BEHAVIORAL SCIENCE Flashcards

Question

WHat does incincidence look at?

Answer 1

NEW CASES (INCIDENTS)

Answer 2

Prevalence = # of existing cases __________________ Population at risk Prevalence ≈ incidence rate × average disease duration.

Answer 3

Prevalence looks at all current cases.

Answer 4

Typically used in case-control studies. Odds that the group with the disease (cases) was exposed to a risk factor (a/c) divided by the odds that the group without the disease (controls) was exposed (b/d). OR= a/c / b/d = ad / bc

Answer 5

The proportion of risk reduction attributable to the intervention as compared to a control. RRR = 1 – RR (e.g., if 2% of patients who receive a flu shot develop flu, while 8% of unvaccinated patients develop the flu, then RR = 2/8 = 0.25, and RRR = 1 – RR = 0.75).

Answer 6

The difference in risk between exposed and unexposed groups, or the proportion of disease occurrences that are attributable to the exposure (e.g., if risk of lung cancer in smokers is 21% and risk in nonsmokers is 1%, then 20% (or .20) of the 21% risk of lung cancer in smokers is attributable to smoking).

Answer 7

AR = a/(a+b) - c/(c+d)

Answer 8

The difference in risk (not the proportion) attributable to the intervention as compared to a control (e.g., if 8% of people who receive a placebo vaccine develop flu vs. 2% of people who receive a flu vaccine, then ARR = 8% - 2% = 6% = .06). (Risk factor +, Disease + = a) (Risk factor +, Disease - = b) (Risk factor - , Disease + = c) (Risk factor -, Disease + = d)

Answer 9

Number of patients who need to be treated for 1 patient to benefit. Calculated as 1/ARR.

Answer 10

Number of patients who need to be exposed to a risk factor for 1 patient to be harmed. Calculated as 1/AR.

Answer 11

Precision: The consistency and reproducibility of a test (reliability). The absence of random variation in a test. (more precision --> less standard deviation) Accuracy: The trueness of test measurements (validity). The absence of systematic error or bias in a test.

Answer 12

Random error

Answer 13

Systemic error

Answer 14

Nonrandom assignment to participate in a study group. Most commonly a sampling bias. Examples include: Berkson bias A study looking only at inpatients Loss to follow-up Studying a disease with early mortality Healthy worker and volunteer biases Study populations are healthier than the general population Reduce bias by: Randomization Ensure the choice of the right comparison/reference group

Answer 15

Awareness of disorder alters recall by subjects; common in retrospective studies. Ex: Patients with disease recall exposure after learning of similar cases Reduce by: Decrease time from exposure to follow-up

Answer 16

Information is gathered in a way that distorts it. Ex: Hawthorne effect — groups who know they’re being studied behave differently than they would otherwise Reduce by:Use of placebo control groups with blinding to reduce influence of participants and researchers on experimental procedures and interpretation of outcomes

Answer 17

Subjects in different groups are not treated the same. Ex:Patients in treatment group spend more time in highly specialized hospital units Reduce by:Use of placebo control groups with blinding to reduce influence of participants and researchers on experimental procedures and interpretation of outcomes

Answer 18

Researcher’s belief in the efficacy of a treatment changes the outcome of that treatment (aka Pygmalion effect; self-fulfilling prophecy). Ex: If observer expects treatment group to show signs of recovery, then he is more likely to document positive outcomes Reduce by:Use of placebo control groups with blinding to reduce influence of participants and researchers on experimental procedures and interpretation of outcomes

Answer 19

When a factor is related to both the exposure and outcome, but not on the causal pathway factor distorts or confuses effect of exposure on outcome. Ex:Pulmonary disease is more common in coal workers than the general population; however, people who work in coal mines also smoke more frequently than the general population Reduce by:Multiple/repeated studies Crossover studies (subjects act as their own controls) Matching (patients with similar characteristics in both treatment and control groups)

Answer 20

Early detection is confused with survival; seen with improved screening techniques. Ex:Early detection makes it seem as though survival has increased, but the natural history of the disease has not changed Reduce by: Measure “back-end” survival (adjust survival according to the severity of disease at the time of diagnosis)

Answer 21

(sum of values)/(total number of values).

Answer 22

middle value of a list of data sorted from least to greatest. If there is an even number of values, the median will be the average of the middle two values

Answer 23

most common value.

Answer 24

how much variability exists from the mean in a set of values. σ = SD; n = sample size.

Answer 25

= an estimation of how much variability exists between the sample mean and the true population mean SEM = σ/√n. SEM decreases as n increases.

Answer 26

bellhaped = normal distribution mean=median=mode

Answer 27

nonnormal distribution Suggests two different populations (e.g., metabolic polymorphism such as fast vs. slow acetylators; suicide rate by age).

Answer 28

Typically, mean > median > mode. Asymmetry with longer tail on right.

Answer 29

Typically, mean < median < mode. Asymmetry with longer tail on left.

Answer 30

Hypothesis of no difference (e.g., there is no association between the disease and the risk factor in the population).

Answer 31

Hypothesis of some difference (e.g., there is some association between the disease and the risk factor in the population).

Answer 32

Stating that there is an effect or difference when one exists (null hypothesis rejected in favor of alternative hypothesis). Stating that there is not an effect or difference when none exists (null hypothesis not rejected).

Answer 33

Stating that there is an effect or difference when none exists (null hypothesis incorrectly rejected in favor of alternative hypothesis). α is the probability of making a type I error. p is judged against a preset α level of significance (usually < .05). If p < 0.05, then there is less than a 5% chance that the data will show something that is not really there. α = you saw a difference that did not exist (e.g., convicting an innocent man).

Answer 34

Stating that there is not an effect or difference when one exists (null hypothesis is not rejected when it is in fact false). b is the probability of making a type II error. b is related to statistical power (1 – b), which is the probability of rejecting the null hypothesis when it is false. b = you were blind to a difference that did exist (e.g., setting a guilty man free). If you sample size, you power. There is power in numbers.

Answer 35

increase sample size (power in numbers) increase expected effect size increase precision of measurement

Answer 36

Pools data and integrates results from several similar studies to reach an overall conclusion. Limited by quality of individual studies or bias in study selection.

Answer 37

Range of values in which a specified probability of the means of repeated samples would be expected to fall. CI = range from [mean – Z(SEM)] to [mean + Z(SEM)] .

Answer 38

The 95% CI (corresponding to p = .05) is often used. For the 95% CI, Z = 1.96. For the 99% CI, Z = 2.58.

Answer 39

then there is no significant difference and H0 is not rejected.

Answer 40

H0 is not rejected.

Answer 41

significant difference exists.

Answer 42

usually no significant difference exists.

Answer 43

Checks differences between means of 2 groups

Answer 44

Checks differences between means of 3 or more groups

Answer 45

Checks difference between 2 or more percentages or proportions of categorical outcomes (not mean values).

Answer 46

r is always between -1 and +1. The closer the absolute value of r is to 1, the stronger the linear correlation between the 2 variables. Positive r value positive correlation. Negative r value negative correlation. Coefficient of determination = r 2 (SQUARED = value that is usually reported).

Answer 47

Prevent disease occurrence (e.g., HPV vaccination).

Answer 48

Screening early for disease (e.g., Pap smear)

Answer 49

Screening early for disease (e.g., Pap smear)

Answer 50

Medicare and Medicaid—federal programs that originated from amendments to the Social Security Act. MedicarE (Elderly) is available to patients ≥ 65 years old, < 65 with certain disabilities, and those with end-stage renal disease. Medicaid is joint federal and state health assistance for people with very low income.

Answer 51

identifying patients at risk of unnecessary treatment, protecting from the harm of new interventions

Answer 52

Respect patient autonomy Beneficence(over autonomy+ society) Nonmaleficence (Do no harm) Justice

Answer 53

Assessment of newborn vital signs following labor via a 10-point scale evaluated at 1 minute and 5 minutes. Apgar score is based on Appearance, Pulse, Grimace, Activity, and Respiration (≥ 7 = good; 4–6 = assist and stimulate; < 4 = resuscitate). If Apgar score remains < 4 at later time points, there is an increased risk that the child will develop long-term neurological damage.

Answer 54

Defined as < 2500 g. Caused by prematurity or intrauterine growth retardation (IUGR). Associated with risk of SIDS, and with overall mortality. Other problems include impaired thermoregulation and immune function, hypoglycemia, polycythemia, and impaired neurocognitive/emotional development. Complications include infections, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and persistent fetal circulation.

Answer 55

Disclosure: discussion of pertinent information Understanding: ability to comprehend (assess) Mental capacity: unless incompetent (a legal determination) Voluntariness: freedom from coercion and manipulation

Answer 56

Patient lacks decision-making capacity or is legally incompetent Implied consent in an emergency Therapeutic privilege—withholding information when disclosure would severely harm the patient or undermine informed decision-making capacity Waiver—patient explicitly waives the right of informed consent

Answer 57

parents can’t stop kids from getting treatment for: Sex (contraception, STDs, pregnancy) Drugs (addiction) Rock and roll (emergency/trauma)

Answer 58

Patient is ≥ 18 years old or otherwise legally emancipated Patient makes and communicates a choice Patient is informed (knows and understands) Decision remains stable over time Decision is consistent with patient’s values and goals, not clouded by a mood disorder Decision is not a result of delusions or hallucinations

Answer 59

Instructions given by a patient in anticipation of the need for a medical decision. ``` Oral advance directive Living will (written advance diretive) ``` Medical power of attorny

Answer 60

spouse, adult children, parents, adult siblings, other relatives.

Answer 61

Potential physical harm to others is serious and imminent Likelihood of harm to self is great No alternative means exists to warn or to protect those at risk Physicians can take steps to prevent harm Reportable diseases (e.g., STDs, TB, hepatitis, food poisoning)—physicians may have a duty to warn public officials, who will then notify people at risk The Tarasoff decision—California Supreme Court decision requiring physician to directly inform and protect potential victim from harm Child and/or elder abuse Impaired automobile drivers (e.g., epileptics) Suicidal/homicidal patients

Answer 62

"Parents Start Observing" Primitive reflexes disappear— Moro (by 3 mo), rooting (by 4 mo), palmar (by 6 mo), Babinski (by 12 mo) Posture—lifts head up prone (by 1 mo), rolls and sits (by 6 mo), crawls (by 8 mo), stands (by 10 mo), walks (by 12–18 mo) Picks—passes toys hand to hand (by 6 mo), Pincer grasp (by 10 mo) Points to objects (by 12 mo)

Answer 63

Social smile (by 2 mo) Stranger anxiety (by 6 mo) Separation anxiety (by 9 mo)

Answer 64

Orients—first to voice (by 4 mo), then to name and gestures (by 9 mo) Object permanence (by 9 mo) Oratory—says “mama” and “dada” (by 10 mo)

Answer 65

"Child Rearing Working" Climbs stairs (by 18 mo) Cubes stacked—number = age (yr) × 3 Cultured—feeds self with fork and spoon (by 20 mo) Kicks ball (by 24 mo)

Answer 66

Recreation—parallel play (by 12 mo) Rapprochement—moves away from and returns to mother (by 24 mo) Realization—core gender identity formed (by 36 mo)

Answer 67

Words—200 words by age 2 (2 zeros), 2-word sentences

Answer 68

"Dont Forget theyre still Learning" Drive—tricycle (3 wheels at 3 yr) Drawings—copies line or circle, stick figure (by 4 yr) Dexterity—hops on one foot (by 4 yr), uses buttons or zippers, grooms self (by 5 yr)

Answer 69

Freedom—comfortably spends part of day away from mother (by 3 yr) Friends—cooperative play, has imaginary friends (by 4 yr)

Answer 70

Language—1000 words by age 3 (3 zeroes), uses complete sentences and prepositions (by 4 yr) Legends—can tell detailed stories (by 4 yr

Answer 71

Sexual changes: Men—slower erection/ejaculation, longer refractory period Women—vaginal shortening, thinning, and dryness Sleep patterns: decreased REM ; increased sleep onset latency and increased early awakenings increased suicide rate, fat decreased vision, hearing, immune response, bladder control renal, pulmonary, GI function muscle mass,

Answer 72

high-frequency hearing loss due to destruction of hair cells at the cochlear base (preserved low-frequency hearing at apex).

BEHAVIORAL SCIENCE Flashcards

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