 15 months, and (d) the advocacy of procedures for which there is no credible research evidence. The claims made for the efficacy of this treatment are problematic and essentially violate the principles of evidence-based practice as recommended by the American Speech-Language-Hearing Association (ASHA).