ATC Evidence-Based Practice 4 — Questions and Answers
Question 1: A high sensitivity test is most useful clinically for which purpose?
- Confirming a diagnosis when positive
- Ruling out a condition when negative (Correct answer)
- Determining treatment prognosis
- Assessing treatment adherence
Correct answer: Ruling out a condition when negative
A highly sensitive test with a negative result effectively rules out the condition, as few true cases are missed (SnNout mnemonic).
Question 2: An athletic trainer encounters conflicting research findings on cryotherapy duration. The BEST next step using EBP principles is to:
- Default to the most recent study only
- Apply the most familiar protocol regardless of evidence
- Synthesize available evidence, consider clinical context and patient preference (Correct answer)
- Await a consensus statement before treating
Correct answer: Synthesize available evidence, consider clinical context and patient preference
EBP requires integrating the best available evidence with clinical judgment and patient values, even when evidence is conflicting.
Question 3: Which of the following is an example of a qualitative research method appropriate for EBP?
- Double-blind RCT
- Focus group interview exploring athlete pain experiences (Correct answer)
- Prospective cohort with outcome measures
- Diagnostic accuracy study
Correct answer: Focus group interview exploring athlete pain experiences
Qualitative methods such as focus groups are used to explore experiences, perceptions, and meanings, complementing quantitative research in EBP.
Question 4: In critically appraising a cohort study, which question is MOST relevant to internal validity?
- Was the sample size large enough for generalizability?
- Were confounding variables identified and controlled? (Correct answer)
- Was the study published in a peer-reviewed journal?
- Was the funding source disclosed?
Correct answer: Were confounding variables identified and controlled?
Controlling for confounding variables is essential to internal validity in cohort studies, ensuring observed associations reflect true relationships.
Question 5: An athletic trainer implements a new concussion protocol based on a systematic review. Six months later, a new RCT contradicts the review findings. The BEST approach is to:
- Ignore the new RCT since the protocol is already implemented
- Immediately change the protocol based solely on the new RCT
- Critically appraise the new RCT and weigh it against the existing systematic review (Correct answer)
- Consult only with the team physician
Correct answer: Critically appraise the new RCT and weigh it against the existing systematic review
EBP requires ongoing critical appraisal; a single new RCT should be appraised in the context of existing evidence before changing established practice.
Question 6: Effect size in research refers to:
- The statistical significance of a finding
- The magnitude of the difference or relationship between variables (Correct answer)
- The number of participants in a study
- The p-value threshold used
Correct answer: The magnitude of the difference or relationship between variables
Effect size quantifies the practical magnitude of a treatment effect or relationship, independent of sample size and p-values.
Question 7: Which component of the GRADE system is used to rate the overall quality of a body of evidence?
- CONSORT
- PRISMA
- Risk of bias, inconsistency, indirectness, imprecision, publication bias (Correct answer)
- QUADAS-2
Correct answer: Risk of bias, inconsistency, indirectness, imprecision, publication bias
The GRADE approach evaluates evidence quality across five domains: risk of bias, inconsistency, indirectness, imprecision, and publication bias.
ATC Evidence-Based Practice 4
A high sensitivity test is most useful clinically for which purpose?