module 4 Flashcards
what does prognosis mean
the progress of predicting the future about a patient condition
why is an accurate prognosis important
improved pt edu
helps in developing a plan of care
helps to promote the appropriate allocation of resources
what is a primary prevention stratagie
direct pt care towards preventing a new condition
based on known risk factors
EX: pt with sedentary lifestyle is at risk for developing CVD or obesity
what are 2ndary prevention stratagies
direct pt towards preventing 2nd and tert conditions in pt
EX: prevent chronic back pain to prevent further disability
what does prognosis do for PT practice
risk of adverse future events
patient expected health status over time
likely response to intervention
duration of treatment needed
what are prognostic risk factors
unique characteristics that predict an outcome or an adverse event
medical or behavioral comoribities
demographics
clinical characteristics
PICOT - I
exposure
EX: smoking, inactivity
PICOT - C
non-exposure
PICOT - O
presence or absence of an adverse event
what is the ideal study for a prognostic study
prospective cohort
weaker designs of a prognostic study
case control study
retrospective
what is the defintion of a homo clinical population
ID as a defined and common time point during the course of the disease
how does the prospective study work for prognostic
group of individuals free of outcome of interest
homo groups - one exposed to the risk the others not exposed
follow these groups over time to see if they develop the outcome of interest
what can be ascertained with a prospective study design
temporal relationship between the risk and the outcome of interest
retrospective cohort design
like a prospective but all of the events have occurred in the past
normally using data based or public service databases
what are the two types of cohort studies
prospective and retro
what are thee advantages of a cohort studies
ethically safe
can establish the timing of events
assement of exposure are more accurate - pro
less cost and easier to administer then a RCT
what are thee disadvantages of a cohort studies
exposure may be linked to a hidden cofounder
blinding is hard
for rare disease - long follow up and large n is needed
can still be lengthy and costly what
case control studies and prognosis
ID people with the outcome of interest and those without the outcome of interest
look retro for difference between the two groups
excess the odds of being exposed
advantages of case control studies
groups for comparison
ideal for rare disease
can look a multiple exposure variables at once
cheap and quick
disadvantages of case control studies
potential for selection and info bias
cannot measure the incidence or the prevalence
restricted to studying the outcome of interest
hierarchy of evidence for prognosis studies
- systematic review and meta
- inception cohort
- cohort study
- case-control
- mechanism based reading
what is the STROBE statement
like the STRAND (diagnostic) but for prognostic studies
check list of items that should be included in reports
when does the group of particpants have to be assembled
at a similar disease point or onset of disease
what is an inception cohort
this is the more ideal
enrolling patients from the time the disease first manifest itself
what must be true of cohort study groups
they must be fairly homo to reduce confounding
