Forensic & Stats Flashcards
Case that relates to competence (to consult a lawyer; have rational+factual understanding of proceedings against them; process info; participate)
Dusky vs US
This is a tool used to determine competence:
McGarry instrument (13 piece guide)
These are needed to demonstrate competence to stand trial:
i. Knowledge of charges
ii. Knowledge of circumstances on which charges are based
iii. Knowledge of important persons in the case
iv. Knowledge of the possible outcomes of the various types of pleas that the defense may enter in his behalf
v. Above all, must demonstrate an ability to collaborate with their defense lawyer
(Don’t need to be able to decide plea, testify on own behalf)
Although no longer used, this case decided that a criminal is not responsible for crime if due to a mental illness (broadened conditions of insanity)
Durham vs the US
This case refined “Durham vs. the US” to include a volitional component by using “irresistible impulse test.” (basically, lacked capacity at time of crime, due to mental illness)
US vs. Brawner
This case decided that you cannot force involuntary tx if pt could survive outside tx.
O’Connor vs Donaldson
This was a case where pt developed TD, and it was decided that the doctor should have monitored for the symptom:
Clites vs State
This case decided that a pt must be competent in order to be executed.
Ford vs. Wainwright
Can Psychiatrists participate in state-mandated executions? (Yes, No, Sometimes)
No (ethically bound not to)
Need a pt be competent when creating their advanced directive?
Yes
What are the rights that a pt has while hospitalized? (6)
- communication w/outside
- visitation
- privacy (toileting, bathing, storage space, personal space)
- wear own clothing
- carry own money
- refuse tx
When can pt’s rights during hospitalization be removed?
When DTS/DTO
Are therapy notes considered part of medical record?
No
If subpoenaed, do you have to turn in pt’s therapy notes?
No, unless pt provides written consent to do so and they are specifically requested by court.
Do pts have a right to their own therapy notes?
No
Define “Respondent superior”
legal concept stating that a person at the top of a hierarchy is responsible for the actions of those at the bottom
What are the 2 components of a criminal act? (define each)
Actus reus: voluntary conduct.
Mens rea: evil intent.
This rule applies to mens rea, and asks, “did defendant have ability to distinguish right from wrong at time of criminal act?”
M’Naughten rule
What are the 4 components one must satisfy when making a will?
a. Know they’re making a will
b. Knows what a will does
c. Knows nature of property to be distributed
d. Knows who they’re distributing it to
List the levels of proof, from least to most:
a. Probable cause
b. Preponderance of evidence
c. Clear and convincing proof
d. Beyond a reasonable doubt
What burden of proof would be required for reporting child abuse?
Probable cause
How much certainty is required for Preponderance of Evidence?
51% certain
What is the default level of proof in most civil cases?
Preponderance of Evidence
What level of proof is required for civil cases where more than money is at stake? (civil commitments, paternity testing, legal insanity, restraining order)
Clear and convincing proof
What type of proof is required to convict in criminal cases?
Beyond a reasonable doubt
In cases requiring “beyond a reasonable doubt,” what must a jury take into account in determining the conviction? (2)
Jury has moral certainty that
1. all aspects of the crime has been committed
2. no reasonable alternative exists.
What is “parens patriae”?
the government, or any other authority, regarded as the legal protector of citizens unable to protect themselves.
What is “power”, in stats?
Probability of rejecting a null when it should be rejected
Probability of finding a true difference b/w 2 samples
Power is determined by these 3 quantities:
(i) magnitude of type I error.
(ii) size of the exposure effect, delta.
(iii) sample size
What is ADA’s definition of disability?
Recorded physical or mental impairment that substantially limits 1+ major life activities
What is reliability?
Consistency
What is validity?
Accuracy
Define face validity.
dx based on consensus amongst experts
Define descriptive validity.
dz based on characteristics that distinguish it from other dz’s
Define predictive validity.
dx allows for prediction of tx response and clinical course
Define construct validity.
dz based on underlying pathophysiology
Define internal validity.
extent to which changes in the independent variable cause changes in the dependent variable
State how many and what types of variables in the following tests:
Chi2
1 binary predictor, 1 binary outcome variable
(for categorical outcome)
State how many and what types of variables in the following tests:
T-test
1 binary predictor, 1 continuous outcome variable
(for continuous outcome)
State how many and what types of variables in the following tests:
ANOVA
2+ binary predictors, 1 continuous outcome variable
(T test but for multiple predictors)
State how many and what types of variables in the following tests:
Correlation (Pearson)
1 continuous predictor, 1 continuous outcome variable
measures degree of relationship b/w 2 independent variables (summarizes relationship)
State how many and what types of variables in the following tests:
Regression analysis
2+ continuous or binary, 1 continuous outcome variable
(correlation but multiple predictors and can be binary)
What range of value can a correlation have?
-1 to +1
What is kappa?
determines rate of agreement b/w 2 raters in a study (used for binary data)
What is specificity?
% of people who don’t have dz and test negative for it
a. TN / TN + FP
b. SPIN: if positive, rule IN
What is sensitivity?
% of people who have dz and test positive for it
a. TP / TP + FN
b. SNOUT: if negative, rule OUT
PPV?
PPV = TP / TP + FP
NPV?
NPV = TN / TN + FN
Does sensitivity affect PPV or NPV?
High sensitivity = low false negatives
therefore, ^ NPV
Does specificity affect PPV or NPV?
High specificity = low false positives
therefore, ^PPV
Predictive value is determined by the ____________ of the disease in a population.
prevalence
How does increased prevalence affect PPV and NPV?
^ prevalence = ^ PPV, v NPV
How does decreased prevalence affect PPV and NPV?
v prevalence = v PPV, ^ NPV
What did the Wetterling act establish?
All states require sex offenders to register (at least 10 years, but for life if “sexually violent predator”)
3 parts of informed consent:
- mental capacity
- adequate info
- voluntariness
(confidentiality technically not part of it)
What does Phase I of a clinical trial aim to establish?
bioavailability, pharmacokinetics, side effects
- uses multiple doses
What does Phase II of a clinical trial aim to establish?
Dose-finding
- open-label or double-blind
What does Phase III of a clinical trial aim to establish?
efficacy, safety, tolerability
- Double-blind RTC
What does Phase IV of a clinical trial aim to establish?
clarify potential uses of drug
After what stage of a drug trial is the drug potentially brought to market?
Stage III
What is pre-test probability measuring?
proportion of people in a population, at risk, who have the disease.
What is post-test probability measuring?
proportion testing positive who truly have dz (like PPV but also includes a pt-based probability (pre-existing clinical info)
Is pre-test or post-test probability more akin to prevalence?
Pre-test probability
