Exam (elaborations)
Chapter 13 Outcomes Research
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- Nursing research
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- University Of Kansas School Of Pharmacy
Chapter 13 Outcomes Research
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Chapter 13: Outcomes ResearchTest Bank
MULTIPLE CHOICE
1. Sampling in outcomes studies differs from that in traditional quantitative research in several
ways. Which of the following is true?
a. A heterogeneous sample is preferred.
b. A random sample is required.
c. A small, focused sample is artificially assembled.
d. The sample is selected before an intervention occurs.
ANS: A
The preferred methods of obtaining samples are different in outcomes studies; random
sampling is not considered desirable and is seldom used. Heterogeneous, rather than
homogeneous, samples are obtained. Rather than using sampling criteria that restrict subjects
included in the study to decrease possible biases and that reduce the variance and increase the
possibility of identifying a statistically significant difference, outcomes researchers seek large
heterogeneous samples that reflect, as much as possible, all patients who would be receiving
care in the real world.
DIF: Cognitive Level: Comprehension REF: Page 306
2. A preference for type I error, as compared with type II error, in outcomes research means
that
a. The outcomes researcher is not particularly concerned with drawing incorrect conclusions.
b. The outcomes researcher would rather identify a possible connection that doesn’t end up
being true than miss something.
c. The outcomes researcher would rather establish definite causation than an indefinite
connection.
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d. Patients usually don’t recognize what quality of care really is.
ANS: B
Donabedian (1987) identified the following problem-solving styles: (1) routine approaches to
care versus flexibility, (2) parsimony versus redundancy, (3) variations in degree of tolerance
of uncertainty, (4) propensity to take risks, and (5) preference for type I errors versus type II
errors. In a type I error, the null hypothesis is rejected when it is true; this means that a
promising glimmer that may affect outcomes is not noted.
DIF: Cognitive Level: Synthesis REF: Page 294
3. A researcher is studying the likely occurrence rate of secondary cancers after a new schedule
of chemotherapy for childhood leukemia, using a biochemical marker obtained by blood draw
six months after the initiation of chemotherapy. What is the rationale for using this marker as
a proximate outcome, rather than counting the actual rate of secondary cancers?
a. Research on recurrent cancers in children labels them as vulnerable, causing psychological
harm.
b. The final endpoint is not obtainable over a reasonable span of time, since secondary cancers
can occur at any age.
c. Most proximate endpoints are unreliable variables and should not be used unless there are no
final endpoints.
d. The researcher is not interested in whether children suffer a secondary malignancy;
the researcher is merely interested in the marker value.
ANS: B
At the outset of a research project, there may be as yet little scientific basis for judging the
precise relationship between factors and outcome. Many of the influencing factors may be
outside the jurisdiction or influence of the healthcare system or of the providers within it,
occurring much later in time, when subjects have been lost to follow-up. One solution to this
problem of identifying relevant outcomes is to define a set of proximate outcomes specific to
the condition for which care is being provided. Critical pathways and care maps may help the
researcher to define at least proximate outcomes.
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