module 1 Flashcards
what is diagnosis
a process where patient data is collected and elevated to determine prgnosis and possible interventions
what is the purpose of diagnosis
to increase the certity of making a diagnosis beyound the threshold of clinical desion
in PT what can diagnosis do
steer an examination toward specific body region/system
rule out red flags that require refferals
assist in classifiy a patient into a specific group
why are diagnostic tests helpful for clincians
ID the accuracy of commonly used tests
ID other properties of diagnostic tests -reliablity, acceptablity, and feasiblity in the clinic
ID other tests
what is the first step in the EBP progress
ask
PICOT - I diagnostic
diagnostic test
PICOT - C diagnostic
goals standard, or another diagnostic test
PICOT - O diagnostic
the condition of interest
shoulder pain
PICOT - T diagnostic
time frame
what is a cross sectional study
a type of research design in which you collect data from many different individuals at a single point in time
what is a longitudinal study
A longitudinal study is a research design that involves repeated observations of the same variables over long periods of time.
what is the optimal study design for diagnostic studies
prospective blind comparison
gold standard vs diagnostic test
Is cross section study or long better for diagnostic studies
cross sectional studies
looking at the diagnostic accuracy of the test
Hierarchy of evidence for diagnostic evidence
- systematic review, meta analysis
- cross sectional - reference, blinding
- cross sectional - inconsistance reference, no blinding
- case control
- opinion based, mech-based reason
what is a case control study
group of cases, which are the individuals who have the outcome of interest.
construct a second group of individuals called the controls, who are similar to the case individuals but do not have the outcome of interest.
The researcher then looks at historical factors to identify if some exposure(s) is/are found more commonly in the cases than the controls.
what is a prospective study
A prospective study watches for outcomes, such as the development of a disease, during the study period and relates this to other factors such as suspected risk or protection factor(s)
what is a retrospective study
ooks backwards and examines exposures to suspected risk or protection factors in relation to an outcome that is established at the start of the study
what does the STARD checklist cover
title, absract, keywords
intro
methods
result
discussion
what does the STARD check list look at
used by author/researchers publishing a study on the diagnostic accuracy of a test
what are common threats to validity seen in studies of diagnostics
bad or wrong gold standard
spectrum or selection bias
lack of rater blinding
lack of operation def neg and positive results
absent intermediate test finding
what is selection bias
study sample is not representative of the population being studied
what is a rater
assess the symptoms, signs, and outcomes of clinical trial participants using standardized assessment tools
in order for research to be valid what has to be said about the diagnostic test
the test was described clearly
reliablity of the test stated
in order for research to be valid what has to be said about the gold standard
the diagnostic test of interest (DTI) has to be compared to it
gold standard and DTI has to be performed and interpreted independently
both test applied in a appropriate time frame
in order for research to be valid what has to be done at the conclusion
the results have to be comfirmed in a new set of subjects
test subject and validity
have to make sure that the test subjects are representative of those the test would be applied to
commonly confused diagnosis
typical clinical presentation
mild to serve symptoms
what happens if the study includes only patient with obvious presentations of the disease
this can inflate to the diagnostic capacities of the test
when does selection bias occur
studies with narrow edibility criteria
retrospective study design
during recruitment
what can occur during recruitment to cause selection bias
recruiting from a single location
recruiting from a location where the prevalence of the disease is higher
recruitment of a connivence sample - not random or consecutive
what is spectrum bias
it is a type of selection bias
recruiting only pt who have severe symptoms or classic presentation
when does spectrum bias occur
the same time as selection bias
why should the diagnositc be defined in the paper
to allow the test to be replicated
what must be included in the definition of the diagnostic test
the reliability and validity of the test
+/- results
what is a gold or reference standard
this is a measure or test that is assumed to correctly ID the presence of absence of a disease 100% of the time
what are the characteristic of a gold standard
acceptable in clinical practice
evidence of its validity, reliability, and accuracy
impractical for routine use
may be expensive or invasive
what must be included with the gold standard in the paper
references to support the tests
results of the gold standard and the DTI and rater
the results of the gold standard should not be known to those who interpret the DTI
evaluaters of the DTI should be blinded to the results of the gold standard
in what circumstance would the gold standard not be tested on everyone
there is no circumstance
it has to be tested on everyone
what happen when a gold standard cannot be applied to a pt - risk
another reference test that has similar validity can be applied
what time frame must a gold standard and DTI be applied
in a reasonable time frame where changes in the patient health status are not expected
too much difference in timing of test my lead to inaccuracy
why must the result be confirmed on a new set of subjects
results may be due to unique characteristics of subject pop
what does the rep of a test on a new set of subjects tell us
tells us about the generalizability and test consistency
what is a clinical measure
tell you about a individuals state of function or impairment
scores on these tests can tell us the severity of the problem
what is a diagnostic test
detects the presence or absence
example of clinical measure
TUG
5 STS
10 MWT
