(M) Analytic - Epidemiologic Approach Flashcards

1
Q

Event of interest

disease or death

A

Outcome

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2
Q

should proceed before the outcome

A

Exposure

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3
Q

Health-related event of interest

A

Outcome

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4
Q

death, disease condition like AIDS

A

Outcome

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5
Q

when someone got pregnant, whats the outcome and determine exposure

A

Exposure - tite, and fertilization of sperm with egg cell
outcome - blessing

blessing - anak

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6
Q

Having, or being exposed to, a potential cause or risk factor for disease or other outcome

A

Exposed

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7
Q

being a smoker or having sex with someone who has an STI

A

Exposed

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8
Q

Not having, not being exposed to, a potential cause or risk factor for disease or other outcome

A

Unexposed

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9
Q

Individuals that are disease positive

A

Cases

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10
Q

Individuals that are disease negative

A

Controls

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11
Q

Test the hypothesis of relationship between at minimum, two variables

A

Analytic Studies

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12
Q

what are the 2 variable that concerns with ANALYTIC studies

A
  • one independent variable (exposure)
  • one dependent variable (disease)
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13
Q

Analyitc studies - T or F

There is a comparison between comparator group (exposed and unexposed; positive and negative etc..)

A

T

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14
Q

Determine the factor, and outcome

Hypothesis – Is smoking related to hypertension?

A
  • Factor – Smoking
  • Outcome – Hypertension
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15
Q

in cross sectional what comes first. population or selected sample

A

Population

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16
Q

Cross-sectional

other name for it

A

Prevalence study

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17
Q

cross - sectional

Exposure and Outcome are measured at

A

One-point in time

sabay

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18
Q
A
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19
Q

Cross-sectional

if one point at a time, what will be the weakness?

A

Exposure should come first before outcome

– which means we cannot actually determine which came first

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20
Q

Cross-sectional

what are the categories?

A
  • With Exposure, With Outcome
  • With Exposure, Without outcome
  • Without Exposure, With outcome
  • Without Exposure, Without Outcome
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21
Q

Uses of Cross-sectional Study - T or F

Estimate burden of disease (prevalence)

A

T

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22
Q

Uses of Cross-sectional Study - T or F

Establish baseline data

A

T

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23
Q

Uses of Cross-sectional Study - T or F

Determine association between non-existing variables

A

F

Coexisting Variables

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24
Q

Cross-sectional

What are the 2 analysis

A
  • Measures of Disease Occurence
  • Measure of Association
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25
Q

Cross-sectional: Analysis

under measures of disease occurrence

A
  • Prevalence in the population
  • Prevalence among exposed
  • Prevalence among unexposed
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26
Q

Cross-sectional: Analysis

under measure of association

A

Prevalence ratio

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27
Q

Advantages of cross-sectional studies

A
  • Resource-eficient
  • Does not suffer from attrition
  • Generalizable
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28
Q

Disadvantages of cross-sectional studies

A

Difficult to establish causality

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29
Q

why is it hard to establish causilty using cross-sectional?

A

Temporal ambiguity between exposure and outcome: Which came first?

temporal ambiguity is also a concern for ecological studies

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30
Q
A
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31
Q

if u see this card

A

go over the formula for prevalence proportion and Prevalence ratio

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32
Q

PR = 1

A

Exposure is not associated with the outcome

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33
Q

Numerator = Denominator

A

The ratio = 1, no relationship.

no relationship with exposure and outcome

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34
Q

PR < 1

A

Exposure variable negatively associated with the outcome

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35
Q

Unexposed > Exposed

A

The ratio: < 1

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36
Q

the exposure variable is protective of the disease

A

Unexposed > Exposed; The ratio = < 1

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37
Q

PR > 1

A

Exposure variable positively associated with the outcome

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38
Q

Exposed > unexposed

A

The ratio: > 1

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39
Q

prevalence of the disease is higher among the exposed than among the unexposed

A

the ratio is > 1

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40
Q

T or F

The exposure variable is a risk factor to the disease

A

True

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41
Q

what is the PRINCIPLE in a cohort study?

A

Exposure First, then A follow up
- the follow up is to know if there is a CONCERNED OUTCOME

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42
Q

This approach is suitable in determining the influence of a particular risk factor in the causation of an event, such as a particular disease.

A

Cohort Study

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43
Q

Begins with the identification/selection of a group exposed to a risk factor, and a comparable group not exposed.

A

Cohort Study

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44
Q

In cohort study Both groups are then observed if they will develop the ?

A

sickness

if mag kaka cancer sila or what disease they were exposed to

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45
Q

what should be the characteristic of the group in a cohort study?

A

Distinct set of characteristics; secondary to:
* Common setting
* Common experience

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46
Q

Refers to the secular change of disease frequency in a group as influenced by membership in that particular group.

A

Cohort Effect

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47
Q

Exposure is measured at the present time and the participants are followed up to measure Outcome at a future time

A

Cohort Study

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48
Q

other names for cohort study

A
  • Follow Up Study
  • Longitudinal Study
  • Incidence Study (something new; positive sa disease)
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49
Q

Types of Cohort Study

A
  • Prospective/concurrent
  • Retrospective/non-concurrent
  • Ambispectibe
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50
Q

Types of cohort

starts at the beginning

A

Prospective/concurrent

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51
Q

Types of cohort

starts at the end(future) of the study

A

Retrospective/non-concurrent

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52
Q

Types of Cohort

mixed of both

A

Ambispective

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53
Q

Uses of Cohort Study - T or F

Calculate risk of developing disease

A

T

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54
Q

Uses of Cohort Study - T or F

Establish the temporal relationship between study variables

A

T

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55
Q

Uses of Cohort Study - T or F

Expedient in examining single outcomes

A

F - MULTIPLE

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56
Q

Uses of Cohort Study - T or F

Practical in studying rare exposures

A

T

Cause there is already a established person with the disease, just need to retrospective the exposure and not randomly try to guess which exposure lead to the outcome

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57
Q

Cohort Study: Analysis

what are measures under this?

A
  • Measures of Disease Occurrence
  • Measures of Association
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58
Q

Cohort Study

under the measure of disease occurrence

A
  • Incidence Proportions
  • Incidence Rates
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59
Q

Cohort Study

under measures of association

A
  • Risk Ratio
  • Rate Ratio
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60
Q

Advantages of Cohort Study

A
  • More likely to determine causality (as compared to a cross-sectional study)
  • Followed the natural history of disease
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61
Q

At the start, those with the outcome of interest should be excluded.

A

Cohort Study

If they have sickness, out na sa study

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62
Q

Disadvantages of Cohort Study

A
  • Resource-intensive
  • Sufferes from attrition
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63
Q

If u see this card

A

Go over the formula for incidence proportion and Incidence Rate

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64
Q

Cohort Study

  • Describes the average risk for developing a disease condition
  • More useful in determining etiologic/risk factors of diseases more than prevalence proportion
A

Incidence proportion

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65
Q

Cohort Study

  • Describes the speed at which new cases occur
  • “Time at risk”
A

Incidence Rate

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66
Q

period or duration at which each person is vulnerable (“at risk”) of developing the disease

A

“Time at risk”

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67
Q

Relative Risk is also known as?

A
  • Risk Ratio
  • Rate Ration
    *
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68
Q

Cohort Study

if comparing incidence proportions

A

Risk Ratio

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69
Q

Cohort study

if comparing incidence rates

A

Rate Ratio

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70
Q

RR > 1

A

Exposure variables is a risk factor

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71
Q

shows an association

A

RR > 1

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72
Q

conclusion can be read “those with the exposure were more likely to develop disease.”

A

RR > 1

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73
Q

exposure variable is protective factor

A

RR < 1

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74
Q

T or F

OR is just an estimation of the RR.

OR = odd ratio

A

True

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75
Q

The RR is a more powerful effect measure than the?

A

OR (ODD RATIO)

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76
Q

if u see this card

A

Go over the example for RISK RATIO yung mahaba

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77
Q

A type of study that attempts to capture the advantages of both the cross-sectional study and the cohort study

A

Case-Control Study

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78
Q

It tries to eliminate the temporal ambiguity of the cross-sectional study while at the same time shortening the duration of the study

A

Case-Control Study

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79
Q

Outcome is measured at the present time and Exposure of the participants in the past is estimated

A

Case-Control Study

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80
Q

Case Contol

1st step process

A

We select the cases from a target population.

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81
Q

Case Control Study

3rd Step

A

Then select another group of individuals without the outcome or disease as Controls

ex. Women without breast cancer of the reproductive age group

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82
Q

Case Control Study

2nd Step

A

Cases are a group of individuals with the outcome or disease

ex. Women with breast cancer of the reproductive age group

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83
Q

Case-control Study

4th Step

A

Go back in time (retrospective) to determine exposure in the cases and in the control

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84
Q

Case-Control Study

5th Step

A

Compares the exposure status among the cases and among the controls

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85
Q

Uses of Case-Control Study - T or F

Determine association between variables

A

T

86
Q

Uses of Case-Control Study - T or F

Estimate ratio risk

A

F - Relative Risk

87
Q

Uses of Case-Control Study - T or F

Expedient in examining multiple exposures

A

T

88
Q

Uses of Case-Control Study - T or F

Practical in studying rare diseases

A

Because it already started with a case, which will not give a hard time to trace back

89
Q

if u see this card

A

go over the example for case-control study

90
Q

Case-Control Study: Analysis

what are the measures under this?

A
  • Measure of Exposure occurrence
  • Measure of Association
91
Q

why is there no measure of disease occurrence under case-control??

A

cannot compute for prevalence and incidence

92
Q

Case-control

Exposure Odds

A

Measure of Exposure Occurrence

93
Q

case-control

Odds Ratio

A

Measure of Association

94
Q

Advantages of case-control study

A

Less resource- intensive (as compared to a cohort study)
No attrition

95
Q

Advantages of case-control studyDisadvantages

A

Likely to suffer from problems with recall

96
Q

if u see this card

A

go over the formula for ODDS and EXPOSURE ODDS

97
Q

The ratio of two odds. The odds ratio calculated from a case-control study is the ratio of the odds of exposure among the cases to the odds of exposure among the controls.

A

Odds Ratio

98
Q

the conclusion is the “those with the disease are more likely to have the exposure”

A

OR > I

99
Q

Exposure variable is a risk factor

A

OR > I

100
Q

the exposure and disease are not associated.

A

OR = I

101
Q

Exposure variable has no effect on outcome

A

OR = I

102
Q

it can be said that the exposure has a protective effect against the disease

A

OR < I

103
Q

difference of odd ratio and risk ratio?

A

odd ratio is from case control, risk ratio is from cohort

104
Q

why odd ratio is not better than risk ratio?

A

it is just an estimation and RR talks more about LIKELINESS TO DEVELOP, whereas OR talks about EXPOSURE ALONE

105
Q

The previous approaches: Cross-sectional, Cohort and case control study are all approaches that just

A

OBSERVES DATA!

the data? NO MANIPULATION!

106
Q

OBSERVATIONAL ANALYTIC STUDIES

A
  • Cross-sectional
  • Cohort
  • case control study
107
Q

what is the main key of characterization for experimental study?

A

INTERVENTION! - there is an employent intervetion or manipulation

108
Q

Experimental study - T or F

Randomize into Test (Experimental) group and Control group

A

T

109
Q

Experimental study - T or F

Randomization ensures that both groups’ characteristics will become straight (the same), EXCEPT for the treatment

A

F - HOMOGENOUS

110
Q

A cohort study, only with assignment/manipulation of Experimental + Randomization/random allocation

A

Experimental Study

111
Q

Best study design for controlling confounders

A

Experimental Study

112
Q

Provide strongest causal inference

A

Experimental Study

113
Q

Limitation of experimental?

A

ethical issue!
But if solved, it will be the best design

114
Q

Random Allocation

A

Randomization

115
Q

Process of assigning each participant into a group—whether experimental or control—by chance

A

Randomization

116
Q

A defining feature of a modern trial design

A

Randomization

117
Q

Absence in an experimental study makes the study quasi-experimental in nature

A

Randomization

118
Q

please

A

study the process for randomization now na

119
Q

what are the classification of experimental Study

A
  • Clinical Trial
  • Community Trial
  • Therapeutic Trial
  • Prolyphlactive Trial
  • Parallel Design
  • Crossover Design
120
Q

Intervention is allocated to individuals

A

Clinical Trial

121
Q

Intervention is allocated to an entire community

A

Community Trial

122
Q

intervention is a treatment agent

A

Therapeutic Trial

123
Q

Intervention is a preventive agent

A

Prolyphlatctic Trial

124
Q

AKA. “between-subjects” design

A

Parallel Design

125
Q

AKA. “within-subjects” design

A

Crossover Design

126
Q

Initially 1 in control group and experimental group- wash out period will happen and there will be cross over of group

A

“within-subjects” design

Crossover Designq

127
Q

Experimental Study: Analysis

A
  • Measures Disease Occurrence
  • Measures of Association
128
Q

Experimental Study: Analysis

Incidence Proportions
Incidence Rates

A

Measures Disease Occurrence

129
Q

Experimental Study: Analysis

Risk Ratio
Rate Ratio

A

Measures of Association

130
Q

Disadvantage of Experimental study

A
  • Ethical Considerations
  • Resoure Intensive
131
Q

if u see this card

A

go over all of the formula for experimental study

132
Q

Experimental - Clinical

Number of events or Disease (risk) in the experimental group. (among the exposed)

A

Experimental Event Rate (EER)

133
Q

Experimental - Clinical

Number of events or Diseases (risk) in the control group

A

Control Event Rate (CER)

134
Q

Experimental - Clinical

ratio of the risk of the disease in the experimental group (EER) and the risk in the control group (CER).

A

Risk Ratio

135
Q

Experimental - Clinical

also called the Risk difference is the difference in the event rates for the EER and CER.

A

Absolute Risk Reduction (ARR)

136
Q

Experimental - Clinical

relative to those who are in the control group

A

Relative Risk Reduction (RRR)

137
Q

Experimental - Clinical

he number Of patients who would have to receive the treatment for one of them to benefit.

A

Numbers Needed to Treat (NNT)

138
Q

if u see this card please PLEASE

A

go over the intention to treat vs. per protocol analysis

diko sinama TOO MANY FUCKER

139
Q

“a review of the evidence on a clearly formulated question that uses systematic and explicit methods to identify, select and critically appraise relevant primary research, and to extract and analyze data from the studies that are included in the review.” The methods used must be reproducible and transparent.

A

Systematic Review

140
Q

A comprehensive review of all relevant studies on a particular clinical or health-related topic/question.

A

Systematic Review

141
Q

created after reviewing and combining all the information from both published and unpublished studies (focusing on clinical trials of similar treatments) and then summarizing the findings (STUDY OF OLD DATA)

A

Systematic Review

142
Q

what needs to be combined in a systematic review?

A

all the information from both published and unpublished studies

143
Q

Systematic Review - T or F

The scope of the review is identified in advance (eg review question and sub‐questions and/or sub‐group analysis to be undertaken)

A

T

144
Q

Systematic Review - T or F

Comprehensive search to find some relevant studies

A

F - ALL

145
Q

Systematic Review - T or F

Use of explicit criteria to include / exclude studies

A

T

146
Q

Systematic Review - T or F

Application of established standards to critically appraise study quality

A

T

147
Q

Systematic Review - T or F

Explicit methods of extracting and synthesizing study findings (qualitative or quantitative)

A

T

148
Q

Systematic Review - T or F

Need to include a meta-analysis (quantitative synthesis)

A

F - may only (optional baga)

149
Q

Uses or Limitation of Systematic Review

Identifies, appraises and synthesizes all available research that is relevant to a particular review question

A

Uses of Systematic Review

150
Q

Uses or Limitation of Systematic Review

Systematic reviews with narrowly defined review questions provide specific answers to specific questions

A

Limitation

151
Q

Uses or Limitation of Systematic Review

Alternative questions that have not been answered usually need to be reconstructed by the reader

A

Limitation

152
Q

Uses or Limitation of Systematic Review

Collates all that is known on a given topic and identifies the basis of that knowledge

A

Uses

153
Q

Uses or Limitation of Systematic Review

Comprehensive report using explicit processes so that rationale, assumptions and methods are open to scrutiny by external parties

A

Uses

154
Q

Uses or Limitation of Systematic Review

Can be replicated / updated

A

Uses

155
Q

Advantages of Systenatic Review - T or F

Exhaustive review of the current literature and other sources (unpublished studies, ongoing research)

A

T

156
Q

Advantages of Systenatic Review - T or F

more costly to review prior studies than to create a new study

A

F - less costly

157
Q

Advantages of Systenatic Review - T or F

Less time required than conducting a new study

A

T

158
Q

Advantages of Systenatic Review - T or F

Results can be generalized and extrapolated into the general population more broadly than individual studies

A

T

159
Q

Advantages of Systenatic Review - T or F

More reliable and accurate than ecological studies

A

F - individual studies

160
Q

Advantages of Systenatic Review - T or F

Considered an evidence-based resource

A

T

161
Q

Disadvantages of Systematic Review

A
  • Very time consuming
  • May not be easy to combine studies
162
Q

Design Pitfalls to Look Out For

Studies included in systematic reviews may be of varying study designs, but should collectively be studying the same outcome.

A

Is each study included in the review studying the same variables?

163
Q

Design Pitfalls to Look Out For

Some reviews may group and analyze studies by variables such as age and gender; factors that were not allocated to participants.

A

Do the analyses in the systematic review** fit the variables** being studied in the original studies?

164
Q

A subset of systematic reviews:

A

Meta-Analysis

165
Q

A method for systematically combining pertinent qualitative and quantitative study data from several selected studies to develop a single conclusion that has greater statistical power.

A

Meta-analysis

166
Q

This conclusion is statistically stronger than the analysis of any single study, due to increased numbers of subjects, greater diversity among subjects, or accumulated effects and results.

A

Meta-Analysis

167
Q

Meta-analysis provides a

A

logical framework to a research review

168
Q

provides a logical framework to a research review where similar measures from comparable studies are listed systematically and the available effect measures are combined wherever possible.

A

Meta-Analysis

169
Q

It reduces the quantity of data by summarizing data from multiple resources and helps to plan research as well as to frame guidelines.

A

Fundamental Rationale of META ANALYSIS

170
Q

t also helps to make efficient use of existing data, ensuring generalizability, helping to check consistency of relationships, explaining data inconsistency, and quantifies the data.

A

Fundamental Rationale of META ANALYSIS

171
Q

It helps to improve the precision in estimating the risk by using explicit methods.

A

Fundamental Rationale of META ANALYSIS

172
Q

Uses of Meta-Analysis - T or F

To establish statistical significance with studies that have conflicting results

A

T

173
Q

Uses of Meta-Analysis - T or F

The data is combined thats why it is much stronger

A

T

174
Q

Uses of Meta-Analysis - T or F

To develop a less correct estimate of effect magnitude

A

F - MORE CORRECT

175
Q

Uses of Meta-Analysis - T or F

To provide a more simple analysis of harms, safety data, and benefits

A

F - COMPLEX ANALYSIS

176
Q

Uses of Meta-Analysis - T or F

To examine subgroups with individual numbers that are not statistically significant

A

T

177
Q

Advantages or Disadvatanges (Meta-analysis)

Greater statistical power

A

Advantages

178
Q

Advantages or Disadvatanges (Meta-analysis)

Confirmatory data analysis

A

Advantages

179
Q

Advantages or Disadvatanges (Meta-analysis)

Difficult and time consuming to identify appropriate studies

A

Disadvantages

180
Q

Advantages or Disadvatanges (Meta-analysis)

Greater ability to extrapolate to general population affected

A

Advantages

181
Q

Advantages or Disadvatanges (Meta-analysis)

Not all studies provide adequate data for inclusion and analysis

A

Disadvantages

181
Q

Advantages or Disadvatanges (Meta-analysis)

Requires advanced statistical techniques

A

Disadvantages

182
Q

Advantages or Disadvatanges (Meta-analysis)

Heterogeneity of study populations

A

Disadvantages

183
Q

Advantages or Disadvatanges (Meta-analysis)

Considered an evidence-based resource

A

Advantages

184
Q

Design Pitfalls to Look Out For - Meta Analysis

The studies pooled for review should be similar in type (i.e. all randomized controlled trials).

A

Are the studies being reviewed all the same type of study or are they a mixture of different types?

185
Q

Design Pitfalls to Look Out For - Meta Analysis

The analysis should include published and unpublished results to avoid publication bias.

A

Does the meta-analysis include any appropriate relevant studies that may have had negative outcomes?

186
Q

refer to the entire process of collecting, reviewing, and presenting all available evidence

A

Systematic review

187
Q

refer to the statistical technique involved in extracting and combining data to produce a summary result.

A

Meta-analysis

188
Q

the goal is to produce SUMMARY RESULT

A

Meta-analysis

189
Q

Systematic Review vs Meta-Analysis

Statistical techniques employed

A

Meta-analysis

190
Q

Systematic Review vs Meta-Analysis

entire process of collecting, reviewing, and presenting all available evidence

A

Systematic Review

191
Q

gold standard for demonstrating causality between the use of a specific medicine and intended and unintended effects under ideal conditions.

A

Randomized Controlled Trials (RCTs)

192
Q

Limitations of RCT - T or F

Limited to evaluating specific interventions one by one

A

T

193
Q

Limitations of RCT - T or F

When selecting the patient sample according to strict inclusion and exclusion criteria, they have reduced external validity (or generalization), which maximizes the transfer of their results.

A

F - LIMITS the transfer

194
Q

Limitations of RCT - T or F

The highly selective populations examined within the setting of RCTs are often not comparable with the more heterogeneous populations in clinical practice.

A

T

195
Q

Limitations of RCT - T or F

Heterogeneous population in the real world setting

A

T

196
Q

Limitations of RCT - T or F

“Efficacy-effectiveness gap” (Eichleretal)

A

T

197
Q

disparity of findings on the therapeutic efficacy of medicines from tightly controlled RCT settings and the effectiveness of medicines in the real world.

A

“Efficacy-effectiveness gap” (Eichleretal)

198
Q

observational studies based on real data obtained from daily clinical practice.

A

real-world data (RWD)

199
Q

evidence obtained from real-world data (RWD)

A

Real world evidence (RWE)

200
Q

studies that collect data relevant to human health that do not come from conventional randomized clinical trials.

A

Real World Data

201
Q

RWD - T or F

They document the real care that patients receive in the clinic and include a variety of cases (for example, patients suffering from several diseases at once) without limiting strict inclusion and exclusion criteria.

A

True

202
Q

what is generated in RWD

A

long-term data – on the effectiveness and safety of health interventions

203
Q

RWD provides?

A

useful information for economic health analyses

204
Q

RWD and RWE provide

A

external validity that RCTs lack

205
Q

Advantages over RCTs of RWD - T or F

lower cost, larger sample size, and greater representativeness than other research designs, and high external validity.

A

T

206
Q

Advantages over RCTs of RWD - T or F

single sources – patient registries, administrative claims, and social media channels

A

F - FROM VARIOUS SOURCES

207
Q

Advantages over RCTs of RWD - T or F

Application – Different real environments providing insights into drug safety, in health and financial terms, and its long-term effects.

A

T

208
Q

Real-world data can improve decision-making, pre-authorization, and reimbursement of new drugs and treatments and benefit medical research and patient outcomes.’

A

Advantages over RCTs

209
Q

if u see this card

A

study the quality of evidences hierarchy

210
Q

if u see this card

A

go na sa next dami pa yung validity of study designs