module 1 Flashcards

1
Q

what is diagnosis

A

a process where patient data is collected and elevated to determine prgnosis and possible interventions

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2
Q

what is the purpose of diagnosis

A

to increase the certity of making a diagnosis beyound the threshold of clinical desion

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3
Q

in PT what can diagnosis do

A

steer an examination toward specific body region/system

rule out red flags that require refferals

assist in classifiy a patient into a specific group

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4
Q

why are diagnostic tests helpful for clincians

A

ID the accuracy of commonly used tests

ID other properties of diagnostic tests -reliablity, acceptablity, and feasiblity in the clinic

ID other tests

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5
Q

what is the first step in the EBP progress

A

ask

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6
Q

PICOT - I diagnostic

A

diagnostic test

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7
Q

PICOT - C diagnostic

A

goals standard, or another diagnostic test

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8
Q

PICOT - O diagnostic

A

the condition of interest

shoulder pain

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9
Q

PICOT - T diagnostic

A

time frame

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10
Q

what is a cross sectional study

A

a type of research design in which you collect data from many different individuals at a single point in time

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11
Q

what is a longitudinal study

A

A longitudinal study is a research design that involves repeated observations of the same variables over long periods of time.

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12
Q

what is the optimal study design for diagnostic studies

A

prospective blind comparison

gold standard vs diagnostic test

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13
Q

Is cross section study or long better for diagnostic studies

A

cross sectional studies

looking at the diagnostic accuracy of the test

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14
Q

Hierarchy of evidence for diagnostic evidence

A
  1. systematic review, meta analysis
  2. cross sectional - reference, blinding
  3. cross sectional - inconsistance reference, no blinding
  4. case control
  5. opinion based, mech-based reason
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15
Q

what is a case control study

A

group of cases, which are the individuals who have the outcome of interest.
construct a second group of individuals called the controls, who are similar to the case individuals but do not have the outcome of interest.

The researcher then looks at historical factors to identify if some exposure(s) is/are found more commonly in the cases than the controls.

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16
Q

what is a prospective study

A

A prospective study watches for outcomes, such as the development of a disease, during the study period and relates this to other factors such as suspected risk or protection factor(s)

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17
Q

what is a retrospective study

A

ooks backwards and examines exposures to suspected risk or protection factors in relation to an outcome that is established at the start of the study

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18
Q

what does the STARD checklist cover

A

title, absract, keywords

intro

methods

result

discussion

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19
Q

what does the STARD check list look at

A

used by author/researchers publishing a study on the diagnostic accuracy of a test

20
Q

what are common threats to validity seen in studies of diagnostics

A

bad or wrong gold standard

spectrum or selection bias

lack of rater blinding

lack of operation def neg and positive results

absent intermediate test finding

21
Q

what is selection bias

A

study sample is not representative of the population being studied

22
Q

what is a rater

A

assess the symptoms, signs, and outcomes of clinical trial participants using standardized assessment tools

23
Q

in order for research to be valid what has to be said about the diagnostic test

A

the test was described clearly

reliablity of the test stated

24
Q

in order for research to be valid what has to be said about the gold standard

A

the diagnostic test of interest (DTI) has to be compared to it

gold standard and DTI has to be performed and interpreted independently

both test applied in a appropriate time frame

25
Q

in order for research to be valid what has to be done at the conclusion

A

the results have to be comfirmed in a new set of subjects

26
Q

test subject and validity

A

have to make sure that the test subjects are representative of those the test would be applied to

commonly confused diagnosis
typical clinical presentation
mild to serve symptoms

27
Q

what happens if the study includes only patient with obvious presentations of the disease

A

this can inflate to the diagnostic capacities of the test

28
Q

when does selection bias occur

A

studies with narrow edibility criteria

retrospective study design

during recruitment

29
Q

what can occur during recruitment to cause selection bias

A

recruiting from a single location

recruiting from a location where the prevalence of the disease is higher

recruitment of a connivence sample - not random or consecutive

30
Q

what is spectrum bias

A

it is a type of selection bias

recruiting only pt who have severe symptoms or classic presentation

31
Q

when does spectrum bias occur

A

the same time as selection bias

32
Q

why should the diagnositc be defined in the paper

A

to allow the test to be replicated

33
Q

what must be included in the definition of the diagnostic test

A

the reliability and validity of the test

+/- results

34
Q

what is a gold or reference standard

A

this is a measure or test that is assumed to correctly ID the presence of absence of a disease 100% of the time

35
Q

what are the characteristic of a gold standard

A

acceptable in clinical practice

evidence of its validity, reliability, and accuracy

impractical for routine use

may be expensive or invasive

36
Q

what must be included with the gold standard in the paper

A

references to support the tests

37
Q

results of the gold standard and the DTI and rater

A

the results of the gold standard should not be known to those who interpret the DTI

evaluaters of the DTI should be blinded to the results of the gold standard

38
Q

in what circumstance would the gold standard not be tested on everyone

A

there is no circumstance

it has to be tested on everyone

39
Q

what happen when a gold standard cannot be applied to a pt - risk

A

another reference test that has similar validity can be applied

40
Q

what time frame must a gold standard and DTI be applied

A

in a reasonable time frame where changes in the patient health status are not expected

too much difference in timing of test my lead to inaccuracy

41
Q

why must the result be confirmed on a new set of subjects

A

results may be due to unique characteristics of subject pop

42
Q

what does the rep of a test on a new set of subjects tell us

A

tells us about the generalizability and test consistency

43
Q

what is a clinical measure

A

tell you about a individuals state of function or impairment

scores on these tests can tell us the severity of the problem

44
Q

what is a diagnostic test

A

detects the presence or absence

45
Q

example of clinical measure

A

TUG

5 STS

10 MWT