Question 1
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Systematic Reviews are rated as the ‘highest level of evidence’ in the evidence hierarchy pyramid.
Question 2
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The Cochrane Library is a database of systematic reviews and meta-‐analyses.
Question 3
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Using one database to search for information is best as this ensures you don’t mix your results.
Question 4
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PubMed only provides abstracts which are useful to then search for relevant studies elsewhere.
Question 5
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Common Boolean logic terms consist of AND, WITH & OR
Question 6
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There is no need to read the whole article because abstracts provide a complete summary of the content within.
Question 7
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Searching different databases with the same terms provides the same results.
Question 8
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Because they are often conducted with blinding, Randomised Control Trials (RCTs) provide the highest level of evidence. Because of this, using the filter to restrict results to only show RCTs provides you with the best evidence.
Question 9
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The use of the ‘OR’ operator narrows the amount of titles found.
Question 10
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‘Exploding’ a heading removes that heading from the search results.
Question 11
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MeSH terms are not always picked up when entered, so it is important to check and see that relevant items are being included.
Question 12
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PICO is the most reliable format for conducting a search as it highlights the keywords that can be entered into databases.
Question 13
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Before using a database, it is a good idea to research the terms to find possible synonyms.
Question 14
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Before using a database, it is a good idea to research the terms to find possible synonyms.
Question 15
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The Cochrane Library provides access to Cochrane Systematics Reviews and to other forms of literature.
Question 16
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The library subscriptions provide access to more full text articles so logging in furthers your reach for finding good evidence.
Question 17
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Databases are a tool for finding information, but it is important to familiarise yourself with different databases to make searching as efficient as possible.
Question 18
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Using MeSH terms searches for like-terms and increases the chances that important research is captured.
Question 19
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Having a systematic approach to searching for evidence is a good way to ensure that you are not overwhelmed with information.
Question 20
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P values provide clinicians and patients with the information they most need.
Question 21
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Clinicians do not need to use confidence intervals to properly use research results in decision making processes.
Question 22
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Narrow Confidence intervals result from a large sample size and events which provide, a definitive conclusion about recommending therapy.
Question 23
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Statistical significance questions whether confidence intervals exclude the null value.
Question 24
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Statistical significance is used to inform clinical significance.
Question 25
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Treatments becomes clinically significant because the difference between treatments is statistically significant.
Question 26
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Clinical significance can be inferred from statistical significance if P value is ≥0.05
Question 27
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The P value measures the strength of the evidence that supports the null hypothesis.
Question 28
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Clinical significance asks whether any of the values in the confidence interval are big enough to care about
Question 29
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Huge samples create a more accurate P value.
Question 30
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P values are a tool for separating real effects from chance.
Question 31
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For studies with a negative result, clinicians should examine the lower boundary of the confidence interval.
Question 32
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To determine if the sample size in a study is inadequate, you examine the lower boundary of the confidence interval.
Question 33
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If the confidence interval overlaps the smallest treatment benefit, the study is not definitive and a larger study is needed.
Question 34
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P values ≤ 0.05 indicates strong evidence against the null hypothesis with 95% certainty.
Question 35
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P values ≥0.05 indicates strong evidence against the null hypothesis with 95% certainty.
Question 36
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Primary sources are the best source of information to use when conduction a search.
Question 37
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The PICO format is best technique used in evidenced based medicine to frame and answer for a clinical question.
Question 38
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Wikipedia is one of these best databases to use.
Question 39
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Combining searches is an effective way at finding relevant information to a clinical question.
Question 40
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When searching a database filters narrow the search to clinically important articles.
Question 41
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Databases allow you to choose which article types you want to search for.
Question 42
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When searching PubMed with a single term into the search box it automatically carries out both a textword and thesaurus search.
Question 43
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When having found a useful article in PubMed there is a related hyperlink that searches for similar items within the database.
Question 44
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Medline is the leading resource for systemic reviews.
Question 45
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The Cochrane library has a wide range of study types
Question 46
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The best way to search a database is to type in your complete question
Question 47
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When searching PubMed, the researcher must enter in all related terms as there is no textword or thesaurus search function
Question 48
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The P in PICO stands for population/patient.
Question 49
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Databases like PubMed, Medline and CINAHL allow you to search for studies within specific years.
Question 50
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A good literature search shouldn’t include unpublished work and studies with negative findings.
Question 51
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You only have to use 1 database when trying to answer a clinical question.
Question 52
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Confidence intervals are the range within which the true treatment effect might plausibly lie, when given the trial data.
Question 53
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In regards to confidence intervals, greater precision results from smaller sample sizes and small numbers of events.
Question 54
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When clinicians are trying to determine whether a trial with a positive effect is sufficiently large, they should focus on the upper boundary of the confidence interval.
Question 55
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A P value of equal to or less than 0.05 tells us that we can rule out the null effect/hypothesis with 95% certainty.
Question 56
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P values are not usually helpful for studies with large sample sizes.
Question 57
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Clinical significance asks whether any of the values in the confidence interval are big enough to care about.
Question 58
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Statistical significance can be inferred from clinical significance.
Question 59
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If the statistical power of a study is increased, the sample size is also increased.
Question 60
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The “Number-needed-to-treat” is an estimation of the number of patients that need to be treated in order to have an impact on one person.
Question 61
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Big sample sizes in trials means that small discrepancies will go undetected.
Question 62
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The Pearson correlation coefficient is a measure of strength of the association between 3 variables.
Question 63
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Differences in treatment groups less than the smallest effect of clinical interest are more like to be found statistically significant when the sample size is increased.
Question 64
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Is it important for clinicians to think about the smallest amount of benefit that would justify therapy when examining a new study?
Question 65
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In some cases, outcomes of a study and research may not be considered significant by the patients, especially if the new/changed intervention involves a considerable amount of time and effort on their behalf.
Question 66
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When calculating the sample size in clinical trials, the minimum power usually recommended to have is 70% or above.
Question 67
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Whenever an effect is insignificant, all values within the confidence interval will be on the same side of zero.
Question 68
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Case reports are high quality literature, according to most levels of evidence
Question 69
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It is not important for a researcher or clinician to know the difference between levels of evidence
Question 70
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Clinical trials are always the best type of study design in medical experiments
Question 71
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Exposure to confounding variables does not increase the potential risk of bias in a study design
Question 72
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Systematic reviews are often unreliable sources of information and should not be relied upon for clinical decision making
Question 73
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A researcher does not need to consider which study design is the most appropriate to answer their question when planning their investigation
Question 74
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Sources of evidence higher on the hierarchy of evidence usually only investigate small populations of patients for a particular outcome
Question 75
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Those sources higher up on the hierarchy of evidence are always superior to those below them
Question 76
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Levels of evidence are a method of grading literature quality
Question 77
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Debate exists about the rigidity of the hierarchy of evidence
Question 78
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Different levels of evidence are appropriate for use depending on the setting and intended audience involved
Question 79
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Each study design must be considered for its own strengths and weaknesses prior to selection
Question 80
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Several models exist for the hierarchy of evidence
Question 81
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Expert opinions are considered to be poorer quality evidence, according to most hierarchies
Question 82
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The design of a study affects its position on the hierarchy of evidence
Question 83
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The term 'levels of evidence' was first used and described within a 1979 report by the Canadian Health Task Force on Periodic Health Examination
Question 84
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CINAHL stands for ‘Cumulative Index to Nursing and Allied Health Literature’.
Question 85
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Systematic reviews and meta-analyses are the most reliable forms of evidence.
Question 86
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Randomised controlled trials are the best form of evidence in non-synthesised medical information.
Question 87
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Expert opinion has a lot of bias and is therefore located at the bottom of the hierarchy of evidence.
Question 88
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Studies that limit bias to a greater extent are considered to be better sources of evidence compared to those which don’t.
Question 89
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Randomised control trials aren't always practical or feasible.
Question 90
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A randomised control study in which participants and researchers are blinded gives a higher level of evidence and is a more reliable source.
Question 91
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Cochrane Reviews are systematic reviews of primary research in the health industry and are recognised as the highest standard and most reliable of sources in evidence-based health care resources.
Question 92
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Clinical trials and cohort studies are more reliable sources than expert opinion.
Question 93
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Double blinding lowers a sources evidence strength.
Question 94
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Randomising participants in a randomised control study makes the study less reliable as a source.
Question 95
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The levels of evidence hierarchy is very rigid and studies which are higher on the hierarchy are always better than those which are lower.
Question 96
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Meta-analyses tend to have more bias than cohort studies.
Question 97
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Meta-analyses tend to have more bias than case studies.
Question 98
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Study design has no effect on a studies’ evidence strength.
Question 99
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Expert opinion is the most reliable form of evidence.
Question 100
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There are more meta-analyses available than there are randomised control studies.
Question 101
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Systematic Reviews are rated as the ‘highest level of evidence’ in the evidence hierarchy pyramid.
Question 102
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The Cochrane Library is a database of systematic reviews and meta-‐analyses.
Question 103
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CINAHL stands for ‘ Cumulative Index to Nursing and Allied Health Literature’.
Question 104
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The ‘C’ term within ‘PICO’ stands for comparison.
Question 105
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The TRIP database has a ‘PICO’ search option, which allows users to create a structured clinical question.
Question 106
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To conduct a comprehensive search more than one database should be used.
Question 107
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The ‘wildcard’ symbol can be used to find words with the same stem in order to increase the scope of successful searching.
Question 108
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‘MeSH’ is an indexing feature that stands for Medical Subject Headings.
Question 109
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‘AND’, ‘ OR’ and ‘NOT’ are terms that should never be used while searching medical databases
Question 110
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It is often only necessary to use one database, as they are all linked and have the same results.
Question 111
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Cohort studies are rated as the ‘highest level of evidence’ in the evidence hierarchy
pyramid.
Question 112
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Randomized Control Trials often provide unreliable evidence and should be overlooked when conducting searches.
Question 113
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It is always necessary to have a comparison when conducting a ‘PICO’ search.
Question 114
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Conducting a thorough search should only take around half an hour.
Question 115
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‘MeSH’ is the abbreviation for methanethiol and is irrelevant to the field of evidence-‐based medicine.
Question 116
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Online databases are updated infrequently and as a result textbooks are often more reliable when searching for examples.
Question 117
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The P in PICO stands for Patient.
Question 118
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In PICO the outcome is the end point of interest to you or your patient.
Question 119
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In PICO the comparison is the intervention against which the intervention is measured
Question 120
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A fifth element time is often added to the PICO list.
Question 121
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5. The strongest design for evaluation of a clinical question is a systematic review of multiple randomised clinical trials.
Question 122
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6. You can further filter your search by language, year, or age group.
Question 123
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7. Choosing the right key words and search strategy and using appropriate databases are essential starting points. 8. Advanced searching includes the use of the medical subject headings thesaurus and other strategies to refine and focus the search.
Question 124
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What matters to the practitioner are the most important outcomes.
Question 125
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PICO stands for Patient, Interaction, Comparison and Outcome.
Question 126
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PubMed is not a credible source when researching an article.
Question 127
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Using Mesh headings are irrelevant to the search strategy.
Question 128
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CINAHL is not useful when studying nursing as a prime database.
Question 129
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Having the same search strategy across databases is not necessary.
Question 130
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Endnote is a good database when looking for a systematic review.
Question 131
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When searching for a article filters are unnecessary and time consuming.
Question 132
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The database for nursing and allied health studies is called CINAHL.
Question 133
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The outcome in the ‘P I C O’ principle refers to patient-‐relevant consequences of the intervention.
Question 134
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The AND operator is used when you wish to recall those records containing both search terms.
Question 135
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The intervention in the ‘P I C O’ principle refers to the management strategy of interest.
Question 136
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Medical subject headings (MeSH terms) are a controlled vocabulary device used by the National Library of Medicine to cross-‐reference every Medline article.
Question 137
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The OR operator is used when at least one of the terms must appear in the record, broadening the search and increasing the number of citations received.
Question 138
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The wildcard symbol can be used to find all of the words with the same stem.
Question 139
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Boolean instructions, such as AND, OR, and NOT, operate within most databases and must be typed in upper case.
Question 140
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Finding all relevant studies that have addressed a single question is an easy task.
Question 141
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The NOT operator is used to retrieve records containing both search terms.
Question 142
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PubMed does not retain previous search results on the ‘history’ function on the features bar.
Question 143
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Additional terms cannot be added to an existing search, and therefore multiple searches cannot be combined.
Question 144
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The population in the ‘P I C O’ principle refers to the total population in the patient’s household.
Question 145
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The abstract must not be used as a ‘starting point’ to assist the reader in determining the relevance of the study.
Question 146
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All research questions must contain the comparison component of the ‘P I C O’ principle.
Question 147
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There is no database for psychological studies.
Question 148
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Statistical significance tells us how confident we can be when an effect of an intervention is true/real.
Question 149
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Statistical significance does not tell us if the impact is large enough to be implemented.
Question 150
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Statistical significance is a mathematical phenomenon.
Question 151
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Statistical significance depends on sample size, precision of data and effect size.
Question 152
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Statistical significance looks at the 95% confidence interval.
Question 153
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p values and confidence intervals (CI) are the most commonly used measures of statistical significance.
Question 154
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If a small effect size is found, the treatment may not be clinically important.
Question 155
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The null hypothesis is the basis for formal testing of statistical significance
Question 156
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Clinical significance does not measure how large the differences in treatment effects in clinical practice.
Question 157
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The 35% CI is used to measure statistical significance.
Question 158
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If the sample size is large, the clinical significance will always be large.
Question 159
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The higher the statistical significance the higher the clinical outcome.
Question 160
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Clinical significance is not of importance to a treatment effect.
Question 161
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Statistical significance equates to clinical usefulness.
Question 162
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To be clinically useful, the therapy must do more harm than good.
Question 163
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If a hazard ratio is less than 1,it is not statistically significant.
Question 164
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When a sample size is large, differences that are minute can be detected.
Question 165
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When judging clinical significance 95% confidence intervals should be considered over p-‐ values for large sample sizes.
Question 166
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Clinical significant results make enough of a difference to change the method of practice.
Question 167
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Clinical significance is judging whether the values in the confidence intervals are large enough to care about.
Question 168
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When studies have very large sample sizes, p-‐values can be considered almost obsolete.
Question 169
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Any effect no matter how small, can be seen as statistically significant if the sample size is large enough.
Question 170
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A clinician should decide that the study was large enough and the confidence intervals were small enough to warrant clinical significance.
Question 171
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To determine whether a positive result is clinically significant, the lower boundary of the confidence interval should be looked at.
Question 172
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When a p-‐value is <0.05 the result is considered clinically significant.
Question 173
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A clinical board must reach a unanimous decision to define a result as clinically significant.
Question 174
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Statistical significance shows whether confidence intervals include the null value.
Question 175
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Statistical p-‐values are most helpful for finding clinical significance, when looking at huge sample sizes.
Question 176
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The larger a sample size is the wider a confidence interval becomes, reducing the relevance of statistical significance.
Question 177
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P-‐values depend on the overall sample size, proving clinical significance with large enough numbers.
Question 178
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As huge studies become more prevalent, the difference between clinical significance and statistically significance are becoming irreverent.
Question 179
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Thresholds which patients would consider important in terms of treatment, can not define whether a result is clinically significant.
Question 180
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RCT’s are not always practical. This may be due to ethical issues.
Question 181
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An example of a retrospective study design is a case-‐control study.
Question 182
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The hierarchy of evidence provides a guide towards categorising clinical research.
Question 183
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Studies that limit bias to the greatest extent are higher levels of evidence.
Question 184
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The first step in assessing the validity of a research study is to determine study design.
Question 185
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A systematic review would be an effective trial design to research which NSAID is the least likely to cause a heart attack.
Question 186
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Strengths of case reports and case series study designs are that they are cheap and relatively easy do with existing medical records.
Question 187
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A limitation when using a cohort study design for rare diseases may be that there are not enough patients to be statistically or clinically significant.
Question 188
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RCT’s are generally very inexpensive study designs.
Question 189
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Expert opinion is a higher level of evidence than a case report.
Question 190
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The strength of a case-‐control study design is that you can study a number of diseases and outcomes at any given time.
Question 191
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Cohort studies are not ideal for etiology, harm or prognosis.
Question 192
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Using the term 'safe' to a consumer is preferred rather than using the term 'low risk' as it gives consumer 100% confidence.
Question 193
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It is not appropriate to ask a patient if there is a particular side effect they are concerned about, always list every possible side effect.
Question 194
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Clinical trials never involve human experiments.
Question 195
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Case reports, case series and cross-‐sectional studies are all longitudinal studies.
Question 196
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Systematic reviews is used as a stronger evidence as compared to the expert opinions.
Question 197
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All health professionals should use appropriate language for communication that is understandable to all level of patients.
Question 198
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Visual demonstration is the convenient way to convey the health message across the patients with poor literacy level.
Question 199
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It is the responsibility of the health care provider to provide the effective treatment to the patient.
Question 200
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Strong research method will not only help to get the better outcomes but it also prevent from getting the misleading result, which might be harmful for the patient.