B5-021 EBM C. difficile Flashcards
causative agent of antibiotic associated colitis
C. difficile
most common microbial cause of HAIs in US hospitals
C. difficile
how does a C. difficle superinfection occur?
- C. dif acquisition
- Antibiotics knock out normal GI flora
- C. diff superinfection and antibiotic associated colitis
how many patients experience recurrence following C. diff infection?
1 in 5
what was the null hypothesis in a non-inferiority trial?
is the new treatment inferior to the standard treatment
what is the biggest limitation of a systematic review?
lack of clarity in the primary study question
major differences in the outcome seen among the studies included in systematic reviews
heterogeneity
- frequently used to estimate treatment effects
- can provide justification for formal RCT
observational cohort study
what does heterogenity suggest in systematic reviews that include both RCTs and observational cohort studies?
confounding in observational studies
what type of bias are we concerned about in a systematic review?
confounding
PICO
Population
Intervention
Control
Outcome
why do we randomize patients?
to ensure both groups are relatively equal at baseline
NNT calculation
1/ARR
study population is defined on the basis of outcome status with backwards directionality
case control study
works well in situations where the outcome of interest is rare
case control study
small study that aggregates information on a few studies and is typically used to describe a new or novel clinical presentation
case series study
compares frequency of and exposure and outcome at a population level
ecologic study
when the exposure of interest and outcome of interest are assessed at the same time, a […] design is employed
cross sectional
conducted using one time survey
cross sectional study
used to calculate prevalence of certain condition, exposure, or state
cross sectional study
used to describe continous data
mean
median
mode
best used to describe cumulative data across study populations
mean and standard deviation
best used for categorical data
risk
allows researchers to compare two treatments and evaluate if the treatment of interest is as good as the control
non inferiority trial
bias of concern in cross sectional and case control designs
recall
addresses possible problems in the makeup of the study population
selection bias
- observer-expectancy effect
- researcher unconsciously influences study participants due to some unrecognized cognitive bias
pygmallion effect
participants change behavior because they are being observed
Hawthorne effect
length of time between detection of disease and the time when usual clinical presentation will occur is altered due to study
lead time bias
why survival time is not used as an indicator of screening test effectiveness in RCT
lead time bias
time is added preferentially to the screened group just because the disease was detected prior to typical clinical presentation
lead time bias