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3 EBP > Prognostic Studies > Flashcards

Prognostic Studies Flashcards

1
Q

Area under the curve

A

measure of the accuracy of a quantitative diagnostic test

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2
Q

ROC Curves Axis

A

Y = true positive
X = false positive

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3
Q

ROC Curve

A

a plot of sensitivity against 1=specificity, used to determine the most effective cut-off score to make a diagnosis/prognosis

defines cutoff scores, helps predict the outcome of interest

the more area under the curve, the better it is at predicting the outcome of interest

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4
Q

What is the significance of RR/OR?

A

RR and OR are estimates and are subject to error

you need to have a p value or confidence interval to determine that the result is not due to chance

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5
Q

Odds Ratio

A

proportion of participants who have the outcome of interest compared to the proportion of participants who do not have the outcome of interest

comparing columns

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6
Q

Relative Risk

A

proportion of participants who have the risk factor and the outcome compared to the proportion of participants without the risk factor who have the outcome

comparing rows

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7
Q

Relative Risk ratio calculation

A

(Outcome +, Risk factor +)/ (Outcome +, Risk factor +) PLUS (outcome -, risk factor +)

DIVIDED BY

(outcome +, risk factor -)/(outcome +, risk factor -) PLUS (outcome -, risk factor -)

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8
Q

Clinical Significance

A

<1 = decreased risk or odds of developing outcome

(>) 1 = increased risk or odds of developing outcome

= 1, 50/50 chance

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9
Q

Risk Ratio

A

predicts the probability of an outcome when a risk factor is present vs not present

used in longitudinal cohort studies

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10
Q

Logistic Regression

A

used to predict a categorical outcome variable

Ex: fall vs no fall, discharge vs no discharge

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11
Q

Multiple Regression

A

used when there are multiple variables contributing to an outcome variable or when the outcome is a continuous variable

uses a weighting process

y=a+bx1+bx2+bx3…

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12
Q

B is equivalent to

A

slope of the line
regression coefficient

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13
Q

A is equivalent to

A

intercept of the regression line at y
also known as a regression constant

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14
Q

Y is equivalent to

A

outcome of interest or the value you are trying to predict

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15
Q

Simple Linear Regression

A

exam of two variables that are linearly related to determine how well a variable predicts (x) an outcome (y) variable

can be positive or negative
y = a+bx

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16
Q

Standard error of the estimate

A

represents the average error of prediction for the regression equation

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17
Q

Confidence Intervals

A

provides info about the accuracy of the prediction

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18
Q

P-value

A

estimates the probability that chance contributed to the prognostic equation

does not indicate clinical meaningfulness

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19
Q

r²

A

coefficient of determination

represents the robustness of the regression model

proportion of variance that is shared by two variables

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20
Q

Regression

A

Used to make predictions from one or more variables about the outcome of interest

uses a regression analysis to find the line of best fit to predict the outcome variable

the closer R2 is to 1, the more robust the prediction

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21
Q

Correlation can be useful for

A

developing prediction or prognostic models

22
Q

Correlation does not equal

A

causation

23
Q

Very high correlation

A

.9 - 1.0

24
Q

High correlation

A

.7 - .89

25
Q

Moderate correlation

A

.5 to .69

26
Q

Low correlation

A

.26 to.49

27
Q

Little or no correlation

A

0 to .25

28
Q

Negative correlation

A

as one variable increases, the other decreases

29
Q

Positive correlation

A

as one variable increases, so does the other

30
Q

Correlation

A

a measure of the extent to which two variables are associated. calculated as a correlation coefficient

can either be positive or negative

31
Q

Interpret the results of prognostic study

A

what statistics were used to determine the prognostic statements?

Were the stats appropriate (correlation/regression)?

32
Q

Study Process

A

Were evaluators masked/blinded to reduce bias?

Was the study time frame long enough for the participants to experience the outcome of interest?

Was the monitoring process appropriate?

Were all participants followed to the end of the study?

33
Q

Outcome measures and factors associated w/these measures

A

Were end points clearly defined?

Are the factors associated with the outcome well justified in terms of the potential for their contribution to prediction of the outcome?

should be systematic, precise, relevance, defined, reliable, valid

34
Q

Determining quality of prognostic study

A

study design
study sample
outcome measures and factors associated w/measures
study process

35
Q

Is there a defined, representative sample of pts assembled at a common point that is relevant to the study question?

A

Were they randomized into groups vs part of a cohort or case-control group?

Were they assembled at a common point?

Are there enough pts?

Study participants must not already have the study outcome

36
Q

Types of prognostic studies

A

Cohort
Case Control
Cross-Sectional

37
Q

Classification measures

A

sensitivity
specificity
predictive values

clinicians need to verify the chosen thresholds is relevant for their pt

38
Q

Discrimination is the same as

A

accuracy

39
Q

Calibration is the same as

A

reliability

40
Q

Performance measures

A

Prognostic Models must demonstrate: Calibration, Discrimination

without these, model may be inaccurate and can mislead decision-making of PT

41
Q

Clinical Decision Rules

A

suggest a course of action

treatment-effect modifiers are used to build a CDR

guides clinicians in their decision-making and care pathways by predicting treatment response

represented as regression/classification tree, score chart rules, or survival groups/meta-models

42
Q

Clinical Prediction Rules

A

estimates the probability of future outcomes

prognostic factors help to build it

should be consistent to be helpful

presented as regression formula/calculator, nomogram or table/score chart

43
Q

Treatment-Effect Modifiers

A

Characteristics that predict a pt’s response to a treatment

influence the relationship between an intervention and an outcome

used to create clinical decision rules

44
Q

Prognostic factors

A

characteristics found in individuals with a disease

can influence the course of the disease

used to create clinical prediction rules

45
Q

Risk Factors

A

characteristics found in individuals that are healthy

factors that increase the risk of developing a health condition

important to PTs who have an interest in prevention

46
Q

Dimensions of Prognosis

A

Risk Factors
Prognostic Factors
Treatment-effect modifiers

47
Q

Why is it beneficial to target prognostic factors?

A

improve treatment decision-making process

personalize rehab approaches

enhance pt outcomes

help better align clinical practice with value-based care principles

48
Q

Contemporary view of prognosis

A

prognostic-related findings must inform clinical decision making to enhance patient health outcome

49
Q

Traditional prognosis method

A

prognosis is driven by pathoanatomical diagnosis to guide treatment and guide prognosis. has variable outcomes

50
Q

Prognosis definition

A

predicting which patient will have the best outcome or respond to a particular treatment

traditional and contemporary views

3 EBP (10 decks)

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