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Study Plan Step 1 > Behavioral Science > Flashcards

Behavioral Science Flashcards

1
Q

What is the Cross-Sectional study?

A

Collects data from a group of people to assess frequency of disease (and related risk factor) at a particular point in time.
Measures/example: disease prevalence.

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2
Q

The observational study where asks, “What is happening?”

A

Cross-sectional study.

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3
Q

What is the Case-control study (retrospective)?

A

Compares a group of people with disease to a group without disease. Looks for prior exposure or risk factor.
Measures: Odds ratio (OR).

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4
Q

The observational study where asks, “What happened?”

A

Case-control study (retrospective).

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5
Q

What is the Cohort study (prospective or retrospective)?

A

Compares a group of people with a given exposure or risk factor to a group without such exposure. Looks to see if exposure increase the likelihood of disease.
Measure: Relative risk (RR).

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6
Q

The observational study where asks, prospective “Who will develop disease?” Retrospective “Who developed the disease?”

A

Cohort study

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7
Q

What is the Twin concordance study?

A

Compares the frequency with which both monozygotic twins or Dizygotic twins develop the same disease.
Measures heritability and influence of environmental factors.

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8
Q

What is the adoption study?

A

Compares siblings raised by biological vs adoptive parents.

Measures heritability and influence of environmental factors.

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9
Q

What is the clinical trial ?

A

Study that involving humans. Compares therapeutic benefits of 2 or more treatments or placebo.

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10
Q

How many types of clinical trial exists?

A

Randomized, controlled, double-blinded and triple blind.

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11
Q

How many phases involve drug study?

A

IV

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12
Q

What is the typical study sample and purpose of the phase I in a drug trial?

A

Typical study sample: Small number of healthy volunteers.

Purpose: Assess safety, toxicity, Pharmacokinetics Pharmacodynamics.

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13
Q

The Phase of the drug trial where asks, “Is it safe?”

A

Phase I

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14
Q

What is the typical study sample and purpose of the phase II in a drug trial?

A

Typical study sample: Small number, with disease of interest.
Purpose: Assesses treatment efficacy, optimal dosing, adverse effects.

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15
Q

The Phase of the drug trial where asks, “Does it work?”

A

Phase II

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16
Q

What is the typical study sample and purpose of the phase III in a drug trial?

A

Typical study sample: Large number of patients randomly assigned to treatment or placebo.
Purpose: compares the new treatment to the current standard of care.

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17
Q

What is the typical study sample and purpose of the phase IV in a drug trial?

A

Typical study sample: Postmarketing surveillance of patients after treatment is approved.
Purpose: Detects rare or long-term adverse effects. Can result in treatment being withdrawn from market.

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18
Q

The Phase of the drug trial where asks, “Is it as good or better?”

A

Phase III.

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19
Q

The Phase of the drug trial where asks, “Can it stay?”

A

Phase IV.

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20
Q

What is the sensitivity?

A

The probability that a test detects disease when disease is present.
Approaching 100% ruling out disease and indicates a low false-negative rate.

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21
Q

What is the sensitivity equation?

A

Sensitivity = TP/ TP + FN.

Highly sensitivity test, when negative, rules out disease.

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22
Q

What is the specificity?

A

The probability that a test indicates no disease when disease is absent. Approaching 100% desirable ruling in disease and indicates a low false positive rate.

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23
Q

What is the equation of specificity?

A

specificity = TN / TN + FP.

Highly specificity test, when positive, rules in disease.

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24
Q

What is the Positive Predictive value (PPV)?

A

Probability that person actually has the disease given a positive test result.

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25
Q

What is the equation of PPV?

A

PPV = TP / TP + FP.

PPV varies directly with prevalence or pretest probability: Highest pretest probability -> High PPV.

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26
Q

What is the Negative predictive value (NPV)?

A

Proportion of negative test results that are true negative.

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27
Q

What is the NPV equation?

A

NPV = TN / TN + FN.
NVP varies inversely with prevalence or pretest probability:
High pretest probability -> low NPV.

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28
Q

What is the Incidence and which is its equation?

A

Incidence looks at new cases (incidents).
Incidence rate = # of new cases / # of people at risk.
During a time period.

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29
Q

What is the prevalence and which is its equation?

A

Prevalence looks at all current cases.
Prevalence = # of existing cases / # of people at risk.
At a point in time.

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30
Q

What is the Odds ratio (OR)?

A

Used in case-control studies.
Odds that the group with the disease was exposed to a risk factor dived bye the odds that the group without the disease was exposed.

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31
Q

What is the equation of Odds Ratio?

A

OR = a/c / b/d

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32
Q

What is the Relative risk (RR)?

A

Used in cohort studies. Risk of developing disease in the exposed group divided by risk in the unexposed group.

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33
Q

If 21% of smokers develop lung cancer vs 1% of nonsmokers, what is the Relative Risk of this problem?

A

RR = 21/1 = 21.

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34
Q

What is the attributable risk (AR)?

A

The difference in risk between exposed and unexposed groups or the proportion of disease occurrences that are attributable to the exposure.

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35
Q

What is the Relative Risk Reduction (RRR) and which is its equation?

A

The proportion of risk reduction attributable to the intervention as compared to a control.
RRR = 1-RR.

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36
Q

What is the absolute risk reduction (ARR)?

A

The difference in risk attributable to the intervention as compared to a control.

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37
Q

If 8% of people who receive a placebo vaccine develop the flu vs 2% of people who receive a flu vaccine, what is the Absolute Risk Reduction?

A

ARR = 8% - 2% = 6% = 0.06

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38
Q

What is the Number needed to treat (NNT)?

A

The number of patients who need to be treated for 1 patient to benefit. The equation is NNT = 1/ARR.

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39
Q

What is the number needed to harm (NNH)?

A

Number of patients who need to be exposed to a risk factor for 1 patient to be harmed. Equation: NNH = 1/AR.

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40
Q

What is the precision?

A

The absence of random variation in a test. (Reliability).

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41
Q

What are the characteristics of precision?

A

High precision decrease standard deviation and increase statistical power (1-B).
Random error decrease precision in a test.

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42
Q

What is the accuracy?

A

The trueness of test measurements (validity). The absence of systematic error or bias in a test.

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43
Q

What is the characteristic of accuracy?

A

Systematic error decrease accuracy in a test.

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44
Q

How many of categories of Bias and study errors exists?

A

1) Recruiting participants: Selection bias.
2) Performing study: Recall, Measurement, procedure, observer-expectancy.
3) Interpreting results: Confounding and lead-time.

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45
Q

Which is the most commonly sampling bias?

A

Selection bias.

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46
Q

What selection bias means?

A

Error in assigning subjects to study group resulting in an unrepresentative sample.

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47
Q

What types of selection bias are there?

A

Berkson bias_ population selected from hospital is less healthy than general population.
Healthy worker effect_ population healthier than the general population.
Non-response bias_ participating subjects differ from nonrespondents in meaningful ways.

48
Q

What are the strategy to reduce selection bias?

A

Randomization and ensure the choice of the right comparison / reference group.

49
Q

What is the recall bias?

A

Awareness of disorders alters recall by subjects; common in retrospective studies.

50
Q

What is the measurement bias?

A

Information is gathered in a way that distorts it.

51
Q

What is the procedure bias?

A

Subjects in different groups are not treated the same.

52
Q

What is the observer-expectancy bias?

A

Researcher’s belief in the efficacy of a treatment changes the outcome of that treatment.

53
Q

What is the Aka Pygmalion effect?

A

It is the phenomenon whereby higher expectations lead to an increase in performance

54
Q

What is the self-fulfilling prophecy?

A

It is a prediction that directly or indirectly causes itself to become true, by the very terms of the prophecy itself,due to positive feedback between belief and behavior.

55
Q

Which are the strategy to reduce procedure and observer-expectancy bias?

A

Blinding and use of placebo reduce influence of participants and researchers on procedures.

56
Q

What is the confounding bias?

A

When a factor is related to both the exposure and outcome, factors distorts or confuses effect of exposure on outcome.

57
Q

Which are the strategy to reduce confounding bias?

A

Multiple / repeated studies, crossover studies and matching.

58
Q

What is the lead-time bias?

A

Early detection is confused with high survival.

59
Q

What is the strategy to reduce lead-time bias?

A

Measure “back-end” survival.

60
Q

What is the mean equation?

A

Mean = middle value of a list of data sorted from least to greatest.

61
Q

What is the mode equation?

A

Mode = most common value.

62
Q

What is the standard deviation?

A

Standard deviation = How much variability exists from the mean in a set of values.

63
Q

What is the standard error of the mean?

A

It is a type a measure of dispersion, Standard error of the mean = an estimate of how much variability exists between the sample mean and the true population mean.

64
Q

What is the normal distribution and which is the percentage in the Gaussian?

A

Gaussian, also called bell-shaped. Mean=median=mode.
68%: -1¢, +1¢.
95%: -2¢, +2¢.
99.7%: -3¢, +3¢.

65
Q

What are the types of Nonnormal distribution?

A

Bimodal, positive skew and negative skew.

66
Q

Which is the Nonnormal distribution that suggests two different populations?

A

Bimodal

67
Q

Which is the Nonnormal distribution that is asymmetry with longer tail on right?

A

Positive Skew, typically, mean>median>mode.

68
Q

Which is the Nonnormal distribution that is asymmetry with longer tail on left?

A

Negative skew, typically mean

69
Q

What are the types of statistical hypotheses?

A

Null (H0) and Alternative (H1).

70
Q

What is the type of statistical hypotheses where there is not association between the disease and the risk factor in the population?

A

Null (H0)

71
Q

What is the type of statistical hypotheses where there is some association between the disease and the risk factor in the population?

A

Alternative (H1).

72
Q

What are the two types of incorrect result?

A

Type I error (alpha) and type II error (beta).

73
Q

On incorrect result what does alpha means?

A

Alpha is the probability of making a type I error.

74
Q

What does beta means? (Incorrect result)

A

Type II error, beta is related to statistical power (1-B).

75
Q

Which characteristics of the study increase power and decrease Beta error?

A

High sample size, high expected effect size and high precision of. Measurement.

76
Q

Which is the incorrect result that is known as “False-positive error”?

A

Type I error (alpha).

77
Q

Which is the incorrect result that is known as “False-negative error”?

A

Type II error (Beta).

78
Q

Normally in type I error p is judged against a preset alpha level of significance, what is level of significance?

A

Usually

79
Q

What is the confidence interval?

A

It is the range of values in which a specified probability of the mean s of repeated samples would be expected to fall.

80
Q

Which are the values of the confidence intervals?

A

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

81
Q

What is the common statistical test that checks differences between means of 2 groups?

A

T-test.

Example: comparing the mean blood pressure between men and women.

82
Q

What is the common statistical test that checks differences between means of 3 or more groups?

A

ANOVA ( Analysis of variance).

Example: comparing the mean blood pressure between members of 3 different ethnic groups.

83
Q

What is the common statistical test that checks differences between 2 or more percentages or proportions of categorical outcomes (not mean values)?

A

Chi-square (X^2), Chi-tegorical.

Example: comparing the percentage of members of 3 different ethnic groups who have essential hypertension.

84
Q

What is Pearson correlation coefficient (r)?

A

R is always between -1 and +1.

85
Q

What is the correlation with a positive R value?

A

Positive r value –> Positive correlation

86
Q

What is the correlation with a negative r value?

A

Negative r value –> Negative correlation.

87
Q

Which are the categories of the disease prevention?

A

Primary, Secondary and Tertiary.

88
Q

What is the main idea for primary disease prevention?

A

Prevent disease occurrence.

89
Q

What is the main idea for secondary disease prevention?

A

Screening early for disease.

90
Q

What is the main idea for tertiary disease prevention?

A

Treatment to reduce disability from disease.

91
Q

What is the main idea for Quaternary disease prevention?

A

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

92
Q

What are the federal programs that originated from amendments to the Social Security Act?

A

Medicare and Medicaid.

93
Q

What are the characteristics of Medicare?

A

Medicare is available to patients > or equal to 65 years old,

94
Q

What are the characteristics of Medicaid?

A

Medicaid is joint federal and state health assistance for people with very low income.
MedicaiD is for Destitute.

95
Q

What is the core ethical principle that belong the following idea… Honor in patient preference in accepting or not accepting medical care.

A

Autonomy

96
Q

What are the core ethical principles?

A

Autonomy, Beneficence, Nonmaleficence and Justice.

97
Q

What is the beneficence within the core ethical principles?

A

Physicians have a special ethical duty to act in the patient’s best interest.

98
Q

What parts conform the informed consent?

A

Disclosure, Understanding, Capacity and Voluntariness.

Patient must be informed that he or she can revoke written consent at any time, even orally.

99
Q

What are the exceptions to informed consent?

A

1) Patient lacks decision-making capacity or legally incompetent.
2) Implied consent in an emergency.
3) Therapeutic privilege.
4) Waiver.

100
Q

What is a minor?

A

A minor is generally any person

101
Q

When you do not need the parental consent?

A

Parental consent should be obtained unless emergent treatment is required even if it opposes parental religious/cultural beliefs, or if a minor is legally emancipated.

102
Q

In which situations the parental consent is usually not required?

A

Sex, drugs and rock and roll.
Sex (contraception, STIs, pregnancy).
Drugs (addiction).
Rock and roll (Emergency/Trauma).

103
Q

What are the components of decision making-capacity?

A

1) > or equal 18 years old or otherwise legally emancipated.
2) Patient makes and communicates a choice.
3) Patient is informed.
4) Decision remains stable over time.
5) Decision is consistent with patient’s values and goals.
6) Decision is not a result of altered mental status.

104
Q

Which are the advance directives?

A

1) Oral advance directive.
2) Living will (Written advance directive).
3) Medical power of attorney.

105
Q

What is the order of surrogates in the surrogate decision-maker?

A

Spouse > Adult children > Parents > Adult siblings > other relatives.

106
Q

What is the confidentiality?

A

Confidentiality respects patient privacy and autonomy.

107
Q

Which are the general principles for exceptions to confidentiality?

A

Potential physical harm to others.
Likelihood of harm to self is great.
No alternative means exists to warn or protect those at risk.
Physicians can take steps to prevent harm.

108
Q

Write some examples of exceptions to patient confidentiality.

A 
Reportable diseases.
The Tarasoff decision.
Child and/or elder abuse.
Impaired automobile drivers.
Suicidal/homicidal patients.
109
Q

What is Presbycusis?

A

Sensorial hearing loss due to destruction of hair cells at the. Cochlear base.

110
Q

Common causes of death by age:

A 
#1 Congenital malformations.
#2 Preterm birth.
#3 SIDS.
111
Q

Common causes of death by age: 1-14 YR.

A 
#1 Unintentional injury.
#2 Cancer.
#3 Congenital malformations.
112
Q

Common causes of death by age: 15-34 YR.

A 
#1 Unintentional injury.
#2 Suicide.
#3 Homicide.
113
Q

Common causes of death by age: 35-44 YR.

A 
#1 unintentional injury.
#2 Cancer.
#3 Heart disease.
114
Q

Common causes of death by age: 45-64 YR

A 
#1 Cancer.
#2 Heart disease.
#3 Unintentional injury.
115
Q

Common causes of death by age: 65 + Yr

A 
#1 Heart disease.
#2 Cancer.
#3 Chronic respiratory disease.

Study Plan Step 1 (1 decks)

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