CHY Flashcards
High yield
95% confidence intervals
Range of values that is 95% likely to contain the true value
Standard deviation
Value that shows how much variation there is from the mean
- 68% of values in dataset lies between -/+ 1 SD
- 95% between 2SD
- 99.7% between 3SD
P value
Likelihood that the observed result is due to change
P > 0.05 is not statistically significant
Odds ratio
Ratio of odds that something will happen, to the odds that it won’t happen.
Used in case control studies.
Blinding
Patients/clinicians/researchers are prevented from knowing certain information that may lead to conscious or subconscious bias on their part
Concealment of allocation
The procedure for protecting the randomisation process
Person randomising the patient does not know what the treatment allocation will be
Prevents selection bias affecting which patients are give which treatment (the bias the randomisation is designed to avoid)
Intention to treat analysis
Analysis based on the initial treatment intended from allocation,
Intention to treat (ITT) analysis means all patients who were enrolled and randomly allocated to treatment are included in the analysis and are analysed in the groups to which they were randomized, not the treatment eventually administered.
I.e. “once randomized, always analyzed”
Treatment fidelity
How accurately the intervention is reproduced from a manual, protocol or model
Number needed to treat
NNtT
Number of patients that are needed to be treated with the experimental therapy to prevent one negative outcome
E.g. After myocardial infarction, 18 people need to take an angiotensin-converting enzyme (ACE) inhibitor to prevent one heart attack (NNT = 18)
It is defined as the inverse of the absolute risk reduction.
1/Absolute risk reduction
Purpose of randomisation?
To try and ensure that any characteristics of the sample population that may affect the results (confounders) are distributed equally between the 2 study groups, and avoid selection bia
Which type of studies are often affected by recall bias?
Case control
What is recall bias?
The participant either cannot remember back to when they were exposed or their outcome changes their perception of the exposure
Internal validity
Accuracy
How well the study was conducted.
Taking confounders into account and removing bias.
External validity
Generalisability
How well it can be applied to different scenarios, patients, environments.
List 4 methods that can be used to limit confounding variables.
(may be used in cohort studies!)
Restriction:
- Limit participants of study that have possible confounders
- Means less data available
- This method can be difficult with multiple confounders
Matching:
- Make comparison groups (with and without the confounder)
- Used for things like age and sex in case-control studies
Stratification:
- Analyse exposure with sub-groups of the confounder
- Adjust for confounding (if there are few variables)
- Recombine data
- Means sometimes these subgroups have very few participants in them
Multiple variable regression:
- Coefficients are established for the confounder groups
- Allows for better adjustment
Case-control studies are prone to recall bias in general
Cohort studies are prone to selection bias in general
Population attributable risk (PAR)
The portion of the incidence of a disease in the population (exposed and non-exposed) that is due to exposure
It is the incidence of a disease in the population that would be eliminated if the cause of exposure was eliminated
This can be expressed as a value or percentage
Allocative efficiency
Investing in worthwhile interventions
Technical efficiency
Investing in the interventions that make the best use of scarce resources
SPIKES
Setting Perception Invitation Knowledge Empathy Summary
Kubler-Ross model of grief
Denial Anger Bargaining Depression Acceptance
Bowlby model of grief
Numbing
Yearning/searching
Disorganisation
Reorganisation
Most common cancers in men
Lung Prostate Colorectal Stomach Liver Bladder Oesophagus Non-Hodgkin Kidney Leukaemia
Most common cancers in women
Breast Lung Colorectal Cervical Thyroid Uterine Stomach Ovarian Liver Non-Hodgkin