# Measurement, Statistics, and Appraisal Tasks

This article covers NRS 433 Topic 4: Measurement, Statistics, and Appraisal Tasks.

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## NRS 433 Topic 4: Measurement, Statistics, and Appraisal Tasks

Topic 4: Measurement, Statistics, and Appraisal Tasks

## Topic 4 DQ 1

Compare independent variables, dependent variables, and extraneous variables. Describe two ways that researchers attempt to control extraneous variables. Support your answer with peer-reviewed articles.

Re: Topic 4 DQ 1

Variables are the key features for method of inquiry during a science experiment. Experimental methods objectively investigate a hypothesis or research question in order to avoid any bias. The independent variable is the variable which is manipulated in an attempt to have a direct effect on the dependent variable. The dependent variable is the part of the experiment which is being tested and measured and is ‘dependent’ on the independent variable. (McLeod, 2019)

Extraneous variables are the undesirable variables, which is of no particular interest to the researcher, and may influence the outcome of an experiment. Confounding variables are a type of extraneous variable which directly affects how the independent variable acts on the dependent variable. It can lead the researcher to think there is a cause and effect where there is not. Controlling extraneous variables can be done with random sampling. Although random sampling does not completely exclude any extraneous variables, it does help with equality within all groups. (Statistics How To, 2019) Randomized control groups allow chance to select the groups so any confounding variable can be cancelled out, as long as there is a large enough sample group. (Shuttleworth, 2009) Another way the researcher can attempt to control extraneous variables is matching during selection of the study sample. Matching equates participants on the variables being controlled such as age or gender. It involves balancing subjects from a set of background variables before assigning them to the experiment. (Extraneous variables and control techniques, n.d.)

References

Extraneous variables and control techniques. (n.d.). Extraneous variables and control techniques. Retrieved from http://resourcecentre.foodrisc.org/medialibrary/2013/05/10/c504834b/Extraneous%20variables%20and%20control%20techniques.pdf. Topic 4: Measurement, Statistics, and Appraisal Tasks

McLeod, S. (2019, August 1). What are independent and dependent variables? Retrieved from Simply Psychology: https://www.simplypsychology.org/variables.html

Shuttleworth, M. (2009, March 12). Randomized controlled trials. Retrieved from Explorable.com: https://explorable.com/randomized-controlled-trials

Re: Topic 4 DQ 1
In research independent variables are the interventions and are plotted on the X axis, and the dependent variables are the outcome to the intervention plotted on the Y axis (Grand Canyon, 2018). The straighter the line is when plotting the data the stronger the relation is between the intervention and the outcome, this also indicated the validity of the research (Grand Canyon, 2018). Extraneous variables are any variable other than the independent variable that could affect the outcome of the research study. Thus these factors should be controlled as much as possible to assist in providing other explanation of the effect (Mcleod, 2019). Types of extraneous variables are investigator effects, situational, and personal. Some ways to help effects of extraneous Variables is Randomization of group assignments and using Double blinde methods where neither the researcher or participant know if they are receiving the intervention (Grand Canyon, 2018). These methods of controlling extraneous variables help to maintain the validity, however there is no to prove cause and effect 100% as there is no way to account for every extraneous variable, thus we use positive and negative correlation. If there is a positive correlation there is a cause and effect from the intervention. Topic 4: Measurement, Statistics, and Appraisal Tasks
Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice.Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1,ch.4Mcleod, S. (2019, July 30). Extraneous Variable. Retrieved from https://www.simplypsychology.org/extraneous-variable.html

## Topic 4 DQ 2

Describe the “levels of evidence” and provide an example of the type of practice change that could result from each.

Re: Topic 4 DQ 2

Evidence based medicine (EBM) is field that involving seeking evidence and using the evidence to make clinical decisions. The levels of evidence were originally illustrated in the report on periodic health examination in 1979. Randomized clinical trials were described as the highest level of evidence since they are unbiased and less likely to result to systemic error. This because there is randomizing of confounding factors which bias the results. According to this report case series and expert opinion were considered as the lowest levels because of their high probability of being biased based on author experience and lacks control of confounding factors. However this level keeps on being modified based on different settings. According to Centre for Evidence based Medicine, randomized clinical trials are not essential when finding a prognosis of a disease, thus they consider cohort studies and systemic review of cohort studies as the highest of levels of evidence. The levels of evidence are as demonstrated below in the table of levels of evidence for therapeutic studies.

Level 1A – Systemic review of randomized clinical trials (RCT).

Level 1B -Individual RCT.

Level 1C- All or none studies.

Level 2A – Systemic review of cohort studies.

Level 2B – Individual cohort studies.

Level 2C – Research and ecological studies outcomes.

Level 3A – Case-control study systemic review.

Level 3B – Individual study of case-control.

Level 4 – Case series.

Level 5 – Expert opinion.

These levels of evidence has impacted a lot on nursing practice resulting to a lot of practice change. These levels assist the nurses in decision making when considering the best medical intervention to give to the patients. For example, level 4 level of evidence for care report that finger injection with epinephrine results to finger ischemia, this evidence has resulted to nurses avoiding giving finger injections of epinephrine. For the high levels of evidence, health care providers should follow a strong recommendation unless an alternative compelling rationale is available. For the lower levels as the nurses follow the recommendations, they should be alert for new information and respect the preference by the patient.

References.

Centre for Evidence-Based Medicine, http://www.cebm.net

Plast Reconstr Surg. 2011 Jul; 128(1): 305-310. doi 10.10997/PRS.0b013e318219c171.

McCarthy CM, Collins ED, Pusil AL. Where do we find the best evidence? Plast Reconstr Surg. 2008; 122:1942-1947. (PubMed).

Re: Topic 4 DQ 2

Evidence-based practice is a conscientious, problem-solving approach to clinical practice that incorporates the best evidence from well-designed studies, patient values and preferences, and a clinician’s expertise in making decisions about a patient’s care. Evidence based practice in healthcare is about finding evidence and using that evidence to make clinical decisions. In healthcare research, it is generally expected to find the highest level of evidence to answer clinical questions.

Level A evidence, which is the highest level include Randomized Control Trials. Subjects here are selected randomly and assigned to groups randomly. They undergo rigorously controlled experimental conditions or interventions. There is systematic review or meta-analysis of all relevant RCTs. A systematic review is a critical assessment of existing evidence that addresses a focused clinical question, includes a comprehensive literature search, appraises the quality of studies and reports results in a systematic manner. Meta-analysis is a study design that uses statistical techniques to combine and analyze data from many RCTs.

Level B Evidence is obtained from well-designed control trials without randomization. In this type of study, random assignment is not used to assign subjects to experimental and control groups. Therefore, this type of research is less strong in internal validity because it can’t be assumed the subjects in the study are equal on major demographic and clinical variables at the beginning of the trial. Frequent problems with this type of study include intentional or unintentional bias in sample enrollment; nonblinding, unclear criteria for participant selection; or unreliable or invalid tools. Clinical cohort study: an examination of groups of people who have common characteristics or exposure experiences to compare outcomes in those exposed vs. outcomes in those not exposed (e.g., development of heart disease after exposure or nonexposure to 10 years of secondhand smoke).

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Case-controlled study: use of an observational approach in which subjects known to have a disease or outcome are compared with subjects known not to have that disease or outcome. Subjects are matched on characteristics so that they are as similar as possible except for the disease or outcome. Case-control studies are generally designed to estimate the odds (using an odds ratio) of developing the studied condition or disease and can determine if an associated relationship exists between the condition/disease and risk factors. Uncontrolled study: studies that do not control participant selection or interventions (e.g., a convenience sample, such as patients on a given unit, may be studied because it’s the only group reasonably available). Epidemiological study: studies that observe people over a long time to determine risk or likelihood of developing diseases. These studies include retrospective database searches or prospective studies that follow a population over time. Qualitative study/quantitative study: descriptive, word-based phenomena, such as symptoms, behaviors, culture and group dynamics. Quantitative studies use statistical methods to establish numerical relationships that are correlational or cause and effect.

LEVEL C: Evidence obtained from consensus viewpoint and expert opinion: a study that obtains agreement about specific practices from all clinical experts on a review panel. Expert opinion involves obtaining agreement from a majority of clinical experts on a review panel. Note: This level of evidence is used when there are no quantitative or qualitative studies in a particular area. Meta-synthesis: a systematic review that synthesizes findings from qualitative studies using an interpretive technique to bring small study findings, such as case studies, to clinical application. And finally LEVEL ML (multilevel): clinical practice guidelines, recommendations based on evidence obtained from: More than one level of evidence.

Level I – Experimental study, randomized controlled trial (RCT), Systematic review of RCTs, with or without meta-analysis

Level II – Quasi-experimental Study, Systematic review of a combination of RCTs and quasi-experimental, or quasi-experimental studies only, with or without meta-analysis.

Level III – Non-experimental study. Systematic review of a combination of RCTs, quasi-experimental and non-experimental, or non-experimental studies only, with or without meta-analysis. Qualitative study or systematic review, with or without meta-analysis

Level IV – Opinion of respected authorities and/or nationally recognized expert committees/consensus panels based on scientific evidence.
Includes: – Clinical practice guidelines, Consensus panels

Level V is Based on experiential and non-research evidence. Includes: Literature reviews, Quality improvement, program or financial evaluation, Case reports, and Opinion of nationally recognized expert(s) based on experiential evidence.

The levels of evidence are an important component of EBM. Understanding the levels and why they are assigned to publications and abstracts helps the reader to prioritize information. This is not to say that all level 4 evidence should be ignored and all level 1 evidence accepted as fact. The levels of evidence provide a guide and the reader needs to be cautious when interpreting these results.

Reference

Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The levels of evidence and their role in evidence-based medicine. Plastic and reconstructive surgery, 128(1), 305–310. doi:10.1097/PRS.0b013e318219c171

Nurse.com (n.d.) Evidence Based Practice Retrieved from https://www.nurse.com/evidence-based-practice. Topic 4: Measurement, Statistics, and Appraisal Tasks

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

LopesWrite Policy

• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

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Late Policy

• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

• Communication is so very important. There are multiple ways to communicate with me:
• Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
• Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.