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MFSRH 2021 > Stats/research/commissioning/audit/appraisal/revalidation > Flashcards

Stats/research/commissioning/audit/appraisal/revalidation Flashcards

1
Q

What is sensitivity?

A

proportion of people who test positive among all those who actually have the disease (SNOUT rules out)

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2
Q

What is specificity?

A

proportion of people who test negative among all those who actually do not have that disease. (SPIN rules in)

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3
Q

How is sensitivity calculated?

A

True Pos/(true pos+false neg)

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4
Q

How is specificity calculated?

A

True neg/(true neg+false pos)

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5
Q

What is PPV?

A

the probability that following a positive test result, that individual will truly have that specific disease.

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6
Q

How is PPV calculated?

A

True pos/(true pos + false pos)

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7
Q

What is NPV?

A

probability that following a negative test result, that individual will truly not have that specific disease.

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8
Q

How is NVP calculated?

A

True neg/(true neg + false neg)

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9
Q

What type of study is one with individual data and an intervention?

A

RCT

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10
Q

What type of study is one with individual data and an observation with NO comparison group?

A

Case series

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11
Q

What does a cohort study ask?

A

What will happen, compares 2 groups with and without exposure to see if exposure increased chances of disease, Measures relative risk

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12
Q

What does a cross sectional study ask?

A

What is happening. Frequency of disease and risks at the same time. A snap snot in time.

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13
Q

What does a case control study ask?

A

What happened. Compares group with a disease to one without and looks for prior exposure/risk factor.

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14
Q

In the commissioning of sexual health care what is the CCG responsible for

A

Vasectomy
ToP
Non-sexual health psychosexual counselling
Gynae

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15
Q

In the commissioning of sexual health care what is NHS England responsible for

A 
HIV care
GP contraception and STI testing 
Prison sexual health
Cx screening
SARC
Foetal medicine
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16
Q

In the commissioning of sexual health care what is the local authority responsible for

A

Contraception
STI tx and care
sexual health psychosexual medicine
Specialist sexual health services (YP/outreach/promotion)

17
Q

What are the 6 NICE quality standards for sexual health

A

sexual hx taking

discuss prevention/testing for those at STI risk

Condom distribution schemes

Access
<2 working days for people requesting access for STI. <5/7 for LARC

Repeat STI testing for MSM at risk every 3/12
Partner notification

18
Q

10 stnadards of care outlines by DoH for sexual health

A
  1. sexual health networks
  2. promoting sexual health
  3. empowering and involving service users
  4. identifying sexual health needs
  5. access to services
  6. detecting and tx STIs
  7. contraception advice and provision
  8. Pregnancy testing and support
  9. TOP services
    10 Protection/use of sexual health information

https://www.gov.uk/government/publications/commissioning-sexual-health-services-and-interventions-best-practice-guidance-for-local-authorities

19
Q

What is clinical audit

A

Clinical audit is a process that has been defined as “a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change”.

20
Q

what is quality improvement

A 
Quality improvement (QI) is a systematic, formal approach to the analysis of practice performance and efforts to improve performance.
Tpically used a plan, do, study, act (PDSA) cycle.
21
Q

what is clinical appraisal and how often should it take place for a doctor

A

Medical appraisal is a process of facilitated self-review supported by information gathered from the full scope of a doctor’s work.

It is a protected time, once a year, for a doctor to focus, with a trained colleague, on their scope of work.

This includes:

looking back at achievements and challenges and lessons learnt, including reviewing the previous year’s personal development plan objectives

looking forwards to their aspirations, learning needs and the recording of new personal development plan objectives

22
Q

what is revalidation and it’s purpose and how often should it take place for a doctor

A

Medical revalidation is the process by which the General Medical Council (GMC) confirms the continuation of a doctor’s licence to practise in the UK. All doctors who wish to retain their licence to practise need to participate in revalidation.

Takes place 5 yearly.

The purpose of revalidation is to provide greater assurance to patients and the public, employers and other healthcare professionals that licensed doctors are up-to-date and fit to practise. It is a key component of a range of measures designed to improve the quality of care for patients

23
Q

how does revalidation work

A

Revalidation is based on a local evaluation of doctors’ practice through appraisal. Through a formal link with an organisation, determined usually by employment or contracting arrangements, each doctor relates to a senior doctor in the organisation, the responsible officer.

The responsible officer makes a recommendation about the doctor’s fitness to practise to the GMC. The recommendation will be based on the outcome of the doctor’s annual appraisals over the course of five years, combined with information drawn from the organisational clinical governance systems.

Following the responsible officer’s recommendation, the GMC decides whether to renew the doctor’s licence.

The responsible officer is accountable for the quality assurance of the appraisal and clinical governance systems in their organisation. Improvement to these systems will support doctors in developing their practice more effectively, adding to the safety and quality of health care. This also enables early identification of doctors whose practice needs attention, allowing for more effective intervention.

24
Q

The 4 components of a sample size justification/calculation (power calculation)

A

What effect size is the study powered to detect?

What is the power of the study?

What level of significance is being used?

Has the target sample size accounted for attrition? i.e. participants dropping out over the course of the study

25
Q

What is the Hawthorn effect in research

A

that being studies changes participant behaviour

26
Q

What are the Bradford Hills Criteria for Causality

A 
Strength
Consistency
Specificity
Temporality
Biological gradient
Plausibility
Coherence
Experiment
27
Q

what does chi squared test

A

Assesses association between two categorical variables

How likely the observation is due to chance between two categorical (continuous) non parametric (doesn’t fit a known distribution) data sets.

28
Q

what does fishers exact test test

A

The small sample size chi squared

Assesses association between two categorical variables

29
Q

what does a Mann Whitney U test do

A

compares the difference between two independent groups with continuous data which is non-parametric

30
Q

what does a Wilcoxon test do

A

compares two related samples to check if they are statistically different to each other
Non parametric

31
Q

what does an unpaired T test do

A

compares the mean between two UNRELATED groups

32
Q

what does a paired T test do

A

compares the same group under two scenarios

33
Q

What is type 1 error

A

chance of rejecting the null hypothesis if it were true (false positive)

34
Q

What is a type 2 error

A

change of accepting the null hypothesis if it were false (false positive)

35
Q

What does a P value look at

A

The probability of observing the data by chance (sometimes known as alpha, usually <0.05 is significant)

36
Q

What does a P value of 0.05 mean

A

that the result is 95% not due to chance

37
Q

What is the typical value power (beta) is set to?

A

80-90%

MFSRH 2021 (13 decks)

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