The Use of Data

Question 1

What is the WHO definition of health?

Answer 1

A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Question 2

What are some factors which may affect the uptake of care?

Answer 2

1. Lay referral “granny knows best”
2. Sources of info i.e. peers, family, TV or internet
3. Medical factors i.e. new symptoms, visible symptoms or increasing severity
4. Non-medical factors i.e. crisis, peer pressure, patient’s beliefs, social class, age, culture and gender.

Question 3

What may be some of the issues from the patient’s point of view when being told they have to start medication for AF for example ?

Answer 3

1. The patient may believe themselves to be healthy.
2. They may be physically fit.
3. If treatment was proposed how would they feel better?

Question 4

What may be some of the issues from the GP’s point of view when diagnosing and treating a patient?

Answer 4

1. Performing tests i.e. ECG

2. Worried about the patient’s long term health.

Question 5

What are the 3 main aims when providing information to a patient ?

Answer 5

Description
Explanation
Disease control

Question 6

What is epidemiology ?

Answer 6

The comparison of groups in order to detect differences which point to:

1. Aetiological clues (what causes the problem)
2. The scope of prevention
3. The identification of high risk or priority groups in society

Question 7

What is relative risk?

Answer 7

The measure of the strength of an association between a suspected risk factor and the disease under study.

RR = Incidence of disease in exposed group/ Incidence of disease in unexposed group

Question 8

What is the purpose of health literacy ?

Answer 8

It is about people having the knowledge, skills, understanding and confidence to use health information to be an active partner in their care and to navigate health and social care systems.

Question 9

What is the CHADS2 score ?

Answer 9

Clinical prediction rules for estimating the risk of stroke in patients with non-rheumatic AF

Question 10

What are NOACs ?

Answer 10

New drugs which do not require regular blood monitoring like Warfarin.

Are not easily reversed like warfarin.

Question 11

What is the HAS-BLED score?

Answer 11

A tool which is used to calculate the risk of bleeding in an individual who is on warfarin.

Question 12

What is a descriptive study?

Answer 12

A study which attempts to describe the amount and distribution of a disease in a given population.

Does not provide definitive conclusions about disease causation but may give clues to possible risk factors and candidate etiologies.

Question 13

What type of study is a cross-sectional study and what is its purpose?

Answer 13

Analytic study which observes a single point in time

Question 14

What type of study is a case control study and what is its purpose?

Answer 14

Analytic study in which 2 groups of people are compared:

1. A group of individuals who have the disease of interest are identified (cases)
2. A group pf individuals who do not have the disease (controls)

They compare these 2 groups and look at both of their previous exposures.

Question 15

What type of study is a cohort study and what is its purpose?

Answer 15

Analytic study.

In cohort studies, baseline data on exposure are collected from a group of people who do not have the disease under study.

The group is then followed through time until a sufficient number have developed the disease to allow analysis .

There will be an exposed and non-exposed group who will be compared with each other. There will be diseased and not diseased groups from each group.

Question 16

What is a trial ?

Answer 16

Experiments used to test ideas about etiology or to evaluate interventions.

Done often through a randomized control trial (RCT)

Question 17

When interpreting results from a study what are some factors which we should consider?

Answer 17

Standardization 
Standard Mortality ratio
Quality of data
Case definitions
Coding and classification
Ascertainment

Question 18

What is Bias ?

Answer 18

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

Question 19

Name 4 types of bias

Answer 19

Selection bias
Information bias
Follow-up bias
Systematic bias

Question 20

What is the criteria for causality ?

Answer 20

Its difficult to prove causation between exposure and a disease.

Often the best that is achieved is to demonstrate a weight of evidence in favor of a casual relationship.

A number of criteria have been devised to help investigators assess the available evidence known as the criteria for causality.

Question 21

If you were to carry out an audit what would be the steps?

Answer 21

Know what you wish to assess.
Audit criteria and standards (own or outside standards).
Try the audit.
Results.
Intervention before repeat audit.
Limitations of the audit.