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Red Block > Ethics + SFSBM + EBM > Flashcards

Ethics + SFSBM + EBM Flashcards

1
Q

What is the Developmental Origins Hypothesis?

A

If the beginning and ending environments match, it’s okay; if not, a mismatch leads to increased health risks

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2
Q

What aspect of evolution lead to DM2?

A

energy conservation (environmental mismatch)

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3
Q

What aspect of evolution lead to coronary heart disease?

A

clotting after injury (environmental mismatch)

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4
Q

What aspect of evolution lead to autoimmunity?

A

co-evolution with rapidly mutating pathogens

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5
Q

What aspect of evolution lead to cystic fibrosis?

A

persistence of harmful alleles due to heterozygous advantage

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6
Q

What aspect of evolution lead to cancer?

A

selective pressure against post-reproductive maintenance and repair

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7
Q

What are the levels of the social ecological model?

A
  • individual
  • social networks
  • institutional
  • community
  • society (policy, environmental change, cultural change)
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8
Q

What are the social and physical influences on health?

A
  • inadequacies of healthcare system (10%)
  • behavioral factors (50%)
  • environmental hazards (20%)
  • human biological factors (20%)
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9
Q

What are the major factors that contribute to health inequities among racial and ethnic minorities?

A
  • timeliness
  • effectiveness
  • safety
  • efficiency
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10
Q

What is primary intervention and its outcome?

A

intervention before disease/predisposition to disease onset –> no health event

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11
Q

What is secondary intervention and its outcome?

A

intervention before illness onset –> no symptoms

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12
Q

What is tertiary intervention and its outcome?

A

intervention once disease is diagnosed –> minimize risk of recurrence or clinical deterioration

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13
Q

What are the indications for immunizations?

A

infectious disease and select cancer prevention

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14
Q

Pharmaceuticals have a __ probability of non-specific effect.

A

low

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15
Q

Herbs have a __ probability of non-specific effect.

A

low

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16
Q

Chiropractic medicine has a __ probability of non-specific effect.

A

medium

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17
Q

Acupuncture has a __ probability of non-specific effect.

A

medium-high

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18
Q

Homeopathy has a __ probability of non-specific effect.

A

high

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19
Q

Distance healing has a __ probability of non-specific effect.

A

high

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20
Q

What are the theoretical mechanisms underlying the placebo effect?

A

expectancy and learned response

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21
Q

What is an impure placebo?

A

intervention with a non-zero but extremely low probability of producing a specific physiologic effects

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22
Q

What are the key attributes of a healthcare system?

A
  • accessible to all (access + equity)
  • high quality
  • affordable
  • prevention focused
  • mutually accountable
23
Q

What are the stakeholder groups that affect US healthcare?

A
  • patients
  • providers
  • insurers
  • employers
  • government
24
Q

What are the impacts of the ACA to date?

A
  • number of uninsured has fallen
  • healthcare is more affordable for lower-income
  • delivery system innovation is accelerating
  • overall health spending growth is down
  • 37 states have expanded Medicaid
25
Q

What is the healthcare system as a three legged stool?

A

Access, cost, quality

26
Q

What is the Triple Aim?

A
  • patient experience
  • population health
  • per capita cost
27
Q

What is the Quadruple Aim?

A
  • patient experience
  • population health
  • per capita cost
  • care team well being
28
Q

What are the components of Medicare?

A

A - hospital
B - doctor
C - Medicare advantage (A/B/D + additional benefits)
D - prescription

29
Q

What is an externality?

A

An impact, positive or negative, on any party not involved in a given economic transaction or act

30
Q

What does fee for service incentivize?

A

do more

31
Q

What does bundle payment incentivize?

A

maximize the number of bundles among some, exclude bundles for others

32
Q

What does global payment/capitation incentivize?

A

avoid risk, do less

33
Q

What does salary incentivize?

A

no direct financial incentives, might incentivize laziness

34
Q

What are the basic building blocks of family life?

A
  • coherence
  • organization
  • communication
  • values and beliefs
35
Q

What are the significant components of parenting?

A
  • nurturance
  • structure
  • affiliation
  • attachment
36
Q

What are the components of geriatric care management?

A
  • reduce cost through prevention
  • reduce number of medications
  • improve cognition and function
  • decrease fall risk
  • reduce hospitalizations, expensive tests, etc.
37
Q

What is the usefulness equation?

A

usefulness = (relevance x validity) / work

38
Q

What is patient-oriented evidence geared towards?

A

morbidity, mortality, quality of life

39
Q

What is disease-oriented evidence geared towards?

A

pathology, physiology, pharmacology, etiology of disease

40
Q

What is sensitivity?

A

the percent of patients with the disease who have a positive test

41
Q

What is specificity?

A

The percent of patients without the disease who have a negative test

42
Q

What is positive predictive value?

A

the percent of patients with a positive test who have the disease

43
Q

What is negative predictive value?

A

the percent of patients with a negative test who do not have the disease

44
Q

What are summary reviews?

A

provide an overview of the disease etiology, diagnosis, prognosis, or management (background question)

45
Q

What are synthesis reviews?

A

define one or two specific questions and carefully find all available evidence, evaluate its validity, and report their answer to the question (foreground question)

46
Q

What is a meta-analysis?

A

A statistical technique for combining finding from independent studies; used to treat the data from different studies as if they were from one large study

47
Q

What does a Chi-squared test indicate?

A

Higher p value is evidence of homogeneity between studies

48
Q

What do the degrees of inconsistency (I^2) indicate?

A

0-40% - might not be important
30-60% - may represent moderate heterogeneity
50-75% may represent substantial heterogeneity
75-100% - considerable heterogeneity

49
Q

What is a funnel plot?

A

Compares variability of data; balanced on both sides of the mean shows there was no publication bias

50
Q

What is the hierarchy of evidence?

A

controlled trials > case controls > case series > expert consensus > pathophysiologic reasoning

51
Q

What is the best approach to analyze the results of a study?

A

intention to treat analysis

52
Q

What is the equation for number needed to treat?

A

NNT = 100 / (% in treatment group - % in control group)

53
Q

What are the three types of guidelines?

A
  • authority based guidelines
  • evidence based guidelines
  • evidence linked guidelines

Red Block (1 decks)

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