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BMS > Introduction to Evidence Based Medicine > Flashcards

Introduction to Evidence Based Medicine Flashcards

1
Q

The father of westernized medicine

-Questioned the idea that gods caused illness and disease

A

Hippocrates

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2
Q

A prominent example of how scientific findings are not always accepted

A

Pellegra

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3
Q

In the early 1900’s Pellegra was contracted by over 100,000 Americans, mainly in the deep south. What are the symptoms?

A

The 4 D’s

  1. ) Diarrhea
  2. ) Dermatiti
  3. ) Dimentia
  4. ) Death
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4
Q

Mostly seen in hospital for insane persons, orphanages, prisons, and very low income areas

-Attributed to a microbial infection

A

Pellegra

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5
Q

Worked in the US department of hygiene and was the first to postulate that Pellegra was due to dietary deficiencies. But his results were not accepted

A

Dr. Joseph Goldberg

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6
Q

In the 1920’s it was demonstrated that Pellegra was caused by

A

Niacin (Vitamin B3) Deficiency

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7
Q

Demonstrated that stomach ulcers were caused by a bacterial infection from Heliobacter pylori in 1984. But their results were not accepted until 1997.

-Won nobel prize in 2005

A

Barry Warren and J. Robin Marshall

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8
Q

What are five types of medical evidence?

A
  1. ) Diagnostic Studies
  2. ) Prognostic Studies
  3. ) Treatment Studies
  4. ) Prevention Studies
  5. ) Etiology Studies
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9
Q

Ask, “how sure can I be that a patient has a diagnosis?”

A

Diagnostic Studies

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10
Q

Ask “What should this patient expect following this surgery, this exposure, this diagnosis?”

A

Prognostic Studies

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11
Q

Asks “What are the causes or risk factors for the condition?”

A

Etiology Studies

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12
Q

When an old treatment is tested, and the results find that the treatment makes the patient no better, or no worse

A

Reversal

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13
Q

When a new treatment is tested and the treatment is found to be beneficial

A

Replacement

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14
Q

The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients

A

Evidence Based Medicine (EBM)

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15
Q

Who originated evidence based medicine?

-designed the first randomized control trial (RCT)

A

Sir Bradford Hill

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16
Q

According to Archie Cochrane (1971) an intervention is only “effective” if it has been demonstrated, preferably by a RTC to

A

Do more good than harm

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17
Q

Anything that has an “effect” can also have

A

Side effects and risks

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18
Q

Out of 100 children with strep throat,

A

86 correctly detected w/ the rapid tes

-14 will be missed

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19
Q

Out of 100 children with non-strep sore throat

A

95 will be correctly classified w/ the rapid test

-5 will be misdiagnosed

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20
Q

What are the five A’s that evidence-based medicine includes to access the medical literature and determine its relevance to the patient?

A

Ask, Acquire, Appraise, Apply, Assess

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21
Q

“POEMS” are patient oriented outcomes that matter. They encompass the 5 D’s, which are?

A

Death, Disease, Discomfort, Disability, Dissatisfaction

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22
Q

Addresses areas of uncertainty and change in medical practice

A

Evidence-based medicine

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23
Q

All the people in a defined setting or with certain defined characteristics that the researcher is interested in

A

Population

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24
Q

The subjects from the population who are studied

A

Samples

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25
Q

The goal of clinical research is to generalize the results to the rest of the

A

Population of interest

26
Q

The confidence with which the results can be accurately generalized to the population

A

External validity

27
Q

A representative sample looks like the

A

Population

28
Q

Are non-representative samples that decrease external validity

A

Biased Samples

29
Q

To get a more representative sample, we want

A

Larger sample sizes

30
Q

Identify who will be in the study

A

Inclusion criteria

31
Q

Makes the sampling more manageable, controls variability (improving internal validity), and limits generalizability (external validity)

A

Inclusion and Exclusion criteria

32
Q

When each member of the population has an equal chance to be included in the research

A

Probability sampling

33
Q

The most common form of probability sampling

A

Simple random sampling

34
Q

To ensure that critical variables are represented in the sample, subjects are stratified by traits and then randomly sampled

A

Stratified random sampling

35
Q

A type of random sampling done when subjects are ordered.

-For example, the 3rd person from each letter of the alphabet can be chosen

A

Systematic sampling

36
Q

Systematic sampling can incorporate stratification if there is a

A

Meaningful order

37
Q

Non-probability sampling methods do not involve random selection. Three examples are

A

Purposive sampling, convenience sampling, and quota sampling

38
Q

Hand-picking patients

A

Purposive sampling

39
Q

People are chosen based on availability of volunteering

A

Convenience sampling

40
Q

Convenience sampling with specific quotas included. This is like stratified sampling

A

Quota sampling

41
Q

Factors or attributes in a research study that can have different values (ex: occupation, height, BMI, etc)

A

Variables

42
Q

Variables that can be manipulated by the researcher

A

Independent variables

43
Q

Measured outcomes. These may be “primary endpoints” or “secondary endpoints” in a study, aka: response variables or outcome variables

A

Dependent variables

44
Q

In a study that seeks to determine if a drug works to relieve pain, what is the

  1. ) Independent variable?
  2. ) Dependent variable?
A
  1. ) Drug: Drug has 2 levels, drug and no drug

2. ) Pain reliefe

45
Q

Other variables in the study that may affect the relationship between the independent and the dependent variables

A

Extraneous variables

46
Q

If researchers wanted to examine whether relaxation therapy was better than drug therapy for reducing the number of tension headaches in medical students, what would be some extraneous factors to control or account for?

A

Diet, other medications, severity of headaches

47
Q

A process at any stage of interference tending to produce results that depart from the true values

A

Bias

48
Q

Occurs when comparisons are made between non-equivalent groups

A

Selection Bias

49
Q

When extraneous factors, selection bias, or measurement bias occur, a study is

-A fatal flaw in research

A

Confounded

50
Q

Occurs when the methods of measurement are dissimilar among groups of patients

A

Measurement bias

51
Q

Occurs when two factors are associated (travel together) and the effect of one is confused with or distorted by the effect of the other

A

Confounding

52
Q

The variation in the measurements that occurs for any reason

-expressed as spread in the data

A

Random Error (Chance error)

53
Q

How can we limit the random error?

A

Limit the population, improve the measurements, and control the testing environment

54
Q

The internal health of the study, i.e. how free it is from bias and chance

A

Internal validity

55
Q

The degree to which you can generalize the results of the study back to the population of interest

A

External validity

56
Q

If you wanted to study grade school kids, and you wanted to be absolutely sure you got a representative sample from each grade level, you would use

A

Stratified sampling (i.e. take a SRS from 1st grade, then 2nd grade, then 3rd, and so on)

57
Q

Used less in clinical studies, but more in epidemiology studies

A

Probability sampling

58
Q

Seen often in a qualitative study

A

Purposive sampling

59
Q

If two groups you are studying have different diets or different types of headaches, or differ in any way, this is an example of

A

Selection bias

60
Q

If extraneous variable are not controlled,they result in

A

Confounding

BMS (62 decks)

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