OCC OCC Clinical Trials & Evidence-Based Practice 2 — Questions and Answers
Question 1: Which study design provides the HIGHEST level of evidence for evaluating the effectiveness of a new chemotherapy regimen?
- Case series
- Expert consensus guidelines
- Randomized controlled trial (RCT) (Correct answer)
- Retrospective cohort study
Correct answer: Randomized controlled trial (RCT)
The randomized controlled trial is the gold standard study design for establishing causal efficacy by minimizing bias through randomization and controlled comparison.
Question 2: A patient's oncologist recommends a treatment listed as Category 1 in the NCCN Guidelines. What does this designation mean?
- The treatment is experimental and only available in clinical trials
- High-level evidence with uniform consensus that the recommendation is appropriate (Correct answer)
- The treatment is approved by the FDA for this indication
- Expert opinion supports this as a preferred option with limited evidence
Correct answer: High-level evidence with uniform consensus that the recommendation is appropriate
NCCN Category 1 designations indicate high-level evidence (usually from RCTs) with uniform consensus among NCCN panel members supporting the recommendation.
Question 3: The oncology nurse is reviewing a study that reports a hazard ratio (HR) of 0.65 with a 95% CI of 0.50-0.85 for a new drug versus placebo. What does this mean?
- The new drug increases the risk of the event by 35%
- The new drug reduces the risk of the event by 35%, and this is statistically significant (Correct answer)
- The result is not statistically significant because the CI crosses 1.0
- The drug has no effect because the HR is less than 1.0
Correct answer: The new drug reduces the risk of the event by 35%, and this is statistically significant
An HR of 0.65 means a 35% reduction in the hazard (risk) of the event; since the 95% CI (0.50-0.85) does not cross 1.0, the result is statistically significant.
Question 4: Which quality improvement model is MOST commonly used in oncology nursing practice to implement and evaluate evidence-based changes?
- PDSA (Plan-Do-Study-Act) cycle (Correct answer)
- Root cause analysis (RCA)
- Failure mode and effects analysis (FMEA)
- Six Sigma DMAIC
Correct answer: PDSA (Plan-Do-Study-Act) cycle
The PDSA cycle is the most widely used quality improvement model in nursing and oncology practice for iterative, evidence-based practice change.
Question 5: A nurse wants to find the best evidence for managing chemotherapy-induced nausea. Which resource provides the MOST credible, peer-reviewed clinical practice guidelines?
- General internet search engines
- Pharmaceutical manufacturer prescribing information only
- ASCO, ONS, or NCCN clinical practice guidelines (Correct answer)
- Patient advocacy websites
Correct answer: ASCO, ONS, or NCCN clinical practice guidelines
Professional organization guidelines from ASCO, ONS, and NCCN are developed through systematic evidence review and expert consensus, providing the most credible clinical practice guidance.
Question 6: A nurse is implementing a new evidence-based protocol for central line care. Which approach BEST demonstrates integration of evidence-based practice (EBP)?
- Applying the protocol as written without adaptation to the patient population
- Combining current best evidence, clinical expertise, and patient preferences to guide implementation (Correct answer)
- Implementing the protocol only after all staff agree it is superior
- Using only the most recent published study without consulting clinical experts
Correct answer: Combining current best evidence, clinical expertise, and patient preferences to guide implementation
Evidence-based practice integrates the best available research evidence with clinical expertise and individual patient values and preferences.
OCC OCC Clinical Trials & Evidence-Based Practice 2
Which study design provides the HIGHEST level of evidence for evaluating the effectiveness of a new chemotherapy regimen?