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4 steps in the Scientific Research Process - correct answer ✔✔1. Pose a research question and hypothesis

2. Develop and implement a research plan
3. Perform data collection and analysis
4. Prepare a research report What framework helps develop a strong research question? and what are some examples of each? - correct answer ✔✔PICOTS Framework

• Population (children, adults, elderly)
• Intervention (medication, device, service)
• Comparator (placebo, treatment, usual care)
• Outcomes (economic, clinical, humanistic)
• Timeline (short-term, intermediate, long-term)
• Setting (outpatient, inpatient, long-term) Differentiate the 2 research design classifications - correct answer ✔✔Experimental: Strongest design to test a research hypothesis. Observational: Designs like cohort study or cross-sectional studies provide the evidence of associations or relationships. define Research Methodology - correct answer ✔✔Provides specific details on data collection and measurement techniques.

Define descriptive statistics VS Inferential statistics - correct answer ✔✔Descriptive statistics: summarize study sample characteristics (e.g. mean, median, mode) Inferential statistics: make inferences or draw conclusions based on data collected (e.g. t-test, analysis of variance) What are the sections (IMRaD) of a research report - correct answer ✔✔Sections (IMRaD): Title Abstract Introduction Methods Results Discussion and/or Conclusions What is found in the introduction of a research report? - correct answer ✔✔- Review of existing literature

• Study rationale and objective What is found in the methods of a research report? - correct answer ✔✔- Description of study design
• Research methods and statistical tests What is found in the results of a research report? - correct answer ✔✔- Findings of descriptive analyses
• Findings of inferential statistics What is found in the discussion and/or conclusions of a research report? - correct answer ✔✔- Explanation of findings
• Study limitations Define Evidence-Based Medicine (EBM) - correct answer ✔✔The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients

Integration of best research evidence with clinical expertise and patient values 4 steps in EBM - correct answer ✔✔1. Asking an appropriate and answerable question

2. Finding evidence
3. Appraising evidence
4. Applying evidence to practice Role of the Pharmacist in EBM - correct answer ✔✔- Practitioner

• Encourager
• Teacher
• Consumers
• Contributors Strengths of EBM - correct answer ✔✔- Attempts to find interventions that actually work, not those that should work or seem to work
• Fosters communication with other clinicians through standardized language
• If combined with information mastery, it can improve one's ability to keep up with new information Weaknesses of EBM - correct answer ✔✔- Focuses on if intervention works, not how/why
• Requires specialized knowledge, skills, and

support mechanisms

• Labor intensive (especially if not combined with information mastery)
• Relative lack of good "Evidence" for many topics
• Some feel following the best evidence is contrary practitioner independence, experience and the "art" of medicine EBM from oldest to most recent - correct answer ✔✔1. Clinical Experience

2. Animal Models
3. Numerical Method
4. Experimental Evidence
5. Evidence-Based Medicine
6. Information Mastery Drug/Medical Information (Centers and Specialists) created in the 1950s? - correct answer ✔✔Poison control centers Drug/Medical Information (Centers and Specialists) created in the 1962? - correct answer ✔✔First DI center Drug/Medical Information (Centers and Specialists) created in the 1971? - correct answer ✔✔- MEDLINE® - first online database

• Mr. Yuk Define primary literature.
• examples

• pros and cons
• length of the information cycle - correct answer ✔✔- original research, Foundation for all other literature
• Many types: clinical studies, case reports, pharmacoeconomic stterm-9udies, posters, conference presentation
• Pros: Ability to obtain current, complete, detailed, and relevant information
• Cons: Must conduct a comprehensive search (via secondary sources), takes time and expertise to evaluate the literature
• info cycle is months-years (more frequent) Between what years was there a peak # of DI centers? - correct answer ✔✔1980-90s What year and how many hospitals had formal DI centers? - correct answer ✔✔2010: ~5% of hospitals had formal DI centers Define secondary literature
• examples
• pros and cons
• length of the information cycle - correct answer ✔✔- indexing tools - help you find primary or tertiary (how to get to original research)
• usually search engines - medline (pubmed), scopus, embase, IPA, google scholar
• Usually electronic databases
• Differ in time frame, literature coverage, source county, and area of specialty
• Important to choose the appropriate database to search
• Search methodology differs between databases

• info cycle: updated daily-weekly (more frequent) Define tertiary literature
• examples
• pros and cons
• length of the information cycle - correct answer ✔✔- summaries and overviews of medical literature does not come up with new data itself
• includes practice guidelines, reviews, textbooks, compendia (lexicomp, micromedex), package inserts, prescribing information, etc. examples: AFP, NEJM, JAMA, BMJ, Annals of internal medicine in the clinic series
• Pros: Easy to use and convenient
• Cons: Limited depth/scope, Bias, Risk of misinterpretation, Evaluation challenging
• Tertiary guidelines, review articles and electronic drug info resources are updated more frequent
• Tertiary textbooks are updates less frequently (around every 3-4 years) Hierarchy of evidence pyramid - correct answer ✔✔The top of the pyramid is the most reliable information Top to bottom: Systematic reviews and meta analyses Randomized trials Cohort studies Case control studies Case series and case reports Opinions

(Cohort studies, case control studies, and case series/reports are considered observational) Characteristics of Case reports and series - correct answer ✔✔- Descriptive studies (they just describe what happened)

• Used to highlight rare or unusual events
• Case report: single case of a new disease or manifestation
• Case series: multiple similar cases Characteristics of Case-control - correct answer ✔✔- Comparison of exposure status among individuals from a population, Is the outcome associated with exposure to the risk factor.
• Cases: patients with the disease or outcome of interest
• Controls: patients without the disease or outcome
• Used to study rare events
• Retrospective Characteristics of Cohort - correct answer ✔✔- The most powerful observational study design, but still no randomization
• Exposed and Unexposed followed until the development of outcome of interest
• Prospective or retrospective Characteristics of Retrospective Cohort - correct answer ✔✔Describes the degree of risk exposure to a risk factor may confer Characteristics of RCTs aka clinical trials - correct answer ✔✔- Gold standard - efficacy and safety
• Always prospective - specific intervention according to pre-planned protocol (a priori)
• Randomization (2 or more groups)
• Intervention vs placebo or active comparator (control)
• Increases internal validity
• Causality

Systematic Reviews (SR) VS Meta-Analysis (MA) - correct answer ✔✔- Research of existing research Systematic Review (SR): A structured process for identifying and summarizing existing studies that address a specific question Meta-analysis (MA): A quantitative synthesis of data derived from individual studies identified through a systematic review Classification of DI Questions/Requests, their complexity, definitions, and examples - correct answer ✔✔Background:

• simple
• Common, well-known, established, uncomplicated info
• Examples:

1. What doses of __ are available?
2. Why can't I administer these medications together?
3. What is this tablet? Foreground:

• complex
• Multifaceted
• Require patient specific knowledge
• Examples:

1. Is emergency contraception effectiveness impacted by weight? Which types of literature are used to answer background questions? And which answer foreground questions? - correct answer ✔✔Background:

• Tertiary resource may answer
• May require primary literature ex) Which statin has the highest rate of muscle pain?
• Foreground question in disguise

ex) What is the dose of vancomycin? Foreground:

• Require multiple resources and primary literature
• May require you to answer background questions first
• Utilize PICO form and the systematic approach the steps involved in the systematic approach to drug DI questions/requests - correct answer ✔✔1. Demographics = Secure requestor demographics

2. Background info = Obtain background information
3. Ultimate question = Determine and categorize the ultimate question
4. Search = Develop a search strategy and conduct a search
5. Information = Evaluate, analyze, and synthesize the information
6. Response= Formulate and provide a response
7. Follow-up/documentation = Conduct follow-up and documentation How does the systematic approach fit into EBM steps? - correct answer ✔✔EBM steps: asking an appropriate and answerable question -demographics -background info -ultimate question finding evidence -search Appraising evidence -information

Applying evidence to practice -response -documentation/follow up What information is collected when securing requestor demographics? - correct answer ✔✔- Name

• Contact info
• Location, affiliation
• Frame of reference (job title, profession, rank)
• Patient-specific vs academic
• Urgency (negotiate response time and format What information is collected when obtaining background information? - correct answer ✔✔- Obtain all necessary patient specific information oAge oHeight/Weight oGender oPMH oMedications oAllergies oPregnancy/lactation status
• Previous management/treatment to date
• Resources already consulted What background information is needed for our question today? General Medical Information Quality Measures - correct answer ✔✔- No standard criteria
• Reputable sources, well-referenced
• Author credentials
• Expertise

• Disclosures/bias
• EBM/Searching skills
• Timing of publication
• Peer review •-Websites
• Domain/associated organizations
• Editorial process/code of conduct
• Lack of advertisements
• Quality seals What 3 things need to be done with the information? - correct answer ✔✔• Evaluate: to determine the significance, worth, or condition of usually by careful appraisal and study
• Analysis: a detailed examination of anything complex in order to understand its nature or to determine its essential features: a thorough study
• Synthesize: the combining of often diverse conceptions into a coherent whole How should the response be given in an DI approach? - correct answer ✔✔Tailor delivery format to requestor's preference What is followed up in an DI approach? - correct answer ✔✔- Outcomes
• Further DI questions The basic indicators of quality for medical literature - correct answer ✔✔-No standard criteria -Reputable sources, well-referenced -author credentials - expertise, disclosures/bias, EBM/searching skills -timing of publication -peer review

-websites: domain/associated organizations, editorial process/code of conduct, lack of advertisements, quality seals The peer review process for medical literature - correct answer ✔✔1. Scientist study something

2. Scientists write about their results
3. Journal editor receives an article and sends it out for peer review
4. Peer reviewers read the article and provide feedback to the editor
5. • Editor may send reviewer comments to the scientists who may then revise and resubmit the article for further review

• If an article does not maintain sufficiently high scientific standards it may be rejected at this point

5. If an article finally meets editorial and peer standards it is published in a journal