CSC Research & Evidence-Based Practice 3 — Questions and Answers
Question 1: Which component of the PICO framework identifies the patient group for a clinical research question about atrial fibrillation management?
- P — Population/Problem (Correct answer)
- I — Intervention
- C — Comparison
- O — Outcome
Correct answer: P — Population/Problem
The 'P' in PICO stands for Population or Problem, defining the specific patient group of interest in the clinical question.
Question 2: A study reports a hazard ratio of 0.72 (95% CI 0.55–0.94) for cardiovascular death with a novel anticoagulant. What does crossing 1.0 imply for statistical significance?
- The result would be statistically significant
- The result would not be statistically significant (Correct answer)
- The effect size would increase
- The confidence interval would narrow
Correct answer: The result would not be statistically significant
If the 95% CI for a ratio measure crosses 1.0, the result is not statistically significant at p < 0.05.
Question 3: In which phase of a clinical trial is the primary goal to determine the optimal dose and safety profile of a new cardiac drug?
- Phase I
- Phase II (Correct answer)
- Phase III
- Phase IV
Correct answer: Phase II
Phase II trials focus on dose optimization and preliminary efficacy and safety in a larger group after initial safety is established in Phase I.
Question 4: A systematic review of cardiac resynchronization therapy studies uses funnel plot asymmetry. What is being assessed?
- Clinical heterogeneity between studies
- Publication bias (Correct answer)
- Confounding variables
- Measurement error across studies
Correct answer: Publication bias
Funnel plot asymmetry is used to detect publication bias, where smaller negative studies may be underreported.
Question 5: Which study design is considered the gold standard for establishing causality in cardiac pharmacotherapy research?
- Prospective cohort study
- Randomized controlled trial (Correct answer)
- Systematic review without meta-analysis
- Case series
Correct answer: Randomized controlled trial
The randomized controlled trial (RCT) is the gold standard because randomization controls for known and unknown confounders.
Question 6: A cardiologist reads that a new device has a sensitivity of 90% for detecting paroxysmal AF. A patient tests negative. Which term describes the probability the patient truly does not have AF?
- Positive predictive value
- Negative predictive value (Correct answer)
- Specificity
- Likelihood ratio negative
Correct answer: Negative predictive value
Negative predictive value (NPV) is the probability that a patient with a negative test result truly does not have the disease.
Question 7: In Sackett's original EBP model, which three elements must be integrated for optimal clinical decisions in cardiology?
- Best evidence, clinical expertise, and patient values (Correct answer)
- Guidelines, protocols, and peer review
- Research design, statistical power, and cost analysis
- Randomized trials, meta-analyses, and expert consensus
Correct answer: Best evidence, clinical expertise, and patient values
Sackett defined EBP as the integration of best research evidence, clinical expertise, and patient values and preferences.
CSC Research & Evidence-Based Practice 3
Which component of the PICO framework identifies the patient group for a clinical research question about atrial fibrillation management?