Informatics an Interprofessional Approach 1st Edition By Nelson Staggers-Test Bank
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Sample
Test
Chapter 3: Evidence-Based Practice and Informatics
Test Bank
MULTIPLE CHOICE
1. Knowledge
is the point of convergence across the areas of:
|
a. |
evidence-based practice,
quality assurance, and informatics. |
|
b. |
evidence-based practice,
improvement, and informatics. |
|
c. |
evidence-based practice,
quality assurance, and improvement. |
|
d. |
improvement, quality
assurance, and informatics. |
ANS: B
Knowledge is the point of convergence across the areas of
evidence-based practice, informatics, and improvement. None of the other
answers include all of these aspects.
DIF: Cognitive Level:
Remember
REF: p. 42
2. Which
two hurdles does the STAR Model address in employing evidence-based practice?
|
a. |
The volume and form of
knowledge |
|
b. |
The quality and form of
knowledge |
|
c. |
The volume and outcomes of
knowledge |
|
d. |
The adequacy and form of
knowledge |
ANS: A
The STAR Model addresses two major hurdles in employing
evidence-based practice (EBP). These two hurdles are the volume of current
professional knowledge and the form of knowledge that healthcare professionals
attempt to apply in practice.
DIF: Cognitive Level: Remember
REF: pp. 43-44
3. What
is the form of knowledge in discovery research?
|
a. |
Single research studies |
|
b. |
Meta-synthesis |
|
c. |
Systematic review |
|
d. |
Meta-analysis |
ANS: A
Discovery research represents knowledge produced in the form of single
research studies. The other three choices represent synthesis of multiple
studies.
DIF: Cognitive Level:
Remember
REF: p. 44
4. Which
type of review is considered the most rigorous?
|
a. |
Literature reviews |
|
b. |
Systematic reviews |
|
c. |
Integrative reviews |
|
d. |
Single study reviews |
ANS: B
Evidence summaries include evidence synthesis, systematic
reviews, integrative reviews, and reviews of the literature, with systematic
reviews being the most rigorous approach to evidence summary.
DIF: Cognitive Level:
Remember
REF: pp. 44-45
5. A
facility calls in experts to review evidence developed in research and develop
guidelines for clinical practice. Which stage of EBP is represented?
|
a. |
Evidence summary |
|
b. |
Translation to guidelines |
|
c. |
Practice integration |
|
d. |
Evaluation of process and
outcomes |
ANS: B
In the third stage of EBP, translation, experts are called on to
consider the evidence summary, fill in gaps with consensus expert opinion, and
merge research knowledge with expertise to produce clinical practice guidelines
(CPGs).
DIF: Cognitive Level:
Understand
REF: pp. 46-47
6. Which
indicators have been established for healthcare improvement and for public
reporting?
|
a. |
Quality indicators |
|
b. |
Efficiency indicators |
|
c. |
Cost indicators |
|
d. |
Longevity indicators |
ANS: A
Evaluation of specific outcomes has risen to a high level of
public interest. As a result, quality indicators are being established for
health improvement and public reporting.
DIF: Cognitive Level:
Knowledge
REF: p. 50
MULTIPLE RESPONSE
7. The
goal of the intersection of informatics and evidence-based practice is to
transform healthcare to be: (select
all that apply.)
|
a. |
reliable. |
|
b. |
safe. |
|
c. |
effective. |
|
d. |
efficient. |
ANS: A, B, C
The field of informatics and the concept of evidence-based
practice (EBP) intersect at the crucial junction of knowledge for clinical
decisions with the goal of transforming healthcare to be reliable, safe, and
effective. While efficiency is always a goal in healthcare, it is not a primary
goal of EBP.
DIF: Cognitive Level:
Knowledge
REF: p. 40
8. Which
of the following are evidence summaries: (select all that apply.)
|
a. |
Literature reviews |
|
b. |
Systematic reviews |
|
c. |
Integrative reviews |
|
d. |
Single study reviews |
ANS: A, B, C
Evidence summaries include evidence synthesis, systematic
reviews, integrative reviews, and reviews of the literature.
DIF: Cognitive Level:
Knowledge
REF: pp. 44-45
9. Using
the STAR Model, which of the following points indicate knowledge transformation
has occurred? (Select
all that apply.)
|
a. |
Discovery research |
|
b. |
Evidence summary |
|
c. |
Translation to guidelines |
|
d. |
Practice integration |
|
e. |
Testing the hypothesis |
|
f. |
Evaluation of process and
outcomes |
ANS: A, B, C, D, F
The knowledge transformation process in the STAR Model occurs at
five points, which can be conceptualized as a five-point star. These five
points include discovery research, evidence summary, translation to guidelines,
practice integration, and evaluation of process and outcomes. Testing the
hypothesis is not a specific point in the STAR Model.
DIF: Cognitive Level:
Knowledge
REF: pp. 43-44
10. Standardized
terminology is requisite for: (Select
all that apply.)
|
a. |
naming evidence. |
|
b. |
classifying evidence. |
|
c. |
tagging evidence. |
|
d. |
locating evidence. |
|
e. |
simplifying evidence. |
ANS: A, B, C, D
Standardized terminology is requisite for naming, classifying,
tagging, and locating evidence in order to use it in practice.
DIF: Cognitive Level:
Knowledge
REF: p. 42
Chapter 4: Knowledge Discovery, Data Mining, and Practice-Based
Evidence
Test Bank
MULTIPLE CHOICE
1. Which
measure is most important for evaluating the performance of classifiers, models
that predict class membership?
|
a. |
Root mean squared error
(RMSE) |
|
b. |
Area under the receiver operating
characteristic (ROC) curve |
|
c. |
Percentage of correctly
classified cases |
|
d. |
Hosmer-Lemeshow statistic |
ANS: B
The area under the receiver operating characteristic (ROC) curve
is the most important overall measure of classifier performance.
DIF: Cognitive Level:
Remember
REF: p. 62
2. Which
specialized method(s) is (are) used in knowledge discovery and data mining?
|
a. |
Stratified sampling |
|
b. |
Conceptual analytic methods |
|
c. |
Selection of the optimal
subset of variables/features for use in modeling |
|
d. |
Machine learning |
ANS: C
Knowledge discovery and data mining (KDDM) makes use of
specialized analytic methods, characteristically machine learning, to identify
patterns in a semi-automated fashion.
DIF: Cognitive Level:
Remember
REF: p. 56
3. The
process of knowledge discovery and data mining is best characterized as:
|
a. |
machine learning, use of
statistical methods, large amounts of data. |
|
b. |
a process wherein patients
are selected for clinical trials. |
|
c. |
“fishing” for information
in data. |
|
d. |
cleaning data for further
analysis using other methods. |
ANS: A
Knowledge discovery and data mining (KDDM) is a process in which
machine learning and statistical methods are applied to analyze large amounts
of data.
DIF: Cognitive Level:
Remember
REF: p. 56
4. Which
characteristic is an advantage that practice-based evidence studies have over
RCTs?
|
a. |
Large sample sizes can be
obtained easily. |
|
b. |
Multiple sites are typically
enrolled, resulting in greater generalizability. |
|
c. |
Study efficacy is greater. |
|
d. |
Multiple variables can be
studied. |
ANS: C
Practice-based evidence (PBE) designs trade away the internal
validity of RCTs for external validity. PBE designs have high external validity
because they include virtually all patients with, or at risk for, the condition
under study, as well as potential confounders that could alter treatment
responses. PBE designs attempt to minimize threats to internal validity by trying
to collect information on all patient variables – demographic, medical,
nursing, functional, and socioeconomic – that might account for differences in
outcome. By doing so, PBE designs minimize the need for compensating
statistical techniques such as instrumental variables and propensity scoring to
mitigate selection bias effects, unknown sources of variance, and threats to
internal validity.
DIF: Cognitive Level:
Understand
REF: pp. 62-64
5. Which
is not a common step in a practice-based evidence study?
|
a. |
Assemble a
multidisciplinary project team |
|
b. |
Measure patient severity |
|
c. |
Obtain patient consent |
|
d. |
Collect data |
ANS: C
It is not necessary to obtain patient consent when treatment is
not altered.
DIF: Cognitive Level:
Understand
REF: pp. 66-67
6. Practice-based
evidence studies differ from traditional observational designs in several main
ways. What is one of those main differences?
|
a. |
Exhaustive attention paid
to patient characteristics |
|
b. |
Excluding clinicians in the
study design to improve treatment efficacy |
|
c. |
Use of small sample sizes
and specific patient sources/settings |
|
d. |
General, unstructured
documentation of interventions |
ANS: A
Practice-based evidence involves intense attention to patient
characteristics; including clinicians in the design; use of large sample sizes
and diverse patient sources/settings; and detailed, standardized structured
documentation of interventions.
DIF: Cognitive Level:
Apply
REF: p. 56
MULTIPLE RESPONSE
7. Which
methods are examples of data mining? (Select
all that apply.)
|
a. |
Decision trees |
|
b. |
Stratified random sampling |
|
c. |
Bayesian networks |
|
d. |
Artificial neural networks |
|
e. |
Factor analysis |
ANS: A, C, D
Decision trees, Bayesian networks, and artificial neural
networks are methods commonly used in data mining.
DIF: Cognitive Level:
Remember
REF: p. 61; Table 4-2
8. Practice-based
evidence requires close partnering with informatics specialists to: (select all
that apply)
|
a. |
design screens and terms to
capture interventions. |
|
b. |
create and maintain the
databases required for PBE studies. |
|
c. |
upgrade EHR modules so all
sites are on the same version of software. |
|
d. |
ensure all end users are trained. |
ANS: A, B
While upgrades are an informatics responsibility, sites do not
have to be on the same version of software to do PBE studies.
DIF: Cognitive Level:
Understand
REF: pp. 66-67
9. In
which aspects does practice-based evidence differ from evidence-based practice?
(select all that apply)
|
a. |
PBE incorporates patient
choices in decision-making. |
|
b. |
EBP determines best
practices using best evidence like results from RCTs. |
|
c. |
PBE includes family
involvement. |
|
d. |
PBE is prospective, while
EBP is retrospective. |
|
e. |
PBE attempts to capture the
complexity and variability of actual clinical care. |
ANS: B, D, E
EBP refers to identifying the evidence for clinical practice and
conducting practice according to the best evidence. PBE is an innovative
prospective research design that uses data gathered from current practice to
identify what care processes work in the real world. PBE study designs attempt
to capture the complexity presented by patient and treatment differences,
offering a naturalistic view of treatment by examining what actually happens in
the care process, not altering or standardizing the treatment regimen to
evaluate efficacy of a particular intervention, as one does in an RCT or other
types of experimental designs. EBP is about using evidence to guide practice.
PBE is about obtaining evidence from practice.
DIF: Cognitive Level:
Analyze
REF: pp. 62-64
COMPLETION
10. ___________________
refers to the assignment of individual records or rows in a data set to a
specific purpose: model development (training, incremental testing of models
during development) or validation (data held out from the development process
for the purpose of unbiased performance estimation).
ANS:
Partitioning
Partitioning refers to the assignment of individual records or
rows in a data set to a specific purpose: model development (training,
incremental testing of models during development) or validation (data held out
from the development process for the purpose of unbiased performance
estimation).
DIF: Cognitive Level:
Remember
REF: p. 59
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