NonSystems Flashcards
Medicare
people over 65
end-stage renal disease regardless of age
Scales of Measurement
nominal: “classification scale”, categories, names
-types of breath sounds, blood types
ordinal: “ranking scale”, intervals between the rankings may not be equal or known
-MMT grades, pain scale
interval: intervals between values are equal, but there is no true zero point
-temperature
ratio: intervals between values are equal, but there is a true zero point
-ROM, distance walked (m)
Measurement Reliability
(repeatability of measurements)
alternate forms reliability: “parallel forms”, assesses consistency or agreement between different forms of a test
internal consistency: the extent to which items or elements that contribute to a measurement reflect one basic phenomenon or dimension
intra-rater reliability: consistency or equivalence of repeated measurements made by the same person
interrater reliability: consistency or equivalence of repeated measurements made by more than one person
test-retest: consistency or equivalence of repeated measurements made on the same individual on separate occasions
Measurement Validity
(degree to which useful or meaningful interpretation can be inferred from a measurement)
face: the degree to which a measurement appears to test what it is supposed to (insufficient documentation of validity
content: the degree to which a measurement reflects the meaningful elements of a construct and the items in a test adequately reflect the content domain of interest and not extraneous elements
construct: the degree to which a theoretical construct is measured by a test or measurement
criterion related: the validity of the measurement is established by comparing it to either a different measurement often considered to be a “gold standard” or data obtained by different forms of testing
- concurrent: an interpretation is justified by comparing a measurement to a gold standard measurement simultaneously (or approximately)
- predictive: the measurement is considered to be valid because it is predictive of a future behavior or event
- prescriptive: the measurement suggests the form of treatment the person should receive
Research Sampling (some terms, not all)
Probability sampling: uses some form of random selection of subjects
- simple random: “luck of the draw”
- systematic: subjects are selected by taking the nth subject from the population
- stratified random: the population is divided into subgroups (strata) and then simple random is used
- cluster: the population is divided into clusters/areas, and then random samples of the cluster are selected
Non-probability sampling: any method that does not use a random selection of subjects
- convenience: selected out of convenience
- purposive: selected based on predefined criteria
- quota: similar to stratified random except convenience sampling is used, not simple random
- snowball: using existing subjects to identify names of other potential participants
Experimental Designs (some, not all)
clinical trial: tests how well methods of screening, prevention, dx, or tx of a disease work in people
randomized control trial: a clinical trial in which a group of people is randomly assigned to an experimental group and a control group
Hypothesis Testing (some terms, not all)
effect size: a measure of the magnitude fo a difference between 2 txs or the magnitude of the relationship between 2 variables
- <0.1 = trivial effect
- 0.1-0.3 = small effect
- 0.3-0.5 = moderate effect
- >0.5 = large effect
statistically significant: the probability is small that the difference between groups or the relationship between variables is due to chance
minimal clinically important difference (MCID): the smallest difference in a patient’s condition that the patient or clinician considers worthwhile and that would, in the absence of side effects and excessive costs, warrant a change in the patient’s mgmt
minimal detectable difference/change (MDD/MDC): the minimum detectable change in a patient’s condition beyond the threshold of a measurement error
-smallest difference/change that would be statistically significant
Inferential Statistics (some terms, not all)
- parametric statistics
ANOVA: analysis of variance; used to test the equality of means between 2 or more populations by analyzing sample variance
- one way ANOVA: only one independent variable is examined
- two way ANOVA: 2 independent variables are examined
confidence interval (CI): a range of values used to estimate a population parameter
confidence level: the probability that the CI actually contains the unknown population parameter
- ie: 95% confidence level = if sampled 100 times and CIs are calculated on each sample, 95 of the resulting CIs would be expected to contain the true population parameter
t-test: estimating a population mean or comparing two means when the population is normally distributed and the population variance is not known
- independent
- dependent
- one sample
- one-tailed
- two-tailed
Inferential Statistics (some terms, not all)
- nonparametric statistics
chi square test
Kruskal-Wallis test
Statistical measures of validity for diagnostic and screening tests (some terms, not all)
sensitivity: the percentage of people who test positive for a specific disease among a group of people who have the disease
specificity: the percentage of people who test negative for a specific disease among a group of people who do not have the disease
spPin: in a test with high specificity, a (+) diagnostic test rules IN the diagnosis
snNout: in a test with high sensitivity, a (-) diagnostic test rules OUT the diagnosis
Epidemiology
incidence: number of new cases of a particular disease or condition in the population at risk during a specified time frame
- often expressed as new cases per 100,000 people at risk
prevalence: number of existing cases of a disease or condition at a point in time, including new and pre-existing
- often expressed as existing cases per 100,000 people at risk
odds ratio (OR): odds of an event happening to one group versus the same event happening to another group
>1.0 exposure increases the risk
<1.0 exposure decreases the risk
1.0 means equal odds in both groups
relative risk (RR): risk of an event happening to one group versus the same event happening to another group
>1.0 exposure increases the risk
<1.0 exposure decreases the risk
1.0 means equal odds in both groups
Levels of Evidence for Articles about Therapy/Interventions
(strongest to weakest)
systematic review
meta-analysis
RCT
cohort study
case-control study
cross-sectional study
case report or case series
ideas/opinions
Stages of Dying (Kubler Ross)
denial
anger
bargaining
depression
acceptance
Domains of Learning
affective: attitudes, emotions, and values
cognitive: knowledge and understanding
psychomotor: physical action or motor skill
Transtheoretical Model (Stages of Change)
pre-contemplation
contemplation
preparation
action
maintenance
Health Insurance Types
private
independent
government
- Medicare
- Medicaid
PT Responsibilities
- interpret referrals
- intial exam and re-exam
- eval, dx, and prognosis
- development and modficaiton of POC
- revision of POC
- conclusion of episode of care
- hand off communication
- oversight of documentation
- consultation
PTA Responsibilities
- may modify an intervention only in accordance with changes in patient status and within established POC made by PT
- implement POC
- record record patient progress
- patient education
Accessibility Requirements (wheelchairs)
Doorways and Hallways
doorway:
- min 32 inch width
- max 24 inch depth
hallway clearance:
- 36 inch width
carpet: 1/2 inch pile or less
threshold:
- less than 3/4 inch (sliding doors)
- less than 1/2 inch (other doors)
Accessibility Requirements (Wheelchair)
Ramps, Bathrooms, Hotels, and Requirements
1 foot long for every 1 inch high
min of 36 inch width
handrails if height is >6 inches
turning radius: 60 inch width x 78 inch length
bathroom sink:
- not less than 29 inch height
- not greater than 40 inches from floor
- 17 inch min depth
bathroom toilet:
- 17-19 inches from floor to top of toilet
- no less than 3ft grab bar length
- grab bar 33-36 inches up from floor level
hotels: ~2% total rooms must be accesible
parking space:
- 96 inch width
- 240 inch length
- ~ 2% of total spaces must be accesible
CPR (adult and child)
adult: 30:2 (1 or 2 rescuers)
child/infant: 30:2 (1 rescuer) 15:2 (2 rescuers)
Airborne Precautions
(examples: tuberculosis, SARS, measles, varicella)
- private room with monitored negative air pressure, door should stay closed
- if private room not available, place patients together who are presumed to have same infection - wear N95 or higher level respirator when entering room
- patient should be in surgical mask with others in the room - limit patient transport outside of room for only essential purposes
- patient should wear mask during transport
Droplet Precautions
(examples: meningitis, pneumonia, sepsis, pertussis, flu, strep, mumps, rubella, diphtheria)
- private room, dor can remain open
- if private room not available, place patients together who are presumed to have same infection; ensure that patients are at least 3ft apart - don a mask upon entry into the pt’s room; pt should also be wearing a mask
- wear a mask when within 3-6 ft of pt - limit patient transport outside of room for only essential purposes
- patient should wear mask during transport
Contact Precautions
(examples: GI, resp, skin, or wound infections, stool incontinence, e. coli, MRSA, herpes, scabies, impetigo
- private room, dor can remain open
- if private room not available, place patients together who are presumed to have same infection; ensure that patients are at least 3ft apart - don gloves upon entry; change with direct contact to infectious material
- wear a gown if there will be substantial close contact with the patient or contaminated objects
- take gloves/gown off prior to leaving the room and perform proper hand hygiene
- limit patient transport outside of room for only essential purposes
- infected or colonized areas of pt’s body should be covered during transport - dedicate non-critical patient care equipment to one patient; do not share between patients, or disinfect properly prior to use on another patient
Donning/Doffing
Don: bottom up with gloves LAST
-gown, mask, goggles/face shield, gloves
Doff: top down with gloves FIRST mask last
-gloves, goggles/face shield, gown, mask
Chi squared test
