One Word_Behavioral Science Flashcards
X2 (chi-square) test
checks difference between 2 or more percentages or proportions of categorical outcomes (not mean values)
Ways to reduce bias (4)
- Blind studies (double blind is better) 2. Placebo responses 3. Crossover studies (each subject acts as own control) 4. Randomization
Type II error (β)
Stating that there is not an effect of difference when one exists (to fail to reject the null hypothesis when in fact H0 is false)
Type I error (α)
Stating that there is an effect or difference when none exists (to mistakenly accept the experimental hypothesis and reject the null hypothesis)
Twin concordance study
Compares the frequency with which both monozygotic twins or both dizygotic twins develop a disease. Measures heritability
Tanner stages of sexual development
- Childhood 2. Pubic hair appears (adrenarche); breast enlarge 3. Pubic hair darkens and becomes curly; penis size/length ↑ 4. Penis width ↑, darker scrotal skin, development of glans, raised areolae 5. Adult; areolae are no longer raised
t-test
checks difference between the means of 2 groups
Sleep terror disorder
Periods of terror with screaming in the middle of the night; most common in children; occurs during slow-wave sleep; no memory of arousal
Sleep patterns of depressed patients (6)
- ↓slow-wave sleep 2. ↓REM latency 3. ↑REM early in sleep cycle 4. ↑total REM sleep 5. Repeated nighttime awakenings 6. Early-morning awakenings (important screening question)
Selection bias
nonrandom assignment to study group (e.g., Berkson’s bias)
Sampling bias
subjects are not representative relative to general population; therefore, results are not generalizable
Reportable diseases (in all states)
AIDS, chickenpox, gonorrhea, hepatitis A and B, measles, mumps, rubella, salmonella, shigella, syphilis, and TB
Recall bias
knowledge of presence of disorder alters recall by subjects
Pygmalion effect
occurs when a researcher’s belief in the efficacy of a treatment changes the outcome of that treatment
Procedure bias
subjects in different groups are not treated the same - e.g., more attention is paid to treatment group, stimulating greater compliance
Precision
- The consistency and reproducibility of a test (reliability) 2. The absence of random variation in a test
Power (1 - β)
Probability of rejecting null hypothesis when it is in fact false, or the likelihood of finding a difference if one exists. It depends on: 1. Total number of end points experienced by population 2. Difference in compliance between treatment groups (differences in the mean values between groups) 3. Size of expected effect
Positive skew
mean > median > mode Asymmery with tail on right
Pathologic grief
includes excessively intense grief; prolonged grief lasting >2 months; or grief that is delayed, inhibited, or denied. May experience depressive symptoms, delusions, and hallucinations
Null hypothesis (H0)
Hypothesis of no difference (e.g., there is no association between the disease and the risk factor in the population)
Nonmaleficence
“Do no harm.” However, if the benifits of an intervention outweigh the risks, a patient may make an informed decision to proceed (most surguries fall into this category)
Negative skew
mean < median < mode Asymmetry with tail on left
Medicare
is available to patients >65 years of age, <65 with certain disabilities, and those with ESRD
Medicaid
is federal and state health assistance for people with very low income
Lead-time bias
early detection of confused with ↑ survival; seen with improved screening (natural history of disease is not changed, but early detection makes it seem as though survival ↑)
Late-look bias
information gathered at an inappropriate time - e.g., using a survey to study a fatal disease (only those patients still alive will be able to answer survey)
Kubler-Ross grief stages
Denial; Anger; Bargaining; Grieving (depression); Acceptance
Justice
To treat persons fairly
Informed consent legally requires
- Discussion of pertinent information 2. Patient’s agreement to the plan of care 3. Freedom from coercion
Hawthorne effect
occurs when the group being studied changes its behavior owing to the knowledge of being studied
Exceptions to parental consent
not required in emergency situations; when prescribing contraceptives; or in treatment involving STDs, medical care during pregnancy, or the management of drug addiction
DOC: Narcolepsy
Treat with stimulants (e.g., amphetamines, modafinil) and sodium oxybate (GHB)
Disease prevetion (3)
1-prevent disease occurrence (e.g., HPV vaccination) 2-early detection of disease (e.g., Pap smear) 3-reduce disability from disease (e.g., chemotherapy) PDR: Prevent; Detect; Reduce disability
Cross-sectional study
Collects data from a group of people to assess frequency of disease (and related risk factors) at a particular point of time. Measures Disease prevalence
Consent for minors
A minor is any person <18 years of age. Parental consent must be obtained unless minor is emancipated (e.g., is married, is self-supporting, has children, or is in military)
Confounding bias
occurs with 2 closely associated factors; the effect of 1 factor distorts or confuses the effect of the other
Confidentiality
Confidentiality respects patient privacy and autonomy. Disclosing information to family and friends should be guided by what the patient would want. The patient may waive the right to confidentiality (e.g., insurance companies)
Cohort study
Compares a group with a given exposure or risk factor to a group without. Measures Relative risk (RR)
Caution in calculating incidence
don’t forget that people currently with the disease, or those previously positive for it, are not considered at risk
Case-control study
Compares a group of people with disease to a group without. Measures Odds Ratio (OR)
Beneficence
Physicians have a special ethical (fiduciary) duty to act in the patient’s best interest. May conflict with autonomy. If the patient can make an informed decision, ultimately the patient has the right to decide
Autonomy
Obligation to respect patients as individuals and to honor their preferences in medical care
Apgar score
Assessment of newborn health via a 10-point scale evaluated at 1 minute and 5 minutes (Appearance, Pulse100/min, Grimace, Activity, Respiration)
ANOVA
checks difference between the means of 3 or more groups
Alternative hypothesis (H1)
Hypothesis that there is some difference (e.g., there is some association between the disease and the risk factor in the population)
Adoption study
Compares siblings raised by biologic vs. adoptive parents. Measures heritability and influence of environmental factors
Accuracy
is the trueness of test measurements (validity)
A systematic error
reduced accuracy in a test
A random error would mean …
reduced precision in a test
