Pcm Test 2

Front 1

A Recommendation for Colon Cancer Screening for patients 50 to 75 yrs of age

Back 1

1. Three stool cards yearly
2. Flexible sigmoidoscopy every 5 years and stool cards every 3 years


3. Colonoscopy every 10 years

Front 2

When to begin earlier than 50-75 colonoscopy

Back 2

1 family history of first degree relative diagnosed before age 60
2 family history of nonpolyposis colorectal CA
3. Personal history of ulceritive colitis

Front 3

Target Groups for Influenza Vaccine

Back 3

Over 65
between 50-65
health care workers
children 6 months to 18 years
pregnant women
chronic cardiovascular, pulmonary, other chronic disorders
other impaired respiratory disorders

Front 4

Quality Improvement Steps

Back 4

Baseline measurement opportunity to improve
Standard/target defined
Implementing a change
Make someone responsible
Remeasure and asses

Front 5

Pre-test probability

Back 5

prevalence of disease among patients presenting with similar symptoms and exam findings

Front 6

Pre-test odds

Back 6

prevalence disease/1-prevalence of disease

Front 7

RELIABILITY

Back 7

reproducibility, consistency, precision

Front 8

Accuracy

Back 8

truth, absence of bias, Validity

Front 9

Sensitivity

Back 9

Proportion of patients with disease who have a given physical exam finding
Proportion of actual positives which are correctly identified

Front 10

Remember SNout

Back 10

Sensitive finding negative-rule out disease

Front 11

Specificity

Back 11

Proportion of patients without disease who do not have a particular exam finding
Remember SPin-(Specific finding positive-rule in disease)
Proportion of actual negatives which are correctly identified

Front 12

Positive predictive value

Back 12

number of true positive tests divided by all positive tests

Front 13

Negative predictive value

Back 13

number of true negatives divided by all negative tests

Front 14

Positive likelihood ratio (+LR)

Back 14

Proportion of patients with disease who have a particular finding divided by the proportion of patients without disease who also have the same finding

Front 15

sensitivity

Back 15

Proportion of patients with disease who have a particular finding (true positives)

Front 16

Proportion of patients without disease who have a particular finding

Back 16

1-specificity (false positives)

Front 17

Post-test odds

Back 17

pre-test odds x positive LR

Front 18

Post-test probability

Back 18

post-test odds/(1+post-test odds)

Front 19

Negative likelihood ratio

Back 19

describes how probability changes when the exam finding is absent.
The lower the negative LR, the less likely disease is present given the absence of an exam finding
If the LR is one (or close to it) then the absence of an exam finding is not helpful and it won’t change the pre-test probability of disease
(1-sensitivty)/(specificity)= FN/TN

Front 20

Case-control study

Back 20

An “observational” design comparing exposures in disease cases vs. healthy controls from same population Exposure data collected retrospectively

Front 21

Cohort studies

Back 21

Collect information on exposures (smoking, diet, activity, drugs…) and then follow them for disease occurrence
As long as information on the exposure was documented before the outcome, it is a cohort study
Compares incidence in exposed and non-exposed
Subjects selected before disease detection

Front 22

Randomized controlled trial

Back 22

Randomization ensures that groups are equal for both known or measured factors and unknown or unmeasured factors

Front 23

Healthy person bias

Back 23

people that enroll in a trial are more likely on average to be more health conscious and will follow doctors advice better- i.e. they are more healthy.