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75 Cards in this Set
- Front
- Back
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What is the design of a case-control study?
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compared a group of people with disease to a group without
looks for prior exposure or risk factor asks what happened |
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case control: observational, prospective, restrospective?
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observational and retrospective
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What is the design of a cohort study
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compared a group with a given exposure or risk factor to a group without
looks to see if exposure inc. the likelihood of disease asks what will happen |
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cohort: observational, prospective, restrospective?
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observational and prospective
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What is the design of a cross-sectional study
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collects data from a group of people to assess frequency of disease (and related risk factors) at a particular point in time
asks what is happening |
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odd ratio....
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case control
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what is odds ratio
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odds of having a disease in exposed group divided by odds of having disease in unexposed group
approx. relative risk if prevalence of disease is not too high |
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What is the design of a twin concordance study
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compares the frequency with which both monozygotic or both dizygotic twins develop a disease
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What is the design of an adoption study
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compared siblings raised by biological vs. adoptive parents
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What are the phases of a clinical trial
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phase I: small number of patients, usually healthy volunteers
Phase II: small number of patients with disease of interest Phase III: large number of patients randomly assigned either to the treatment under investigation or to the best available treatment (or placebo) Phase IV: postmarketing surveillance trial of patients after approval |
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What is the purpose of each phase
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Phase I: assess safety, toxicity, and pharmacoKINETICS
Phase II: assesses treatment efficiacy, optimal DOSING, and adverse effects Phase III: compared the new treatment to the current standard of care Phase IV: detects rare or long-term adverse effects |
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What is meta-analysis
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pools data from several studies to come to an overall conclusion. achieves greater statistical power and integrates results of similar studies. highest echelon of clinical evidence
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define sensitivity
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proportion of all people with disease who test positive, or the ability of a test to detect a disease when it is present
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define specificity
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proportion of all people WITHOUT disease who test negative or the ability of a test to indicate non-disease when disease is not present
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what is the formula for sensitivity
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= TP/ (TP+FN)
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what is the formula for specificity
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= TN/(TN+FP)
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define PPV & give formula
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proportion of positive test results that are true positive
= TP/(TP+FP) |
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define NPV & give formula
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proportion of negative test results that are true negative
= TN/(TN+FN) |
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formula for prevalence
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= total cases in pop. at gien time/ total pop. at given time
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define incidence
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new cases in pop over a given time period/ total pop at risk during that time period
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prevalence
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incidence * disease duration
prevalence> incidence for chronic disease prevalence = incidence for acute disease |
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define relative risk
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relative probability of getting disease in the exposed group compared to the unexposed group
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define attributable risk
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the difference in risk between exposed and unexposed groups or the proportion of disease occurrences that are attributable to the exposure
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how is relative risk calculated
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percent with disease in exposed group/ percent with disease in unexposed group
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absolute risk reduction- define
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the reduction in risk assoc. with a treatment as compared to a placebo
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define number needed to treat
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measured effectiveness of health care intervention esp. meds
= 1/absolute risk reduction |
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define number needed to harm
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number of patients that need to be exposed to risk over a period to cause harm in 1 patient that otherwise wouldn't have been harmed
= 1/attributable risk |
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define selection bias (berkson bias)
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nonrandom assignment to study group
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define recall bias
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knowledge of presence of disorder alters recall by subjects
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define sampled bias
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subjects are not representative relative to general population therefore results are not generalizable
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define late-look bias
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information gathered at an inappropriate time (ex. survey for fatal disease)
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define procedure bias
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subjects in different groups are not treated the same
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define confounding bias
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occurs with 2 closely assoc. factors; the effect of 1 factor distorts or confuses the effect of the other
can be issue of interpretation |
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define lead-time bias
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early detection confused with inc. survival; seen with improved screening
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define pygmalion effect
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occurs when a researcher's belief in the efficacy of a treatment changes the outcome of that treatment
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hawthorne effect
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occurs when the group being studied changes its behavior owing to the knowledge of being studied
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mean median mode in positive skew
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mean>median>mode
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mean median mode in negative skew
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mean<median<mode
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define null (H0) hypothesis
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hypothesis of no difference (there is no association between the disease and the risk factor in the population)
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define alternative hypothesis (H1)
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hypothesis that there is some difference (e.g. there is some association between the disease and the risk factor in the population)
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Type I error (alpha)
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stating that there IS an effect or difference when none exists
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define p
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probability of making a type I error.
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define type II error (beta)
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stating that there is NOT effect of difference when one exists (to fail to reject the null hypothesis when in fact H0 is false)
beta is the probability of making a type II error |
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reportable diseases
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In all states:
AIDS chickenpox gonorrhea hep A hep B measles mumps rubella salmonellla shigella syphilis TB Other diseases incl HIV vary by state |
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leading causes of death in infants
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congenital anomalies, SIDS, respiratory distress syndrome
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leading causes of death in ages 1-14
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injuries, cancer, congenital anomalies, homicide, heart disease
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leading causes of death in ages 15-24
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injuries, homicide, suicide
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leading causes of death in ages 25-64
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cancer, heart disease, unjuries
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leading causes of death in ages 65+
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heart disease, cancer, stroke
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What are the parts of medicare
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Part A = inpatient care in hospitals, skilled nursing, hospice, home health care
Part B = outpatient care, doctor's services, PT/OT, dialysis, ambulance services, medical equipment Part C - combo of A&B Part D = stand-alone prescription drug coverage |
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what does informed consent require
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1 - discussion of pertinent information
2 - patient's agreement to the place of care 3 - freedom from coercion |
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what are the exceptions to informed consent
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1 - patient lacks decision making capacity of is legally incompetent
2- implied consent is an emergency 3- therapeutic privilege - withholding information when disclosure would severely harm the patient or undermine informed decision making capacity 4- waiver - patient waives the right of informed consent |
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when is paternal consent not required
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emergency situations
prescribing contraceptives treatment involving STDs medical care during pregnancy management of drug addiction |
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exceptions to confidentiality
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1 - potential harm to others is serious
2 - likelihood of harm to self is great 3- no alternative means exist to warn or protect those at risk 4 - physicians can take steps to prevent harm examples: 1- infectious disease 2- tarasoff decision 3 - child/elder abuse 4- impaired automobile drivers 5- suicidal/homicidal patients |
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what does malpractice require for civial suit
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duty, dereliction, damage, direct
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what does APGAR stand for
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appearance, pulse, grimace, activity, respiration
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what are the complications of low birth weight
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infections, RDS, necrotizing enterocolitis, intraventricular hemorrhage, persistent fetal circulation
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age of rooting reflex
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birth-3mo
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age that orients voice
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birth-3mo
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age of social smile
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3mo
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age holds head up
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3mp
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age moro reflex disappears
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3mo
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age baby sits alone
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7-9mo
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age kid crawls
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7-9mo
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age of stranger anxiety
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7-9 mo
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age when says few words
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15 mo
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age when separation anxiety appears
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15 mo
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age when walks
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15 mo
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age babinski disappears
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15mo
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age climbs stairs
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12-24mo
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stacks 3 blocks
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1 y
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stacks 6 blocks
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2 y
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age of object permanence
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12-24 mo
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200 words and 2 word sentences
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age 2
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core gender identity, parallel play
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24-36 mo
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