14. Biostats Flashcards

1
Q

2 types of continuous data

A

interval data and ratio data

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2
Q

Interval data definition and example

A

No meaningful zero (zero does not equal none)
Example: temperature scale (0 celcius does not mean no temp)

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3
Q

Ratio data definition and example

A

Meaningful zero (zero equals none)
Example: HR (0 BPM is cardiac arrest)

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4
Q

2 types of discrete data

A

nomial and ordinal

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5
Q

Nomial data definition and example

A

Subjects are sorted into arbitrary categories (names) , order of categories does not matter
Example: gender, ethnicity, martial status, mortality

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6
Q

Ordinal data defintion and example

A

Ranked and has a logical order
Example: pain scale
Note: ordinal scale categories do not increase by the same amount (pain scale 4 is not necessarily 2x more than pain scale 2)

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7
Q

In normal distributions, ___% of values fall within 1 standard deviation of the mean

A

68%

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8
Q

In normal distributions, ___% of the values fall within 2 standard deviations of the mean

A

95%

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9
Q

In normal distributions, 99.7% of the values fall within ___ standard deviations of the mean

A

3 SDs

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10
Q

More lower values in data set and outliers are high values, data is skewed to (left/right), aka (negative/positive) skew

A

Right, positive

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11
Q

More higher values in data set and outliers are low values, data is skewed to (left/right), aka (negative/positive) skew

A

Left, negative

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12
Q

T/F: the null hypothesis and alternative hypothesis are always complementary; when one is accepted, the other is rejected

A

True

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13
Q

Define null hypothesis

A

There is no statistically significant difference between groups

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14
Q

Alpha (error margin) is the threshold for rejecting the null hypothesis. In medical research, alpha is commonly set at ____

A

5% or 0.05

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15
Q

T/F: If the p-value is less than alpha, the null hypothesis is rejected

A

True

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16
Q

T/F: If the p-value is greater than alpha, the null hypothesis is rejected

A

False - if p-value is greater than alpha, the study failed to reject the null hypothesis and results are not statistically significant

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17
Q

If alpha is 0.05, the study reports ___% confidence intervals

A

95%

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18
Q

If p-value is <0.01, it means __% probability (confidence) that the conclusion is correct; less than __% change it’s not

A

99% confidence, 1% chance it’s not

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19
Q

When comparing difference data (means, based on subtraction), the result is statistically significant if the CI range does not include ___

A

zero

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20
Q

When comparing ratio data (relative risk, odds ratio, hazard ratio, based on division), the result is statistically significant if the CI range does not include ___

A

one

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21
Q

A (narrow/wide) CI range implies high precision and a (narrow/wide) CI range implies poor precision

A

narrow, wide

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22
Q

False positive is considered to be a type __ error (null hypothesis was rejected in error)

A

Type 1 error

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23
Q

False negative is considered to be type __ error (null hypothesis is accepted when it should have been rejected)

A

Type 2 error

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24
Q

Study __ is the probability that a test will reject the null hypothesis corrected (i.e. the power to avoid a type 2 error)

A

Study power

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25
Type 2 error is denoted as __
beta (ß)
26
Power equation
Power = 1 - ß
27
If beta is set at 0.2, the study has __% power which means there is a __% chance of missing a true difference and making a type ___ error
80%, 20%, type 2 error
28
____ is the ratio of risk in the exposed group (treatment) divided by risk in the control group
Relative risk
29
Relative risk formula
RR = risk in treatment group / risk in control group
30
RR=1 (100%) implies ____ risk of outcomes in the treatment group
no difference (compared to control)
31
RR > 1 (100%) implies ___ risk of outcomes in the treatment group
greater
32
RR < 1 (100%) implies ___ risk of outcomes in the treatment group
lower
33
Relative risk reduction (RRR) formula
RRR = (%risk in control - % risk in treatment) / % risk in control group RRR = 1 - RR (decimal form)
34
Absolute risk reduction (ARR) formula
ARR = (% risk in control) - (% risk in treatment)
35
ARR of 12% interpretation
12 out of every 100 patients benefit from the treatment For every 100 patients treated, 12 fewer patients will have the outcome
36
____ is the number of patients who need to treat for a certain period of time in order for 1 patient to benefit
Number needed to treat (NNT)
37
Number needed to treat (NNT) and Number needed to harm (NNH) formula
NNT (or NNH) = 1 / (risk in control - risk in treatment) NNT (or NNH) = 1 / ARR *risk and ARR expressed as decimals
38
If ARR is 12%, what is the NNT?
NNT = 1/0.12 = 8.3 --> rounded to 9
39
____ is the number of patients need to treat for a certain period of time in order for 1 patient to experience harm
Number needed to harm (NNH)
40
NNT is rounded (up/down) and NNH is rounded (up/down)
Up, down
41
NNH 90 interpretation
One additional case of outcome expected to occur for every 90 patients taking treatment vs placebo
42
___ is used to estimate the risk of unfavorable events a/w treatment or intervention
Odds ratio
43
Odds ratio (OR) formula
OR = AD/BC A-Treatment outcome present B-Treatment outcome absent C-Control outcome present D-Control outcome abset
43
In a survival analysis, ___ is the rate at which an unfavorable event occurs within a short period of time
Hazard ratio
43
Hazard ratio (HR) formula
HR = Hazard rate in treatment / hazard rate in control
43
OR or HR = 1 interpretation
event rate is same in both groups
44
OR or HR > 1 interpretation
Event rate is higher in treatment group
45
OR or HR < 1 interpretation
Event rate is lower in treatment group
46
___ t-test is used when data from a single sample group is compared with known data from the general population
One-sample t-test
47
___ t-test is used when a single sample group is used for a pre-/post-measurement
Paired t-test
48
___ t-test is used when the study has 2 independent samples: treatment and control groups
Student t-test
49
___ is used to test for statistical significance when using continuous data with 3 or more samples or groups
Analysis of variance (ANOVA) or F-test
50
For nominal or ordinal data, a ___ test is used to determine statistical significance between treatment groups
Chi-square
51
(sensitivity/specificity) describes how effectively a test identifies patients WITH the condition
Sensitivty
52
(sensitivity/specificity) describes how effectively a test identifies patients WITHOUT the condition
Specificity
53
Sensitivity formula A-Positive test, have condition B-Positive test, does not have condition C-Negative test, have condition D-Negative test, does not have condition
Sensitivity = A / (A+C) x 100
54
Specificity formula A-Positive test, have condition B-Positive test, does not have condition C-Negative test, have condition D-Negative test, does not have condition
Specificity = D / (B+D) x 100
55
Sensitivity of 28% interpretation
Only 28% of patients with the condition will have a positive RF result, test will be negative in 72% of patients with disease (missed dx)
56
Specificity of 87% interpretation
Test will be negative in 87% of patients without the disease but 13% of patients without the disease may test positive (false dx)
57
___ analysis includes data for all patients originally allocated to each treatment group even if they did not complete the trial
Intention to Treat
58
___ analysis only include data for patients who completed the trial
Per protocol
59
Name type of study: retrospective comparisons of cases (patients with a disease) and controls (patients without a disease)
Case-control study
60
Name type of study: retrospective or prospective comparisons of patients with an exposure to those without an exposure
Cohort studies
61
Name type of study: prospective comparison of patients who were randomly assigned to groups
Randomized controlled trials
62
Name type of study: analyzes the results of multiple studies
Meta-analysis
63
What type of study is most reliable?
Systematic reviews and meta-analysis
64
List type of studies in order of most reliable to least reliable: Expert opinion, cohort studies, case series and reports, case-controlled studies, randomized controlled trials, systematic reviews and meta-analysis
Systematic reviews and meta-analysis Randomized controlled trials Cohort studies Case-controlled studies Case series and case reports Expert opinion
65
Examples of direct medical costs
Drug prep and administration (including home infusion supplies) Inpatient direct costs: hospital bed, administration, medical staff, surgeries, procedures, labs Outpatient direct costs: office and clinical visits
66
Examples of direct non-medical costs
Travel and lodging costs for patients and caregivers traveling to hospital or clinic Household costs such as childcare or elder care Home health aides, to help with dressing/bathing and other ADLs
67
Examples of indirect costs
Lost work time Low work productivity Morbidity: costs from having the disease and related disability Mortality (death)
68
Examples of intangible costs
Pain, suffering, anxiety, fatigue
69
What type of cost?: A caregiver was hospitalized and needs to pay for eldercare
Non-medical direct cost
70
What type of cost?: Traveling and lodging costs to get to hospital/clinic
Non-medical direct cost
71
What type of cost?: pain/suffering
Intangible
72
What type of cost?: Lost work time
Indirect
73
What type of cost?: Morbidity (costs from having disease and related disability)
Indirect
74
____ represents the change in costs and outcomes when 2 treatment alternatives are compared
Incremental cost-effectiveness ratios
75
Incremental cost ratio formula
Incremental cost ratio = (C2 - C1) / (E2 - E1) C-costs E-effects
76
____ is used when 2 or more interventions have demonstrated equivalence in outcomes and the costs of each intervention are being compared
Cost-minimization analysis (CMA)
77
____ is a systematic process for calculating and comparing benefits and costs of an intervention in terms of monetary units (dollars)
Cost-benefit analysis (CBA)
78
____ is used to compare the clinical effects of 2 or more interventions to the respective costs
Cost-effective analysis (CEA)
79
Cost minimization analysis limitation
Can only compare alternatives with demonstrated equivalent outcomes (example: captopril vs lisinopril, both considered therapeutically equivalent in literature)
80
Cost effectiveness analysis limitation
Cannot compare different types of outcomes (example: asthma program vs diabetes program)
81
____ is a specialized form of CEA that includes QOL component of morbidity assessments (QALY or DALYs)
Cost-utility analysis