The Use of Data (2nd year)

Question 1

what is the difference between disease and illness?

Answer 1

disease is the signs, s symptoms and diagnosis - the biomedical perspective
the illness is the ideas, concerns and expectations, the patients experience

Question 2

give an example of a disease with no illness.

Answer 2

hypertension

the patient has a high blood pressure but they feel no symptoms

Question 3

why does the hierarchal structure of primary-secondary-tertiary care sometimes not correlate to the severity ?

Answer 3

because disease and illness don’t always correlate.
someone may have a severe disease that they are in secondary care for however it is not a severe illness as it doesn’t really affect their life

whereas someone with a long term illness which severely impacts on their lives are just treated in primary care

Question 4

you have recent diagnosed someone with AF and you arrange a review consult.

what might you want to cover in the consultation?

Answer 4

any other symptoms he is having

may want to perform a few other tests such as clotting screen to assess risk of PE

Question 5

you have recent diagnosed someone with AF and you arrange a review consult.

what issues might you want to bring up?

Answer 5

potential treatment/medication
any worries he has about taking the medication forever
the change in life style he may want to address

Question 6

you have recently diagnosed someone with AF and you arrange a review consult.

what issues might the patient bring up?

Answer 6

his worries about taking medication

worries about taking it forever - side effects, addiction etc

Question 7

you have recently diagnosed someone with AF and you arrange a review consult.

what tools might you use to assist you?

Answer 7

be positive but honest (fine balance)
suggest information such as leaflets, websites etc
practise nurses for backing up and reinforcing things for the patient

Question 8

what are the 3 main aims for epidemiology?

Answer 8

description - amount and distribution of disease in populations

explanation - natural history, identify etiological factors for disease

disease control - basis for preventative measures, public health practises etc monitored for disease control

Question 9

epidemiology compares groups in order to detect differences in order to …..

Answer 9

determine what causes the disease
who are at risk
how to prevent it

Question 10

does minor illnesses have a high or low prevalence?

Answer 10

high incidence

low prevalence

Question 11

what is relative risk?

Answer 11

the measure of strength of an association between a suspected risk factor and the disease that is under study

Question 12

how do we calculate relative risk?

Answer 12

incidence of disease in an exposed group / incidence of disease in unexpected group

Question 13

where would you find epidemiological data? (sources of epidemiological data)

Answer 13

mortality data
hospital activity statistics
reproductive health statistics
cancer statistics
accident statistics
general practise morbidity
health and household surveys
social security statistics
drug misuse databases
expenditure data from NHS

Question 14

what is health literacy?

Answer 14

health literacy is about having the knowledge, skills, understanding and confidence to use health information, to be active partners in their care and to navigate health and social care system

Question 15

what is the literacy action plan for scotland that was introduced?

Answer 15

making it easy

Question 16

what is the purpose of the SIGN guidelines?

Answer 16

help health and social care professionals and patients to understand medical evidence and use it to make decisions about care

reduce unwanted variations in practise and make sure patient get the best care available no matter where they live

improve health care across scotland by focussing on patient-important outcomes

Question 17

what are the 4 different types of studies?

Answer 17

descriptive study
cross-sectional study
case control study
cohort study

Question 18

what are trials used for?

Answer 18

used to test ideas about aetiology or to evaluate interventions

Question 19

what type of trial is the definitive method of assessing any new treatment in medicine?

Answer 19

randomised control trial

Question 20

what type of studies may be useful in primary care?

Answer 20

descriptive studies
case control studies
cohort studies

Question 21

what type of studies may be useful in secondary care?

Answer 21

case control study

trials

Question 22

what is a case control study?

Answer 22

2 groups of individuals are compared
one with the disease and one without
data is gathered on each individual to determine whether or not they have been exposed to the suspected etiological factor
exposure between two groups is compared to determine significant differences

Question 23

what is a cohort study?

Answer 23

baseline data on exposure are collected rom a group of people who don’t have the disease
they are followed up until a significant number have developed the disease to allow analysis

Question 24

what factors have to be considered when carrying out a study?

Answer 24

standardisation
standardised mortality ratio
quality of data
case definition
coding and classification
ascertainment

Question 25

what is bias?

Answer 25

any trend in the collection, analysis, interpretation or review of data that lead to conclusions that are systematically different from the truth

Question 26

what are the different types of bias?

Answer 26

selection bias
information bias
follow up bias
systematic error

Question 27

what are confounding factors?

Answer 27

a factor which is associated independently with both the disease and with the exposure under investigation and so distorts the relationship between exposure and disease

Question 28

what are the most common confounding factors?

Answer 28

age
sex
social class

Question 29

what are ways to deal with confounding factors?

Answer 29

randomisation in trails

eligibility criteria so only certain kinds of study subjects can participate

subjects in different groups can be matched for likely confounding factor

results can be stratified according to confounding factor

results can be adjusted to take account of suspected confounding factors

Question 30

what are the criteria for causality?

Answer 30

strength of association
consistency
specificity
temporality
biological gradient
biological plausibility 
coherence
analogy
experiment

Question 31

what is the importance of data for patients?

Answer 31

when a doctor is explaining something to a patient i.e. blood pressure being too high, we need to be explain tot he patient why it is abnormal to be high as well as give evidence which supports what we are saying i.e. from studies
data is required to back up a doctors need for treating something as to why it is abnormal