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BMS I > EBM Day 5 > Flashcards

EBM Day 5 Flashcards

1
Q

when not best to perform RCT (4)

A
  1. unnecesary
  2. inappropraite
  3. impossible
  4. inadequate (not best test design)
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2
Q

equipose

A

not sure which treatment is better

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3
Q

RCT sampling

A

decrease variation

  • reduce internal error
  • incrae internal validity
  • reduces external validiy
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4
Q

exclusion criteria

A 
comorbidty
limited longevity
adherence/retention concerns
non-cooperation
highly selected-not much like everyday patient
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5
Q

random allocation

A

avoid potential confounding

factors related to prog are distriburted if groups are large enough

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6
Q

problems after randomization

A

cross over
co interntion
nonadherence

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7
Q

4 levels of blinding

A

allocation concealment

blinding subjects

bliding treating physicians

blining investigators

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8
Q

Open trial

A

no blinding

ideal for test that can’t have blinding (surgury)

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9
Q

Outcomes

A

primary

secondary-too many cause t1 error

composite-evaluate secondary components sep and together

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10
Q

NNT

A

1-abs risk reduction

How many patients one would we need to treat, on average, to prevent one outcome event

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11
Q

Abs risk reduction

A

incidence affected %- incidence unaffected%

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12
Q

Efficacy vs effectiveness

A

does trx work under ideal conditions vs under circumstances of care

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13
Q

Intention to treat vs per protocol analysis

A

Analyze in group should be in

  • preserves original randomization
  • answers which trx choice is best

analyze only who completed study per protocol

  • answers does actually taken trx instead of being offered make better
  • concern about bias
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14
Q

superiority, equivalnce, noninferiority trials

A

equivalence is different in any direction

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15
Q

Type 2 error causes

A

small sample size, poor adherence, co-interventions, crossing over, loss to follow up , differential/nondifferential measurement error

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16
Q

Cluster randomized trials

A

Naturally occurring groups of patients are randomized as a unit

17
Q

Cross over trails

A

each patients get all trials after wash out period

controls for difference in response to trx among patients

Practical for outcomes that recur and trx is transient

18
Q

Prevention levels

A

primary-before disease
secondary-after exposure
teritary-after disease is recognizable
quay-too much trx-hurting now

19
Q

Commune

A

clusters of unvaccinated susceptible children or adults

20
Q

Vaccine controversey

A

morality, necessity, safety

autism-time around when autism presents
also remve the mercury from vaccine in US-must keep refrigerated

21
Q

Herd protection

A

must have 90% vaccination rate to work

1 with disease-disease mutate-vaccine no work

22
Q

Lead time bias

A

illusion screening-detect test earlier indicating prolonged survival

23
Q

Pricipals for screening disease

A 
High prevalence problem that is understood
accepted trx with means to trx
suitable latent and symptomatic stage
suit test for diagnosis
acceptable
agree whom to treat
cost of finding economically balanced with overall health
continuous process-
24
Q

Lead time bias

A

discover disease early on-patient lives longer

makes screening look effective

25
Q

length time bias

A

slower killing disease keep you alive longer

makes screening look effective

26
Q

Compliance bias

A

people who participate in screening likely to participate in follow up

makes screening look effective

27
Q

Slow growing cancers and screening lead two which error

A

false positive-type 1 error

28
Q

screening in low prevalaence diseases

A

not done
few true positives
many false positives
PPV is low
True negatives are high
-follow up on positive screen (ELISA and WESTERN)
-if second test is biopsy many complications can occur

29
Q

chemorprevention

A

usage of drugs, diet sups to reduce disease chance

30
Q

USPTF

A

US preventative task force

read literature and say what screens are worth it

says evidence is insufficient a lot

BMS I (30 decks)

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