module 2 Flashcards

1
Q

what do we mean when we ask if the diagnostic tests are accurate

A

does the diagnostic test provide sufficient information to reliably distinguish individuals with or without the condition of interest

how much does the probablity change pre and post test

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2
Q

are diagnostic clinical test ever 100% accurate

A

no

  • there is alway a chance of false negatives and positives
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3
Q

what does sensitivity address

A

how good in the test ID people with the disease

snOUT - rule out

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4
Q

what does specificity addres

A

how good is the test at ID without the disease

spIN

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5
Q

what does the positive predictor rule address

A

if a person test positive - what is the probability that they have the condition

ID those who have the disease amongst those who tested positive

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6
Q

what does the negative predictor rule address

A

if a person test neg, what is the prob that they do not have the condition

ID those who do not have the disease among those who have a neg test result

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7
Q

positive LR addresses

A

how much more likely is a positive test found in someone with the disease than in someone without it

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8
Q

negative LR addresses

A

how much more likely is a neg found in someone without the disease compare to someone who has it

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9
Q

is sensitivity a true positive or true negative rate

A

true positive

test with high sensitivity have few false negatives

therefore neg result rule out the condition

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10
Q

is specificity a true positive or true negative rate

A

true negative

have few false positives so if you have a positive it rules in the conditions

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11
Q

false positives impact spin or snout

A

spin

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12
Q

false negative impact spin or snout

A

snout

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13
Q

what is the difference between sn/sp and PPV/NPV - sn/sp

A

calculated from those who have the disease and those who do not

stable regardless of the disease prevelence in different populations

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14
Q

what is the difference between sn/sp and PPV/NPV - PPV/NPV

A

calculated from those who are positive and those who are negative

influence by disease prevelance

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15
Q

pre test and post test sn/sp

A

sn/sp do not provide us information on shift from pre and post test

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16
Q

LR and pre and post test

A

these can tell about the shift pre and post test

qualifies the shift from pre and post test

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17
Q

what does LR examine

A

how likely the disease is given a positive or negative test result

18
Q

postive LR - what does it tell us

A

given a positive test, are the odds the odds of having the condition larger

expresses the change in odds favoring the condition during a positive test

19
Q

negative LR - what does it tell us

A

express the changes in odds favoring the codition given a neg result

given a neg result, are the odds of the condition smaller

20
Q

what is pre test probality

A

what we know before applying the diagnostic test

clinician best guess

21
Q

post test probability

A

what we know after applying the DTI

can be quatified by using LR

22
Q

large positive LR indicates what

A

the condition is more likely

23
Q

small negative LR indicates what

A

the condition is less likely

24
Q

high specificity and +LR

A

larger + LR

due to the low false positive rate

25
Q

high sensitivity and -LR

A

small -LR rate

due to low false negative

26
Q

how can we tell the precision of the diagnostic accuracy esitmates

A

CI
- do not want to cross 0

27
Q

if you have a larger CI is your information precise

A

no

28
Q

over all what is the reason why we use LR

A

show the change in probability pre and post test

29
Q

how do you know if a diagnostic test is reliable, accurate, and precise

A

is the test reproducible - good intra and inter rater reliablity

how accurate is the test (sn, sp, LR)

30
Q

Intrarater reliability

A

how consistent an individual is at measuring a constant phenomenon

31
Q

interrater reliability

A

how consistent different individuals are at measuring the same phenomenon

32
Q

what % of sp or sn is good

A

80

33
Q

sp + sn test to avoid

A

do not equal at least 100

34
Q

what is youdans index

A

showing the diagnostic perfromance of a test
sn + sp - 1 >.5 (ideally 1)

35
Q

what is a reciever operant curve

A

used when there is an overlap between those with or without a presentation

graphic method to calculate sn and sp when a range of test scores are bing considered

36
Q

what is an ROC used for

A

determine the optimal cut value between healthy and disease states

determine the MCID

37
Q

what is plotted on ROC’s

A

true positive rate vs false positive rate

38
Q

where is the optimal threshold value found in ROC

A

in the point closest to the upper left corner

39
Q

what does the area under thee curve depend on

A

the true positive rate

40
Q

a large area under the curve tells us what

A

better diagnostic accuracy

41
Q

what happens if the AUC is a flat line

A

this is a worthless test
AUC = .5