EBP & Ethics
A clinician is deciding between two treatment approaches. Which option BEST represents Evidence-Based Practice?
A. Choosing the treatment the clinician has used most often
B. Choosing only the treatment supported by the newest article
C. Integrating research evidence, clinical expertise, and the patient's perspective
D. Allowing the patient to select any treatment they prefer
C. EBP integrates current best evidence, clinical expertise, and the patient's perspective.
Identify the Missing PICO Element
A researcher wants to investigate whether intensive voice therapy improves vocal loudness in adults with Parkinson's disease.
Comparison
Mention 3 components of a good interview.
• Start by building rapport – a warm-up question can be useful.
• Create an interview guide but try to memorize it. Don’t follow the guide, but the interviewee if new directions arise.
• Ask one question at a time.
• Minimize questions that require yes/no responses.
• Frequently restate the interviewee’s responses.
• Encourage statements that reflect their own feelings and opinions.
• Refrain from making critical judgements.
• Empathy and respect for differences and diversity are important principles of ethnographic interviews and questionnaires.
• Learn to embrace silence: this may lead the interviewee to reflect and amplify their response.
• Active listening is key!
• You, as the interviewer, need to be balanced: do not talk too much or too little.
• Your last question should wrap up the session and, ideally, leave the interview on a high note
A treatment study begins with 50 participants. Over the course of the study, 15 participants drop out before completing the post-treatment assessment.
What type of bias may this introduce?
Attrition bias
BONUS
What could researchers do to prevent or minimize attrition?
Participants in an RCT do not know which treatment condition they have been assigned to, but the researchers and clinicians do.
This study is _____-_____
Single-blinded
Participants are told what the study involves, potential risks, and that they can withdraw at any time without penalty.
Which ethical principle is MOST clearly illustrated?
Respect for Persons.
Researchers investigate whether a new voice treatment increases vocal intensity in adults with Parkinson's disease.
What is the independent variable?
The treatment
Following COREQ, a reflexivity/positionality statement should be included in the analysis in order to account for ____________.
Author bias
Efficacy or Effectiveness?
A treatment is tested under highly controlled conditions with carefully selected participants and a standardized treatment protocol.
The researchers primarily want to know:
Can this treatment work under ideal conditions?
Efficacy
A study examines the effects of an intervention intensively in one participant, with repeated measurement of behavior over time.
This type of research design is called a __________ design.
Single-subject design
If a treatment has the strongest research evidence, EBP requires the clinician to use it even if it conflicts with the patient's cultural values.
False. Patient perspective and cultural considerations are part of EBP.
A study defines speech intelligibility as:
“Percentage of words correctly understood by three unfamiliar listeners from a 2-minute speech sample.”
This is an example of:
A. A null hypothesis
B. Operationalization
C. A comparison condition
D. Clinical significance
B. Operationalization.
A qualitative researcher has conducted 18 interviews. During the last several interviews, participants are no longer providing new information relevant to the research question.
The researcher may have reached __________.
Data saturation.
Participants in a treatment study know they are being observed. During the study, they begin practicing their speech exercises much more consistently than they normally would.
This change in behavior simply because they know they are being observed is known as the __________.
Hawthorne effect
Following a phenomenological approach, what is a potential research question if you want to study aphasia after stroke?
Keywords: experience, perceive
A study is investigating a new treatment for adults with aphasia.
Inclusion criterion: “Participants must have moderate aphasia.”
What is the problem with this inclusion criteria?
It is not specific enough. The researchers need to define how “moderate aphasia” will be determined or measured (e.g., using a specified assessment/score or other clearly defined criterion).
Researchers hypothesize:
Children receiving Treatment A will produce significantly more correct /r/ productions than children receiving Treatment B.
What would the null hypothesis be?
There will be no difference in correct /r/ productions between children receiving Treatment A and Treatment B.
How can we assess reliability in a qualitative study?
Transcript verification
Constant comparison of data that has been coded/cross-checking codes
Regular meetings with the research team.
BONUS:
And validity?
An RCT compares Treatment A and Treatment B. The same clinicians who provide the treatments also conduct the pre- and post-treatment evaluations, and they know which treatment each participant received.
Why might you be concerned?
Potential performance and detection bias: Performance bias may occur when participants are aware of their treatment allocation, potentially influencing their behavior or reported outcomes. Detection bias may arise when evaluators know the treatment allocation, potentially influencing outcome assessments.
Unlike systematic reviews, scoping reviews do not typically require a critical appraisal of the included studies because their main purpose is to map the existing evidence and identify gaps in the literature.
True.
Scoping reviews aim to map the available evidence, provide an overview of existing knowledge, and identify research gaps rather than formally assess the quality of the evidence. Therefore, critical appraisal is generally optional, although it can be included depending on the review's objectives.
A new intervention may cause substantial fatigue. Researchers believe the study could produce useful information, but they have not developed procedures to monitor fatigue or stop testing when participants become excessively tired.
Which ethical principle is most relevant, and what should the researchers reconsider?
Beneficence. Researchers need to minimize potential harm/risk and consider whether the anticipated benefits justify those risks.
A researcher interviews several bilingual SLPs. After repeatedly observing similar patterns in their responses, she develops a broader explanation about how clinicians make assessment decisions.
Is her reasoning primarily inductive or deductive? Explain.
Inductive. She moves from individual observations/patterns toward a broader conclusion or explanation.
Mention some differences between COREQ and RTAG.
COREQ: Focuses on transparent reporting of qualitative research, including how themes were developed and how participants’ experiences and perceptions were represented.
RTAG (Reflexive Thematic Analysis): Focuses on interpreting participants’ experiences and understanding the deeper meanings and patterns within the data. Themes are actively constructed by the researcher rather than simply emerging from the data.
COREQ: Includes reporting practices related to trustworthiness, such as coding procedures, member checking, and other strategies used to support research rigor.
RTAG: Does not rely on traditional measures of reliability, validity, inter-rater agreement, replication, or data saturation. Researcher subjectivity is acknowledged as an inherent part of the analytical process, and quality is demonstrated through reflexivity, theoretical coherence, and interpretive depth.
Thirty adults receive a new aphasia treatment and show significant improvement from pre- to post-treatment. However, the study has no control group.
The researchers can report improvement, but they cannot establish __________ because they cannot confidently attribute the change to the treatment.
Treatment effects
Define an experiment.
An experiment is a procedure used to establish cause-and-effect relationships between variables under controlled conditions.