Public Health Sciences Flashcards
cross sectional study
frequency of disease and risk-related factors
measures prevalence
case control study
odds ratio
cohort sutdy
given exposure
results in relative risk
can be prospective or retrospective
twin concordance study
frequency with which both monozygotic and dizygotic twins
measures heritable and influence of environmental factors
phase I clinical trial
is it safe
phase II
does it work-efficacy, dosing, and adverse effects
phase III
compares new to current standard of care
phase IV
adverse effects
PPV and NPV
depend on disease prevalence
sensitivity
true positive
rules out disease
good for screening
specificity
low false positive rate
used for confirmation
rules in
high pretest probability
high PPV
low NPV
lowering cutoff
increase FP and decreases FN
N (sensitivity and NPV increase)
raising cutoff
increase FN and decreases FP
P (specificity and PPV increase)
likelihood ratio
can be multiplied with pretest odds of test to estimate posttest odds +>10 and <0.1
number needed to treat
1/ARR
low number means better treatment
number needed to harm
1/AR (diff subtraction than ARR)
incidence
new cases
prevalence and disease duration
incidence(duration)=prevalence
precision
reliability
absence of random variation
increases statistical power (1-beta)
accuracy
validity
trueness of test measurement
systemic error decreases accuracy in a test
selection bias
nonrandom sampling
berkson
from hospital-less healthy
non-response bias
participating subjects differ from nonrespondents
hawthorne effect
participants change their behavior in response to awareness of being observed
pygmalion effect
researcher belief in efficacy changing outcome
reduction of confounding bias
multiple studies crossover studies matching restriction randomization
reduction of lead-time bias
measure back-end survival
standard error
decreases and number increases
positive skew
mean>median>mode
type 1 error
stating there is an effect when none exists
alpha
type 2
not effect when one exists
beta
increase power
increase sample size
increase effect size
increase precision of measurement
Z for 95%
1.96
Z for 99% CI
2.58
CI includes 0 for mean and ratios
no difference
CI do not overlap
significant difference exists
chi squared
differences between 2 or more percentages or proportions of categorical outcomes
beneficence conflict
with autonomy vs what is best with society
requirements of informed consent
disclosure of pertinent information
understanding
capacity to make decision
voluntariness
exceptions to informed consent
lack decision making capacity
implied in emergency
therapeutic privlege
waiver
components of decision making capacity
>18 communicated informed stable consistent with values of patient
medical power of attorney
more flexible than living will
exceptions to confidentiality
suicidal/homicidal patients abuse protect victim epileptic reportable diseases
social smile
2 montsh
stranger anxiety
6 months
separation anxiety
9 months
object permanency
9 months
parallel play
24-36 months
gender identity
36 months
cooperative play
4 years
rear facing car seats
until 2
harness
until 4
booster
until 8
sleep changes in elderly
decrease REM and slow-wave sleep
increase onset latency
increase early awakenings
tertiary
reduce complications from disease
HMO
limited panel of providers
POS
still requires referral
PPO
no referral
medicare
> 65
<65 with disabilities and those with end-stage renal disease
part a
insurance, home hospice
part b
basic medical bills
part d
prescription drugs
hospice
<6 months to live
principle of double effect
prioritization of positive effects over negative effects
mood disorders
common in medicaid and uninsured
standardization of procedures
improves reliability
simplification
reduces waste
PDSA cycle
plan, do, study, act
plot quality measurements
run and control charts
swiss cheese model
focuses on systems
differing layers
active error
frontline operator, immediate impact
latent error
processes indirect from operator
different types of pumps
accident waiting to happen
root cause analysis
records to identify underlying problems
retrospective
plot root cause analysis
fishbone (cause and effect) diagram
failure mode and effects analysis
identify ways process might fail
forward-looking approach
