CCM Research Methods & Evidence-Based Practice 2 — Questions and Answers
Question 1: Which study design is considered the gold standard for establishing cause-and-effect relationships in clinical research?
- Cross-sectional survey
- Randomized controlled trial (RCT) (Correct answer)
- Case-control study
- Retrospective cohort study
Correct answer: Randomized controlled trial (RCT)
RCTs use random assignment to treatment and control groups, minimizing bias and allowing causal inference.
Question 2: A care manager uses a validated depression screening tool because multiple studies confirm its accuracy. This practice best exemplifies:
- Clinical intuition
- Evidence-based practice (EBP) (Correct answer)
- Anecdotal reasoning
- Peer benchmarking
Correct answer: Evidence-based practice (EBP)
EBP integrates best available research evidence with clinical expertise and patient values in decision-making.
Question 3: In a research study, internal validity refers to:
- The degree to which findings can be generalized to other populations
- Whether the study measures what it intends to measure
- The accuracy of statistical analyses used
- The extent to which results are free from confounding variables (Correct answer)
Correct answer: The extent to which results are free from confounding variables
Internal validity is threatened when confounders, selection bias, or measurement errors distort the true relationship between variables.
Question 4: A systematic review differs from a traditional narrative literature review primarily because it:
- Includes only qualitative studies
- Uses transparent, reproducible methods to identify and synthesize all relevant studies (Correct answer)
- Focuses on a single institution's findings
- Is conducted by a single expert reviewer
Correct answer: Uses transparent, reproducible methods to identify and synthesize all relevant studies
Systematic reviews follow explicit, pre-specified methods to minimize bias when locating, appraising, and synthesizing evidence.
Question 5: Which level of the evidence hierarchy provides the weakest support for clinical decision-making?
- Meta-analysis of RCTs
- Single RCT
- Expert opinion and case reports (Correct answer)
- Cohort studies
Correct answer: Expert opinion and case reports
Expert opinion and case reports sit at the bottom of the evidence hierarchy due to high susceptibility to bias.
Question 6: A care manager notices that patients who choose a new program tend to be healthier than those who do not. This is an example of:
- Information bias
- Attrition bias
- Selection bias (Correct answer)
- Observer bias
Correct answer: Selection bias
Selection bias occurs when the groups being compared differ systematically in ways other than the exposure or intervention under study.
Question 7: In quantitative research, a p-value of 0.03 means:
- There is a 3% chance the null hypothesis is true
- There is a 97% chance the findings are clinically meaningful
- There is a 3% probability of observing the results if the null hypothesis were true (Correct answer)
- The effect size is small
Correct answer: There is a 3% probability of observing the results if the null hypothesis were true
The p-value represents the probability of obtaining results as extreme as observed, assuming the null hypothesis is true.
CCM Research Methods & Evidence-Based Practice 2
Which study design is considered the gold standard for establishing cause-and-effect relationships in clinical research?