Midterm 1

Question 1

Epidemiology

Answer 1

study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems

Question 2

what is considered primary literature?

Answer 2

peer-reviewed research articles that describe studies done by the authors

Question 3

what is considered secondary sources?

Answer 3

those that share the findings of primary literature but did not conduct the research themselves (examples: blogs, science journalism, podcasts, presentations.

Question 4

Week 2 Objective

Recognize the use of epidemiology in veterinary medicine

Answer 4

Veterinary epidemiologists respond to and prevent disease outbreaks in animal populations. They work at the intersection of human, animal, and environmental wellness to address some of the most complex health problems we face.

Question 5

Week 2 Objective

Describe the most common study designs in veterinary medicine

Answer 5

Cross-sectional surveys are the most frequently designed observational studies in veterinary epidemiology, likely because they are rapid, inexpensive and of moderate difficulty.

research gate

Question 6

Week 2 Objective

Recognize the strengths and weaknesses of different study designs with respect to how they inform clinical decision making

Answer 6

When clinicians evaluate the scientific literature
to answer a clinical question, they should consider the
clinical relevance, clinical importance, and validity of

the research. Common errors that may invalidate re-
search findings can be identified by becoming familiar

with the typical methods used to control for bias, en-
sure appropriate allocation and handling of experimen-
tal units, and deal with the structure of research data

or populations. Research articles can be reviewed in a

time-efficient and meaningful manner when a system-
atic approach is used.

Question 7

Week 2 Objective

Identify potential sources of bias in research (selection, misclassification & confounding) and understand how these may influence the extrapolation of study findings to clinical work

define selection bias

Answer 7

Selection bias exists when animals differ among study groups in more ways than just the intervention
or putative risk factor assessed. In clinical practice, veterinarians routinely use information about a pa-
tient’s signalment, history, comorbid conditions, and other variables to develop diagnostic and treatment
plans. Although clinically reasonable, this approach to decision making introduces selection bias, which
prevents accurate comparisons among interventions or other factors of interest.

Question 8

Week 2 Objective

Identify potential sources of bias in research (selection, misclassification & confounding) and understand how these may influence the extrapolation of study findings to clinical work

Question 9

Week 2 Objective

Identify potential sources of bias in research (selection, misclassification & confounding) and understand how these may influence the extrapolation of study findings to clinical work

Answer 9

Confounding can occur when 2 factors are associated with each other but not evenly distributed among the subjects evaluated, making it difficult to identify which factor is truly associated with the outcome of
interest. Because of the aforementioned complexity of
biological systems, confounding is a common problem when clinical observations are used to make assump-tions about disease causation or treatment effective-ness.

Question 10

Week 3 Objectives: Medical Error

List, and give examples of, common factors that lead to intrinsic errors

Answer 10

Doctor error/ Misdiagnosis (erroneous clinical reasoning or personal biases)

clinical reasoning errors: premature closure, availability heuristic, recency effect
doctor errors: time and pressure, exhaustion, distraction
owner/patient attributes: aggressive patient, demanding owners, financial constraints (how we feel about a client or their animal can also influence)
other circumstances: filling in a new clinic, unfamiliar record systrem, new geographic area

Question 11

Week 3 Objectives

List, and give examples of, common factors that lead to systemic errors

Answer 11

Error of execution (failure of a planned action to be completed as intended)

complex systems: training not standard, data across multiple systems
communications: written and oral
large clinics: specialization, transfers/shifts (only seeing one part of animal, flawed switch)
Other circumstances: poorly organized spaces, lack of leadership, lack of error reporting system

Question 12

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error:
Premature closure

Answer 12

Concluding evidence gathering and making a diagnosis prior to thorough
reflection on all the data. The error is commonly associated with pattern recognition

Question 13

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: false consensus

Answer 13

This is a form of premature closure. You offer limited analysis and/or
information because you believe that others have reached an identical conclusion

Question 14

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: confirmatory bias

Answer 14

The tendency to seek or favor data that confirms one’s preferred diagnosis while ignoring or disregarding data that would disfavor the diagnosis

Question 15

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: unintentional sequestration of data

Answer 15

Pertinent information is unintentionally omitted by
someone on the team, e.g., clinical sign, previous medical history, etc.

Question 16

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: illusory transactive memory system

Answer 16

this can be related to unintentonal sequestration of data error. A transactive
memory system is a fancy term for the method(s) by which groups of people store and retrieve
knowledge. In a medical setting, an illusory (illusion‐based) transactive memory system provides
the medical team with a deceptive sense of security that because you’re working with a team,
someone before you got all the data that you need. In other words, “Someone must have read
the chart.”

Question 17

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: contagious illusion

Answer 17

Respect for authority or desire for consensus allows data to be interpreted
as valid by others, e.g., a supervising clinician states that a collection of clinical signs means the
patient has [x] disease

Question 18

Week 3 Objective

Define, and differentiate, the following clinical reasoning error: selective perception

Answer 18

Expectations influence your senses such that you can feel, hear or see
something that you expect to hear.

Question 19

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: primary effect

Answer 19

Initial events in the patient’s medical history or disease are weighted more
heavily that events that occur later

Question 20

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: recency effect

Answer 20

The most recent events in the patient’s medical history or disease are more
heavily the events that occurred earlier

Question 21

Week 3 Objectives

Define, and differentiate, the following clinical reasoning error: availability heuristic

Answer 21

Estimating what is more likely by what is most available in your memory,
which is inherently biased toward vivid, unusual, or emotionally charged examples. Heuristic
(pronounced “h’yer‐IST‐ic”) is a fancy word for the process of figuring something out on your
own; obviously, since our memories are unique to each of us, the availability heuristic tends to
bias each of us toward things that tend to come to mind easily…which again, tend to be biased
toward vivid / unique / unusual examples

Question 22

Week 3 Objectives

Analyze a case and identify the most likely intrinsic (clinical reasoning, specifically) and/or systemic errors that may have led to the outcome.

Answer 22

Clinical reasoning cycle:
identify the patient
acquire data (and each tiem you acquire data, proceed through the cycle)
summarize data
problem list (not just “anemia” but blood count)
generate differentials/ “rule-outs” (for EACH problem)
justify differentials (what fits, what doesn’t fit)
list top differntial(s) (can be more than one)

Question 23

Week 3 Objectives

Definition of error

Answer 23

an adverse event, which is “an unintended injury caused by medical management that resulted in measurable disability.

Question 24

define malpractice

Answer 24

a failure of one charged with
exercising ordinary diligence, care and skill commensurate with members of his profession.

Question 24

Define negligence

Answer 24

[the] failure to exercise the standard of care that a reasonably prudent person would
have exercised in a similar situation,”

Question 25

Week 1

Recognize the difference between primary, secondary and tertiary prevention

Answer 25

Primary prevention aims to prevent disease or injury before it ever occurs.
Secondary prevention aims to reduce the impact of a disease or injury that has already occurred.
Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects.