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Y3 - Transition Block > Evidence Based Medicine > Flashcards

Evidence Based Medicine Flashcards

1
Q

What is the order of levels of evidence?

A 
Systemic reviews
Randomised controlled trials
Cohort studies
Case-control studies
Case series, case reports
Editorials, expert opinion
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2
Q

What is a cross-sectional study?

A

A selected sample from the population is divided into:

  • Those with the risk factor and the disease
  • Those with the risk factor and no disease
  • Those with no risk factor and the disease
  • Those with no risk factor and no disease
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3
Q

What is a case-control study?

A

Subjects that have the disease are analysed to determine whether they were exposed or unexposed to a risk factor, and this is compared to controls who don’t have the disease

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4
Q

What is a cohort study?

A

Study participants with risk factors present are exposed, or not exposed to a factor. The outcome of individuals in each group is evaluated

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5
Q

What is a randomised control trial?

A

Random - the population receiving the intervention and the population being compared are only different because of random variation
Control - the intervention is being compared to something else: a placebo, a gold-standard, best practice

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6
Q

What is the inclusion criteria for patient selection?

A

Likely to benefit from treatment - definitely has the disease, likely to respond
Unlikely to be harmed - no known adverse reactions/contraindications

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7
Q

What is the exclusion criteria for patient selection?

A

Clear preference for intervention or control - by patient or doctor
Patient unlikely to adhere to treatment/complete follow-up

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8
Q

What are different types of control?

A

Placebo
Nothing
Current best practice
“standard care”

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9
Q

What is confounding?

A

When the association between an exposure and an outcome is in fact the result of another variable

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10
Q

What is a systemic review?

A

A review of the evidence available on a question that uses systematic methods to extract and analyse data from studies

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11
Q

What is absolute risk?

A

The number of events in treated or control groups, divided by the number of people in that group

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12
Q

What are ARC and ART?

A

Absolute risk of control group (ARC) and treatment group (ART)

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13
Q

What is ARR - absolute risk reduction?

A

ARC - ART

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14
Q

What is RR - relative risk?

A

ART/ARC

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15
Q

What is RRR - relative risk reduction?

A

(ARC - ART) / ARC

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16
Q

What is NNT - number needed to treat?

A

1/ARR

17
Q

What is triangulation?

A

The area under investigation is looked at from different perspectives

18
Q

What are the 4 phases of clinical trials?

A
  1. Clinical pharmacology - determine dosage, safety
  2. Initial clinical assessment - determine likely effectiveness, common adverse effects
  3. Rigorous testing - randomised control trial
  4. Post-marketing surveillance - find less common adverse effects
19
Q

What should a screening test be?

A

For an important condition with a recognisable latent or early symptomatic phase
A test that is accurate, simple, safe and precise
For a condition with effective and available treatment
Cost effective

20
Q

What is sensitivity?

A

How well the test detects having the disease

High sensitivity = few false negatives

21
Q

What is the calculation for sensitivity?

A

Number of results where disease is detected in people with the disease / number of people with the disease x 100

22
Q

What is specificity?

A

How well the test detects not having the disease

Highly specificity = few false positives

23
Q

What is the calculation for specificity?

A

Number of ‘normal’ results where disease is not detected in people without the disease / number of people without the disease x 100

24
Q

What is positive predictive value?

A

How reliable is the test result when it shows disease is present

25
Q

What is the calculation for positive predictive value?

A

Number of people with a positive test result and have the disease / number of people with a positive test result x 100

26
Q

What is negative predictive value?

A

How reliable is the test result when it shows disease is not present

27
Q

What is the calculation for negative predictive value?

A

Number of people who have a negative test result and do not have the disease / number of people with a negative test result x 100

28
Q

What is opportunity cost?

A

Refers to a benefit that a person could have received, but gave up, to take another course of action

29
Q

What is the definition of a QALY?

A

Quality adjusted life year

A composite measure of gains in life expectance and quality of life

30
Q

What is ICER?

A

Incremental cost-effectiveness ratio

The extra cost per QALY gained

Y3 - Transition Block (1 decks)

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