First Aid 31-54 Flashcards
Collects data from a group of people to assess frequency of a disease/related risk factors at one point in time
Cross-sectional study
A study that assesses disease prevalence
Cross-sectional study
Compares a group of people with disease to a group of people without disease; looks for prior exposure or risk factor
Case control study
A study that measures odds ratio
Case-control study
Compares a group of people with a given exposure or risk to a group of people without; can be prospective or historical
Cohort study
A study that looks to see if exposure affects the likelihood of disease
Cohort study
A study that measures relative risk
Cohort study
Compares the frequency with which both momozygotic or both dizygotic twins develop the same disease
Twin concordance study
Compares siblings raised by biological vs adoptive parents
Adoption study
Phase I clinical trial
Small number of healthy volunteers;
Is it safe?
Phase II clinical trial
Small number of patients with disease of interest;
Does it work?
Phase III Clinical trial
Large number of patients randomly assigned either to treatment or placebo/best available treatment;
Is it as good or better?
Phase IV clinical trial
Postmarketing surveillance of patients after treatment is approved;
Can it stay?
PPV equation
TP/(TP + FP)
proportion of people with the disease who test positive
NPV equation
TN/(TN + FN)
PPV and NPV vary based on
disease prevalence
Sensitivity equation
TP/(TP+FN)
the probability that all people with the disease will test positive
High sensitivity test used in screening in diseases with
low prevalence
Specificity equation
TN/(TN+FP)
Proportion of all people without the disease who test negative
High specificity test used when
A sensitivity screening test was positive
What is point A? B? C?
A = 100% sensitivity cutoff
B = practical compromise between sensitivity and specitificity
C = 100% specificity cutoff
**Lower B –> increase FP, lower FN –> increase sensitivity and NPV
Raise B –> increase FN, lower FP –> increase specificity and PPV
new cases/# people at risk
Incidence
of existing cases / population total
Prevalence
Prevalence is about the pre-test probability
(a/c) / (b/d)
Odds ratio
Odds people with disease were exposed / odds the group without disease was exposed;
Case-control studies
a/(a+b) / c/(c+d)
relative risk
cohort studies
risk of developing disease in exposed group divided by risk in unexposed group
When prevalence is low, OR is about equal to
RR
a/(a+b) - c/(c+d)
Attributable risk;
difference in risk between exposed and unexposed groups
The proportion of risk reduction attributable to the intervention as compared to the control
Relative risk reduction;
1-RR = 1- a/(a+b) / c/(c+d)
The difference in risk attributable to the intervention as compared to the control
Absolute risk reduction
c/(c+d) - a/(a+b)
NNT
1/ARR
NNH
1/AR
An increase in precision leads to
An increase in statistical power = 1-ß
The absense of random variation in a test
The absence of systematic error or bias in a test
Accuracy
The trueness of a measurement
Sampling bias is an example of
Selection bias;
Fix with randomization
Confounding bias
When a factor is related to both the disease and the outcome, but is not causal
Lead-time bias
Early detection is confused with increased survival
1 SD includes
68%
2 SDs –> 95%
3 SDs –> 99.7%
Give an example of bimodal distribution
Fast vs slow acetylators
Stating that there is an effect or difference when none exists
Type I error (alpha error);
You “a”bserved a difference that did not exist
p is judged against a pretest alpha level. If p<0.05 then
there is a less than 5% chance the study shows something that is not really there
alpha is the probability of
making a type I error
Beta is the probability of
making a type II error
Ways in increase the power of a study
increase sample size;
increase expected effect size
increase precision of measurement
The closer the absolute value of r is to +1, then
the stronger the linear correlation between the two variables;
Positive r value –> one variable up means other variable up and vice versa
Moro reflex disappears by
3 months
Rooting reflex disappears by
4 months
Palmar reflex disappears by
6 months
Babinski reflex disappears by
12 months