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MRSA theory > Legal Issues in Surgery > Flashcards

Legal Issues in Surgery Flashcards

1
Q

what are the two types of diathermy?

A

monopolar and bipolar

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2
Q

Advantages of bipolar?

A

heating is localised to the area between the two electrodes and surrounding tissue damage is minimised

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3
Q

Hazards of diathermy?

A

Patient burn
Explosion or fire

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4
Q

How to calculate relative risk?

A

relative risk = EER / CER
Event rate/control event rate

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5
Q

How to calculate positive predictive value?

A

Positive predictive value = TP / (TP + FP)

The chance that the patient has the condition if the diagnostic test is positive

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6
Q

How to calculate sensitivity?

A

TP / (TP + FN )
Proportion of patients with the condition who have a positive test result

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7
Q

How to calculate specificity?

A

TN / (TN + FP)
Proportion of patients without the condition who have a negative test result

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8
Q

How to calculate negative predictive value?

A

TN / (TN + FN)

The chance that the patient does not have the condition if the diagnostic test is negative

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9
Q

How to calculate likelihood ratio for a positive test result?

A

sensitivity / (1 - specificity)
How much the odds of the disease increase when a test is positive

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10
Q

How to calculate the likelihood ratio for a negative test result?

A

(1 - sensitivity) / specificity How much the odds of the disease decrease when a test is negative

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11
Q

what is the bolam test?

A

The Bolam test defines if a decision made by a doctor is in agreement with the professional standard of medical practise.

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12
Q

What is consent 1?

A

For competent adults who are able to consent for themselves where consciousness may be impaired (e.g. GA)

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13
Q

What is consent 2?

A

For an adult consenting on behalf of a child where consciousness is impaired

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14
Q

What is consent 3?

A

For an adult or child where consciousness is not impaired

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15
Q

What is consent 4?

A

For adults who lack capacity to provide informed consent

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16
Q

what components are needed to make a power calculation?

A

Size of effect
Significance level
Sample size used to detect the effect
Desired power value

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17
Q

What is a type 1 statistical error?

A

A test rejects a true null hypothesis. Analogus to false positive. It usually equates to the significance level assigned to a test.

18
Q

what is a type 2 statistical error?

A

A test fails to reject a false null hypothesis. It is related to the power of a test.

19
Q

What is statistical power?

A

Statistical power
The power of a test is the probability that the test will reject the null hypothesis when it is false (thereby avoiding a type 2 error)
Usually a value of 0.8 is selected.

20
Q

What is pre-test probability?

A

The proportion of people with the target disorder in the population at risk at a specific time (point prevalence) or time interval (period prevalence)

21
Q

What is post-test probability?

A

The proportion of patients with that particular test result who have the target disorder

Post-test probability = post test odds / (1 + post-test odds)

22
Q

what are pre test odds?

A

The odds that the patient has the target disorder before the test is carried out

Pre-test odds = pre-test probability / (1 - pre-test probability)

23
Q

What are post-test odds?

A

The odds that the patient has the target disorder after the test is carried out

Post-test odds = pre-test odds x likelihood ratio

where the likelihood ratio for a positive test result = sensitivity / (1 - specificity)

24
Q

which test corrects against multiple statistical analyses that might provide an erroneous result?

A

Bonferroni method in which the observed p values are multiplied by the number of tests performed

25
Q

what is incidence?

A

the number of new cases per population in a given time period

26
Q

what is prevalence?

A

the total number of cases per population at a particular point in time

27
Q

What is absolute risk reduction?

A

the decrease in risk of a given activity or treatment in relation to a control activity or treatment

1/(difference between 2 groups)

28
Q

What is the inverse of absolute risk reduction?

A

number needed to treat

29
Q

What is number needed to treat?

A

how many patients would need to receive a treatment to prevent one event. It is the absolute difference between two treatments.

30
Q

Properties of normal distribution?

A

symmetrical i.e. Mean = mode = median
68.3% of values lie within 1 SD of the mean
95.4% of values lie within 2 SD of the mean
99.7% of values lie within 3 SD of the mean
this is often reversed, so that within 1.96 SD of the mean lie 95% of the sample values

31
Q

How is data from multiple RCT’s best presented?

A

forest plot

(good for meta analyses)

32
Q

What is nominal data?

A

Data can be allocated a numerical code that is arbitrary. For example allocating people as alive or dead using codes of 0 or 1

33
Q

What is ordinal data?

A

Data using numbers that can be used on a scale. Severity of pain is often measured in this way

34
Q

What is interval data?

A

Data is measured numerically. However, the zero point is arbitrary

35
Q

What is continuous data?

A

Data is measured numerically where the numerical value is a real number and may be any value. Examples include height and weight

36
Q

What test should be used when sample size is small?

A

Fishers exact test

37
Q

What are the 6 pillars of clinical governance?

A

Clinical effectiveness
Research and development
Openness
Risk management
Education and training
Clinical audit

38
Q

When is a IMCA required?

A

a best interests decision is required because the doctor has assessed the person as not having the capacity to make the decision themselves
the person does not have family or friends with whom it is appropriate to consult about the decision.

39
Q

What is montgomery ruling?

A

the significance of a given risk for that particular patient, and the nature of the risk, such as the effect it would have on the patient’s life if it were to occur.

[fact sensitive and patient characteristic sensitive]

40
Q

What is the usual outcome of a cohort study?

A

relative risk

41
Q

What is the usual outcome measure of a case-control study?

A

odds ratio

MRSA theory (20 decks)

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