PMHP Flashcards
1
Q
- Name three reasons which D3mft graph shows a difference between 2 areas? (3)
A
- Socioeconomic status of the area
- Access to dental care/healthcare
- Health behaviours- smoking, diet, alcohol
- Income (can affect diet etc.)
- Different area based preventative measures implemented by different health boards
2
Q
- What does the 3 in d3 mean?
A
- Obvious decay into dentine of the tooth (using visual methods only)
3
Q
- At population level name 3 fluoride delivery methods?
A
- Water fluoridation
- Fluoride varnish application in schools
- School water fluoridation
- School milk initiative
- Fluoridated salt
4
Q
- What 3 health interventions are done in Scotland on a population bases?
A
- Smoking ban in public areas
- Sugar tax
- School food policy
- Alcoholic minimum unit pricing
5
Q
- What is D3t, Mt and Ft?
A
- D3t- decayed teeth
- Mt- missing teeth (XLa due to decay)
- Ft- filled teeth
6
Q
- What is SIMD?
A
- Scottish index of multiple deprivation
- Area based index which use a range of data from a range of sources to decide which neighbourhoods are most deprived by ranking data zones in order of deprivation from quantile/decile 1 (most deprived) to quantile 5/decile 10 (least deprived)
7
Q
- Give 7 factors influencing deprivation?
A
- Employment status
- Income
- Health and healthcare services
- Crime
- Housing, living and working conditions
- Educations, skill and training
- Geographical access to services
8
Q
Evidence Based Dentistry & Studies-
1. What type of study provides the highest level of evidence?
A
- Cochrane review- systematic review of all the relevant randomised controlled trials
9
Q
- List 4 aspects of this type of study?
A
- Specification or participants- Inclusion and exclusion criteria
- Control (of comparison)
- Randomisation
- Blinding
10
Q
- Give 3 other study designs?
A
- Cohort (prospective)
- Case control (retrospective)
- Case study (one patient)
11
Q
- What is incidence?
A
- The number of new disease cases developing over a specific period of time in a defined population
- Incidence rate= no of new cases of disease in period / no of individuals in population at risk
- Incidence estimates are obtained from longitudinal studies or derived from registers
12
Q
- What is prevalence?
A
- The number of disease cases in a population at a given time
- Prevalence= no of affected individuals/ total number of persons in a population
- Prevalence estimates are obtained from cross-sectional studies or derived from registers which can related to attributes or to absence or presence of disease
13
Q
- What is prevalence?
A
- The number of disease cases in a population at a given time
- Prevalence= no of affected individuals/ total number of persons in a population
- Prevalence estimates are obtained from cross-sectional studies or derived from registers which can related to attributes or to absence or presence of disease
14
Q
- What is a case control study?
A
- Retrospective study which involves comparing one group (usually with disease) with one control (without disease) to find risk factors associated
15
Q
- How can you reduce bias?
A
- Randomisation into groups
- Double blind. Blinding or participants and researchers
16
Q
- What 2 things show that it was random?
A
- Randomised controlled trial
- Computer generated assignment of participants to intervention groups; ensure participants have equal chance of being allocated to either group avoiding bias and ensures fair mis of participants found in each group
- (Blinding or masking or participant or researcher/assessor)
17
Q
- What is a PICO? (NB. May have to work out what this is from a leaflet.)
A
- Population
- Intervention
- Comparison
- Outcome
18
Q
- What is confidence intervals?
A
Normally the confidence interval is 95% this means that 95x out of 100 if you repeat the trial that your results will be between your plus or minus variations from the mean.
- Range of values the absolute risk difference will take in the population
- 95 times out of 100 the CI will contain the true ARD- 95% sure if we repeated the trial the ARD would eb between the two numbers of the CI
- Is the value of the confidence interval for ARD overlap 0 (value of no difference) there is not sufficient evidence to support
19
Q
- What is relative risk?
A
- Ratio of incidence rate in exposed groups (case) to incidence rates in non-exposed groups (control)
- It is a measurement of proportionate increase or decrease in disease rates of exposed groups
- AKA absolute risk ratio
20
Q
- What would you tell the patient- were the results significant or not; given confidence intervals and risk ratio?
A
- If confidence interval overlaps value of no difference then there is insufficient evidence to support a reliable different between the two groups and the results are not significant.
- If measured using absolute risk ratio- value of no difference is 1
- Is measured using risk absolute risk difference then the value of no difference is 0
- ‘There is sufficient/insufficient evidence to suggest that (description of treatment effect) than (placebo group description) as the confidence interval straddles/does not straddle value of no different (O/1) then state value.’ Give further description if necessary
21
Q
- What would you tell the patient- were the results significant or not; given confidence intervals and risk ratio?
A
- If confidence interval overlaps value of no difference then there is insufficient evidence to support a reliable different between the two groups and the results are not significant.
- If measured using absolute risk ratio- value of no difference is 1
- Is measured using risk absolute risk difference then the value of no difference is 0
- ‘There is sufficient/insufficient evidence to suggest that (description of treatment effect) than (placebo group description) as the confidence interval straddles/does not straddle value of no different (O/1) then state value.’ Give further description if necessary
22
Q
- What two other things should you consider when evaluating the results of a study?
A
- Size of the study
- Duration of the study
- Population investigated in the study
- Confounding variables
23
Q
Spilt Mouth Study Design-
1. What are the advantages of split mouth study design?
A
- Each participant acts as own control which reduced inter-individual variation (same environment for control and intervention)
- Fewer participants are required to obtain the same study power as parallel non split-mouth group
- Every participant receives both intervention, therefore this is good for determining preferences
24
Q
- What are the disadvantages? Split mouth design
A
- Carry across affect- may get carries effect from one side to the other (can’t be used for toothpaste, mouthwash etc.)
- Selection of patients (need to have matching carious teeth) might limit external validity
- Statistical analysis more sophisticated and usually not done
- Patient cannot be blinded which added more bias into the reporting
25
Q
- What are confidence intervals?
A
- The range of values the absolute risk difference will take in the population (representation of the study finding to the real world population)
- 95 times out of 100 the CI will contain the true ARD- 95% sure if we repeated the trial the ARD would eb between the two numbers of the CI
26
Q
- What values regarding confidence interval are important?
A
- For ARD if confidence interval range overlaps 0= null hypothesis
- For RR if confidence interval range overlap 1= null hypothesis
27
Q
- What a P value?
A
- Used to determine statistical significance of your results
- P value <0.05 means you reject the null hypothesis and your results are statistically significant
28
Q
Consent-
1. Give three types of consent?
A
- Implied- patients action or lack of action clearly indicated their wishes
- Verbal- patient clearly states their consent for procedure
- Written- patient signs declaration that they consent to procedure