Research and Evidence-Based Practice Flashcards

A music therapist conducts a single-subject study using an ABAB reversal design to measure the effect of rhythmic auditory stimulation on gait in a patient with Parkinson's disease. After the second withdrawal phase (second B→A reversal), the target behavior does NOT return to baseline levels. What is the most accurate methodological interpretation of this finding?

Answer: A carryover effect may have occurred, limiting the internal validity of the reversal design for this behavior

When a behavior fails to reverse during the withdrawal phase of an ABAB design, it may indicate a carryover effect — the treatment's impact persists even after it is removed. This compromises the internal validity of the reversal design because the design depends on demonstrating experimental control through reversibility. It does not automatically invalidate the study, reclassify its design, or confirm external validity.

Which of the following best describes the difference between a systematic review and a meta-analysis in the context of evidence-based music therapy practice?

Answer: A meta-analysis is a type of systematic review that statistically pools effect sizes across studies, while a systematic review may not include quantitative synthesis

A meta-analysis is a specific type of systematic review that goes a step further by statistically combining effect size data from multiple studies to produce an overall quantitative estimate. A systematic review may synthesize evidence qualitatively without pooling statistics. Both can include various study designs depending on the research question. Meta-analyses are generally considered high-level evidence, not lower than systematic reviews.

A music therapist reads a study reporting that p = 0.03 for an intervention's effect on anxiety scores. The study had n = 8 participants. Which of the following is the most critical concern when evaluating this finding?

Answer: Statistical significance with a very small sample provides limited information about clinical meaningfulness; effect size and confidence intervals should be examined

A statistically significant p-value in a very small sample (n = 8) can be misleading because it may reflect a large but imprecisely estimated effect, or may result from chance. Effect size (e.g., Cohen's d) and confidence intervals provide crucial context for clinical meaningfulness. The appropriate response is critical appraisal, not wholesale dismissal, and no universal p < 0.01 standard exists for music therapy specifically.

When applying the PICO framework to formulate a clinical question for a music therapy evidence search, which component is most frequently omitted in music therapy research yet is critical for meaningful evidence synthesis?

Answer: Comparison (C), because many music therapy studies lack an active control group, making comparative evidence limited

The Comparison (C) component — specifying what the intervention is being compared to (e.g., standard care, active control, waitlist) — is frequently absent in music therapy literature. Many studies compare music therapy only to no treatment, or have no control condition at all, making it difficult to isolate the specific effects of music therapy versus non-specific factors like social attention. This is a known limitation in synthesizing MT evidence. Outcomes in MT are measurable and the population/intervention components are typically specified.

A board-certified music therapist is reviewing a qualitative phenomenological study on the lived experience of grief in hospice patients who received music therapy. The study reports rich, detailed narratives from 6 participants. A colleague argues the study is 'not scientific' because it lacks statistical data. Which is the most accurate and professionally grounded response?

Answer: Qualitative phenomenological research is scientifically rigorous when it meets criteria such as credibility, transferability, dependability, and confirmability, and addresses questions that quantitative methods cannot

Qualitative research, including phenomenological approaches, is a legitimate and rigorous form of inquiry evaluated by criteria such as Lincoln and Guba's trustworthiness standards (credibility, transferability, dependability, confirmability). It answers questions about meaning, experience, and process that quantitative methods cannot address. In evidence-based practice, qualitative evidence informs clinical judgment, patient values, and contextual understanding — all core EBP pillars. It does not require quantitative replication to be valid.

A music therapist working in a neurological rehabilitation unit wants to implement Neurologic Music Therapy (NMT) techniques based on published research. She finds three RCTs supporting the technique for stroke patients but notes all three were conducted by the same research group. Which evidence-based practice concern does this most directly raise?

Answer: Allegiance effect and lack of independent replication, which threaten the generalizability and confidence in the evidence base

When multiple supporting studies originate from the same research group, there is a risk of allegiance effect — researchers who develop or strongly favor an intervention may unconsciously (or consciously) design studies, analyze data, or report results in ways that favor positive outcomes. The absence of independent replication is a significant limitation in confidence-building for any evidence base. This is distinct from researcher degrees of freedom (which refers to analytical flexibility), therapeutic equivalence, or confirmatory bias in searching.