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First Aid Behavioral Science > Epidemiology/Biostats > Flashcards

Epidemiology/Biostats Flashcards

1
Q

Cross-sectional Study

A

Observational, collects data from a group of people to assess frequency of disease (and related risks) at a particular point in time.
“What is happening?” Disease prevalence

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2
Q

Case-Control Study

A

Observational and retrospective
compares a group of people with the dx vs without
looks for prior exposure or risk factor
Odds Ratio

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3
Q

What type of study is this: “patients with COPD have higher odds of hx of smoking than those without COPD”

A

Case-Control Study

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4
Q

Relative Risk is associated with what type of Study?

A

Cohort Study

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5
Q

Compares a group with a given exposure or risk factor to a group without such exposure. looks to see is exposure increases likelihood of disease

A

Cohort study (can be prospective or retrospective

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6
Q

Twin concordance study

A

compares the frequency with which both monozygotic and dizygotic twins develop the same disease
measures inheritability and influence of environmental factors

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7
Q

Adoption Study

A

compares siblings raised by biological vs adoptive parents (measures heritability vs environmental influence)

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8
Q

Compares therapeutic benefit of 2+ tx or tx and placebo.

randomized, controlled, and double blinded (or triple blind)

A

Clinical trial

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9
Q

Phase I Drug Trial

A

small number of healthy volunteers to determine how safe the drug is

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10
Q

Phase II Drug Trial

A

small number of patients with dx of interest to see is tx works.
asses efficacy, optimal dosing, and A/E

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11
Q

Phase III Drug Trial

A

Lg # of patients randomly assigned either experimental tx and a placebo (or known outcome tx)
compares new tx to current std of care

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12
Q

Phase IV Drug Trial

A

Postmarketing surveillance trial of patients after approval

detects rare or LT A/E

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13
Q

Sensitivity

A

true-positive rate, high sensitivity test used for screening disease with low prevalence
TP/(TP+FN)

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14
Q

Specificity

A

True-negative rate, the probability that a test indicates non-dx when dx is absent
high specificity used for confirmation after +screening test
TN/(TN+FP)

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15
Q

Positive Predictive Value

A

probability that person actually has the dx when receives a + test result
TP/(TP+FP)

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16
Q

Negative Predictive Value

A

Probability that person is actually dx free when give a (-) test result
TN/(FN+TN)

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17
Q

Incidence

A 
New Cases
(#new cases)/(pop at risk at same time)
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18
Q

Prevalence

A

ALL CURRENT CASES
(#existing cases)/(pop at risk)
or (incidence rate) * (av dx length)

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19
Q

Odds ratio

A

used in case-control

odds that group with dx was exposed to risk factor divided by odds that group w/o dx was exposed

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20
Q

Relative Risk

A

Cohort studies

risk of developing a dx in exposed group divided by risk in unexposed group

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21
Q

Relative Risk Reduction

A

proportion of risk reduction attributable to the intervention as compared to a control
RRR= 1-RR

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22
Q

Attributable RIsk

A

difference in risk between exposed and unexposed groups, or proportion of dx occurrences that are attributable to exposure

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23
Q

Absolute Risk Reduction (ARR)

A

The difference in risk attributable to the intervention as compared to the comtrol.

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24
Q

Number Needed to Tx

A

number of patients who need to be treated for 1 patient to benefit is 1/ARR

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25
Number Needed to Harm
number of patients who need to be exposed to risk factor to 1 patient to be harmed. 1/AR
26
Reduces Precision in a test
Random Error
27
Reliability, consistency and reproducibility of a test
Precision | absence of random variation in a test
28
increase precision
decrease std deviation
29
Validity, Trueness of test measurements
Accuracy
30
Absence of systemic error or bias in a test
Accuracy
31
Nonrandom assignment to particpate in a study group.
selection bias
32
Berkson bias
a study looking only at inpatients, a type of selection bias
33
How to reduce selection bias
randomization
34
Recall Bias
Awareness of disorder alters recall by subjects; common in retrospective studies
35
Strategy to reduce recall bias
decrease time from exposure to follow up
36
Hawthorne Effect
Groups who know they are being studied behave differently than they would otherwise, this is a type of measurement bias
37
Strategy to reduce Hawthorne effect
use palcebo control groups with blinding to reduce influence of participants and researchers
38
Procedure Bias
subjects in different groups are not treated the same
39
Observer-expectancy Bias
researcher's belief in the efficacy of a tx changes the outcome of that tx
40
Pygmalion effect
observer-expectancy bias | researcher expects + outcome and will more likekly see + outcome whether it be true or not
41
Confounding Bias
When a factor is related to both the exposure and outcome, but not on the causal pathway factor distorts effect of exposure
42
Lead-time bias
early detection is confused with increased survival; seen with improved screening techniques
43
Mean
(sum of values)/(total # of values)
44
Median
Middle value of a list of data sorted from least to greatest
45
Mode
most common value
46
Standard Deviation
how much variability exists from the mean in a set of values
47
Standard error of the mean
an estimation of how much variability exists between the sample mean and the true population mean SEM = SD/sqrt(N) n being sample size SEM decreases and sample size increases
48
Gaussian
bell-shaped, normal distribution mean = median = mode 68%, 98%, 99.7%
49
Bimodal
suggests two different populations, double hump distributions
50
Positive Skew
mean>median>mode | longer tail on the right
51
Negative Skew
mean < median < mode | longer tail on the left
52
Null Hypothesis (Ho)
hypothesis of no difference. There is no association between the disease and the risk factor
53
Alternative Hypothesis (H1)
there is some association between the disease and the risk factor
54
Correct Result
Stating there is an effect or difference when on exists (Ho is rejected) Stating that there is not an effect of difference when non exists (H1 is accepted)
55
Type I error (alpha)
False positive error alpha is the probability of making a type I error p is judged by a preset alpha level of significance
56
p < 0.05
there is evidence against the null hypothesis, reject the null hypothesis the test is acceptable
57
Type II error (beta)
false negative error
58
Statistical power
1-beta, beta being the probability of making a Type II error | probability of rejecting the null hypothesis when it is false
59
How to increase Power
increase sample size, increase expected effect size, increase precisionof measurement
60
Meta-analysis
Pools data and integrate results from several similar studies to reach an overall conclusion this is limited by bias or quality of studies selected
61
Confidence Interval
range of value in which a specified probability of the means of repeated sample would be expected to fall
62
t-test
checks differences between means of 2 groups
63
Ex. comparing the mean BP between men and women, what test would you use'?
t-test
64
ANOVA
checks differences between means of 3 or more groups
65
Ex. Comparing mean BP between 3 different ethnic groups, what test would you use?
ANOVA
66
Chi-square
checks difference between 2+ percentages or populations of CATEGORICAL outcomes
67
Ex. comparing the percentage of members of 3 different ethnic groups who have essential HTN
Chi-square
68
Pearson correlation coefficient
r is always between -1 and 1. closer to absolute 1, the more linear it is. -r has negative correlation, +r has positive correlation
69
Primary Disease Prevention
Prevent disease from occurring
70
Secondary Disease Prevention
Screening Early for disease
71
Tertiary Disease Prevention
treatment to reduce disability from disease
72
Quaternary Disease Prevention
identifying patients at risk of unnecessary treatment, protecting from the harm of new interventions
73
Medicare
for patient >65y/o or <65 with certain disabilities, and those with end-stage renal disease
74
Medicaid
Joint federal and state health assistance for people with very low income
75
Obligation to respect patients as individuals and honor their preference in accepting/not accepting medical care
Respect of Patient Autonomy
76
Act in the patient's best interest.
Beneficence
77
"Do no harm"
Nonmaleficience
78
Treat people fairly and equitably
Justice
79
4 think informed consent legal requires
disclosure: discussion of pertinent info understanding: ability to comprehand mental capacity: unless incompetent a legal determination voluntariness: freedom from coercion and manipulation
80
Situations in which parental consent is usually not requires
Sex like contraception, STDs and pregnancy, Drugs like addiction, or "rock and roll" emergency/trauma
81
Priority of surrogates in decision making
spouse; adult children; parents; adult siblings; other relatives
82
general exceptions of patient confidentiality
potential physical harm to others, harm to self, no alt. means to warn ot protect those at risk reportable disease, abuse, impaired drivers like epilepsy, suicidal/homicidal
83
Tarasoff Decision
California Supreme Court, physician can directly inform and protect potential victim from harm
84
Who lives in a pineapple under the sea?
SPONGEBOB SQUAREPANTS

First Aid Behavioral Science (4 decks)

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