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EBM and Public Health > Curriculum > Flashcards

Curriculum Flashcards

1
Q

4th YEAR

The sensitivity of the test is

A

the proportion of diseased patients who have a positive test result

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2
Q

4th YEAR

The specificity of the test ….

A

is the proportion of healthy patients who have a normal test result

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3
Q

1st YEAR

The prevalence of the disease

A

number of individuals with disease ÷ total population at risk

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4
Q

1st YEAR

Define the incidence risk

A

The probability that an event will occur

number of new cases of a disease in a given period ÷ population at risk (initially disease free)

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5
Q

1st YEAR

Define Incidence Rate

A

The incidence rate is the number of new cases per population at risk in a given time period

No.new cases of disease ÷ (population at risk * time interval)

No. = number

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6
Q

1st YEAR

Define Risk Difference

A

risk of outcome in exposed - risk of outcome in non exposed

where risk = probability

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7
Q

1st YEAR

Define Rate Difference

A

frequency of outcome in exposed - frequency in unexposed

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8
Q

1st YEAR

Define number needed to treat

A

Inverse of the risk difference

Number of people with a specified condition who need to be treated for a specific period of time according to a specified protocol in order to positively impact one person

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9
Q

1st YEAR

Define Odds and Odds Ratio

A

Odds

p / (1 - p)
where p = probability

Odds Ratio

a measure of association between an exposure and an outcome

OR represents the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure

Odds of outcome in exposed ÷ odds of outcome in non exposed

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10
Q

1st YEAR

Calculate the standard error of a single mean using the formula involving standard deviation

A

Standard deviation ÷ sqrt (N)

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11
Q

1st YEAR

Calculate the standard error of a single proportion

A

Standard deviation ÷ sqrt (N)

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12
Q

1st YEAR

Interpret the 95% CI of a single mean

A

We can say with 95% confidence that the true value of the parameter, mean, is contained within the interval

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13
Q

1st YEAR

Interpret the 95% CI of a single proportion

A

We can say with 95% confidence that the true value of the parameter e.g. mean, RR is contained within the interval

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14
Q

1st YEAR

95% CI

Difference in means
Difference in proportions

using the formula involving standard error

A

We can say with 95% confidence that the true value of the parameter e.g. mean, RR is contained within the interval

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15
Q

1st YEAR

Reference range formula for upper limit and lower limit

A

mean + (degrees of freedom * (SD*

mean - (degrees of freedom * (SD*

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16
Q

4th YEAR

Incremental Cost Effectiveness Ratio

A

is a statistic used in cost-effectiveness analysis to summarise the cost-effectiveness of a health care intervention.

It is defined by the difference in cost between two possible interventions, divided by the difference in their effect. Where the effect is measured through QALYs

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17
Q

4th YEAR

Net Monetary Benefit Statistic

A

Net monetary benefit
re-arrange the formula to calculate ICER

(Ea - Eb) lambda - (Ca - Cb)

where lamba = cost effectiveness threshold - the amount of health gained for money spent

18
Q

4th YEAR

Likelihood Ratio

A

The Likelihood Ratio (LR) is the likelihood that a given test result would be expected in a patient with the target disorder compared to the likelihood that that same result would be expected in a patient without the target disorder.

The likelihood ratio of a positive test result (LR+) is sensitivity divided by 1- specificity.

The likelihood ratio of a negative test result (LR-) is 1- sensitivity divided by specificity.

19
Q

4th YEAR

Positive Predictive Value

If a test subject has an abnormal screening test (i.e., it’s positive), what is the probability that the subject really has the disease?

A

True Positives

Positive predictive value is the probability that subjects with a positive screening test truly have the disease.

(ratio of true positives to combined true and false positives)

20
Q

4th YEAR

Negative Predictive Value

If a test subject has a negative screening test, what is the probability that the subject really does not have the disease?

A

True Negatives

Negative predictive value is the probability that subjects with a negative screening test truly don’t have the disease.

Specificity: probability that a test result will be negative when the disease is not present (true negative rate)

21
Q

Interpret Statistical Information

A 
Low P Value
High P Value
RR
Risk Difference
Confidence Interval
22
Q

Critically Appraise Available Evidence

RCT
Systematic Review
Qualitative Research

A

RCT - BIAS, Blinding, Allocation Concealment, Randomisation, confounding, completeness of follow up, intention to treat

Systematic Review - Publication Bias

Qualitative Research

23
Q

Systematic Reviews
Observational Study Design
RCT

A

FINISH

Heterogeneity
Publication Bias
Search Integrity

24
Q

Appraise Diagnostic Tests
Screening
Prognosis

A

Likelihood Ratio
PPV
NPV

25
Q

Define Public Health

A

preventing disease, prolonging life, and promoting health through organised efforts of society”.

26
Q

Define approaches to disease prevention

1) Define health improvement
2) Define disease prevention,
3) explain their relevance to clinical care
4) primary disease prevention,
5) secondary disease prevention
6) tertiary disease prevention
7) contrast high-risk and population strategies of health promotion and disease prevention
8) Outline some of the methodological, ethical and practical challenges associated health promotion/disease prevention interventions

A

1) Wider factors that affect health and wellbeing
Healthy lifestyles and choices
Inequalities

2)

4) prevent the onset of disease
(reduces the incidence of disease)

5) early identification and treatment of disease
sometimes refers to identifying and treating risk factors
(acts on prevalence: cures or prevents progression of disease)

6)
Tertiary prevention
rehabilitate people with established disease

8) Prevention paradox
‘…a large number of people at small risk may give rise to a larger number of cases of disease than the small number of cases who are at high-risk’
but…
‘….a preventative measure which brings much benefit to the population offers little to each participating individual’

27
Q

Health determinants and strategies

A

FINISH

28
Q

Infectious Disease epidemiology

Control and Immunisations

A

FINISH

29
Q

Qualitative Research and Methods

A

FINISH

30
Q

Health economic evaluation and Quality of Life

A

QALY

31
Q

Genetic Epidemiology

A

FINISH

32
Q

Prevalence vs Incidence which is more useful for research where interest is in risk factors for disease onset

A

Incidence

33
Q

Prevalence vs Incidence which is more useful for service planning where need for service is the same among old and new cases of the disease

A

Prevalence

34
Q

Mortality rate

A

No. deaths of disease ÷ (population at risk x time interval)

35
Q

What does RR > 1 suggest

A

exposure predisposes to outcome

36
Q

What does RR < 1 suggest

A

exposure protects against outcome

37
Q

RR indicates strength of association between exposure and outcome

However just because there is an association does this mean the association must be the cause?

A

NO

38
Q

Calculate Risk Ratio (Relative Risk)

A

Risk of outcome in exposed ÷ Risk of outcome in unexposed

39
Q

Define economics

A

Allocation of scarce resources

40
Q

How do you know an intervention is cost effective

A

+ve Net Monetary Benefit value + more QALYs

41
Q

Interpreting ICER

Incremental cost effectiveness ratio

A

Interpretation: The ICER will result in a valuation

        £X per case detected or 
        £Y per death avoided or
        £Z per QALY gained

EBM and Public Health (5 decks)

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