ACBN Research & Evidence-Based Practice 4 — Questions and Answers
Question 1: When translating research findings into clinical practice, which step is most critical in the evidence-based practice model?
- Finding the study with the largest sample size
- Integrating research evidence with clinical expertise and patient values (Correct answer)
- Following the most recent published guideline without modification
- Replicating the exact research protocol in the clinical setting
Correct answer: Integrating research evidence with clinical expertise and patient values
Evidence-based practice requires integrating the best available research evidence with clinical expertise and individual patient values and preferences.
Question 2: A nutritionist identifies a statistically significant result (p<0.05) showing that a supplement reduces HbA1c by 0.05%. The clinician should recognize that:
- Statistical significance guarantees clinical relevance
- A small effect can be statistically significant but not clinically meaningful (Correct answer)
- The result should be immediately applied to all diabetic patients
- The p-value confirms the supplement is effective
Correct answer: A small effect can be statistically significant but not clinically meaningful
Statistical significance depends on sample size and does not ensure that an effect is large enough to be clinically meaningful or worth recommending.
Question 3: Publication bias in nutrition research refers to the tendency for:
- Authors to publish research in high-impact journals only
- Positive or significant results to be published more frequently than null findings (Correct answer)
- Industry-funded studies to be retracted more often
- Open-access journals to have lower quality standards
Correct answer: Positive or significant results to be published more frequently than null findings
Publication bias skews the evidence base because studies with null or negative results are less likely to be published, inflating the apparent efficacy of interventions.
Question 4: In a prospective cohort study examining diet and cancer risk, confounding occurs when:
- Participants misreport their dietary intake
- A third variable is associated with both the diet exposure and the cancer outcome (Correct answer)
- The study follow-up period is too short to observe outcomes
- Participants are lost to follow-up at different rates
Correct answer: A third variable is associated with both the diet exposure and the cancer outcome
A confounder is a variable that is associated with both the exposure and the outcome, potentially creating a spurious or distorted association.
Question 5: The GRADE system in nutrition research is used to:
- Score individual study quality on a 1–10 scale
- Rate the overall certainty of evidence for specific outcomes across a body of literature (Correct answer)
- Rank nutritionists by their research productivity
- Grade the nutritional quality of foods in clinical trials
Correct answer: Rate the overall certainty of evidence for specific outcomes across a body of literature
GRADE (Grading of Recommendations Assessment, Development and Evaluation) classifies the certainty of a body of evidence as high, moderate, low, or very low.
Question 6: Which of the following best describes an 'intention-to-treat' analysis in a nutrition RCT?
- Analyzing only participants who fully complied with the dietary protocol
- Analyzing all randomized participants in their originally assigned groups regardless of adherence (Correct answer)
- Excluding participants who experienced adverse events from the analysis
- Using the most favorable outcome timepoint for each participant
Correct answer: Analyzing all randomized participants in their originally assigned groups regardless of adherence
Intention-to-treat analysis maintains the integrity of randomization by including all participants regardless of protocol adherence, reducing bias.
Question 7: A nutritionist applies PICO to frame a clinical question. In PICO, the 'C' stands for:
- Clinical context of the patient population
- Comparison or control intervention (Correct answer)
- Certainty of the evidence quality
- Co-morbidities affecting the outcome
Correct answer: Comparison or control intervention
In PICO, C stands for Comparison — the alternative intervention or control condition being compared to the primary intervention of interest.
ACBN Research & Evidence-Based Practice 4
When translating research findings into clinical practice, which step is most critical in the evidence-based practice model?