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First Aid Behavioral Science > Epidemiology/Biostats > Flashcards

Epidemiology/Biostats Flashcards

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Biology 101 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
Q

Number Needed to Harm

A

number of patients who need to be exposed to risk factor to 1 patient to be harmed.
1/AR

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26
Q

Reduces Precision in a test

A

Random Error

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27
Q

Reliability, consistency and reproducibility of a test

A

Precision

absence of random variation in a test

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28
Q

increase precision

A

decrease std deviation

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29
Q

Validity, Trueness of test measurements

A

Accuracy

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30
Q

Absence of systemic error or bias in a test

A

Accuracy

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31
Q

Nonrandom assignment to particpate in a study group.

A

selection bias

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32
Q

Berkson bias

A

a study looking only at inpatients, a type of selection bias

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33
Q

How to reduce selection bias

A

randomization

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34
Q

Recall Bias

A

Awareness of disorder alters recall by subjects; common in retrospective studies

35
Q

Strategy to reduce recall bias

A

decrease time from exposure to follow up

36
Q

Hawthorne Effect

A

Groups who know they are being studied behave differently than they would otherwise, this is a type of measurement bias

37
Q

Strategy to reduce Hawthorne effect

A

use palcebo control groups with blinding to reduce influence of participants and researchers

38
Q

Procedure Bias

A

subjects in different groups are not treated the same

39
Q

Observer-expectancy Bias

A

researcher’s belief in the efficacy of a tx changes the outcome of that tx

40
Q

Pygmalion effect

A

observer-expectancy bias

researcher expects + outcome and will more likekly see + outcome whether it be true or not

41
Q

Confounding Bias

A

When a factor is related to both the exposure and outcome, but not on the causal pathway
factor distorts effect of exposure

42
Q

Lead-time bias

A

early detection is confused with increased survival; seen with improved screening techniques

43
Q

Mean

A

(sum of values)/(total # of values)

44
Q

Median

A

Middle value of a list of data sorted from least to greatest

45
Q

Mode

A

most common value

46
Q

Standard Deviation

A

how much variability exists from the mean in a set of values

47
Q

Standard error of the mean

A

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
Q

Gaussian

A

bell-shaped, normal distribution
mean = median = mode
68%, 98%, 99.7%

49
Q

Bimodal

A

suggests two different populations, double hump distributions

50
Q

Positive Skew

A

mean>median>mode

longer tail on the right

51
Q

Negative Skew

A

mean < median < mode

longer tail on the left

52
Q

Null Hypothesis (Ho)

A

hypothesis of no difference. There is no association between the disease and the risk factor

53
Q

Alternative Hypothesis (H1)

A

there is some association between the disease and the risk factor

54
Q

Correct Result

A

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
Q

Type I error (alpha)

A

False positive error
alpha is the probability of making a type I error
p is judged by a preset alpha level of significance

56
Q

p < 0.05

A

there is evidence against the null hypothesis, reject the null hypothesis
the test is acceptable

57
Q

Type II error (beta)

A

false negative error

58
Q

Statistical power

A

1-beta, beta being the probability of making a Type II error

probability of rejecting the null hypothesis when it is false

59
Q

How to increase Power

A

increase sample size, increase expected effect size, increase precisionof measurement

60
Q

Meta-analysis

A

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
Q

Confidence Interval

A

range of value in which a specified probability of the means of repeated sample would be expected to fall

62
Q

t-test

A

checks differences between means of 2 groups

63
Q

Ex. comparing the mean BP between men and women, what test would you use’?

A

t-test

64
Q

ANOVA

A

checks differences between means of 3 or more groups

65
Q

Ex. Comparing mean BP between 3 different ethnic groups, what test would you use?

A

ANOVA

66
Q

Chi-square

A

checks difference between 2+ percentages or populations of CATEGORICAL outcomes

67
Q

Ex. comparing the percentage of members of 3 different ethnic groups who have essential HTN

A

Chi-square

68
Q

Pearson correlation coefficient

A

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
Q

Primary Disease Prevention

A

Prevent disease from occurring

70
Q

Secondary Disease Prevention

A

Screening Early for disease

71
Q

Tertiary Disease Prevention

A

treatment to reduce disability from disease

72
Q

Quaternary Disease Prevention

A

identifying patients at risk of unnecessary treatment, protecting from the harm of new interventions

73
Q

Medicare

A

for patient >65y/o or <65 with certain disabilities, and those with end-stage renal disease

74
Q

Medicaid

A

Joint federal and state health assistance for people with very low income

75
Q

Obligation to respect patients as individuals and honor their preference in accepting/not accepting medical care

A

Respect of Patient Autonomy

76
Q

Act in the patient’s best interest.

A

Beneficence

77
Q

“Do no harm”

A

Nonmaleficience

78
Q

Treat people fairly and equitably

A

Justice

79
Q

4 think informed consent legal requires

A

disclosure: discussion of pertinent info
understanding: ability to comprehand
mental capacity: unless incompetent a legal determination
voluntariness: freedom from coercion and manipulation

80
Q

Situations in which parental consent is usually not requires

A

Sex like contraception, STDs and pregnancy, Drugs like addiction, or “rock and roll” emergency/trauma

81
Q

Priority of surrogates in decision making

A

spouse; adult children; parents; adult siblings; other relatives

82
Q

general exceptions of patient confidentiality

A

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
Q

Tarasoff Decision

A

California Supreme Court, physician can directly inform and protect potential victim from harm

84
Q

Who lives in a pineapple under the sea?

A

SPONGEBOB SQUAREPANTS

First Aid Behavioral Science (4 decks)

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