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85 Cards in this Set

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What term does the state pertain to?


"As randomized, so analyzed"

Intent to Treat

What is the difference between Relative Risk and Odds Ratio

RR: proportion; compares an event in relation to all the events


Odds Ratio: ratio of ratios; compares events with non events

What 3 criteria must be present in experimental research?

1. cause must precede effect


2. cause and effect must be correlated


3. correlation cant be explained by another variable

T/F



Compliant subjects usually have better outcomes than non-compliant subjects regardless of treatment

True

Describe a Cohort Study

Prospective

Describe a Case Control Study

retrospective

Describe Efficacy and Effectiveness in RCTs

Efficacy refers to those that received treatment


Effectiveness refers to those who were offered treatment



Efficacy excludes non-compliers

Describe internal and external validity

Internal: Did it make a difference?



External: Can it be applied

Describe the 'last assessment point carried forward' technique

Used for non-compliant data, take the last assessment point before they dropped out and carry it forward to each assessment check point

What are the two ways of dealing with non-compliers?

1. implement strategies to minimize withdrawal


2. report lost data in a flow diagram

Describe the psychological theory of the placebo

It's not the treatment that works, it's the belief that it will work



Irving Kirsch Anti-depressant study

Which study discussed in class emphasizes the subjective nature of pain

Talbot, 2000 Wisdom Teeth

Describe the process-of-treatment theory

showing attention and care for the patient triggers physical reactions that reduce stress and promote healing

what is the gold standard study for epidemiology work?

Cohort

What is the key feature of a cohort study?

time

What are the 2 types of epidemiological study designs and their subcategories? Define each.

Descriptive: Cross Sectional (look at the mean difference)


and Ecological (existing data sets; compare/contrast rate of disease in specific popn)


Analytical: Case-Control


and Cohort (individuals with disease are selected and their exposure is traced back in time)

Is a cross sectional design prospective or retrospective?

retro.

Is a case control design prospective or retrospective?

retro.

Is a cohort design prospective or retrospective?

pro.

What is the limitation of the cross sectional design?

outcome measured at a single time point

What are 3 limitations of an ecological design?

Levelof analysis is the population rather than the individual.



Unableto control for the effects of other factors that could obscure the relationship



Only useful at testing initial hypotheses about exposure

The Morris et al Occupational Physical Activity Study is an example of __________ study design.

Ecological.

The Paffenbarger et al. Harvard Alumni study (PA and heart attack levels) is an example of ________ study design.

Cohort.

The Fish Oil study was a ________ design

Cohort.

What are the pros and cons of a cohort study?

Pros: Temporal sequence, multiple effects


Cons: time, money, loss to follow up, rare disease

An odds ratio calculation is used in ______ study

case control and cohort

incidence rate and relative risk calculations are used in _______ study.

cohort

What does an odds ratio of 0.30 mean?

There is a 70% reduced risk in the disease

What are the pros and cons of a case control study?

Pros: valid estimate of exposure disease, $


Cons: temporal sequencing not ideal, recall bias, recruit control participants

What are the equations for Relative risk and Odds Ratio?

RR=[(a/a+b)/(c/c+d)]




Odds Ratio=[(a/c)/(b/d)]

What are the 3 criteria for experimental research?

1. Cause must precede effect


2. cause and effect must be correlated


3. Correlation cannot be explained by another variable

What are the 4 phases of a clinical trial?

1. Small number of patients; emphasis on how drug should be given (dose, frequency)


2. Proof of principle: safety and how well it works


3. Large number of patients; compare to the current standard (RCT)


4. Large number of patients; drug already being marketed; Evaluate long term side effects, risks and benefits

What is the difference between effectiveness and efficacy?

Effective--> on those offered


Efficacy--> on those who receive it

What is the difference between internal and external validity?

Internal: did the treatment make a difference


External: can it be applied

What is the process of treatment theory?

Showing attention, and care to a patient triggers a physical reaction in the body that promotes healing

What is the Hawthorne effect?

Subjects improve their behavior in response to their awareness of being observed

Pygmalion effect "self-fulfilling prophecy"

the greater the expectation placed upon people, the better they perform

What is Relative Risk?

the dif btw event rates in relative terms

How do we calc RRR

ARR/control

How do we calc ARR?

Treatment-Control

What is Absolute Risk?

The actual difference in event rates

How do we calc NNT?

1 or 100/ ARR

What is the event rate?

the # of people experiencing an event as a proportion of the # of people in the population

What are two ways to collect qualitative data?

Analytical narrative: Short interpretive description


Narrative vignette: Detailed description that conveys a sense of holisticmeaning

What is trustworthiness?

quality achieved in a study when the datacollected generally are applicable, consistent, and natural




Is the study competently conducted?

What are the 4 techniques for determining trustworthiness?

1. Triangulation: need three sources of data


2. Consensual Validation: isthe process of achieving mutual agreement between analysts relative to finalorder of each quote and theme


3. Reliability Check: have someone work backwards—theindependent analyst proceeds sequentially to categorize the quotes into theappropriate lower order levels and themes


4. Data Saturation: occurs when the researcher is nolonger hearing or seeing new information

What is the gold standard for measuring PAEE in the free-living environment?

Doubly Labelled Water (DLW)

What is the most accurate (objective) measurements of PA and Body composition?

Actical and iDEXA

How do you calc effect size?

(Mean of exp-mean of control)/ SD of control

Describe the relationship btw effect size, sample size and power

as ES increases, N decreases for the same power

How does changing the P value influence sample size?

Reducing the P value means we need to increase our sample size

What does an alpha of .05 mean?

there is a 5% chance that the data is due to random variability, and a 95% chance that it is not.

What does a power of .8 mean?

If the study was conducted again, there is an 80% chance that the same result would be found.

What are the equations for eta and omega?

What is the coefficient of determination?

one variable can predict a % of the scores from the other variable

Define moderation and mediation

Moderation: Underwhat conditions does X relate to Y? (A third variable)




Mediation: Whydoes variable X relate to Y under some conditions but not others?

What is a type 1 error

reject the null when the hypothesis is True


(There is no difference but we think there is)

What is a type 2 error

Not reject the null when the hypothesis is False


(There is a difference but we think there isn't)

Define effect size.

ES is meaningfulness. It deals the with strength and magnitude of the finding

Define Power

Poweris the probability of rejecting the null hypothesis when the null hypothesis isfalse (e.g., detecting a real difference)

Define Coefficient of Determination

The coefficient of determinationindicates the portion of total variance in one measure that can be explained,or accounted for, by the variance in the other measure (% of overlap)

Advantages (4) and disadvantages (2) of a case-study

Advantages


-Emphasis on helping


-In-depth analysis of how the variables affect each other


-More informative


-$




Dis.


-External validity


-Opportunity for bias





What does equivocal mean?

not clear cut

What type of study was used for the Rifle Shooter?

Case Study

what is the difference btw a case study and a single subject design?

Case study uses one person, single subject design uses a small number of people

What are the advantages (6) and disadvantages of a single subject design?

Advantages


-Focus on measurement of consistency acrosstrials


-Small n


-ID within and btw subject changes


Everyone receives the intervention


-Not hampered by statistical assumptions -Emphasis on socialvalidation




Dis.



What is the key feature of a Single Subject Design?

ongoing assessment for consistency

How do you calculate inter-observer reliability?

dividethe smaller total of the dependent variable by one observer by the larger totalrecorded by the second observer and then multiply by 100

Describe the 3 types of single subject designs

1. Replication Reversal (ABAB): Light switch; turn treatment on and off


2. Multiple Baseline: Baseline gets progressively longer


3. Alternating Treatment: Compares more than one treatment intervention

Why is visual analysis of data advantageous?

if it’s large enough to see it’s likely to be significant

WHat are 3 statistical tests used in Single Subject Designs?

1. Split Method: Atrend line is made in the baseline and then extended into the interventionperiod.Comparethe proportion of data points above and below the line across the two phases.




2. Two SD method:calculatevariability around the mean, 2points above the SD in the treatment phase indicates a change in performance.




3. Trend (Time Series Analysis): Compare slopes of line of best fits

Epidemiological research is _________ not _______

Observational not experimental

Epidemiology research is used to provide the scientificbackbone for public health endeavors, including:

Magnitude of the problem


risk factors


allocate resources


monitor prevention strategies

Descriptive vs Analytical

D: general observations of disease relationship to demographics


A: test specific hypotheses using purely observational methods

What study was the first time epidemiology was used to link levels of PA to disease?

Harvard Alumni, Paffenbarger et al


Examining activity levels and rates of heart attacks

Clinical Trial

test whether one health care interventionis superior to another

Selection Bias

Occurswhen groups are formed on some basis other than random assignment. Thus, whentreatments are administered, because the groups were different to begin with-->rivalhypothesis that differences are due to the initial selection biasesrather than treatment

How do we deal with withdrawl in an ITT analysis

- Designtrial to minimize withdrawal


-Accuratelyreport withdrawal


-Analyticapproaches (lastobservation carried forward, other imputation techniques) canbe used to reduce, but not remove the effect of withdrawal

Hawthorne effect

Feeling of being studied=perform better

Pygmalion Effect

greater the expectation placed upon people, the better they perform

Expectancy Bias

refersto the experimenters’ or researchers’ anticipating that certain participantswill perform better

How do you calc RRR

1-(treated/untreated)


Or ARR/control

How do you calc ARR

treated-untreated

How do you calc NNT?

1 or 100/ ARR

Statistical Sign.


Clinical Sign.

Stat: is this difference likely to be real (not due to chance)




Clinic: is this difference likely to meet the measurement criteria