Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCC > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Define accuracy vs precision.

A

Accuracy is the ability of a measurement to be correct.

Precision is the ability of a measurement to give the same result. (AKA can I reproduce the same result)

Note:
Good accuracy would be hitting a bulls eye.
Good precision with bad accuracy would be missing the bullseye, but hitting the same spot consistently.
Good precision with good accuracy would be hitting a bullseye consistently.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the four possible scenarios for a diagnosis?

A

True Positive
False Positive (Type I error, alpha error)
True Negative
False Negative (Type II error, beta error)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 3 things do we want in a good screening test?

A

Sensitivity
Specificity
Positive predictive value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define sensitivity and specificity.

A

Sensitivity is the ability of a test to detect a disease when it is present (aka true positive and false negative)

Specificity is the ability of a test to detect a non-disease when it is absent (aka true negatives and false positives)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does increased sensitivity mean?

A

More positives, less false negatives.

trade-off: more false positives as well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the two types of positives/negative I can get?

A

True and false.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is sensitivity measured by?

A

Number of true positives divided by # of people with the disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is specificity measured by?

A

Number of true negatives divided by # of people without the disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the acronym for sensitivity and specificity?

A

SNOUT (sensitivity rules out)
SPIN (specificity rules in)

note:
The specific acronyms are:
Tests high in SeNsitivity. Negative results rules disease OUT.

Tests high in SPecificity. Positive results rules disease IN.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When do we want a highly sensitive test vs a highly specific test?

A

Sensitive tests are generally for screenings, since we just want to make sure a person DOES NOT HAVE the disease.

Specific tests are to confirm positive results, usually for patients that are positive in a screening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do I measure positive and negative predictive values?

A

PPV/PV+ is # of true positives divided by # of total positives.

NPV/PV- is # of true negatives divided by # of total negatives.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does low pre-test probability correlate with?

A

A high number of false positives, which causes low PPV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In class, we learned about the two serologic tests for HIV.
The ELISA test has high sensitivity, rapid, cheap, but not the gold standard.
The Western Blot test has high specificity, gold standard, but costs more and is slower.
When should I use each one?

A

I would use ELISA as the SCREENING test, because it is SNOUT.

If I got a positive, I need to confirm it, so I would use the Western blot since it is SPPIN/SPIN.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 5 classifications used by the USPSTF?

A

A-D and I.
A = highly recommended.
B = recommended, few cons.
C = recommended to select pts, potential benefit.
D = not recommended, likely to cause harm.
I = not recommended due to insufficient evidence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Does correlation = causation?

A

NO!!!!!!! :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the difference between direct and indirect causal association?

A

Direct: If X then Y

Indirect: X can influence A/B/C, which then cause Y.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is sufficient cause?

A

If the cause is present, disease will ALWAYS occur.

Note:
Very rare. Generally only certain genetic anomalies are 100% causal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is necessary cause?

A

The cause must be present for the disease to occur.
The cause may be present without the disease occurring.

AKA EBV causes mono, but getting EBV doesn’t mean you always get mono.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a risk factor?

A

Exposure, behavior, or attribute that CLEARLY increases probability of a particular disease in a group of people w/ the risk factor vs without.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 3 requirements of a causal relationship?

A

Statistical association (AKA outcome must occur significantly more/less in individuals exposed to a presumed cause)
Temporal relationship (Presumed cause must occur prior to outcome)
Elimination of alternatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the criteria for statistical association?

A

Strength
Consistent
Specificity
Biologic
Dose-response (pack year history)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a cross-sectional study?

A

A study that looks at data from a single point in time only.

AKA interview surveys from December of 2022.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the Pros and Cons of a cross-sectional study?

A

Pros;
Quick and easy
Inexpensive
Looking at prevalence and generating a hypothesis.

Cons:
hard to establish a temporal relationship
Small window (selects only for long-lasting and indolent diseases)
Selects for less aggressive cases of a given disease

24
Q

What is a cohort study?

A

Clearly identified group of people to be studied.

25
Q

What are the types of cohort studies and the pros/cons?

A

Prospective and retrospective.

AKA looking forward and looking back.

Pros of prospective:
Control and standardize data collection.
Estimates of risk are true.
Can study lots of stuff at the same time.

Cons:
Everything needs to be set up at the beginning
High cost, lots of subjects
Long wait

Pros of Retrospective:
Less time and cost.
Still can calculate risk

Cons:
Cant monitor and control how data is collected.

26
Q

What is a case-control study?

A

Selection of case and control group based on outcome.
Looking back in time.
Unknown underlying population
Researchers have to estimate relative risk (odds ratio)

27
Q

What are the pros and cons of a case-control study?

A

Pros:
Inexpensive
Great for rare diseases
Many risk factors can be considered

Cons:
Subject to recall bias
Difficult to form a control group
Only estimates relative risk

28
Q

Which studies look at risk factors AFTER the fact?

A

Cohort and case-control.

29
Q

What is the gold standard type of test?

A

Randomized controlled trials!
Minimizes bias.

RCCT = randomized controlled clinical trials (therapeutic intervention in an ill population)
RCFT = randomized controlled field trials (preventative intervention in a well population)

30
Q

Whats the key difference between a cohort study and randomized control trial?

A

In cohort, you know who has and doesn’t have the risk factor.
In a randomized control trial, its a mystery!

31
Q

Whats the difference between a single-blind and double-blind RCT?

A

Single-blind means that the participants don’t know what they’re getting.

Double-blind means that both the participants and the observers don’t know what everyone’s getting.

32
Q

What is a meta-analysis and a decision/cost-effectiveness analysis?

A

Meta analysis = summarizes info obtained in many studies on one topic
Decision/cost-effectiveness = summarizes data and show how it can inform clinical or policy decisions.

33
Q

What is bias in research?

A

A differential error that produces findings consistently distorted in one direction owing to non-random factors.

34
Q

What are the two types of bias?

A

Assembly bias (Selection, allocation, and associated problems of validity)
Detection bias (Measurement, recall)

35
Q

What is assembly bias?

A

The first part of the study, assembling it.

How you choose groups may have assembly bias.

36
Q

What is selection bias?

A

When subjects get to choose what study group they want to be in.

37
Q

What is allocation bias?

A

When investigators choose a NONrandom method of assigning subjects or protocol for randomness is not followed.

38
Q

What are associated validity problems?

A

RCTs have to allow potential study subjects the option to choose to participate or not. AKA there is always an element of self-selection.

AKA people with high cholesterol are probably the ones that volunteer for a study on a new statin.

39
Q

What is internal vs external validity?

A

Internal validity = results of a given study are only valid for the participants in that study.

External validity = Can we generalize the results for a given population based on the current group?

40
Q

What is measurement bias?

A

Baseline data or follow up data.
Did we measure everything the same?

41
Q

What is recall bias?

A

Are members of one study group likely to remember events differently than members of a different group?

AKA mothers with sick children probably remember prenatal history better than mothers with completely healthy children.

42
Q

What is health literacy?

A

The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

43
Q

What does most of the US population fall under in health literacy?

A

Half are intermediate, determine healthy weight from BMI, interpret rx and OTC drug labels.

44
Q

What are some risk factors for low health literacy?

A

Educational status
Health status
Socioeconomic disparities (Age, minority, immigrant, medicare/medicaid)

45
Q

What are the behavioral consequences of low health literacy?

A

High ER use
No preventative health care use
Poor relationships with providers
Don’t take health seriously
Less likely to use meds properly.

46
Q

What are the outcome-related consequences of low health literacy?

A

They perceive healthcare as low quality, low satisfactions, worse safety, and expensive.

Patient health outcomes are worsened, aka more mortality, more complications, more independent risk factors.

47
Q

What are some ways to help improve our communication with patients?

A

Layman’s terms

Goal setting

Matching patients language/vocab

Use analogies

Use Numbers rather than percentages

Use absolute risk instead of relative risk

Ask patients to teach back

Use educational materials

48
Q

What is paternal medicine?

A

The traditional method, aka doctor knows best, be a good patient.

49
Q

What is partnership medicine?

A

New method, provider informs patient and patient works with provider to decide on a mutual plan.

50
Q

What is the patient’s role in healthcare?

A

Participate
Communicate
Continuity (following up)
Engaging

51
Q

What is compliance vs adherence?

A

Compliance is passive, aka patient needs to be a good patient.

Adherence is active, aka patient needs to make their own decisions and adhere to their plan.

52
Q

What are some of the biggest reasons for med non-adherence?

A

Forgetfulness, side effects, affordability, and pt feeling like it is not needed.

53
Q

What are the aspects of shared decision-making?

A

Information (clear and unbiased)
Support
Discussion
Follow-through

54
Q

What is the explanatory model?

A

Asking the pt to explain why they got sick, when, how, etc…

55
Q

What is the BELIEF Model?

A

Beliefs (What caused your illness?)
Explanation (Why did your illness occur?)
Learn (Help me to understand your opinion)
Impact (How is this problem impacting your life?)
Empathy (This must be very difficult for you.)
Feelings (How are you feeling about it?)

PCC (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions