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Epidemiology > Epidemiology Final Exam > Flashcards

Epidemiology Final Exam Flashcards

1
Q

Incidence Proportion

A

of new cases of disease during specified time interval / Population at risk at start of time interval

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2
Q

Synonyms for Incidence Proportion

A

1) Attack Rate. 2) Risk 3) Probability of developing disease 4) Cumulative incidence

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3
Q

Secondary Attack Rate

A

of new cases among contacts / (# of people at risk-primary cases)

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4
Q

Incidence Rate

A

of new cases of disease during specified time interval/ summed person-years of observation or average population during time interval

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5
Q

Point prevalence

A

of current cases (new and preexisting) at a specified point in time / Population at the same specified point in time

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6
Q

Period Prevalence

A

of current cases (new and preexisting) over a specified period of time/Average or mid-interval population

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7
Q

Crude Death Rate (Crude Mortality Rate)

A

Total # of deaths during a given time interval/Mid-interval population

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8
Q

Cause-Specific Mortality Rate

A

of deaths assigned to a specific cause during a given time interval/Mid-interval population

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9
Q

Proportionate Mortality

A

of deaths assigned to a specific cause during a given time interval/Total # of deaths from all causes during the same time interval

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10
Q

Death-to-case Ratio

A

of deaths assigned to a specific cause during a given time interval/# of new cases of same disease reported during the same time interval

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11
Q

Neonatal mortality rate

A

of deaths among children< 28 days of age during a given time interval/# of live births during the same time interval

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12
Q

Postneonatal mortality rate

A

of deaths among children 28-364 days of age during a given time interval/# of live births during the same time interval

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13
Q

Infant mortality rate

A

of deaths among children< 1 year of age during a given time interval/# of live births during the same time interval

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14
Q

Maternal mortality rate

A

of deaths assigned to pregnancy-related causes during a given time interval/Number of live births during the same time interval

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15
Q

Age-Specific Mortality Rate

A

of deaths of people in a particular age group/# of people present in the age group

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16
Q

Sex-Specific Mortality Rate

A

of deaths males OR females/ # of males OR females

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17
Q

Race-Specific Mortality Rate

A

of deaths among people in particular race category/# of people in particular race category

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18
Q

Case Fatality Rate

A

of cause specific deaths among incident cases/ total # of incident cases

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19
Q

infectivity

A

of people infected/ # of people exposed

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20
Q

Pathogenicity

A

of people who develop clinically apparent disease/ # of people infected

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21
Q

Virulence

A

of people who die/ # of people who develop clinically apparent disease

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22
Q

Attributable Risk % (AKA attributable risk reduction ARR)

A

(# case in exposed/total # exposed) - (#cases unexposed/total # unexposed)

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23
Q

Control Group Rate/Risk (CGR)

A

of events in control group/total # of control participants

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24
Q

Experimental Group Rate/Risk (EGR)

A

of events in experimental group/total # of experimental participants

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25
Q

Attributable Risk Reduction

A

Control Group Rate (CGR) - Experimental Group Rate (EGR)

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26
Q

Relative Risk

A

EGR/CGR

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27
Q

Relative Risk Reduction (RRR)

A

1) (CGR-EGR)/CGR
2) 1-(EGR/CGR)
3) 1-RR
*Note: all 3 formulas should give you the same result

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28
Q

Epidemiology

A

The study of the distribution and determinants of health-related states or events in specified populations and the application of this study to control of health problems

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29
Q

Etiology

A

The cause of a disease

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30
Q

Primary Prevention

A

Action taken to prevent the development of a disease in people who do not have the disease Examples: Vaccines, healthy behaviors, etc.

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31
Q

Secondary Prevention

A

Identifying people in whom a disease process has already begun but who have not yet developed clinical signs or symptoms of the disease (preclinical phase) Examples: Cancer screening, mammograms, etc.

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32
Q

Tertiary Prevention

A

Preventing complications in those who have already developed signs and symptoms of an illness and have been diagnosed (those in the clinical phase of illness) Examples: Cancer treatment, physical therapy, etc.

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33
Q

Direct Transmission

A

Disease is transmitted from person to person by direct contact. Examples: STIs

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34
Q

Indirect Transmission

A

Disease is transmitted from person to person by a common vehicle like contaminated air or water or a vector. Examples: yellow fever (mosquitos), Lyme Disease (ticks), etc.

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35
Q

Disease

A

any harmful deviation from the normal structural or functional state of an organism, generally associated with certain signs and symptoms and differing in nature from physical injury. A diseased organism commonly exhibits signs or symptoms indicative of its abnormal state. There is subclinical or non-clinical (change from normal structure or function) vs. clinical disease (change from normal structure or function expressed via signs/symptoms)

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36
Q

Clinical Disease

A

Characterized by signs and symptoms

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37
Q

Nonclinical (inapparent) disease

A

Signs and symptoms have not developed. Includes preclinical, subclinical, persistent, and latent disease.

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38
Q

Preclinical disease

A

Disease is not clinically apparent but is destined to progress to clinical disease

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39
Q

Subclinical disease

A

Disease is not clinically apparent and is not destined to become clinically apparent. Diagnosed by serologic response or culture of the organism

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40
Q

Persistent (chronic) disease

A

Disease or infection that can last for many years or even life

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41
Q

Latent disease

A

Infection with no active multiplication of the agent, only the genetic message is present, not the viable organism

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42
Q

Carrier

A

Person who harbors the organism but is not infected as measured by serologic studies or shows no evidence of clinical illness

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43
Q

Endemic

A

The habitual presence of a disease within a given geographic area

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44
Q

Epidemic

A

The occurrence in a community or region of a group of illnesses of similar nature, clearly in excess of normal expectancy and derived from a common or a propagated source

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45
Q

Pandemic

A

A worldwide epidemic

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46
Q

Common-vehicle exposure

A

Cases arise from the same exposure; Example: food poisoning outbreak from bad chicken at a buffet

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47
Q

Herd immunity

A

The resistance of a group of people to an attack by a disease to which a large proportion of the members of the group are immune

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48
Q

Incubation period

A

The interval from infection to the time of onset of clinical illness. Often measured as the time from exposure until the onset of clinical disease as it is difficult to determine the exact time of infection.

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49
Q

Epidemic curve

A

A graph used to characterized the two primary types of outbreaks (common source and propagated). The y-axis is the number of cases and the x-axis is the date of onset each case patient. Note not all epidemics are common source or propagated- for example with some zoonotic or vector borne diseases.

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50
Q

Primary case

A

A person who acquires the disease from a specific exposure

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51
Q

Secondary case

A

A person who acquires the disease from exposure to a primary case

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52
Q

Epidemiologic surveillance

A

The ongoing systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice closely integrated with the timely dissemination of these data to those who need to know

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53
Q

Passive surveillance

A

Surveillance in which available data on reportable disease are used, or in which disease reporting is mandated or requested by the government or the local health authority, with the responsibility for the reporting often falling on the health care provider or district health officer. Provider initiated; less resource intensive. Also known as ‘passive reporting’

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54
Q

Active surveillance

A

A system in which staff are specifically contact providers or others to carry out a surveillance program. Often more accurate than passive. Health-department initiated; more resource intensive

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55
Q

Rates

A

Tell how fast the disease is occurring in the population

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56
Q

Proportions

A

Tell what fraction of the population is affected

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57
Q

Cumulative incidence proportion

A

Incidence calculated using a period of time during which all of the individuals in the population are considered to be at risk for the outcome.

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58
Q

Person-time

A

The sum of the units of time that each individual was at risk and was observed. Often expressed in person-months or person-years.

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59
Q

Prevalence

A

The number of affected persons present in the population at a specific time divided by the number of persons in the population at that time. What proportion of the population is affected by the disease at that time?

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60
Q

Case fatality

A

What percentage of people who have a certain disease die within a certain time after the disease was diagnosed?

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61
Q

Direct age adjustment

A

A standard population is used in order to eliminate the effects of any differences in age between two or more populations being compared. Most commonly used method.

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62
Q

Indirect age adjustment

A

Used when numbers of deaths for each age-specific stratum are not available or in an occupationally exposed population.

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63
Q

Cohort effect

A

Changes seen are attributable to the characteristics of the particular ‘cohort’ under study, not the variable being studied.

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64
Q

Evidence-Based Medicine (EBM)

A

Conscientiously working with patients to help them resolve (sometimes) or cope with (often) problems related to their physical, mental, and social health

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65
Q

Hierarchies of evidence

A

A system of classifying and organizing types of evidence, typically for questions of treatment and prevention. Clinicians should look for the evidence from the highest position in the hierarchy

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66
Q

Evidence

A

Any empirical observation, whether systematically collected or not.

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67
Q

Evidentialism

A

A theory of knowledge that holds that the justification or reason of a belief is determined by the quality of the believer’s evidence for the belief

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68
Q

GRADE (Grading of Recommendations Assessment, development, and Evaluation)

A

System of rating the quality of evidence and strength of recommendations that is explicit, comprehensive, and increasingly adopted by guideline organizations. Four levels (very low-high).

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69
Q

Secondary evidence-based journals

A

A secondary journal does not publish original research but rather includes synopses of published research studies that meet prespecified criteria of both clinical relevance and methodologic quality

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70
Q

Background questions

A

These clinical questions are about physiology, pathology, epidemiology, and general management and are often asked by clinicians in training. The answers to background questions are often best found in textbooks or narrative review articles.

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71
Q

Foreground questions

A

These clinical questions are more commonly asked by seasoned clinicians. They are questions asked when browsing the literature (e.g., what important new information should I know to optimally treat my patients?) or when problem solving (e.g., defining specific questions raised in caring for patients and then consulting the literature to resolve these problems)

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72
Q

PICO framework

A

Patient, Intervention, Comparison, Outcome. A method for answering clinical questions

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73
Q

Therapy (foreground clinical questions)

A

Determining the effect of interventions on patient-important outcomes (symptoms, function, morbidity, mortality, and costs)

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74
Q

Harm (foreground clinical questions)

A

Ascertaining the effects of potentially harmful agents (including therapies from the first type of question) on patient-important outcomes

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75
Q

Differential diagnosis (foreground clinical questions)

A

In patients with a particular clinical presentation, establishing the frequency of the underlying disorders

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76
Q

Diagnosis (foreground clinical questions)

A

Establishing the power of a test to differentiate between those with and without a target condition or disease

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77
Q

Prognosis (foreground clinical questions)

A

Estimating a patient’s future course

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78
Q

Randomized trial/ Randomized Clinical Trial

A

An experiment in which individuals are randomly allocated to receive or not receive an experimental diagnostic, preventive, therapeutic, or palliative procedure and then followed up to determine the effect of the intervention

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79
Q

Control groups

A

A group that does not receive the experimental intervention. In many studies, the control group receives either usual care or a placebo

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80
Q

Observational studies

A

Includes many study designs that are not randomized such as cohort or case control studies where the exposure to the intervention or disease is not controlled by the researcher

81
Q

Reference standard/Criterion Standard

A

A method having established or widely accepted accuracy for determining a diagnosis that provides a standard to which a new screening or diagnostic test can be compared

82
Q

Random Error

A

A difference between an observed value and a true value due to chance. It is inherent in all measurements. There will always be some variation in all measurements. When the random error is high, the measurement is less precise and we can be less sure of the value of that measurement.

83
Q

Bias/systematic error

A

Sytematic deviation from the underlying truth because of a feature of the design or conduct of a research study. There are many different types of bias such as recall bias, reporting bias, etc.; High levels of bias reduce validity

84
Q

Lost to follow up

A

Patients whose status on the outcome or end point of interest is unknown

85
Q

Risk of bias

A

The extent to which study results are subject to systematic error.

86
Q

Random allocation/randomization

A

The allocation of participants to groups by chance, usually done with the aid of a table of random numbers.

87
Q

Blinding

A

Patients, clinicians, data collectors, outcome adjudicators, or data analysts unaware of which patients have been assigned to the experimental or control gorup

88
Q

Descriptive studies

A

Studies that find patterns among populations among person, place, and time and are used to develop hypotheses to test

89
Q

Analytic studies

A

Hypothesis-testing studies- answer the how and why

90
Q

Case reports

A

Descriptive study- a comprehensive, detailed description of one case under observation

91
Q

Case series

A

Descriptive study- a comprehensive, detailed description of two or more cases under observation

92
Q

Ecological studies

A

Descriptive study- A study of group characteristics; Studying a group of people (for example, everybody in Texas) rather than individuals

93
Q

N=1 studies

A

Descriptive study- one person trial; using the same person and comparing the outcome for the person before and after the intervention

94
Q

Cohort study

A

Observational study- Two groups, one with the exposure and one without the exposure, are followed over time to determine the occurence of disease in each group; can be prospective or retrospective. Exposure is measured BEFORE the outcome

95
Q

Case-control study

A

Observational study- Study involves two groups, one with the disease (cases) and one without the disease (controls), and compares the two groups in respect to previous exposures. Disease is measured BEFORE exposure

96
Q

Cross-sectional

A

Observational study- prevalence surveys in which exposure and disease status are assessed simultaneously among individuals in a well defined population

97
Q

Random assignment (clinical trial)

A

Experimental study- One group has been assigned randomly to receive an experimental agent or intervention and the other group gets a placebo

98
Q

Quasi-experimental study

A

Experimental study- an experiment where the subjects are non-randomly assigned to (or offered) the exposure

99
Q

Nominal

A

Categorical(qualitative)-Different categories with no specific rank or significance in rank; dichotomous (only two possible answers)

100
Q

Ordinal

A

Categorical(qualitative)-Different categories with specific ranks or significance in rank/levels

101
Q

Interval

A

Continuous(quantitative)- equally spaced numerical scale with no true zero point

102
Q

Ratio

A

Continuous(quantitative)- numerical scale with a true zero point

103
Q

Descriptive statistics

A

Describe the characteristics of the sample of individuals that represent the population from which they came from; ratios, mean, standard deviation, etc.

104
Q

Inferential statistics

A

Make inferences or predictions about the whole population from the sample taken of that population; p-values, confidence intervals, point estimates, etc.

105
Q

Hypothesis (significance) testing

A

generating a hypothesis about a population parameter and then using sample statistics to assess the likelihood the hyposthesis is true

106
Q

X variable

A

What we control or change; independent variable; predictor or exposure

107
Q

Y variable

A

What we want to measure; Dependent variable; Response or outcome

108
Q

Null hypothesis

A

There is no difference between groups; reject or accept the null

109
Q

Alternate hypothesis

A

There is a difference between groups

110
Q

P-value

A

What is the probability that the difference observed is due to chance?

111
Q

Type 1 error

A

Concluding that there is a difference between two groups when there is not; alpha

112
Q

Type 2 error

A

Concluding that there is not a difference between two groups when there is a difference

113
Q

power

A

Probability of saying there is a difference when there is in fact a difference between two groups; the likelihood of making the right decision

114
Q

Point estimate

A

What is the single value most likely to represent the true difference between experimental and control treatments?

115
Q

Confidence interval

A

Given the observed difference between experimental and control groups, what is the plausible range of differences within which the true difference might actually lie?

116
Q

Historical controls

A

Comparison group from the past

117
Q

Simultaneous nonrandomized controls

A

simultaneous controls that are not selected in a randomized manner

118
Q

Stratified randomization

A

Assignment method which first stratifies the whole study population into subgroups with same attributes or characteristics then followed by simple random sampling from the stratified groups

119
Q

Planned Crossover

A

Patients are first randomized into two groups and then switched between the groups after a certain time period and again observed for a given time period

120
Q

Carryover

A

In a planned crossover design, the effects from the first treatment the subjects are on may carry over and affect the subject during the second treatment

121
Q

Unplanned Crossover

A

During the course of the study, patients may unexpectedly crossover to a different treatment group

122
Q

Factorial Design

A

Examines how two or more variables (factors) predict or explain an outcome

123
Q

Noncompliance

A

Patients agree to be randomized but do not comply with the assigned treatment

124
Q

Intent to treat

A

Patients for whom data are available are analyzed in the groups to which they are randomized irrespective of what treatment they received

125
Q

Absolute risk reduction (ARR)/risk difference

A

The absolute difference (risk difference) in risks of harmful outcomes between experimental groups (experimental group risk [EGR]) and control groups (control group risk [CGR]); calculated as the risk of harmful outcome in the control group minus the risk of harmful outcome sin the experimental group (CGR-EGR); Used to describe a harmful exposure or intervention

126
Q

Generalizable

A

The degree to which the results of a study can be generalized to setting or samples other then the ones studied

127
Q

Number needed to treat (NNT)

A

the number of patients who must receive an intervention of therapy during a specific period to prevent 1 adverse outcome or produce 1 positive outcome

128
Q

Noninferiority trials

A

Address whether the effect of an experimental intervention is not worse than a standard intervention by more than a specified margin

129
Q

Equivalence trials

A

Trials that estimate treatment effects that exclude any patient-important superiority of interventions under evaluation; helpful when determining if one intervention is neither better nor worse than another

130
Q

Validity

A

The extent to which an instrument measures what it is intended to measure

131
Q

Truncated RCTs

A

Trials stopped early due to apparent harm because the investigators have concluded that they will not be able to demonstrate a treatment effect or because of apparent benefit

132
Q

N-of-1 Randomized Clinical Trials

A

Experiment to determine the effect of an intervention or exposure on a single study participant; patient undergoes pairs of treatment periods organized so that 1 period involves the use of the experimental treatment and 1 period involves the use of an alternate treatment

133
Q

Inclusion criteria

A

Eligible for the study such as having the disease the treatment will target

134
Q

Exclusion criteria

A

Not eligible due to various factors

135
Q

Efficacy

A

Does the treatment work under ideal, controlled conditions?

136
Q

Effectiveness

A

Does the treatment work like it is supposed to in the real world?

137
Q

Efficiency

A

Is the benefit of the treatment worth the cost?

138
Q

Surrogate outcomes

A

Proxy measures, outcomes that substitute for direct measures

139
Q

Composite end points

A

Aggregate measures that used in combination to measure the effect of a treatment; combination of multiple end points

140
Q

Superiority trial

A

Determines the magnitude of increased benefit of the experimental intervention over the standard therapy on effectiveness outcomes

141
Q

Odds Ration (OR)

A

It is the ratio of: the odds of an event in the treatment group to the odds of an event in the control group.

The odds ratio tells us how more likely or less likely an event is to happen

An odds ratio = 1 implies that the event is EQUALLY LIKELY in both groups.
An odds ratio > 1 implies that the event is MORE LIKELY in the first group.
An odds ratio < 1 implies that the event is LESS LIKELY in the first group.

142
Q

Relative Risk (RR)

A

The ratio of the incidence rate of a disease or health outcome in an exposed group to the incidence rate of the disease or condition in a non-exposed group.

143
Q

Confounding

A

A situation in which a measure of association or relationship between exposure and outcome is distorted by the presence of another variable.

Positive confounding-when the observed association is biased away from the null (Inflated Result)

Negative confounding -when the observed association is biased toward the null) (Weakened Result)

144
Q

Four reasons for RCT limits

A

1) Unethical to randomize harmful exposure
2) Insufficient power to detect rare and serious adverse events or effects
3) Limited follow-up, not suitable for long-term effects
4) Most RCTs do not provide info on harm

145
Q

Advantages and disadvantages of Cohort studies

A

Pros
-good for rare exposures
-reduces bias
-shows temporal relationship

Cons
-Not good for rare diseases
-expensive
-time-consuming
-loss to follow up

146
Q

Advantages and disadvantages for case-control studies

A

Pros
-good for several exposures
-good for rare diseases
-less expensive
-no follow up

Cons
-not good for rare exposures
-not good for continuous disease outcomes

147
Q

Advantages and disadvantages for cross-sectional studies

A

Pros
-good for examining several exposure-disease relationships
-inexpensive

Cons
-cannot establish temporal relationship
-not good for rare diseases with short durations

148
Q

Nested case control

A

A case control study within a large cohort; typically seen with large enrollment studies; Controls are a sample of individuals who are at risk for the disease/outcome at the same time each case of the disease develops

149
Q

Case-cohort

A

Same as nested case-control design, except controls are randomly chosen from the cohort at the beginning of the study.

Can study different diseases with same controls because they are not matched with cases

150
Q

Matching

A

adjust for possible confounders and gain efficiency (precision); when a case is matched to a control based on a characteristic
CANNOT study ‘matched’ characteristic

151
Q

Differential misclassification

A

occurs when the information collected differs for the exposed and non-exposed groups and this difference IS related to the exposure or outcome

152
Q

Non-differential misclassification

A

occurs when the information collected differs for the exposed and non-exposed groups and this difference is NOT related to the exposure or outcome

153
Q

selection bias

A

In a cohort or experimental study
-when there are differences in participation or selection of participants in the exposed and non-exposure groups and this difference is related to the outcome

In a case-control study
-when there are difference in participation or selection of participants in the cases and controls and this difference is related to the exposure

154
Q

Information bias

A

occurs due to errors in the measurement of or collection of data which the distorts the association or measures of association (RR, OR etc.). Misclassification of either the exposure or outcome.

155
Q

Sample population

A

people who are in the study

156
Q

Source population

A

population eligible to be in the study and are at risk for the outcome

157
Q

Target population

A

Population you want to target your results to, generalize your results to

158
Q

Correlation

A

A measure of the relationship between two variables

159
Q

Regression

A

primary interest, to examine strength relationship between predictor variable and a target (exposure) , dependent variable (outcome). Predictions!

160
Q

Screening test

A

Used when people are considered to be at high risk of developing a disease or condition, before the clinical phase (pre-clinical phase).

161
Q

Diagnostic test

A

Any kind of medical test performed to aid in the diagnosis or detection of a suspected disease or condition; in the clinical phase.

162
Q

Sensitivity

A

True positive rate

SNout- rules out a disease

Ability to recognize and appreciate the personal characteristics of others

a/a+c

163
Q

Specificity

A

True negative rate

SPin- rule in a disease

Of those without the disease, what’s the probability they will not be detected by the test?

d/b+d

164
Q

Positive Predictive Value (PPV)

A

Helps determine what the probability is that your patient will have the disease given a positive test result

a/a+b

165
Q

Negative Predictive Value (NPV)

A

helps you determine what the probability is that your patient will not have the disease given a negative test result

d/c+d

166
Q

Sequential testing

A

a screening strategy that uses one test followed by one or more additional tests if the first test is positive

Second test is usually more invasive or risky or expensive and is higher sensitivity or specificity

Gain in specificity, loss in sensitivity

167
Q

Simultaneous testing

A

A screening strategy that uses two tests initially if one test is positive then the case is positive

Both tests have to be negative to be considered negative

Gain in sensitivity, loss in specificity

168
Q

intrasubject variation

A

variation within individual subjects

169
Q

intraobserver variation

A

variation in the reading of test results by the same reader

170
Q

Interobserver variation

A

variation between those reading the test results

171
Q

Critical point

A

the point at which we can imagine that, before this point, treatment is more effective and less difficult to administer.

can have one or more critical points

172
Q

Volunteer bias (referral bias)

A

persons seeking preventative care may be healthier than those showing up for acute problems

type of selection bias

173
Q

length-biased sampling

A

So the natural history of disease differs between people and for different diseases and that includes the clinical phase

type of selection bias

174
Q

Lead time bias

A

Bias arising from how much earlier a disease can be diagnosed if disease is detected by screening compared with the usual time of diagnosis if screening was not carried out

175
Q

Over diagnosis bias

A

Due to screening, people without disease labeled as having the disease (false positives)

Results in increased survival due to screening, but this is an artifact of screening

176
Q

Pre-test probability

A

The probability of a patient having the target disorder before a diagnostic test result is known.

177
Q

Testing threshold

A

in diagnostic testing, the point at which the optimal decision is to perform a diagnostic test

178
Q

Treatment threshold

A

In clinical decision making, the point at which a decision is reached to treat the patient without first performing a diagnostic test.

179
Q

Post test probability

A

probability of the disorder once the test results are obtained

180
Q

Spectrum bias

A

Difference in those in that participate in the study in terms of disease spectrum compared to the population the test will be applied to

Lack of external validity

181
Q

Blind assessment

A

Clinical info + diagnostic test results influences final diagnosis of patient and this differs between the two groups (experimental and standard testing groups)

differential misclassification

182
Q

Verification/work-up bias

A

Selection bias

Dependent of the results of one test determines who will receive the confirmatory test

183
Q

Narrative review

A

•review article; does not incorporate methods to assess and minimize bias

184
Q

Synopsis

A

•summary of a primary study, systematic review, or meta-analysis that includes key methodological details

185
Q

Systematic review

A

appraisal of several primary studies to address a focused clinical question; incorporates methods to reduce likelihood of bias

186
Q

Meta-analysis

A

•statistical technique for quantitatively combining results of several primary studies addressing the same outcome via a pooled or summary estimate

187
Q

Paternalistic approach

A

clinician offers minimal info to the patient about options; makes decision without patient input or consideration of patient values or preferences.

188
Q

Clinician-as-the-perfect-agent approach

A

•clinician considers patient’s values and preferences but there is no active involvement of the patient in the decision. Clinician must take careful consideration of being current on patient’s values and preferences- difficult

189
Q

Informed decision making

A

•empowering to patients- clinician provides the patient with information and the patient makes the decision; provider serves as an expert in technical aspects

190
Q

Shared decision making

A

bidirectional approach in which patient and provider both bring information, evidence, values, and preferences in making a decision.

Power gradient must be minimal and the patient must be reassured that the clinician will act according to the patient’s informed values and preferences even if in conflict with that of the providers.

191
Q

Team Talk

A

patient has reasonable options and the physician’s role is to help the patient understand these options and how to consider these options in more detail

192
Q

Option talk

A

•provider is clear about reasonable treatment alternatives and helps patient compare them.

193
Q

Decision talk

A

•asking patient what matters most to them once they understand and compare them treatment options and alternatives. Helps patient form their own views.

194
Q

Patient decision aids

A

based on a systematic review- present information about the disease, treatment options, and potential outcomes in a patient friendly manner- information that is descriptive and probabilistic

195
Q

Four bioethical principles

A

Respect for autonomy
Beneficence
Non-maleficence
Justice

196
Q

Respect for autonomy

A

•preserving an individuals preferences, rights, dignity- retaining and promoting the ability to determine an individual’s own course

197
Q

Beneficence

A

•provider’s responsibility to promote the well-being of others

198
Q

Non-maleficence

A

•provider’s responsibility to actively avoid harm or injuring others

199
Q

Justice

A

•Fair, equitable, and appropriate treatment in light of what is due or owed to a person

Epidemiology (1 decks)

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