Deck 8: The Policy Analysis Process: Evidence-Based Medicine

Question 1

Evidence-based medicine is also sometimes called:

A) alternative medicine.
B) integrated medicine.
C) top-down medicine.
D) homeopathic medicine.

Answer 1

C

Question 2

Evidence-based medicine can be implemented as:

A) a top-down approach only.
B) a bottom-up approach only.
C) neither a top-down nor a bottom-up approach.
D) both a top-down and a bottom-up approach.

Answer 2

D

Question 3

Evidence-based medicine can take into account:

A) patient variability.
B) situational factors.
C) the provider's expertise.
D) all of the above.

Answer 3

D

Question 4

Resistance to evidence-based medicine often stems from:

A) payers' worry over the high costs of implementation.
B) providers' concern that it will remove their independence.
C) the fact that protocols are not based on homogeneous populations.
D) fears that patient preferences are not addressed.

Question 5

Standardizing treatment protocols:

A) causes fewer resources to be wasted.
B) drastically increases the cost of health care.
C) leads to less consistent patient outcomes.
D) strips providers of their autonomy.

Question 6

Why might a provider be interested in using a standardized clinical assessment and management plan (SCAMP)?

A) SCAMPs require providers to standardize treatment, allowing them to see more patients.
B) SCAMPs reduce the amount of paperwork providers must deal with.
C) SCAMPs give providers a bit more flexibility when working with patients.
D) SCAMPs make it easier for providers to submit claims to insurance companies.

Question 7

Which of the following has NOT been an important factor in the rise to prominence of evidence-based medicine?

A) Pressures on providers to conserve time
B) Patient concerns about the cost of health care
C) The sluggish pace of technological change
D) Promotion of negative results

Question 8

Why must policy makers be wary of advocates of so-called policy-based evidence?

A) They start with their desired conclusion and report only evidence that supports it.
B) They want external evidence to completely replace individual clinical experience.
C) They integrate individual clinical expertise with the best available clinical evidence.
D) Their conclusions are based only on statistical analysis involving homogeneous populations.

Question 9

Which of the following is the first step in evidence-based analysis?

A) Assess the validity of available evidence.
B) Search the available literature for information.
C) Implement specific approaches in practice.
D) Generate a problem definition.

Question 10

When one searches for "levels of evidence" online, the MOST reliable evidence consists of:

A) systematic studies that integrate findings from multiple studies.
B) randomized controlled trials.
C) anecdotes, personal opinions, and case reports.
D) meta-analyses involving multiple studies.

Question 11

Generally, how reliable are clinical guidelines?

A) They are the least reliable evidence available.
B) They are fairly reliable, but variable in their underlying levels of evidence.
C) They are roughly as reliable as patient anecdotes.
D) They are among the most reliable evidence available.

Question 12

Why do clinicians find the guidelines of the U.S. Preventive Services Task Force especially helpful?

A) The guidelines are easy to implement and cost almost nothing.
B) Clinicians have had a great deal of input in the development of these guidelines.
C) Guidelines can be implemented by patients themselves, saving clinicians' time.
D) Most clinicians must rely on these guidelines rather than on their own experience.

Question 13

The pyramid of evidence:

A) is topped by randomized controlled trials.
B) is displayed with four to ten levels.
C) does not include meta-analysis.
D) excludes observational studies.

Question 14

Comparative effectiveness studies:

A) are much more tightly controlled than randomized, controlled clinical trials.
B) constitute proof of efficacious treatment.
C) tend to be observational in nature.
D) are not suitable for hypothesis generation.

Question 15

A clinician's experience can often be influenced by:

A) past training.
B) marketing from drug companies.
C) personal economic interests.
D) all of the above.

Question 16

The attempt to connect medical research with clinical practice is called:

A) primary research.
B) translational research.
C) integrative research.
D) transformative research.

Question 17

All of the following are behind the trend toward making patients part of the decision-making process, EXCEPT:

A) a severe shortage of practicing clinicians, especially in large cities.
B) discomfort with the controlling nature of the provider's typical role.
C) a desire by both providers and patients to lower health care costs.
D) the finding that patient-driven care leads to better outcomes.

Question 18

In the collaborative relationship between provider and patient, which of the following would be considered mostly a role for the provider?

A) Engaging in comparison shopping
B) Keeping up with the relevant scientific literature
C) Using consumer satisfaction databases
D) Gathering data on in-network providers

Question 19

Which of the following has proven a significant barrier in the adoption of patient-driven health care?

A) The ACA actively discourages the adoption of patient-driven health care.
B) Evidence indicates that patient-driven health care costs far more than traditional provider-led health care.
C) Many physicians question the ability of patients to understand complex medical information.
D) Current information technology does not support the distribution of decision aids for patients.

Question 20

Most randomized, controlled clinical trials are conducted on:

A) medical devices.
B) physical therapy techniques.
C) proposed prescription drugs.
D) vitamins and nutritional supplements.

Question 21

When evidence-based medicine is implemented with the bottom-up approach, experts form a consensus based on strong empirical evidence, and that consensus is then spread as standard operating procedure.

Question 22

Some providers are concerned about requiring evidence-based practices for diagnoses where there is not enough hard knowledge from which to draw conclusions.

Question 23

Patients are increasingly inclined to question their physician's recommendations because of health-related information they see on television and online.

Question 24

The foundation of evidence-based medicine is continuous personal, professional, and organizational learning.

Question 25

The gold standard for gathering new evidence is the comparative effectiveness study.

Question 26

Patients' self-reports should never be considered when gathering new clinical evidence.

Question 27

The UK's National Institute for Health and Care Excellence includes the views of experts, patients, and providers when it assesses evidence and develops guidelines.

Question 28

Manufacturers tend to support studies in which a placebo is the control, implying that the product being tested merely needs to be better than doing nothing at all.

Question 29

Translational research seeks to improve public health by supporting anecdotal evidence, holistic medicine, and naturopathy.

Question 30

Policy makers in the United States increasingly avoid demanding evidence-based decisions behind closed doors.