Stats/research/commissioning/audit/appraisal/revalidation Flashcards
What is sensitivity?
proportion of people who test positive among all those who actually have the disease (SNOUT rules out)
What is specificity?
proportion of people who test negative among all those who actually do not have that disease. (SPIN rules in)
How is sensitivity calculated?
True Pos/(true pos+false neg)
How is specificity calculated?
True neg/(true neg+false pos)
What is PPV?
the probability that following a positive test result, that individual will truly have that specific disease.
How is PPV calculated?
True pos/(true pos + false pos)
What is NPV?
probability that following a negative test result, that individual will truly not have that specific disease.
How is NVP calculated?
True neg/(true neg + false neg)
What type of study is one with individual data and an intervention?
RCT
What type of study is one with individual data and an observation with NO comparison group?
Case series
What does a cohort study ask?
What will happen, compares 2 groups with and without exposure to see if exposure increased chances of disease, Measures relative risk
What does a cross sectional study ask?
What is happening. Frequency of disease and risks at the same time. A snap snot in time.
What does a case control study ask?
What happened. Compares group with a disease to one without and looks for prior exposure/risk factor.
In the commissioning of sexual health care what is the CCG responsible for
Vasectomy
ToP
Non-sexual health psychosexual counselling
Gynae
In the commissioning of sexual health care what is NHS England responsible for
HIV care GP contraception and STI testing Prison sexual health Cx screening SARC Foetal medicine
In the commissioning of sexual health care what is the local authority responsible for
Contraception
STI tx and care
sexual health psychosexual medicine
Specialist sexual health services (YP/outreach/promotion)
What are the 6 NICE quality standards for sexual health
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
10 stnadards of care outlines by DoH for sexual health
- sexual health networks
- promoting sexual health
- empowering and involving service users
- identifying sexual health needs
- access to services
- detecting and tx STIs
- contraception advice and provision
- Pregnancy testing and support
- 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
What is clinical audit
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”.
what is quality improvement
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.
what is clinical appraisal and how often should it take place for a doctor
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
what is revalidation and it’s purpose and how often should it take place for a doctor
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
how does revalidation work
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.
The 4 components of a sample size justification/calculation (power calculation)
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
