Intro to RM Flashcards
1
Q
Why conduct resaerch on (and for) UHR groups? (4)
A
- We can develop new interventions which minimise risk of transition if we understanding why some people are UHR.
- Use clinical resournces more efficienlty if we can predict who is more likely to develop psychosis- treat the ones who are higher
- Optimse psychosis prevention interventions - If we understand why some UHR people respond to a certain treatment when others don’t
- By studying people at UHR for psychosis, we can explain the neurocognitive basis of vulnerability without the confounding effects of the illness and antipsychotic medication.
2
Q
Why conduct resaerch on (and for) FIP groups? (4)
A
- Develop new interventions aimed at minimising risk of relapse if we understand why some people with FEP relapse
- Use clinical resources more efficiently by targeting those in greatest need (more likely to relapse).
- If we understand why some people with FEP respond to treatment we can optimise interventions aimed at preventing relapse.
- By studying people with FEP, we can explain the neurocognitive basis of the illness while minimising the confounding effects of prolonged exposure to the illness and antipsychotic medication.
3
Q
What are main challanges for conducting resaech in FEP groups? (6)
A
- Defnitions vary across different research studies making it harder to compare and summerise their results (e.g. FEP, relapse)
- How to define inclusion/exclusion criteria. Tricky because you can be exlucing almost everyone and then what’s the point of the study but if you include too much there might be too many confounders/heterogenity = impossible to generalise (catch 22)
- Recruitment and retention
- Hard to have large sample with patient groups
- Longitudional studies have high drop out rates
- Some people are more prone to drop put (e.g. more severly ill, from a specific demographic, with some comorbid personality disorders) skewing the data - Ethical issues
- can’t deny effective treatment (e.g. in RCTs) so many data is skewed by presence of other treatments alongside the investigated one OR by medication - Clinical Heterogeneity in psychosis, there are not identical patients
- Poor Ecological Validity
- Many studies have it becasue they are measuing snip bits of someone’s life–> addresses by technological advancements in reseach allowing monitoring of many factors on daily bases
4
Q
What is a the best study design to study both UHR & FEP?
A
Longitudional design, to investigate who of URH will transiton into psychosis and they will be early detected FEP
+ it allows within group comparison minimising the effects of confounders and biases.
5
Q
What are the main objectives in FEP research?
A
- Identification of diagnostic, prognostic biomarkers (for predicting prognosis), predictive biomarkers (for predicting response to a given treatment) & mnitoring biomarkers (for monitoring illness progression)
6
Q
G x E interaction
A
Genotype creates a vulnerability for the environmental risk factors
7
Q
G x E correlation
A
Genotype encourages exposure to environmental risk factors
8
Q
What are the mian trends in research? (6)
A
- Big data (patient records, meta-(mega)-analysis
- Deep and continuous clinical phenotyping via digital technologies
- Multimodal data integration
- Individual differences (machine learning)
- PPI (patient and public involvment)
- Studies must have strong translational implications (not just sig results)
9
Q
Barriers of implementing reseach findings into everyday clinical practice
A
- Studies tend to invetigate ‘extremes’ comparing healthy groups with most ‘stereotypical’ / ‘severe patients’ which is not applicable to all people with the disorder
- Studies are often underpowered which limits they generalisability / applicability to different cohort groups
- Studies tend to focus on effects that are
statistically significant rather than clinically meaningful. - Most studies still report results at group
level, whereas clinicians have to make clinical decisions about individual patients.
