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Foundations of Medicine > FOM 1.4.1 > Flashcards

FOM 1.4.1 Flashcards

1
Q

What does EBM stand for?

A

Evidence-Based Medicine

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2
Q

Name the three areas that EBM tries to combine.

A

1) Individual Clinical Expertise 2) Best External Evidence 3) Patient Values & Expectations

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3
Q

Define evidence-based medicine.

A

A systematic approach to clinical problem solving that allows the integration of the best available research evidence w/ clinical expertise & patient values.

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4
Q

EBM helps us address what 3 issues

A

1) ever-expanding literature base 2) complexity of modern medicine 3) limited amount of time

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5
Q

What are the 6 steps of the EBM process?

A

1) ask a clinical ? 2) search the literature 3) critically evaluate the info 4) Weigh literature against other info 5) Apply to clinical case 6) Assess effectiveness

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6
Q

What is epidemiology?

A

Study of distribution & determinants of dz

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7
Q

Define clinical epidemiology.

A

Application of population-based info to decision making about individual patients

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8
Q

What are two quantifying measures of occurrence?

A

1) Incidence 2) Prevalence

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9
Q

What is morbidity?

A
  1. A dz’ed condition or state 2. The incidence or prevalence of a dz or of all dz’s in a population
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10
Q

Define Incidence.

A

NEW cases of dz that develop in a susceptible population over a given period of time.

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11
Q

Define prevalence.

A

EXISTING cases of a dz (new & old) in a susceptible population.

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12
Q

Name the type of prevalence that looks at amount of dz at one point in time.

A

Point prevalence. Most commonly used type of prevalence

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13
Q

Name the type of prevalence that looks at amount of dz present in a population during a defined period of time.

A

Period prevalence

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14
Q

Define cumulative incidence (risk).

A

Probability that individual will contract a dz.

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15
Q

Define incidence rate.

A

How fast new occurrences of dz arise.

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16
Q

Prevalence = __ /___

A

of existing individuals with dz / # of persons in population

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17
Q

Cumulative Incidence, CI (risk of acquiring) = __ / __

A

New cases / persons at risk

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18
Q

Incidence Rate (IR) = __ / __

A

of new cases / total person time

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19
Q

Incidence rate: is it a proportion? What is its range?

A

Not a proportion Range: 0 to infinity

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20
Q

What are the units of incidence rate?

A

cases per person-year

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21
Q

In epidemiology, what is the most commonly used type of rate?

A

Avg rates

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22
Q

If you follow 60 people for 6 months and have 90 new cases, what is the incidence rate?

A

3 cases per person-year

23
Q

If you increase the incidence of a dz, how would the affect prevalence?

A

Increase prevalence

24
Q

If a new treatment provides a longer life span for those who are dz’ed, how is the prevalence affected?

A

Increased prevalence (e.g. AIDS)

25
Q

Which occurrence variable do vaccinations directly affect? And, how?

A

Incidence, decrease

26
Q

What happens to prevalence if: number of people dying from the dz increases?

A

Prevalence decreases.

27
Q

An oatmeal manufacturer has an ad campaign claiming that a diet high in grains helps prevent colon cancer. To evaluate this claim, is it necessary to measure incidence or prevalence?

A

Incidence.

28
Q

What does 5-year survival measure?

A

% of patients alive 5 yrs after treatment begins or 5 yrs after diagnosis (measure to prognosis)

29
Q

Define median survival time.

A

Time following diagnosis at which half of patients remain event-free.

30
Q

How does a Kaplan-Meier Method plot look?

A

Like an uneven staircase. Each individual event and tracked (mostly likely different time periods b/t events)

31
Q

Why are hazard rates calculated over shorter periods of time then aggregated?

A

If time period is long, rate may change over time.

32
Q

Cumulative mortality = __

A

Cumulative incidence

33
Q

Mortality rate = __

A

Incidence rate

34
Q

Mortality rate = __ / __

A

of deaths / total person-time observed

35
Q

What is the difference between a crude and adjusted rate?

A

Crude rates are expressions of raw data. In an adjusted rate, the rates can be standardized to allow for comparison b/t groups. (i.e. Adjusting mortality rates to factor in age)

36
Q

Case Fatality = __ / __

A

of ppl dying from dz / # of ppl who contracted dz

37
Q

Is case fatality a proportion?

A

Yes, it’s range is always between 0 and 1.

38
Q

What is years of potential life lost?

A

Measure of premature morality (compares age of death to avg lifespan)

39
Q

What is years of potential life lost?

A

Measure of premature morality (compares age of death to avg lifespan)

40
Q

What is different b/t quality -adjusted life years (QALYs) and years of potential life lost?

A

QALYs applies weight ranges from 0 to 1 (0 = dead) that corresponds to quality

41
Q

What is used to assess value for money of a medical intervention?

A

QALYs

42
Q

What is the complement of QALYs?

A

Disability-adjusted life years (DALYs)

43
Q

What does disability-adjusted life years measure?

A

Healthy years lost

44
Q

How are DALYs and QALYs similar?

A

Both take life expectancy into account.

45
Q

Give an example of nominal calculations.

A

% and proportion

46
Q

Give an example of Ordinal measures.

A

Tumor staging, Likert scales Similar to a race, there is an order but the difference b/t two values may not be the same like distance b/t 1st and 2nd may be different than distance b/t 2nd and 3rd

47
Q

An example of numerical measures.

A

Interval, rate (i.e. Age)

48
Q

What does a large standard of deviation mean? How it affect a graph?

A

It means the values are more spread out. The curve will be flattened over a longer area.

49
Q

What is the importance of having a p-value of 0.05?

A

The data is within two standard deviations

50
Q

When the correlation coefficient (r) of a set of values is 1, how do the individual values fit the line of best fit?

A

They are right on top of it. High correlation.

51
Q

What’s the relationship strength of these (r) values? 0.0 - 0.25: __ 0.25 - 0.5: __ 0.5 - 0.75: __ 0.75 - 1: __

A

0.0 - 0.25: Little 0.25 - 0.5: Fair 0.5 - 0.75: Moderate/good 0.75 - 1: Very good/excellent

52
Q

What does a r value (correlation coefficient) of -1 represent?

A

A perfect negative correlation.

53
Q

Answer

A

No because the prevalence line is rising meaning patients w/ said disease are living longer

Yes, annual incidence are decreasing

Yes, prevalence is rising

No, prevalence is rising

54
Q
A

Foundations of Medicine (79 decks)

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