Chapter 13: Outcomes Research

Chapter 13: Outcomes Research

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Sampling in outcomes studies differs from that in traditional quantitative research in several ways. Which of the following is true?

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

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?

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.

DIF:    Cognitive Level: Analysis                REF:   Page 296

4. Which of the following is a prospective cohort study?

ANS:  C

A prospective study is an epidemiological study in which the researcher identifies a group of people who are at risk for experiencing a particular event. Sample sizes for these studies often must be very large, particularly if only a small portion of the at-risk group will experience the event. The entire group is followed over time to determine the point at which the event occurs, variables associated with the event, and outcomes for those who experienced the event compared with those who did not.

DIF:    Cognitive Level: Comprehension     REF:   Page 309

5. A hospital has recently converted to an “80% BSN staff” policy.” In service of this goal, all newly hired nurses are expected to hold at least a bachelor’s degree in nursing. Within the area of outcomes research, the variable “educational preparation of nurses” is what kind of a variable?

ANS:  B

Structures of care are the elements of organization and administration, as well as provider and patient characteristics, which guide the processes of care. The first step in evaluating structure is to identify and describe the elements of the structure. Various administration and management theories could be used to identify the elements of structure. These elements might be leadership, tolerance of innovativeness, organizational hierarchy, decision-making processes, distribution of power, financial management, and administrative decision-making processes.

DIF:    Cognitive Level: Application           REF:   Page 298