Buzzwordy things

Question 1

Describe Cross sectional

Answer 1

looks at data in one group at a given time
q: What is happening right now?!?!
a: shows risk factor association but not causality
measures DISEASE PREVELANCE

Question 2

Describe Case control

Answer 2

odds ratio
what happened?
looks at people with dz now to see what rf/exposures they had before

Question 3

Describe Cohort study

Answer 3

relative risk
who will or who did get disease?
looks at people with rf now to see if they will or if they did get the diesase

Question 4

Three thigns that increase quality of a clinical study

Answer 4

randomized
controlled
double blind

Question 5

describe triple blind

Answer 5

1) pt doesnt know if getting tx or placebo
2) dr doesnt know if pt getting tx or placebo
3) researcher analyzing data doesnt know which patients got tx and which got placebo

Question 6

what is measured in phase one

Answer 6

is it safe?

safety, toxicity, PK and PD

Question 7

what is measured in phase two

Answer 7

does it work?

efficacy, dosing, a/se

Question 8

what is measured in phase th ree

Answer 8

is it the same or better?

new vrs standard of care tx

Question 9

what is measure in phase four

Answer 9

can it stay?
long term and/or rare effects
can result in tx being pulled from market

Question 10

Define: selection bias

Answer 10

error ir assigning subjects to a study group resulting in an unrepresetnative sample

Question 11

How to decrease selection bias

Answer 11

randomize

ensure choice of the right comparison reference group

Question 12

Define: recall bias

Answer 12

awareness of disorder alters recall by subjects; common in retrospective studies (case control, can be cohort)

Question 13

How to decrease recall bias

Answer 13

decrease time from exposure to follow up

Question 14

Define: measurement bias

Answer 14

information is gathered in a way that distorts it. ie crappy machinery

Question 15

How to decrease measurement bias

Answer 15

use standardized method of data collection

Question 16

Define: procedure bias

Answer 16

subjects in different groups are not treated the same ie ppl with dz will be in hospital

Question 17

How to decrease procedure bias

Answer 17

blind and use placebo - reduces influece of ppts and researchers on procedures and interpretation of otucomes bc will not be aware of allocations of tx/placebo

** same as observer-expectancy bias

Question 18

Define: observer-expectancy bias

Answer 18

researcher’s belief in the efficacy of a treatment changes the outcome of that treatment
ex: pygmalion effect/self-fulfilling prophecy

Question 19

How to decrease observer-expectancy bias

Answer 19

blind and use placebo - reduces influence of ppts and researchers on procedures and interpretation of outcomes bc will not be aware of allocations of tx/placebo

**same as procedure bias

Question 20

Define: confounding bias

Answer 20

when a factor is related to both the exposure and outcome but not the causal pathway– factor will distor or confuse effect of exposure on outcome

Question 21

How to decrease confounding bias

Answer 21

a) multiple/repeated studies
b) cross over studies - subjects act as own controls
c) matching - pts with similar cxtics in each group

Question 22

Define: lead-time bias

Answer 22

early detection is confused with increased survival

Question 23

How to decreased lead-time bias

Answer 23

measure ‘‘back-end’’ survival: adjust survival according to the severity of disease at the time of diagnosis

Question 24

how to increase power

Answer 24

power in numbers

• increase sample size
• increase expected effect size
• increased precision of measurement

Question 25

p-value really means what?

Answer 25

boooo the chance that the data will show something that is not really there usually want this to be less than 5% alpha/type I error --> rejecting the Ho (no difference) in favour of the Hi (yes difference) --> saying there is no difference when there really is. putting an innocent man in jail --> saw guilt when there wasnt any :(

Question 26

confidence interval for means includes zero. what do you say?!

Answer 26

there is no significant difference | Ho is not rejected

Question 27

confidence interval for odds ratio includes one. what do you say?!

Answer 27

there is no significant difference (a/c)/(b/d) Ho is not rejected

Question 28

confidence intergal for relative risk includes one. what do you say?!

Answer 28

there is no significant difference | a/a+b)/(c/c+d

Question 29

confidence intervals overlap. what say you?

Answer 29

usually no significant difference exists

Question 30

confidence intervals do not overlap. what say you?

Answer 30

usually yes significant difference exists.

Question 31

when do you use a t test

Answer 31

Two for tea and tea for two | to check differences between the mean of two groups

Question 32

when do you use ANOVA

Answer 32

analysis of varaince - three words | to check differences between means fo three or more groups

Question 33

when do you use Chi-squared?

Answer 33

CHI-tegorical | to check differences between two or more percentages or proportions of categorical outcomes NOT MEANS

Question 34

define quartenary disease prevention

Answer 34

identifying pts at risk of unnecessary treatment, protecting from the harm of new interventions ***think treatment in hospice** and that one psych disease where can have tons of procedures done....somatiform? **ask jordan on weekend if dont find before then **

Question 35

what are the four parts of medicarE

Answer 35

a: hospitAl insurance b: Basic medical Bills (Dr fees, dxtic testing) c: parts a + b delivered by approved private Companies d: prescription Drugs

Question 36

when is parental consent not required

Answer 36

SEX DRUGS ROCK n ROLL sex - contraception, sti, pregos drugs - addiction rock n roll - emergency/trauma (despite religious/cultural believes) OR emancipated, married, in military

Question 37

what makes an oral directive more valid?

Answer 37

a) patient was informed b) directive was specific c) patient made a choice d) decision was repeated over time to multiple people

Question 38

priority of surrogates in surrogate decision-maker

Answer 38

spouse > adult children > parents > adult siblings > other relatives **uworld q**

Question 39

examples of exceptions to patient confidentiality

Answer 39

a) reportable disease - sti, tb, hep, food poison b) tarasoff decision - physicion directly inofrm and protect potential victim from harm **remember story from bioethics where person was murdered by pt suffering mental illness c) child or elder abuse d) impaired automobile drivers d) suicidal or homicidal patients

Question 40

principles guiding exceptions to patient confidentiality

Answer 40

i) potential physical harm to others is serious and imminent ii) likelihood of harm to self is great iii) no alternative means exists to warn or to protect those at risk iv) physician can take steps to prevent harm

Question 41

17 year old wants an abortion. Medical ethics say what? ***

Answer 41

many states require parental notification or consent for minors for an abortion unless specific medical risks associated with pregnancy, a physician should not attempt to sway the decision of the patient to have an elective abortion regardless of maternal age or fetal condition *** think about this becky, patient before self/fetus remember.

Question 42

A 15 year old is pregnant and wants to keep the child. Her parents want you to tell her to give the child up for adoption

Answer 42

Child/patient retains right to make decisions regarding her child, even if her parents disagree. Educate patient about practical issues of caring for baby. Discuss options if requested. Encourage discussion between teenager and parents to reach best decision

Question 43

Terminally ill patient requests physicain assistance in ednign his/her own ife

Answer 43

in overwhelming majority ot stares, refuse involvement in any form of physician-assisted suicide. physicians may, however, prescribe medically appropriate analgesics that coincidentally shorten the patients life

Question 44

Problems associated with low birth weight (<2500 g)

Answer 44

``` SIDS, increased overall mortalilty impaired thermoregulation impaired immune function hypoglycemia polycythemia impaired neurocognitive/emotional development ```

Question 45

Complications associated with low birth weight (<2500 g)

Answer 45

``` infections respiratory distress syndrome necrotizing enterocolitis intraventricular hemorrhage persistent fetal circulation ```

Question 46

presbycusis

Answer 46

sensorineural hearing loss in elderly - usually associated with high freqeuncy loss due to destruction of hair cells at cochlear BASE

Question 47

frequencies found at cochlear base? | frequencies found at cochlear apex?

Answer 47

base - high frequency --> b kind of looks like an h... ;) OR bass doesnt not equal base. apex - low freqeuncy