Exam 1 - Lecture 3 EBP in Assessment and Diagnosis

Question 1

Define Assessment

Answer 1

Process of identifying the signs and symptoms of a disease or condition and recording the associated data for the purposes of diagnosis

Question 2

Define Diagnosis

Answer 2

Process of determining the cause of a disease or condition through evaluation of a patient’s history, physical exam, and results of laboratory tests and imaging

Question 3

Collecting information about nature of an injury. Assessment or Diagnosis?

Answer 3

Assessment

Question 4

A healthcare practitioner performs a physical exam on an injured leg. Assessment or Diagnosis?

Answer 4

Assessment

Question 5

Xray taken of injured leg. Assessment or Diagnosis?

Answer 5

Assessment

Question 6

Clinician determines leg is fractures in two places. Assessment or Diagnosis?

Answer 6

Diagnosis

Question 7

What is a Reference Standard Test?

Answer 7

The gold standard which all diagnostic procedures are compared because it has been shown to be the most accurate

Question 8

Newly develop diagnostic tests do what three things during testing?

Answer 8

Compared side by side to gold standard
Conducted on patients know to have the disease, AND
Conducted on patients known to NOT have the disease

Question 9

What are the 4 parameters/questions in evaluating the Validity of a diagnostic test?

Answer 9

1. Diagnostic dilemma?
2. Compare test to appropriate, independent reference standard?
3. Blinding those interpreting the test and reference standard?
4. Apply same reference standard to all PTs with dz regardless of results?

Question 10

What are the determining Accuracy factors?

Answer 10

Sensitivity, Specificity, PPV, and NPV

Question 11

Define Sensitivity for a test

Answer 11

Test is positive when patient has the disease or condition

Question 12

Define Specificity for a test

Answer 12

Test is negative when patient does not have disease or condition

Question 13

When test is positive and PT does have disease which measure?

Answer 13

Sensitivity

Question 14

When test is negative and PT does not have disease or condition which measure?

Answer 14

Specificity

Question 15

True Positive is when what two things are positive or negative?

Answer 15

Test positive, disease positive

Question 16

False Positive is when what two things are positive or negative?

Answer 16

Test positive, disease negative

Question 17

False Negative is when what two things are positive or negative?

Answer 17

Test negative, disease positive

Question 18

True Negative is when what two things are positive or negative?

Answer 18

Test negative, disease negative

Question 19

What is Sensitivity formula?

Answer 19

a/(a+c)
a=patients who tested positive and who have condition
c=patients who test negative and who have the condition

Question 20

What is Specificity formula?

Answer 20

d/(b+d)
b=patients who tested positive and do not have condition
d=patients who tested negative and do not have condition

Question 21

Define Positive Predictive Value (PPV)?

Answer 21

Percentage of patients with a positive test who actually have the disease

Question 22

Define Negative Predictive Value (NPV)?

Answer 22

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

Question 23

What is PPV formula?

Answer 23

a/(a+b)
a=patients who tested positive and have the condition
b=patients who do tested positive and do not have the condition

Question 24

What is NPV formula?

Answer 24

d/(c+d)
c=patients who tested negative and have the condition
d=patients who tested negative and do not have condition

Question 25

Define Prevalence

Answer 25

Proportion of individuals in a population having a disease or characteristic. EX: water in the bathrub

Question 26

Define Incidence

Answer 26

Number of new cases that develop in a given period of time. Can die, can be cured, or can be prevented. EX: Water going into tub from spout

Question 27

What happens to PPV and NPV as prevalence of a disease in sample increases?

Answer 27

PPV increases

NPV decreases

Question 28

What happens to Prevalence if PT dies, cured, or prevented from disease?

Answer 28

Die=prevalence down
Cured=prevalence down
Prevented=prevalence up

Question 29

What does a low Sensitivity mean for a test?

Answer 29

Not a good test

Question 30

Why is it better to have a higher Sensitivity than Specificity?

Answer 30

Higher sensitivity to ensure that PTs who have the disease aren’t missed

Question 31

What happens to Specificity as Sensitivity increases

Answer 31

Increased sensitivity=decreases specificity.