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Year 3 > RESS3 > Flashcards

RESS3 Flashcards

1
Q

What is a clinical audit?

A

measures existing practice against evidence-based clinical standards

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2
Q

What is a service evaluation?

A

evaluates a proposed service or current practice with the intention of generating information to inform local decision making

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3
Q

What is your outcome?

A

your health or healthcare issue

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4
Q

What is your exposure?

A

factors affecting the outcome

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5
Q

What does PECOS stand for?

A 
Patient/participant/people
Exposure/event/experimental intervention
Comparison
Outcome
Study design
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6
Q

What are examples of sampling bias and define them

A

external validity- non-representative samples

confounding- selection influences outcome and exposure

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7
Q

What are examples of measurement bias and define them

A

information bias- extent of information varies among participants
observer bias- influenced by prior knowledge or belief
recall/response/prestige bias- influenced by prior knowledge or belief

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8
Q

What are examples of analytical bias and define them

A

loss to follow up- specific participants excluded
omitted variable bias- imprecise adjustment for confounding
attributional bias- interpretation of causality

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9
Q

What is an example of dissemination bias and define it

A

publication bias- ‘eventful’ results more likely to be published

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10
Q

Examples of descriptive (inductive) studies

A 
case control
cross sectional (descriptive)
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11
Q

Examples of Analytical (deductive) studies

A

Observational:

  • cross sectional (analytical)
  • case/control
  • cohort

Experimental:
-trial

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12
Q

What is the hierarchy of analytical study design

A 
meta-analysis (reproducibility)
trail (causality)
cohort (directionality)
case control (between samples)
cross sectional (within a sample)
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13
Q

Ethics, governance and consent

A

ethics- ensuring that projects minimise risks and maximise benefits
governance- ensuring that projects have appropriate permissions
consent- ensuring participation is voluntary and without ‘cost’

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14
Q

What types of projects do not require formal ethical approval?

A

secondary research (data already published)
non-human research
audit/service evaluation (using only existing management data)
service evaluation (collecting new information only on existing service delivery)

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15
Q

What types of projects do require formal ethical approval?

A

Non-human subject covered by the 1986 animal act
service evaluation involving vulnerable groups
experimental research
some non-experimental research

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16
Q

What is a sample?

A

a collection of data drawn from a population

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17
Q

What is the target population?

A

the total finite population we wish to know about from which your sample is drawn

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18
Q

What is the study sample?

A

the units/participants drawn from the target population that constitute our date set

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19
Q

What is a complete sample? Pros and cons

A

the entire study population
P: no bias
c: expensive

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20
Q

What is un-stratified random sampling? Pro and cons

A

every member of the target population has the same chance of being sampled
P: easy to design and conduct
C: smaller groups can be under presented by chance

21
Q

What is stratified random sampling?

A

randomly sample from the target population within strata
P: representative
C: population may not easily be divided into strata, strata may not be known until after sampling

22
Q

What is the difference between a null and alternative hypothesis

A

null- no effect, no difference between groups

alternative- a effect, a difference between groups

23
Q

What is the p-value?

A

the p value is a measure of the probability of obtaining the results of the test given that the null hypothesis is true.
the smaller the p value the less likely the result is to have occurred by chance alone
when the p-value is less than 0.05 the the results are statistically significant

24
Q

what is odds?

A

odds is the number of times the event occurs divided by the number of times it does not occur. Odds ratio calculates relative risk

25
Q

What does a 95% confidence interval mean?

A

if the 95% confidence interval does not include the null (odds ratio =1) then the association is significant (p=0.05). As we increase our sample size, our estimates become more accurate, so our confidence intervals shrink

26
Q

What is power?

A

power is the probability of rejecting the null hypothesis when the null hypothesis is false. I.e. the probability of finding an association if it is there to be found
Usually the aim is 80% power i.e. probability of 0.8 of finding a difference/ detecting an association

27
Q

What is odds ratio

A

a measure of telling us how much more likely an event is to occur amongst those who are exposed
if no effect the odds ratio =1
even if your odds ratio is above 1 if the confidence intervals include 1 then it is not significantly different to the null for a study of this sample size

28
Q

What are co-variates

A

variables that affect the exposure and/or outcome

29
Q

What is a confounder?

A

variables that affect both the exposure and the outcome

30
Q

What is a mediator?

A

variables that cause the outcome and are caused by the exposure

31
Q

What is a competing exposure?

A

Variables that cause the outcome

32
Q

What does DAG stand for?

A

directed acyclic graphs

33
Q

What is a prospective study and give examples

A

they record variables over the study period, with the outcome measured subsequently
cohort (directionality)

34
Q

What is a retrospective study and give examples

A

measure the outcome then look backwards to measure the exposure and other variables
case-control or studies using patients records

35
Q

What is response bias?

A

what the interviewer wants/gets

36
Q

what is prestige bias?

A

what appears favourable

37
Q

What is recall bias?

A

prospective/retrospective

38
Q

What is R2 (squared)

A

the proportion of variation explained by the linear model
takes a value between 0 and 1
higher values indicate that more of the variation is explained by your model, i.e. it is a better fit
1 is a perfect fit so your model perfectly predicts the outcome

39
Q

What are the 3 key concepts in economics?

A

opportunity cost
efficiency
marginal analysis

40
Q

What is opportunity cost?

A

the value of something when a particular course of action is chosen

41
Q

What is efficiency and what are the two types?

A

maximising the benefit for the resource used

technical: meeting a given objective at least cost
allocative: producing the output (supply) that matches consumer want (demand)

42
Q

What does marginal analysis involve?

A

comparing the benefit from that next step (marginal benefit) with the cost of taking the next step (marginal cost)

43
Q

What is economic evaluation?

A

a comparison of two or more alternative courses of action in terms of their costs and their outcomes

44
Q

what is cost effectivness analysis?

A

benefits measured in terms of standard clinical outcome.

also considers life years gaines

45
Q

what is cost utility analysis?

A

considers both quality and quantity life

46
Q

what is cost benefit analysis?

A

considers resource use and health beneifts in monetary terms

47
Q

What is option appraisal?

A

another type of economic evaluation

a structured process for identifying, describing and evaluations alternative methods of acheiving an agreed objective

48
Q

What is the ICER?

A

incremental cost effectiveness ration
cost effectiveness analysis calculates the expected cost per additional unit of health produced by a new intervention compared to current practice

49
Q

What is the cost effectiveness threshold?

A

maximum amount the health service will pay per unit of health gained.
it represents the maximum opportunity cost consistent with improving population healthy by introducing a new intervention

Year 3 (2 decks)

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