Quiz 3 Flashcards
what are the three pathways you can take as a provider when making a medical decision?
- wait and see
- obtain more info-order a new test
- initiate immediate Tx
no fault errors
errors due to masked or unusual presentations of disease or due to patient errors (uncooperative, deceptive)
system-related errors
technical failure and equipment problems, organizational flaws
what are the three types of errors that contribute to either failure to diagnose or misdiagnosis?
- system-related errors
- no fault errors
- cognitive errors
cognitive errors
faulty knowledge, data gathering and/or synthesis
paternalist decision-making
provider decides, most common w/ lower educational and SES
what are the 3 types of decision making?
- paternalist (9%)
- shared (61%)
- consumerist (30%)
shared decision-making
provider and patient deliberate, more common w/ higher education and SES
consumerist decision-making
patient decides
premature closure and how it relates to diagnosis
example in class was about how specialists often diagnose what is familiar
misleading details
often present in patient history, can lead to misdiagnosis
what do you need to consider given a positive test result?
tests are not “yes” or “no”, need to consider the result a probability of a condition now that the test is positive.
shot gunning
ordering multiple tests (often in ED setting) because of uncertainty, lack of time, etc.
what factor did we discuss in class as affecting prevalence?
setting (example family practice setting vs. specialty setting)
discuss test performance curve when differentiating test results in a severe illness
curves only overlap a little bit
discuss test performance curve when differentiating test results in a disease of lower severity
curves have a higher area of overlap
when should you order a test?
when patients w/ and w/o the target condition cannot be distinguished w/o the test
pre-test probability
prevalence of a disease in a defined pop. (TP+FN)/total
pre-test odds
odds of disease before performing a test
prevalence/(1-prevalence)
sensitivity
ability of a diagnostic test to correctly ID the presence of a condition. If high, avoids false positives (good at ruling OUT). Conditional probability of a positive test if the patient has the condition.
TP/(TP+FN)
specificity
ability of a test to judge that subjects do not have a condition. Conditional probability of a negative result when patient do NOT have disease. If high, avoids false negatives .
TN/(TN+FP)
PPV
probability of having the target condition given a positive test result. Depends on prevalence of the disease in the tested pop.
TP/(TP+FP)
NPV
probability of not having the target condition given a negative test result.
TN/(TN+FN)
post-test probabilty
probability of a disease after a positive test result:
post-test odds/(post -test odds +1)
probability of a disease after a negative test result:
post-test odds/(post-test +1)
***yes I know those are the same equations, I double checked in the reading
