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Midterm Flashcards

1
Q

Signalment

A

Includes species, breed, and age. allows you to begin narrowing your list of differentials to consider. Young (infectious, congenital) Old (chronic disease, neoplasia) Breed (Quarter horse- hyperkalemic periodic paralysis; Maine Coon- restrictive cardiomyopathy, holstwins- bovine brachyspina syndrome)

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2
Q

Ecological study

A

a group of people (small or large) applies to a group, not individuals, comparing health, and generating questions

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3
Q

Case series

A

describes something unusual: same characteristics, same disease or exposure, demographics, presentation, prognosis

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4
Q

Cross Sectional/Prevalence Study

A

Health information: questionnaire, health surveys, cant tell casuality, needs to be prerepresentation

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5
Q

Case Control Study

A

Cases are disease, controls are no disease. Generates an odds ration of being exposed

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6
Q

Cohort Studies

A

Studies that have exposed (diseased) and not exposed (disease) Generating a relative risk (Risk of disease- exposed / Risk of disease - unexposed). If RR>1 it is an increased risk. RR=1 Same, RR<1 - lower risk.

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7
Q

Interventional Study

A

Best when randomized and double blinded. good evidence of casuality. expensive though

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8
Q

Meta-analysis

A

studies of similar and similar design- uses data and combines

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9
Q

Systemic Review

A

Reviews of relevant studies- forms a summary

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10
Q

Medical error

A

an adverse event which is an unintended injury caused by medical management results in measurable disability

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11
Q

Neglicence

A

the failure to exercise the standard of care that a reasonabilityprudent person would have exercised in a similar situation

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12
Q

Malpractice

A

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

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13
Q

DeliveryConsequences of medical errors

A

Psychological (guilt, feeling of inadequacy, depression, lowered esteem by peers, reduction in carrerr fulfullment, excessive caution that results in substandard care, public relations, employment status, legal

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14
Q

Systemic errors

A

errors in the delivery of health care where there is a failure of a planned health care intervention
Ex: Wrong-site surgery, Failure of clinician or nerse to recognize drug interactions, miscommunication of verbal orders, mislabeling syringes, fluid bags, improper rate of administration, equipment failure, poor facility lay out

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15
Q

Premature Closure

A

Concluding evidence gathering and making a diagnosis prior to thorough reflection on all of the data. Associated with pattern recognition

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16
Q

False Consensus

A

A form of premature closure where you offer limited analysis and or information because you believe that others have reached an identical conclusion

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17
Q

Confirmatory bias

A

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

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18
Q

Unintentional sequestration of data

A

pertinent information is unintentionally omitted by someone on the team (Clinical sign, previous medical history)

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19
Q

Illusory transactive memory system

A

Groups of people store and retrieve knowledge where provides the medical team with a deceptive sense of security because you are working with a team, “Someone must have read the chart”

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20
Q

Contagious illusion

A

respect for authority or desire for consensus allows data to be interpreted as valid as others (Ie. supervising clinician states that a collection of clinical signs means a patient has x disease

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21
Q

Selective perception

A

expectations influence your sense such that you can feel, hear, or see something you expect to hear

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22
Q

Primacy effect

A

initial events in the patients medical history or disease are weighted more heavily than events that occured later

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23
Q

Recency effect

A

the most recent events in the patient’s medical history or disease are more heavilty the events that occured earlier

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24
Q

Availability heuristic

A

estimating what is more likely by what is most available in your memory, which is inherently biased towards vivid, unusual, or emotionally charged exampled.

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25
Intrinsic errors
Factors that can result in misdiagnosis or consequences, not specifically reasoning errors. Include: Time pressure, overconfidence, faulty or incomplete data gathering, knowledge gap/ inexperience, fatigue, illness, familial issues, conscious or unconscious biases by the doctor: appearance, behavior, body language, demonstrated prejudice or gender bias, gestures, perceived socioeconomic status, and perceived level of commitment to the animal
26
Personal bias intrinsic errors
doctor erros based on aggressive patience (neglect), demanding owners, or financial constraints
27
Circumstantial intrinsic errors
time+pressure, exhaustion, distractions, filling in a new clinic, unfamiliar record system, new geographic area or patient
28
Types of Systemic erros
Complex systems (Training not standard, data across multiple systems), Communications (written and oral), Large clinics (specialization, transfers/shifts), poorly organized spaces, lack of leaderships, lack of error reporting system
29
Steps in outbreak investigation
Confirm (Compare to baseline), Describe, Determine Cause, Control
30
Describe step in outbreak investigation
Provides insight (What is case- case definition), Describe case (time, person, place) Look at graph of point source
31
Determine Cause
a hypothesis to determine likely cause of the outbreak. If unclear, test using analytical epi study Cohort case controlled with factors/environmental. If pathogen known- look at the source
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Control
any stage of intervention to control for an outbreak Transmission pathways, behavioral interventional, vaccination, medication, environment, infection control Place surveillance to see if control
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Communication
must be accurate and timely (internal and external)
34
When is an outbreak considered over
When there is no cases after 2 incubation periods of the pathogen
35
Causation
Multifactorial where the factor (variable) contributes to new cases of the disease.
36
Risk factor
variable associated with an increased risk of disease or infection
37
Protective factor
variable associated with a decreased risk of disease or infection
38
Why do we care about casual factors
by removing it, we will prevent some or all cases of diseases
39
What is the epidemiologic triad
interactions between host, agent, and environment
40
Component Cause
any casual factor (host, agent, environment) - a piece of the pie
41
Necessary Cause
A component cause that is required for disease to occur
42
Sufficient Cause
a set of component causes that is capable of causing disease. when sufficient cause is present, disease can occur
43
Association
an identifiable relationship between exposure and disease. exposure might cause disease, an association is NOT necessarily casual
44
Confounding bias
failure to account ofr a 3rd/unknown variable in design/analysis
45
How to measure association
assess the strength and effect of the association between a factor (Risk factor, protective factor, exposure) and disease Compare disease measurements between groups of individuals. Association of disease with risk factors measures: Relative Risk, Odds Ratio, Chi-Square test, attributable risk, attributable fractions
46
How do you set up a 2x2 table
Rows: Disease +, Disease - Columns: Risk Factor +, Risk Factor -
47
Measures of association
Strength: relative measures- calculated as ratios. No difference if =1. Measured by relative risk (Risk Ratio, RR) and Odds Ratio (OR) Effect: Absolute measures- calculated as difference. No difference if 0. Measured by attributable risk (AR) and attributable fraction (AF)
48
What study is RR not appropriate for?
Case-Control studies, instead use Odds ratio
49
How do you calculate relative risk?
Risk of Disease that were exposed (a/a+b) / Risk of Disease that were unexposed (c/c+d)
50
Odds ratio
the probability of an event occurring to the probability of the event not occurring. (Odds of disease in exposed compared to odds of disease in on-exposed) Used in case-control studies
51
How do you calculate the odds ratio
A*D / B*C (Ex: The odds of laminitis are 2.7 times higher in horses fed grain relative to those who were not fed grain)
52
RR and OR interpretation
1.0 the odds or risk is the same in both exposed an unexposed groups <1.0 the odds or risk is lower for exposed (protective) >1.0 the odds or risk is higher for the exposed
53
Chi-Square (X^2)
a statistical test used to determine whether your experimentally observed results differ from null hypothesis (no effect) use when you have categorical variable data are frequency (counts) rather than numerical scores measure the difference between actual counts and expected counts test the independence of two variables
54
95% confidence interval
the potential range around the estimate in which the real value lies
55
What does it mean when the confidence interval overlaps 1
it is not significant
56
What does it mean when the confidence interval us below or below 1
it is significant
57
Attributable Risk
the risk of disease in exposed due to the exposure itself
58
How do you calculate the attributable risk?
Risk in Exposed - Risk in Unexposed
59
Attributable fraction
the proportion of disease in exposed due to exposure
60
How do you calculate the attributable fraction?
(Risk in exposed) - (Risk in Unexposed / Risk in exposed)
61
Accuracy (validity)
the ability of the test to correctly classify individuals according to disease status.
62
Sensitivity and Specificity
measures of test accuracy, fixed characteristics of a test
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Sensitivity
the ability of the test to correctly identify individuals who have the disease #True Positives / Total Disease positive
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Specificity
the ability of the test to correctly identify individuals who do NOT have the disease #True Negatives / Total Not Diseased
65
If you have a test that has high sensitivity you have
fewer false negatives
66
When is having a high sensitivity important?
You want fewer false negatives (Confidence in the negatives) Rule out disease in early stages of workup (SnOUT), Identify all infected of the diseased individuals (Failure to treat is dangerous, missing the early stages, missing a reportable or foreign animal disease.
67
When do you want a specific test?
When you want fewer false postives. More confidence in your positives. Rule In or confirm the diagnosis SPIN When a false positive is dangerous or undesired (treatment involves a risk, when it is expensive, prior to euthanasia or culling)
68
Cohort
observational study that follows a group of individuals (cohort) over a period of time to investigate the relationship between an exposure or risk factor and a particular outcome *Can be prospective or retrospective Use Relative Risk
69
Case-Control
observational study between two groups, a group of people with a disease vs a group of people without a disease. Both groups are asked about their previous expoires called risk factors Use odds ratio.
70
Randomized Control trial
used to control factors that are not under direct experimental control and involve at least one test factor and one control factor Best study designed for interventional study
71
Case Series/Report
Detailed examination of a particular case within a real world context. Describe characteristic of a group of people with the same disease or same exposure
72
Cross Sectional
observational study that analyzes health data from a population or a representative subset at a specific point. Good for assessing exposure/outcomes Bad way of associating causality
73
Systematic Review
identifies all relevant studies on a topic, assess quality then synthesizes and interprets the findings
74
Meta-analysis
identifies all relevant studies on a topic, assesses quality then synthesizes and interprets the findings. Presents an unbiased, impartial summary
75
Metanalysis
identifies all relevant studies on a topic, assesses quality then synthesizes and interprets the findings.
76

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