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FA - Behavioral Science Flashcards

1
Q

Observational study: Case-control

Comparison? Variable? Time course? Reporting measure?

A
  1. ) Compares group of people with disease to group of people without disease
  2. ) Looks for prior exposure or risk factor
  3. ) Always retrospective
  4. ) Reported as ODDS RATIO (ad/bc)
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2
Q

Observational study: Cohort study

Comparison? Variable? Time course? Reporting measure?

A
  1. ) Compares group of people with exposure to group of people without exposure
  2. ) Looks for incidence of disease
  3. ) Can be prospective OR retrospective
  4. ) Reported as RELATIVE RISK ((a/a+b)/(c/c+d))
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3
Q

Observational study: Cross-sectional study

Method? Reporting measure?

A
  1. ) Collects data from a group of people to assess frequency of disease and related risk factors at a particular point in time
  2. ) Demonstrates disease prevalence and risk factor association
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4
Q

Quantifying risk: Odds ratio

A

Odds that the group with the disease (cases) was exposed to a risk factor (a/c) divided by the odds that the group without the disease (controls) was exposed (b/d) = ad/bc

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5
Q

Quantifying risk: Relative risk & attributable risk percent

A

1.) RR= Risk of developing disease in the exposed group divided by risk in the unexposed group = ((a/a+b)/(c/c+d))
If prevalence is low, RR~OR
2.) ARP= (Risk in exposed-risk in unexposed)/(risk in exposed)=(RR-1)/RR

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6
Q

Quantifying risk: Attributable risk & NNH

A
  1. ) The difference in risk between exposed and unexposed groups, or the proportion of disease occurrences that are attributable to the exposure =((a/a+b)-(c/c+d))
  2. ) NNH=1/AR
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7
Q

Quantifying risk: Absolute risk reduction & NNT

A
  1. ) Absolute reduction in risk associated with a treatment as compared to a control =(event rate in placebo group)-(event rate in treatment group)
  2. ) NNT=1/ARR
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8
Q

Precision

A

Reliability; affected by random error

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9
Q

Accuracy

A

Validity; affected by systematic error

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10
Q

Bias: Selection bias

Definition? Examples? Ways to avoid?

A
  1. ) Nonrandom assignment to participation in a study group
  2. ) Berkson’s bias, loss to follow up
  3. ) Randomization
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11
Q

Bias: Recall bias

A

Knowledge of presence of disorder alters recall by subjects

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12
Q

Bias: Sampling bias

A

Subjects are not representative of the general population so results are not generalizable

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13
Q

Bias: Late-look bias

A

Information gathered at an inappropriate time

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14
Q

Bias: Procedure bias

A

Subjects in different groups are not treated the same

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15
Q

Bias: Confounding bias

Definition? Ways to avoid?

A
  1. ) Occurs when factor is related to both exposure and outcome, but is not on the causal pathway; factor distorts or confuses effect of exposure on outcome
  2. ) Crossover studies, randomization, matching
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16
Q

Bias: Lead-time bias

A

Early detection confused with increased survival; seen with improved screening

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17
Q

Bias: Observer expectancy effect

Definition? Ways to avoid?

A
  1. ) When researcher’s belief in the efficacy of a treatment changes the outcome of that treatment
  2. ) Blinded studies
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18
Q

Bias: Hawthorne effect

A

When the group being studied changes its behavior owing to the knowledge of being studied

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19
Q

Statistical error type: Type 1 error (alpha)

A

Stating that there IS an effect or difference when none exists (mistakingly rejecting the null hypothesis/accepting the alternative)

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20
Q

Statistical error type: Type 2 error (beta)

A

Stating that there is NO effect or difference when one does exist (mistakingly accepting the null hypothesis/rejecting the alternative)

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21
Q

Power (1-beta)

Definition? Influenced by?

A
  1. ) Probability of rejecting the null hypothesis when it is actually false
  2. ) Increases with increased sample size, increased expected effect size, increased precision in measurement
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22
Q

95% and 99% Confidence intervals

A
  1. ) 95% CI: mean +/- 1.96*SEM

2. ) 99% CI: mean +/- 2.58*SEM

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23
Q

Ethics: Core principles

Definitions?

A
  1. ) Patient autonomy - patient as individual/respect wishes
  2. ) Beneficence - duty to act in patient’s best interest
  3. ) Nonmaleficence - do no harm
  4. ) Justice - to treat persons fairly
24
Q

Ethics: Exceptions to informed consent

A
  1. ) Patient lacks decision making capacity/is legally incompetent
  2. ) Implied consent in emergency
  3. ) Therapeutic privilege
  4. ) Patient waives right of IC
25
Q

Ethics: Exceptions to consent for minors

A
  1. ) Emergency situations
  2. ) Prescribing contraceptives
  3. ) Treating STDs
  4. ) Medical care of pregnancy
  5. ) Treatment of drug addiction
26
Q

Ethics: Exceptions to confidentiality and examples

A
  1. ) Potential harm to others is serious
  2. ) Likelihood of harm to self is great
  3. ) No alternative means exists to warn or to protect those at risk
  4. ) Physicians can take steps to prevent harm
  5. ) Reportable diseases, Tarasoff, Child/elder abuse, impaired automobile drivers, suicidal/homicidal patients
27
Q

Ethical situation: Non-adherent patient

A

ID patient’s reason for non-adherence and determine willingness to change; do not coerce or refer

28
Q

Ethical situation: Unnecessary procedure

A

ID patient’s desire for procedure and address underlying concerns; do not refuse to see pt., refer, or submit

29
Q

Ethical situation: Difficulty taking meds

A

Provide written instructions, simplify treatment regiment, use teach-back method

30
Q

Ethical situation: Family members ask about patient’s prognosis

A

Do not provide information about patient without permission

31
Q

Ethical situation: Child wishes to know about illness

A

Ask what parents have told child about illness. Parents have ultimate control over their child’s knowledge

32
Q

Ethical situation: Minor female requests abortion

A

Advise her not to get abortion if she is not at medical risk

33
Q

Ethical situation: Pregnant minor wants to keep the child, parents want her to give up for adoption

A

Patient retains right to make decision about child; counsel her on her options and facilitate discussion

34
Q

Ethical situation: Physician assisted suicide

A

Refuse involvement

35
Q

Ethical situation: Suicidal patient

A

If serious threat, keep patient in hospital on voluntary/involuntary basis

36
Q

Ethical situation: Patient is attracted to you

A

Can never have romantic relationship

37
Q

Ethical situation: Female patient feels ugly after mastectomy

A

Find out why patient feels this way. Do not compliment.

38
Q

Ethical situation: Patient angry about time spent in waiting room

A

Apologize, but do not provide excuses

39
Q

Ethical situation: Patient is upset by treatment by another doctor/office staff

A

Suggest patient confront doctor personally OR assure patient that you will speak to office staff

40
Q

Ethical situation: Referral fee for enrollment in study

A

Physician cannot accept gifts from drug companies for enrolling patients in studies

41
Q

Ethical situation: Physician orders an invasive test for the wrong patient

A

Physician has to inform the patient of the mistake

42
Q

Ethical situation: Patient requires Tx not covered by insurance

A

Never limit or deny care because of expense in time and/or money. Discuss all treatment options with patient

43
Q

APGAR

A

Appearance, Pulse, Grimace, Activity, Respiration

>7 is good, 4-6= assist and stimulate, <4 resuscitate

44
Q

Low birth weight

A

<2500 g; prematurity or IUGR

45
Q

Developmental milestones: 0-3 mos

A
  1. ) Rooting reflex
  2. ) Loss of Moro reflex
  3. ) Holds head up
  4. ) Social smile
  5. ) Orients and responds to voice
46
Q

Developmental milestones: 7-9 mos

A
  1. ) Sits alone
  2. ) Crawls
  3. ) Transfers toys from hand to hand
  4. ) Stranger anxiety
  5. ) Responds to name and simple instructions, uses gestures, peek-a-boo
47
Q

Developmental milestones: 12-15 mos

A
  1. ) Walks
  2. ) Loss of Babinski
  3. ) Separation anxiety
  4. ) Few words
48
Q

Developmental milestones: 12-24 mos

A
  1. ) Climbs stairs
  2. ) Stacking blocks (age x 3)
  3. ) Rapprochement
  4. ) 200 words and 2 word phrases at age 2
49
Q

Developmental milestones: 24-36 mos

A
  1. ) Feeds self with utensils
  2. ) Kicks ball
  3. ) Core gender identity
  4. ) Parallel play
  5. ) Toilet training
50
Q

Developmental milestones: Preschool (3 yrs)

A
  1. ) Rides tricycle
  2. ) Copies line or circle drawings
  3. ) Comfortably spends part of day away from mother
  4. ) 900 words and complete sentences
51
Q

Developmental milestones: Preschool (4 yrs)

A
  1. ) Uses buttons and zippers
  2. ) Grooms self
  3. ) Hops on 1 foot
  4. ) Makes simple drawings
  5. ) Cooperative play, imaginary friends
  6. ) Can tell detailed stories and use prepositions
52
Q

Sleep stages: awake (eyes open)

A

Alert, active mental concentration with beta waves on EEG

53
Q

Sleep stages: awake (eyes closed)

A

Alpha waves on EEG

54
Q

Sleep stages: Stage N1 (5%)

A

Light sleep with theta waves on EEG

55
Q

Sleep stages: Stage N2 (45%)

A

Deeper sleep, bruxism, with sleep spindles and K complexes on EEG

56
Q

Sleep stages: Stage N3 (25%)

A

Deepest, non-REM sleep (slow-wave sleep); sleepwalking; night terrors; bedwetting with delta waves on EEG

57
Q

Sleep stages: REM (25%)

A

Dreaming, loss of motor tone, possible a memory processing function, erections, increased brain O2 use, with beta waves on EEG

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