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EVIDENCE-BASED PRACTICE AND RESEARCH METHODOLOGY

Academic year and teacher
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Versione italiana
Academic year
2022/2023
Teacher
DANILA AZZOLINA
Credits
4
Didactic period
Primo Semestre

Training objectives

EVIDENCE BASED PRACTICE IN FISIOTERAPIA
On completion of the course the student is expected:
-To describe the architecture of quantitative clinical research. To describe the principles of qualitative and mixed-methods research in physiotherapy and rehabilitation. To identify the types of sources useful for EBP in physiotherapy.
-To formulate a clinical question (PICO), find valid and relevant literature (if possible pre-appraised) in the main resources useful in rehabilitation. To recognize the internal and external validity of what has been found (questions for intervention and diagnosis). To Recognize “certainty of evidence” according to the GRADE system. To integrate evidence, his/her own expertise, values and the specific situation of the person for a shared decision-making process.

INFORMATICS APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH
On completion of the course the student is expected to:
Know the main statistical parameters of descriptive statistics applied to data through Microsoft Excel. Use computer software in order to create and process databases, helpful in clinical setting and research.

STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH
The course is intended to teach basic concepts of descriptive and inferential statistics applied to the biomedical field.
The teaching program is designed to providing the basic knowledge for interpreting the main statistical results reported in scientific evidence.

Prerequisites

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Modulo: 53159 - EVIDENCE BASED PRACTICE IN FISIOTERAPIA
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Knowledge and skills deemed already acquired:
Basic elements of statistics and computer science.
Principles for the formulation of a PICO and for online searching in databases of literature

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Modulo: 53167 - INFORMATICA APPLICATA ALLA EBP E ALLA RICERCA IN FISIOTERAPIA
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Basic knowledge of Microsoft Excel

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Modulo: 53168 - STATISTICA APPLICATA ALLA RICERCA IN FISIOTERAPIA
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Conoscenza di base della epidemiologia e della biostatistica.

Course programme

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Modulo: 53159 - EVIDENCE BASED PRACTICE IN FISIOTERAPIA
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Architecture and aims of quantitative clinical research: experimental (RCT, NRCT, NCT) and observational (transversal, prospective, retrospective) studies.
Diagnostic accuracy indexes (sensitivity, specificity, LR + and LR +, PPV and NPV), Fagan nomogram and their use in the EBP process. Statistical and clinical significance. Definition and interpretation of the confidence interval, MCID (minimally important clinical difference) MDC (minimal detectable change) in the EBP process. Aims of qualitative and mixed methods research in rehabilitation. Objectives, structure and interpretation of systematic reviews and meta-analyses. Elements to identify the risk of bias in trials, primary diagnostic studies and systematic reviews. Reporting Guidelines. Pre-appraised literature resources.

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Modulo: 53167 - INFORMATICA APPLICATA ALLA EBP E ALLA RICERCA IN FISIOTERAPIA
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Management of descriptive statistics and relative application to data through e-spreadsheets. Management of variables. Definition of frequency and calculation of distribution frequency for qualitative and quantitative data by means of Microsoft Excel. Graphic representation of data (steam-leaf) and of distribution. Measures of central tendency, position and dispersion for qualitative data. Functions of statistical analyses in Microsoft Excel and their application to data. Relations between indices. Practical exercises on the computer.

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Modulo: 53168 - STATISTICA APPLICATA ALLA RICERCA IN FISIOTERAPIA
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The course will be structured around the following topics:
1) Descriptive Statistics: central tendency and variability indexes.
2) The fundamentals of probability as applied to diagnostic tests and biomedical research.
4) Statistical inference: Interval estimates (confidence intervals) and hypothesis testing with applications and examples in clinical research.
6) Inference on categorical data: the main measures of association such as Odds Ratio (OR) and Relative Risk (RR).


Didactic methods

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Modulo: 53159 - EVIDENCE BASED PRACTICE IN FISIOTERAPIA
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Frontal lessons; Lectures and interactive lessons and group or individual group works (assessment of risk of bias, clinical relevance), e-learning activities

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Modulo: 53167 - INFORMATICA APPLICATA ALLA EBP E ALLA RICERCA IN FISIOTERAPIA
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Frontal lessons with PC.

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Modulo: 53168 - STATISTICA APPLICATA ALLA RICERCA IN FISIOTERAPIA
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The teaching activity of the course is organized in classroom lessons.

Learning assessment procedures

EVIDENCE-BASED PRACTICE and STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH To be admitted to the exam, the student must have completed all the group works provided in the course. The student will receive a systematic review at least 15 days before the exam date, the student should evaluate and understand it.
The exam takes place on computer support, includes closed-ended questions (with 1 or more correct answers) and short open-ended questions (each can be worth a maximum of 3 points, depending on complexity of the question). The maximum overall achievable score is 32. Honors are obtained with> = 31. At least 1 question will concern: choice of evidence sources, identification of question and study design from an abstract, judgment of the risk of bias (trials, diagnostics and systematic reviews), judgment of statistical significance and clinical relevance of study results, meaning of the research qualitative and mixed methods, shared decision-making process. A number of questions will concern the examined systematic review. Maximum time available 1 hour. Students are given the opportunity to perform an online exam simulation.
INFORMATIC APPLIED TO EBP AND PHYSIOTHERAPY RESEARCH:
Students will perform statistical analysis exercises at the PC using Microsoft Excel. For example, given a text file containing quantitative or qualitative data, you will be asked to import it into an Excel worksheet and then analyze its contents in order to obtain: conditional formatting and data filtering, subdivision into classes, absolute and relative frequency, Trend measures such as media and fashion, dispersion measures such as range and variance, graphical representations of data, stem and leaf organizations, analysis based on pivot tables and everything else seen in class. Each exercise will be associated with a maximum score that the student can get by doing it completely correctly. The final grade will be given by the sum of the scores obtained in each year, sufficiency with 18/30 points, maximum score 30/30.
STATISTICS APPLIED TO PHYSIOTHERAPY RESEARCH:
Written exam with multiple choice quiz. For each question, 1 to 4 correct answers are possible.
Weight average of the marks of the tests taken.

Reference texts

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Modulo: 53159 - EVIDENCE BASED PRACTICE IN FISIOTERAPIA
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Herbert R et al ., Evidence-based physiotherapy. Second edition EDRA 2014 (Italian version) or Herbert, Robert, Practical Evidence- Based Physiotherapy, 2nd Edition . Churchill Livingstone, 2011 (English version) or Ramponi N. e Barbari V. edts. Evidence based practice. La guida completa per il professionista della salute. Fisioscience Ed. 2021
Slides, video presentations and articles provided by the teacher .

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Modulo: 53167 - INFORMATICA APPLICATA ALLA EBP E ALLA RICERCA IN FISIOTERAPIA
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Slide and Excel file provided by the teacher.

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Modulo: 53168 - STATISTICA APPLICATA ALLA RICERCA IN FISIOTERAPIA
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• Martin Bland, Statistica Medica, Apogeo Ed. 2009.
• Marcello Pagano, Kimberlee Gauvreau, Fondamenti di Biostatistica, Idelson Gnocchi 2003.
• Bernard Rosner, Fundamentals of Biostatistics, Cengage Learning 2011.