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2021 CAP Question Book > EVIDENCE BASED MEDICINE > Flashcards

EVIDENCE BASED MEDICINE Flashcards

1
Q 
Study of response to SSRI in children
with depression, 60% of those given
SSRI meet response rate criteria, 35% of
those given placebo also meet criteria.
NNT for this study? (2x)
A

4

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2
Q

Construct validity definition? (2x)

A

Degree to which a test measures what it

intends to measure

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3
Q

In an exposed group of 120, 4 have autism
vs. 10 children of 600 in unexposed group
(control), what is the odds ratio for
developing ASD?

A

2

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4
Q 
Study of children with high risk of
depression, 50% in observation group and
25% in treatment group developed
depression. What is the number needed to
treat to prevent 1 case?
A

4

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5
Q

Meta-analysis of antidepressants in
pediatrics. Suicide-related events 4% with
medication, 2% with placebo. Number
needed to harm with medication?

A

4

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6
Q

What is crucial for estimating the
probability of developing bipolar disorder
in a 9 yo?

A

Base rate of mood disorders in children

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7
Q

Consulting literature to see if children
w/Lyme disease have high risk of
developing anxiety/depression in the
future is what type of study?

A

Cohort

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8
Q

Data to review in a research study before
applying to clinical care of a particular
patient?

A

Demographic characteristics of patients in

study

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9
Q

What trial design would help study the
duration of treatment required for
clonidine to control hyperarousal in
children with PTSD?

A

Discontinuation trial

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10
Q

A new drug increases social reciprocity in
ASD study. What is a moderating variable of
treatment response?

A

IQ score

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11
Q

Prospective case control study to measure
growth of children with ADHD treated with
stimulants compared to control groups
with no stimulant exposure. What statistical
method would you use to calculate impact
of socioeconomic status on growth?

A

Logistic regression

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12
Q 
Screening test for autism misdiagnosis 5%
of children below 2 years, and correctly
diagnoses 20% of children who later meet
criteria at age 6. What is the
sensitivity/specificity?
A

Low sensitivity, high specificity

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13
Q

In longitudinal pediatric studies, what

threatens internal validity?

A

Maturation

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14
Q

Summative statistical measure of central

tendency

A

Median

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15
Q

Which resource is most up to date on
potential complementary and alternative
medicine (CAM) and drug interactions?

A

Medline Plus: Drugs and Supplements

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16
Q

Type of research design following 2 groups
of subjects (population of interest vs
control group) over 15 yrs from in-utero?

A

Prospective Cohort study

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17
Q

As prevalence of dx increases, what would

also increase?

A

Positive Predictive Value

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18
Q

Highest level of evidence for psychiatric

treatment interventions?

A

Randomized clinical trial

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19
Q

Factor limiting generalization of a
treatment intervention presented in a
meta-analysis?

A

Significant internal validity variability

between studies

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20
Q

Benefit of a clinical trial with randomized
controlled crossover design vs parallel
design:

A

Subjects serve as their own controls

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21
Q

Way to explain a p value of 0.05 found in a
trial comparing a new antidepressant to
placebo?

A

These results would be only 5% likely if the

antidepressant were not effective.

22
Q

Best type of study for estimating

heritability of ADHD?

A

Twin

23
Q

Common methodology used in a crosssectional study of the point-prevalence of
sleep disorders of children in school?

A

Both parent and child surveys asking about

symptoms of disrupted sleep

24
Q

What type of study looks at the outcome of
cognitive development in 2 groups of
children, 1 exposed to toxin and the other
not exposed?

A

Cohort study

25
Q

Research term for assigning incorrect

diagnosis to patient

A

Commission error

26
Q

Risk factor strength is established by
assessing the _____ between the factor and
the outcome

A

Consistency across developmental stages

27
Q

Study shows concurrent increase in cancer
rate and suicide rate. If occurring in
different age groups can study draw
conclusions related to cancer and suicide?

A

No

28
Q

Advantage of using a longitudinal vs cross
sectional study in studying mental
disorders and aggression?

A

You can discover which disorder is more
persistent, and causal relationship between
disorders

29
Q

What system is described if a clinic
implements an EMR flag if kids on
antipsychotics have an increased BMI?

A

Continuous quality improvement

30
Q 
An antidepressant is moderately
therapeutic and causes weight gain and
transaminitis. To get IRB approval for
conducting study with this medication in
children?
A

Minimize potential risks by research
procedures, and risk benefit for child
should be within reason

31
Q 
Longitudinal prospective study finds
infants of mothers with postpartum
depression finds 3% met mood disorder
criteria by 6 yo, this increased to 6% by 12
yo. Measurement of mood disorder
occurrence?
A

Cumulative incidence

32
Q

Determine sensitivity of new screening tool
for autism. 100 children assessed, 15
correctly identified with autism, 5 children
missed, and 3 children identified
incorrectly.

A

75%

33
Q

Funnel plots assess what type of bias in

systematic reviews and meta-analysis?

A

Publication

34
Q

Research study design that gives each
participant both placebo and active
medication?

A

within subjects

35
Q

What would limit validity in a study that
looks at the efficacy of a medication to
decrease aggression in adolescent males in
a residential facility, when all included
participants scored highest on an
aggression rating scale?

A

Regression

36
Q

How would you describe a p value of 0.05 in
a clinical trial where a new antipsychotic
outperformed the placebo?

A

Results would be only 5% likely if the

antipsychotic were not effective

37
Q

Why are randomized trials at the top of the

hierarchy in evidence-based medicine?

A

Less risk of bias

38
Q

Assent of a minor to participate in research

is?

A

Always needed and binding

39
Q

What type of study should be given the
most weight when assessing benefit of
clinical intervention

A

Systematic review of RCTs

40
Q 
Critical IRB ethical consideration when
evaluating a brain-imaging research project
aimed at recruiting children with
childhood-onset OCD, that will have no
benefit to participants?
A

Determine if study involves only a minor

increase over minimal risk

41
Q

Which of the following steps is considered
“lifelong learning” when an ER physician is
unclear about the etiology of a patient’s
new-onset symptoms of OCD who is
presenting to the hospital.

A

Consult evidence-based journals about

symptoms

42
Q

Clinic sets up a flag in the EMR to alert
physicians to increases in BMI of 2 points
since baseline who are taking
antipsychotics. What is this process?

A

Continuous quality improvement

43
Q

About 60% of depressed adolescents were
excluded from a recent study based on
standard inclusion/exclusion criteria for
clinical trials. What is the likely reason for
the exclusion?

A

High risk for suicide

44
Q 
What is the number needed to harm in a
study looking at suicide related adverse
events, when 4% of medication arm had an
adverse events, compared to 2% in the
placebo arm?
A

50

45
Q

What type of articles would be helpful if a
psychiatrist is reviewing existing research
on a specific subject?

A

Meta-analysis

46
Q

Difference between efficacy and

effectiveness study?

A

Effectiveness study is done under real

world conditions

47
Q

Research design when 5 participants
assigned to receive intervention, while 5
others are assigned to control by lottery?

A

Cluster randomization

48
Q

What is the best statistical test for a study
of TMS on adolescent depression, with
comparison of HAM-D scores between TMS
group and Sham TMS group?

A

T-test

49
Q

What problem does elimination of studies
from a meta-analysis to reduce
heterogeneity create?

A

External validity limited and negative trials

may be eliminated from the study

50
Q

Most important interpretation of a study
when there is a five-fold increased risk of a
rare side effect in those exposed to a
medication vs those not exposed to
medication during the same period of time?

A

Difference between absolute and relative

risk reduction

51
Q

Child involved in study realizes he has to
get blood drawn and refuses, mother
attempts to coerce participation. Next step
for researcher?

A

Child must voluntarily assent to study

52
Q

Researchers want to know if they can
predict suicidal thoughts based on
presenting medical condition in the ER.
What type of variable are suicidal thoughts?

A

Dependent

2021 CAP Question Book (116 decks)

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