Final Exam Flashcards

1
Q

How to calc variance and std dev

A
  • Find diff b/n ea value and the mean; square this difference
  • Add up all the squared diff and divide by total # of values
  • Std Dev= Square root of variance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

FINER

A
  • Feasibility
  • Interest
  • Novel
  • Ethical
  • Relevant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PICOT

A
  • Population
  • Intervention
  • Control
  • Outcomes
  • Time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Categorical Variable (2 types)

A
  • Nominal (no order) v ordinal (high/med/low)

- Use percentages and frequencies for central tendency

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

Skewed Distributions

A
  • Neg/L - more values on high end
  • Pos/R - more value on low end

**if skewed use range and IQR for measure variance NOT variance and SD

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

Central Limit Theorem and Confidence Intervals

A
  • If we take repeated random samples from our population, calculate each sample mean , and plot out those sample means, then:
  • Mean of sample means = population mean
  • Std error=std dev of sample means (std error=sample SD/square root of sample size)
  • Confidence Intervals- range of numbers that population mean will likely be within x% probability given observed sample mean and size
    • 95% CI is approx sample mean +/- 2SE
    • 95% CI is wider than a 90% CI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does p-value mean?

A
  • Probability of observing difference this extreme or more given null hypothesis is true
  • If value is sufficiently small, then reject null hypothesis and accept alternative hypothesis

NOT the probability that the null is true OR that 1-p represents probability that alternate is true

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

3 Ways to Determine Stat Sig

A
  • P-value below cutoff? (.05 normally)
  • Test statistic exceeds the critical value
  • Confidence interval of desired probability EXCLUDE 0 (group difference) or 1 (group ratio)
    • If 2 groups are the same (null is true) then the diff b/n there means would be 0 and the ratio between their means would be 1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Parametric v Non-parametric

A
  • Parametric assume dependent variable is normally distributed so…
    • Takes advantage of known properties of a distribution , allows for efficiency (less subjects, detection of smaller effect size ), allows for effect estimation ( i.e. confidence interval of group effect )
    • Null Hypo- no diff b/n means of groups
  • Non-parametric - dependent variable is not normally distributed or too few observations to assume so…
    • Based on ranks (observations ordered from high to low - ties receive avg ranks)
    • Null Hypo- no diff b/n dist of ranks b/n groups
    • Advantages: Less requirements , useful for dealing with outliers , intuitive , useful for certain categorical data
    • Disadvantages: less efficient , hypothesis testing over effect estimation , too many rank ties problematic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chi Square

A

dependent and independent are categorical

non-para equivalent is Fisher Exact

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

T test

A

cont dependent variable and 2 category indep variable + equal variance b/n groups

non-para equivalent is Mann Whitney

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

Paired t Test

A

same as t test but observations/dependent variables can be paired

non-para equivalent is Wilcoxon Signed Rank Test

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

ANOVA

A

cont dependent variable and 3+ category independent variable

non-para equivalent is Kruskal Wallis Test

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

Pearson Correlation

A

normally distributed/cont dependent and independent variable

non-para equivalent is Spearman Correlation

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

Linear v Logistic Regression

A
  • Linear - cont dep var
    • Output = can determine stat sig of ea independent var b/c gives you coefficient (pos or neg) and CI for ea
    • CI should not include 0 b/c group difference
  • Logistic- dichotomous dep var
    • Output= given in odds ratio (which can then be converted to probability) and CI for ea independent var
    • CI should not include 1 b/c group ratio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Deductive v Inductive Reasoning

A

Deductive reasoning (does pt fit pattern?) -start w disease

Inductive reasoning (what pattern does this pt fit?) - diff diagnosis

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

Accuracy

A

a+d/total

(how many were true either way?)

18
Q

Sensitivity

A

a/a+c
(how many people w/ disease did it pick up?)

-wanted for screening test (catch all)

19
Q

Specificity

A

d/ b+d
(how many people w/o disease also tested neg?)

-wanted for confirmatory test

20
Q

Pos Predictive Value

A

a/a+b

how often is pos test right?

21
Q

Neg Predictive Value

A

d/c+d

how often is neg test right?

22
Q

Receiver Operating Curve

A
  • Sensitivity v 1-specificity

- Higher area under curve = better distinguishing ability

23
Q

Pos and Neg Likelihood Ratios

A
  • Pos LR - sensitivity/ 1-specificity

- Neg LR - 1-sensitvity /specificity

24
Q

Bayes Theorem

A

Pre-test odd of disease X LR of test result = post-test odds of disease

  • Estimate pre-test probability
  • Convert to odds
  • Mult by LR of test result that comes back = post-test odds
  • Convert back to probability to make clinical decision
  • Probability = odd/ 1+ odds
25
Q

Case Control v Cohort

A

Case Control

  • ID pts w/ certain disease then determine exposure status
  • Observational
  • ALWAYS RETRO
  • Adv- quick, cheap, good for rare diseases, can access must factors associated w/ outcome
  • Disadv- cannot calc relative risk b/c do not know prevalence, recall bias, confounders, not causal

Cohort

  • ID people who were exposed —> follow to see if they develop disease
  • Observational
  • Often PROSPECTIVE
  • Adv- less/no recall bias, can access association of mult factors, stronger support for causality if prospective, CAN CALC REL RISK
  • Disadv- need more resources and time, ppl lost to follow-up, confounders, still may not be able to claim cause and effect
26
Q

Relative Risk

A
  • Ratio of probability of developing disease if exposed v not exposed
  • Based on incidence of disease given exposure status
  • Risk among exposed/risk among unexposed
    • =1 then same risk regardless of exposure
    • x>1 then x fold inc in risk if exposed
    • 1/y <1 then y fold dec in risk if exposed
27
Q

Odds Ratio for Case Control

A
  • Odds of exposure among people with disease vs. odds of exposure among people without disease
    • Because start w/ people w/ disease and look for exposure or not
    • Odds for cases/odds for controls
    • OR=1 no relationship
    • OR > 1 there is increased odds of exposure for cases compared to controls
    • OR < 1 there is decreased odds of exposure for cases compared to controls
28
Q

Odds Ratio for Cohort

A
  • Odds of developing disease among exposed vs odds of developing disease among nonexposed
    • Because start w/ people w/ exposure and look for disease or not
    • Odds for exposed/odds for non-exposed
    • OR= 1 no relationship
    • OR > 1 there is increased odds of developing the disease for exposed compared to not exposed
    • OR < 1 there is decreased odds of developing the disease for exposed compared to not exposed
29
Q

Censoring

A
  • unknown survival time for subset of subjects (when event occurs b/n follow-ups
  • Types: Right (after follow up begins), left (before follow up begins), interval
    • Informative censoring: Censoring is related to outcome or systematic
30
Q

Kaplan Meier Method

A

Probability of survival at any given time = prob survived up to that time X prob surviving through that time

  • Curve (time v survival probability)
    • Median survival time = time when 50% survival OR 50% experience outcome
    • Censoring denoted by vertical hash marks
31
Q

Log Rank

A
  • Log Rank - compares 2 survival curves - get p value
    • Null hypothesis: There is no difference in probability of an event at any given point between the 2 groups
  • Assumptions:
    - Uninformative censoring
    - Survival probability the same regardless of recruitment time points
    - Events happened at time specified
  • Limitations:
    - Can only say whether difference exists, not magnitude/range of difference
    - Allows comparison with respect to one factor only
    - Survival curves can’t cross
32
Q

Cox Proportional Hazard Model

A
  • Regression that predicts probability of event occurring (hazard) at specific time for one group over another given mult variables
  • Hazard Ratio (similar to RR)
    • HR =1 no inc or dec in risk
    • HR <1 dec risk
    • HR > 1 inc risk
33
Q

ITT v Per Protocol

A
  • Intention to Treat - analyze according to which group they are assigned to regardless of compliance
    • Effectiveness analysis - real world conditions
    • Preserve random allocation
  • Per Protocol - analyze by actual treatment received
    • Efficacy analysis - ideal conditions
    • Better for safety
34
Q

Sample Size Calc

A
  • Power- probability of detecting diff in groups if one exists (1-B)
  • Effect size- amount of diff b/n groups you wish to detect
  • If higher power, smaller effect size, smaller alpha (tolerance for false pos) …need HIGHER sample size
35
Q

2 RTC Errors

A
  • Type 1 error (a): Rejecting null hypothesis when study arms are not different
    • Usually set at 0.05 or 5%
  • Type 2 error (B): Accepting null hypothesis when the study arms are different
    • Usually set at 0.20 or 20%
36
Q

CER

EER

A

(control event rate)- # in control group w/ outcome

(experimental event rate) - # in experimental group w/ outcome

37
Q

Rel Risk Reduction v Absolute Risk Reduction

A
  • Rel Risk Red (RRR)= (CER-EER)/CER
  • *can exaggerate really small differences**
  • Absolute Risk Reduction (ARR)= CER-EER
38
Q

NNT v NNH

A
  • NNT- number needed to treat - # needed to treat in order to see one positive outcome
    • =1/ARR (in primary/good outcome)
  • NNH - number needed to harm - # needed to treat before harmful event occurs
    • =1/ARR (in safety or bad outcome)
39
Q

CER v ICER

A
  • CER- (cost effectiveness ratio)- cost/# bad outcome prevented OR # good outcomes promoted
    • Compare new/protocol to no action at all
  • ICER - (incremental cost effectiveness ratio) - (Costnew – Costcurrent)/(Effectnew – Effectcurrent)
    • Compare new to current method
40
Q

Forest Plot

A

Systemic Review

  • Shows CI of ea study used plus box for ea study
  • *Box width shows relative contribution of that study to overall summary stat
  • Diamond = combined stat
  • *Stat significant if it does not pass the vertical line of no difference
41
Q

Funnel Plot

A

Systemic Review

  • Used to evaluate publication bias (positive trials more likely to be published)
  • Plot summary stat v sample size
  • Want cluster around combined outcome stat AND equal distribution on both sides