MRCPych Mentor 2 Flashcards
What survey did ECA use?
DS
Which country did the ECA take place?
USA
Partial defences for murder?
Diminished responsibility
Loss of control
Suicide pact
Risk of schizophrenia if cannabis use <18?
4 fold
Risk of schizophrenia if cannabis use >18?
2 fold
What antidepressant has been shown to be effective or depression if given S/L?
Fluoxetine
Who created behavioural activation?
Martell
What drug is licensed for opiate detox in pregnancy?
Methadone
SSRIs to use in breastfeeding?
Paroxetine
Sertraline
SSRIs to use in pregnancy?
Fluoxetine
Amitriptyline
Imipramine
Requirements of testamentary capacity
They must know Extent and value of their property Who the natural beneficiaries are The disposition they are making The plan as to how the property will be distributed
Who coined the term ‘therapeutic community’?
Thomas Main
ARR equation?
CER - EER
NNT equation?
1/ARR
Relative risk reduction equation?
ARR/CER
Relative risk equation?
EER/CER
What measures inter-rater agreement/reliability?
Kappa
Equation for standard error of the mean
SD/square root of n
What does standard error of the mean tell us?
Spread expected for the mean of the observations i.e. how accurate the calculated mean is based on the true population mean
Calculation for variance?
Sum(x - xbar)^2 / n-1
xbar = sample mean
How much of the data lies within 1 SD?
68.3%
How much of the data lies within 2 SD?
95.4%
How much of the data lies within 3 SD?
99.7%
What is GRADE used for?
To rate the quality of evidence of systematic reviews and guidelines
What is linear regression used for?
To predict how much one variable changes when a 2nd variable is changed
What increases as prevalence falls?
NPV
What does cost-effectiveness analysis do?
Compares interventions by relating costs to single clinical measure of effectiveness e.g. sx reduction
In which study are results reported as ICER?
Cost-effectiveness analysis
What is measured in cost-benefit analysis?
Money
What is measured in cost-utility analysis?
Multi-dimensional health outcomes such as QALY
Which economic study can compare treatments across conditions?
Cost-utility analysis
Sensitivity equation
TP/TP+FN
Specificity equation
TN/TN+FP
LR+ equation
sens/1-spec
LR- equation
1-sens/spec
PPV equation
TP/TP+FP
NPV equation
TN/FN+TN
What is opportunity cost?
Value of the next-best alternative that is forgone when a choice is made
How is opportunity cost measured in healthcare?
QALY
Define p value
Probability of rejecting null hypothesis when it is true
Equation for power
1 - beta
How do you find out the lower quartile?
(N+1) / 4th value
How do you find the upper quartile?
3(n+1)/4
What is the middle line in the box of a box-whisker plot?
Median
Define specificity
Proportion of patients without the condition who have a negative test result
Define likelihood ratio for a +ve test result
How much the odds of the disease increase when a test is positive
Define +ve predictive value
The chance that the patient has the condition if the diagnostic test is positive
What does a 95% CI mean?
If the study was repeated then the mean value would be within this interval 95% of the time
What happens to SEM as sample size increases?
Gets smaller
What type of regression is used for dichotomous variables?
Logistic
What is the denominator for the incidence rate?
Total person time at risk during specific time period
What rate provides information on the number of new cases of a disease that occur over a period of time and also accounts for people who leave the population during the time period under study?
Incidence rate
Analytic techniques used in qualitative studies
Content analysis
Constant comparison
Define cumulative incidence
Proportion of a candidate population that becomes diseased over a specified period of time
Define incidence rate
Occurrence of new cases of disease that arise during person-time observation
Calculation for prevalence
Incidence x duration of condition
How can one assess internal consistency?
Average inter-item correlation
Average item-total correlation
Split half correlation
Cronbachs alpha
What is attributable risk?
the rate in the exposed group minus the rate in the unexposed group.
What is the population attributable risk?
the reduction in incidence that would be observed if the population were entirely unexposed.
Methods for assessing validity of qualitative studies
Triangulation
Respondent validation/member checking
Bracketing
Reflexivity
Define p value
Possibility of obtaining a result at least as extreme, assuming the null hypothesis is true
What is triangulation?
Comparing results from 2+ different methods of data collection or sources
What is respondent validation/member checking?
When the investigator’s account is compared with the research subjects
What is bracketing?
Deliberately putting aside ones own belief about the phenomenon under investigation
What is reflexivity?
Sensitive to the ways in which the researcher and research process have shaped the collected data including prior assumptions & experience
What form of analysis for qualitative data is based on grounded theory?
Constant comparison
Name the tests used to check for normal distribution
The Kolmogorov-Smirnov (Goodness-of-Fit) Test (when adapted specifically for this purpose it is sometimes referred to as the Lilliefor's test) Jarque-Bera test Wilk-Shapiro test P-plot Q-plot
Equation for post test probability
Pre-test probability/ (1- pre-test probability)
Which cost study uses a single clinical measure of effectiveness?
Cost-effectiveness analysis
What is the square root of the variance?
SD
Wilson & Junger criteria for sscreening
The condition is an important public health problem
There is acceptable treatment for patients with the recognised disease
Facilities for diagnosis and treatment should be available
There should be recognised latent or early sx stage
Natural hx of the condition should be adequately understood
Test/examination should be acceptable to the population
There should be agreed policy on who to treat
Cost of case-finding should be economically balanced in relation to possible expenditure
Case-finding should be a continuous process and not a ‘once and for all’
How many levels in GRADE?
7
Level 7 of GRADE?
Case reports
Describe GRADE
Systematic r/vs and meta-analysis of RCTs w/ definitive results
RCTs w/ definitive results (CI that dont overlap threshold clinically significant effect)
RCTs with non-definitive results
Cohort studies
Case-control studies
Cross sectional surveys
Case reports
Define variance
Average of SD from mean
x axis of ROC
1- specificity
y axis of ROC
sensitivity
What fraction of people who stop clozapine due to neutropenia or agranulocytosis develop a blood dyscrasia on rechallenge?
1/3
Who developed group psychotherapy?
Moreno
Which antidepressants should be avoided in DM?
TCAs
MAOIs
Risk of fatal agranulocytosis?
1 in 10,000
Primary metabolite of paracetamol?
Benzoquinoneimine
Defence mechanisms of phobias
Repression
Displacement
Defence mechanisms of OCD
Isolation
Undoing
Reaction formation