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Part 2

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  1. appreciate • appraise • apply Part 2 Brenda Boucher PT, PhD, CHT, OCS, FAAOMPT

  2. Reliability & Validity

  3. Patient Management Model Diagnosis

  4. Diagnostics Simoneau, GG, Allison SC. Physical therapists as evidence-based diagnosticians. JOSPT. 2010;40(10):603-605.

  5. Examination History Systems review Selected tests & measures Clusters - Syndromes - Categories

  6. Hypotheses Intake form History Patient’s report Rule-in . . . Rule-out Liklihood?

  7. highly unlikely . . . . . . . highly likely pre-test probability

  8. Interpret test results Select best tests

  9. Diagnostic Accuracy • Examination • History • Systems review • Tests & measures Examination

  10. Tests & Measures rule-in . . . rule-out

  11. Reliability |re-ly-a-bi-li-ti| Yielding the same or compatible results in different clinical trials.

  12. Reliabilty Question: “What is my destiny in life?”

  13. Reliabilty Intra-rater reliability Inter-rater reliability

  14. Intra-rater Reliability Inter-rater Reliability

  15. Reliabilty • Intraclass Correlation Coefficient (ICC):usedforcontinuous data and captures both correlation and agreement among raters • Kappa: used for categorical data and takes into account possibility of chance agreement between examiners

  16. Validity Validity: the extent to which an instrument measures that which it is intended to measure.

  17. Validity My emotional state today . . .

  18. References Simoneau, GG, Allison SC. Physical therapists as evidence-based diagnosticians. JOSPT. 2010;40(10):603-605. Portney LG, Watkins MP. Foundations of Clinical Research: Applications to Practice. Upper Saddle River, NJ: Prentice-Hall, 2000. Gyatt G, Rennie D. User’s Guide to Medical Literature: A Manual for Evidence-Based Clinical Practice. Chicago: AMA Press, 2002. Fritz JM, Wainner RW. Examining diagnostic tests: an evidence-based perspective. Physical Therapy. 2001;81(9):1546-1564. Cleland JA, Noteboom JT, Whitman JM, Allison SC. A primer on selected aspects of evidence-based practice relating to questions of treatment, Part 1: asking questions, finding evidence, and determining validity. JOSPT. 2008;38(8):476-484. Noteboom JT, Allison SC, Cleland JA, Whitman JM. . A primer on selected aspects of evidence-based practice relating to questions of treatment, Part 2: interpreting results, application to clinical practice, and self evaluation. JOSPT. 2008;38(8):485-501. Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Physical Therapy. 2005;85(3):257-268.