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Clinical Informatics Board > Domain 1: Fundamental Knowledge & Skills > Flashcards

Domain 1: Fundamental Knowledge & Skills Flashcards

1
Q

What terms are included in Logical observations, identifiers and numerical codes (LOINC)

A

Lab/radiology tests as well as physical exam findings and SDOH codes (e.g. adverse childhood events)

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2
Q

What is an ontology?

A

Structured concepts and relationships between them.

Ontology is an extension of taxonomy where concepts can be related in multiple different ways in addition to simple parent-child relationships.

Example: Taxonomy may assert that tuberculosis is a kind of pneumonia. An ontology would add that TB is caused by Mycobacterium tuberculosis and tuberculosis has symptom of cough, etc.

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3
Q

What are pre-coordinated vs. post-coordinated items

A

Pre-coordinated items in a vocabulary are those that are included explicitly.

Post-coordinated items are those that are created by the combination of pre-coordinated items

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4
Q

Majority of clinical research in the US is sponsored by

A

Industry

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5
Q

What does an assembler do?

A

Translate assembly language into machine code

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6
Q

What does a compiler do?

A

Translates higher level languages (e.g. FORTRAN) into machine code

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7
Q

Examples of Agile programming

A

Scrum, Xtreme Programming

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8
Q

What is Reference Information Model (RIM)?

A

Basis of HL7 version 3. Requires transmission of metadata which externally defines the meaning of that information. This helps improve semantic interoperability

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9
Q

What is the difference between horizontal and vertical integration

A

Horizontal integration involves connecting each component to the enterprise service bus

Vertical system involves grouping similar systems together

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10
Q

What are the typical steps in a Clinical Practice Guideline algorithm?

A
  • Action
  • Conditional (carry out an action based on defined criteria)
  • Branch (direct flow to one or more additional steps)
  • Synchronization (converge paths back from branches to a common outcome/end point)
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11
Q

What is Job Costing?

A

Calculating how much it costs organization to provide its goods and services

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12
Q

What is margin analysis?

A

Calculating total profit made from various products and services

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13
Q

What is a pro forma sales budget?

A

Estimating the revenue from goods and services for the coming year

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14
Q

What is the primary clinical messaging standard in the US?

A

HL7 version 2

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15
Q

4 basic types of HL7 messages

A
  1. ADT (Admit, Discharge, Transfer)
  2. ORM (ORder Management)
  3. ORU (Observation Result)
  4. DFT (Detail Financial Transaction)
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16
Q

Limitations of HL7 V2

A

Embraced and extended by many developers. As a result, standard often differs between implementations and offers limited interoperability.

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17
Q

What does ASC X 12N do?

A

Establishes standards for communication with insurers.

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18
Q

What is BlueButton Initiative

A

Early attempt at government led interoperability standards, and helps veterans download their health records from VistA (VA hospital EHR)

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19
Q

How to calculate accounting rate of return (ARR)

A

ARR (yearly ROI) = average profit / average investment

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20
Q

How to calculate annual depreciation

A

(initial cost - scrap value) / usable life

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21
Q

How to calculate future value (FV)

A

FV = PV x (1+r)^n

PV = present value
r = discount rate
n = number of years

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22
Q

What is internal rate of return (IRR)

A

Discount rate at which point net present value (NPV) reaches 0.

NPV = sum of PV of all revenues and expenses (i.e. value of the entire investment in today’s dollars)

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23
Q

What 3 interoperability standards did HL7 create?

A
  1. HL7 v2
  2. HL7 Clinical Document Architecture (CDA)
  3. HL7 Fast Health Interoperability Standards (FHIR)
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24
Q

What are 3 major financial account documents?

A
  1. Income statement: Summarizes revenue and expenses during a specific time period.
  2. Balance Sheet: Summarizes assets, liabilities and equity during a specified time period.
  3. Cash flow statement: Summarizes cash inflow and outflow during a specified time period.
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25
Q

What is an operating activity?

A

Operating activity is a component of the Cash Flow Statement and deals with converting items on the income statement to cash.

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26
Q

How is National Drug Codes (NDC) superior to RxNorm

A

NDC is a packing standard maintained by FDA and provides info on number of tablets in a prescription. RxNorm is substance-oriented.

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27
Q

Main problem with NDC

A

Middle 4 digits about product name, strength and dose vary from different manufacturers; therefore, same drug from a different manufacturer will have different middle 4 digits.

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28
Q

What is source of operating vs. capital expenses?

A

Operating expenses - daily cash flow & budgeting process

Capital expenses - retained earnings, fundraising, government grants

29
Q

What does instantiation refer to in object oriented programming?

A

Creating new object and setting initial parameters for the attributes and methods

Ex) Class of “dog” may have attributes for “fur color,” “name,” “breed” and methods for “bark” and “roll-over”

30
Q

What does it mean for class to demonstrate encapsulation?

A

Keep their attributes and methods private

31
Q

What does inheritance mean in object oriented programming?

A

Objets can inherit their structure from parent objects and extend their functionality

Ex) 2 classes (manager & staff) can inherit same basic structure of parent class “employee”

32
Q

What does polymorphism refer to in object oriented programming?

A

Objects can override their parent attributes/methods

Ex) Class “animal” may have a “make noise” method. Subclasses of “animal” (e.g. dog, cat, mouse) will all have a “make noise” method but may implement it differently and can override the parent method.

33
Q

What does accessors refer to in object oriented programming?

A

AKA “getters” are methods used to retrieve variable state

34
Q

What does mutators refer to in object oriented programming?

A

AKA “setters” are methods used to change variable state

35
Q

What is a hash function?

A

Algorithm that maps data of arbitrary length to data of fixed length

Returned value known as hash value, hash code, hash sum or checksum

Used in data integrity, cryptography, indexing

36
Q

In what programming methodology is highest risk tackled early?

A

Spiral

37
Q

What are test case development approaches for software development?

A
  1. White Box - tests inner workings of a program. Ex) Code Coverage where programmer develops set of test conditions for all scenarios/variables/inputs
  2. Black Box - testing from end-user standpoint. Ex) Specification testing
38
Q

4 Different levels of software testing

A
  1. Unit test
    - White box
    - Code coverage
    - Developer driven, can be semi-automated
  2. Integration test
    - White box
    - Interfaces/APIs
    - Developer-driven
  3. System test
    - Black box
    - Test against documented requirements (verification)
  4. Acceptance test
    - Black box
    - Request for user-sign off (validation)
    - Ex) Beta testing
39
Q

Equation for number needed to treat

A

NNT = 1 / Absolute Risk Reduction

40
Q

What did HITECH Act enforce?

A
  • Incentive for EHR adoption, meaningful use
  • Strengthened HIPAA rules (privacy and security)

Ex) Mandated notification of protected health information (PHI) breaches

41
Q

What did Patient Safety and Quality Improvement Act (PSQIA) enforce?

A

Confidential reporting of adverse medical events.

42
Q

Examples of physical safeguards identified by the Security Rule for Health Insurance Portability and Accountability Act (HIPAA)

A

Access controls, data backup, device media control

43
Q

5 Examples of technical safeguards identified by the Security Rule for Health Insurance Portability and Accountability Act (HIPAA)

A
  1. Access Control: enable authorized users to access the minimum necessary information needed to perform job functions
    - Unique user identification
    - Emergency access procedures
    - Auto logoff
    - Encryption & Decryption
  2. Audit controls
  3. Electronic data integrity: Implement policies and procedures to protect electronic protected health information from improper alteration or destruction.
  4. Person and entity authentication
  5. Transmission security

https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf

44
Q

9 Examples of administrative safeguards identified by the Security Rule for Health Insurance Portability and Accountability Act (HIPAA)

A
  1. Security management Process
    - Risk analysis/management
    - Sanction policy
    - IS activity review (i.e. audit)
  2. Assigned security responsibility
  3. Workforce security
    - Authorization and/or supervision
    - Workforce clerance procedure
    - Termination procedures
  4. Information Access management
  5. Security awareness and training
  6. Security Incident procedures
  7. Contingency Plan
  8. Evaluation
  9. Business Associate Contracts and Other Arrangements

https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/administrative/securityrule/adminsafeguards.pdf

45
Q

What is the purpose of U.S. SNOMED CT Content Request System?

A

Allows users to request basic changes to SNOMED CT.

46
Q

3 components of UMLS

A
  1. Metathesaurus - Database of info on concepts that appear in one or more of a number of different controlled vocabularies and classifications used in biomed
  2. Semantic network - generic relationships between semantic types of concepts (e.g. diseases and treatment)
  3. Specialist Lexicon - based on metathesaurus words and terms, designed to assist in natural language processing applications
47
Q

How is unique device identifier (UDI) constructed?

A

UDI = Device Identifier (DI) + Production Identifier (PI)

DI is mandatory and fixed
PI is conditional & variable

48
Q

4 Layers of Healthcare Internet of Things (IoT) / Internet of Medical Things (IoMT)

A
  1. Perception layer - perceiving devices (e.g. sensors, cameras, robots)
  2. Network layer - Data communication (e.g. routing, WiFI, bluetooth)
  3. Processing layer - Data management layer (storage via web services, data centers, cloud infrastructure)
  4. Application layer - app-specific services to user
49
Q

Which image types can use both lossy and lossless algorithms

A

JPEG2000, PDF, TIF

50
Q

Which image and audio types use no compression

A

RAW & WAV

51
Q

What does bioinformatics pipeline refer to?

A

Multiple sets of one or more computational algorithms performed in series/parallel to analyze biological data

*Not limited to Next Generation Sequencing

52
Q

What is a FASTQ file?

A

Simple text file format for genetic (nucleic acid) sequence

52
Q

What is a SAM file?

A

Sequence alignment map (SAM) - describes where the human sequence aligns to the human reference genome

53
Q

What is a VCF file?

A

Variant call format (VCF) - list of variants present in the sample which are not in the human reference genome

54
Q

What does Human Genome Variation Society (HGVS) do?

A

Provides nomenclature for genetic variants

55
Q

What does International System for Human (ISCN) do?

A

Provides cytogenomic nomenclature

56
Q

Big data is characterized by 4 Vs

A

Volume - large amounts of data
Variety - many different types of data
Velocity - constantly accumulating new data
Variability - change in data over time

57
Q

Examples of big data sources

A

Genome interpreters (e.g. PubMed, COSMIC, ClinVar)
LIS
EHR

58
Q

Is big data structured or unstructured?

A

Unstructured data of many types

59
Q

What is the significance of HIPAA Omnibus Rule?

A

Required “genetic information” as defined by GINA to be treated as PHI under HIPAA

60
Q

What is metagenomics?

A

Study of non-human genetic material recovered from patient samples for diagnosis and therapy

61
Q

What is the clinical lab label barcode standard?

A

Clinical & Laboratory Standards Institute (CLSI) AUTO02-A2

  • Code 128 has required check digit
62
Q

What is the blood products bar code standards?

A

ISBT 128 - specifications for symbology, encoded content, printers, and scanning software

63
Q

Difference between DIRECT & CONNECT data exchange methods

A

DIRECT - sending info directly to another health care professional enabling coordinated care.

CONNECT = “pull” model / query-baesd exchange

64
Q

What is type 1 error?

A

False positive rate

65
Q

What is type 2 error?

A

False negative rate

66
Q

Statistical parameter that is most difficult to assess when creating, testing and deploying a CDS alert

A

Negative predictive value since false negative rate cannot be measured directly

67
Q

6 fields included in LOINC

A
  1. Component: what is measured, evaluated, or observed (e.g., potassium)
  2. Property: characteristics of what is measured, evaluated or observed (e.g., concentration)
  3. Time aspect: whether the observation applies to a moment in time or is over a period of time (e.g. 24 hour)
  4. Specimen: Specimen type or context for observation (e.g., urine)
  5. Scale: Scale of measurement: Quantitative, ordinal, nominal or narrative
  6. Method: The procedure used to produce the measurement or operation where relevant (optional)

Clinical Informatics Board (6 decks)

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