Behavioral Science

Question 1

Study measuring disease prevalence and risk factor association in a snapshot of time.

Controls are patients without the risk factor.

Answer 1

CROSS-SECTIONAL STUDY

Prevalence odds ratio.

Question 2

Study comparing prior exposure or risk factors for an outcome of interest.

Controls are patients who do not have the outcome regardless of prior exposure status.

Answer 2

CASE-CONTROL STUDY

Exposure odds ratio.

Susceptible to recall bias (always retrospective)

Control founding with matching

Question 3

Study determining if exposure affects the likelihood of disease - can be prospective or historical.

Controls are patients without the risk factor.

Answer 3

COHORT STUDY

Relative risk.

Question 4

Assessment of safety, toxicity, kinetics, and dynamics of a new drug.

Answer 4

PHASE I

Healthy volunteers.

Question 5

Assessment of efficacy, dosing, and adverse effects of a new drug.

Answer 5

PHASE II

Patients with disease of interest.

Question 6

Assessment of new drug vs standard of care.

Answer 6

PHASE III

Large randomized controlled trial.

Question 7

Assessment of rare or long-term adverse effects.

Answer 7

PHASE IV

Postmarketing surveillance.

Question 8

Proportion of people with disease who test positive.

Answer 8

SENSITIVITY

High sensitivity useful for ruling out disease (screening) - low false-negative rate.

Question 9

Proportion of all people without disease who test negative.

Answer 9

SPECIFICITY

High specificity useful for ruling in disease (confirmatory) - low false-positive rate.

Question 10

Proportion of positive test results that are true positives.

Answer 10

POSITIVE PREDICTIVE VALUE

Increases with increasing pretest probability (prevalence) - high pretest probability means higher PPV

Question 11

Proportion of negative test results that are true negatives.

Answer 11

NEGATIVE PREDICTIVE VALUE

Decreases with increasing pretest probability (prevalence) - high pretest probability means lower NPV

Question 12

Odds of exposure of people with the disease, compared with odds of exposure of people without the disease.

Answer 12

ODDS RATIO

If rows are exposed/unexposed and columns are disease/no disease then OR = ad/bc

Question 13

Relative risk

Answer 13

RELATIVE RISK

Treatment Rate/Control Rate

If prevalence is low, OR = RR (rare disease assumption)

Question 14

Absolute risk increase (Attributable Risk)

Answer 14

Treatment Rate - Control Rate

Question 15

Relative Risk Reduction (RRR) - The proportion of risk reduction attributable to the intervention

Answer 15

RELATIVE RISK REDUCTION

RRR = 1 - RR = ARR/Control Rate

Note: ARP = (RR - 1)/RR

Question 16

Absolute risk reduction (ARR)

Answer 16

Control Rate - Treatment Rate

Question 17

Number needed to treat.

Answer 17

1/ARR

Question 18

Number needed to harm.

Answer 18

1/ARI

Question 19

The absence of random variation in a test.

Answer 19

PRECISION

A measure of reliability/reproducibility

Question 20

The absence of systematic error or bias in a test.

Answer 20

ACCURACY

A measure of validity

Question 21

Null hypothesis incorrectly rejected in favor of alternative hypothesis.

Answer 21

TYPE I ERROR (ALPHA)

Question 22

Null hypothesis is not rejected when it is in fact false.

Answer 22

TYPE II ERROR (BETA)

Statistical power = 1 - Beta

Question 23

Motor milestones.

Answer 23

1 mo: Lifts head
6 mo: Rolls and sits, passes toy hand to hand
8 mo: Crawls
10 mo: Stands, pincer grasp
12 mo: Walks, points
18 mo: Climbs stairs
20 mo: Feeds self
24 mo: Kicks ball
3 yr: Tricycle
4 yr: Copies line or circle, hops
5 yr: Grooms self

Question 24

Social milestones.

Answer 24

2 mo: Social smile
6 mo: Stranger anxiety
9 mo: Separation anxiety
24 mo: Away from mother
24-36 mo: Parallel play
36 mo: Gender identity
3 yr: Time away from mother
4 yr: Cooperative play

Question 25

Verbal/Cognitive milestones.

Answer 25

``` 4 mo: Orients to voice 9 mo: Orients to name, object permanence 10 mo: Mama and dada 2 yr: 200 words, 2 word sentences 3 yr: 1000 words, complete sentences 4 yr: Tells stories ```

Question 26

Sleep chances in the elderly.

Answer 26

Decreased REM sleep and slow-wave sleep Increased sleep onset latency Increased early awakenings

Question 27

Sensorineural hearing loss of higher frequencies (cochlear base).

Answer 27

PRESBYCUSIS

Question 28

Basic information that can be shared to presumed family when patient cannot give consent.

Answer 28

Patient is stable.

Question 29

Procedure in a case of suspected child abuse.

Answer 29

Interview child alone then contact CPS immediately if any suspicion.

Question 30

Selection bias created by selecting hospitalized patients as the control group.

Answer 30

Berkson's bias

Question 31

Difference between confounding variables and effect modification.

Answer 31

After stratification there will be a significant difference in risk in effect modification, but not with a confounding variable.

Question 32

Equation for SE - Used when describing the confidence interval for a sample rather than the normal distribution of a population.

Answer 32

SE = SD/sqrt(n)

Question 33

Observer bias leading to the tendency of subjects to change their behavior as a result of their awareness that they are being studied.

Answer 33

Hawthorne effect

Question 34

Effect describing the fact that a researcher's belief in the efficacy of treatment can potentially affect the outcome.

Answer 34

Pygmalion effect

Question 35

Selection bias in which subjects lost to follow up differ in their risk of developing the outcome compared to the remaining subjects.

Answer 35

Attrition bias

Question 36

Bias occurring when either exposure or outcome is not identified correctly.

Answer 36

Misclassification bias If random (nondifferential) - will affect all groups to the same extent.

Question 37

Study where the unit of analysis is populations rather than individuals.

Answer 37

Ecological study Attempting to connect these results to individuals is known as ecological fallacy

Question 38

Study that starts out as cohort studies and then recruits patients who develop an outcome of interest into a case-control study.

Answer 38

Nested case-control design

Question 39

Bias referring to the fact that a risk factor itself may lead to extensive diagnostic investigation and increase the probability that a disease is detected.

Answer 39

Detection bias

Question 40

Requirement for hospice care.

Answer 40

Life expectancy of < 6 months.

Question 41

Response to suspected intimate partner violence.

Answer 41

Investigate emergency safety plans and give referrals - do not pressure the patient to disclose to act

Question 42

Probably that one event will turn out differently (independent events)

Answer 42

1 - P(all will turn out the same)

Question 43

Standard deviations

Answer 43

1 - 68% 2 - 95% 3 - 99.7% Note - Includes both tails so divide in half for one tail

Question 44

Positive likelihood ratio

Answer 44

Sensitivity/(1-Specificity) Note - Negative LR is (1 - Sensitivity)/Specificity

Question 45

Incidence

Answer 45

New cases/Total at risk Note - Total at risk is total population minus those who already have the disease

Question 46

Covered by Medicare (Federal)

Answer 46

>65 with work history Disabilities ESRD ALS Note - Parts A (hospitalization), B (outpatient, devices), C (dental/vision), D (prescription)

Question 47

Covered by Medicaid (State)

Answer 47

Low-income families Pregnant women Homeless Undocumented immigrants