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High Yield General Principles > Behavioural Sciences > Flashcards

Behavioural Sciences Flashcards

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1
Q

What is a cross sectional study? What can it be used to measure?

A

Assesses frequence of disease (or other factors) in a group of people at a particular point in time - What is happening?

Measures disease prevalence - shows risk factor association with disease NOTE correlation =/= causation

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2
Q

What is a case control study? What does it measure?

A

Compares group with disease to control - Looks for risk factor

Measures Odds ratio

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3
Q

What is a cohort study? What does it measure?

A

Compares group with risk factor to group without risk factor. Looks to see if exposure increases likelihood of disease. Can be retrospective or prospective.

Measure relative risk - e.g. smokers had higher risk of developing COPD than non smokers.

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4
Q

What is a twin concordance study? What does it measure?

A

Compares the frequency with which both monozygotic twins or both dizyogtic twins develop the same disease;

Measures nature vs nurture

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5
Q

What is an adoption study? What does it measure?

A

Compares siblings raised by biological vs adoptive parents

Measures nature vs nurture

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6
Q

What does a triple blinded clinical trial entail?

A

Blinding of patients, doctors and researchers analyzing the data

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7
Q

What is the purpose of a phase I clinical trial?

A

Assesses safety, toxicity, pharmacokinetics and pharmacodynamics

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8
Q

What is the purpose of the phase 2 clinical trial?

A

Assesses treatment efficacy, optimal dosing and adverse effects

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9
Q

What is the purpose of phase 3 clinical trials?

A

Compares new treatment to current treatment or placebo

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10
Q

What is the purpose of phase 4 clinical trials? what does it involve?

A

Postmarketing surveillance of patients after treatment is approved.

Detects rare or long term adverse efects

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11
Q

Define the sensitivity of a test.

A

Probability that a test detets a disease when disease is present.

SN-N-OUT = a highly SeNsitive test, when Negative, rules OUT disease

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12
Q

Define the specificity of a test

A

Probability that the test detects no disease when disease is absent.

SP-P-IN = a highly SPecific test, when Positive, rules IN disease

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13
Q

Define positive predictive value

A

Probability that a person actually has the disease when given a positive test result

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14
Q

Define negative predictive value

A

Probability that person actually is disease free when given a negative test result

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15
Q

Define incidence and prevalence

A

Incidence - no of new cases / no of people

Pevalnce = no of existing cases / no of people at risk

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16
Q

Define odds ratio

A

Odds tht the group with the disease was exposed to a risk factor divided by odds that the group without the disease was exposed

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17
Q

Define the relative risk

A

Risk of developing disease in exposed group divided by risk in unexposed group

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18
Q

Define the attributable risk

A

difference in risk between exposed and unexposed groups

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19
Q

Define relative risk reduction

A

Proportion of risk reduction attributable to the intervention as compared to a control

RRR = 1 - Relative Risk

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20
Q

Define absolute risk reduction

A

Difference in risk attributable to the intervention as compared to a control

ARR = (c/c+d) - (a/a+b)

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21
Q

Define the number needed to treat

A

Number of patients who need to be treated for 1 patient to benefit

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22
Q

Define the number needed to harm

A

number of patients who need to be exposed to a risk factor for 1 patient to be harmed

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23
Q

Define precision of a test

A

absence of random variation in test

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24
Q

Define the accuracy of a test

A

Trueness of test measurements

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25
What is the berkson bias?
Study population selected from hospital is less healthy than general population
26
What is the healthy worker effect?
Study population is more healthy than general population
27
What is the non response bias?
participating subjects differ from nonrespondents in meaningful ways
28
How would you reduce selection bias?
Randomization Ensure the choice of the right comparison group
29
How would you reduce recall bias?
Decrease time from exposure to follow up
30
What is measurement bias and how would you reduce it?
Info is gathered in a way that distorts it Reduced using a standardised method of data collection
31
What is procedure bias and how would you reduce it?
Subjects in different groups are not treated the same Reduce - Blinding and use of placebo to reduce influence of participants and researchers
32
What is observer-expectancy bias and how would it be reduced?
Researcher's belief in the efficacy of a treatment changes the outcome of that treatment - self fulfilling prophecy Reduce by blinding and use of placebo to reduce influence of participants and researchers
33
What is a confounding bias? How would it be reduced?
When a factor is related to both exposure and outcome but isnt on the causal pathway Reduced by multiple studies, crossover studies where the subjects act as their own controls (they receive both treatments although the order in which they receive them are randomised), and matching (patients with similar characteristics in both treatment and control groups)
34
What is lead time bias and how would you reduce it?
Early detection is confused with increased survival Reduced by measuring back end surbvival (adjust survival rate according to the severity of disease at time of diagnosis)
35
Define standard error
an estimate of how much variability exists between sample mean and true population mean
36
What is bimodal distribution?
2 peaks of distribution, suggesting 2 different populations
37
What is positive and negative skew distribution?
Positive - Asymmetry with longer tail on right due to mean \> median \> mode Negative - asymmetry with longer tail on left due to mean \< median \< mode
38
What is the null hypothesis?
no relationship between factor and outcome
39
What is the alternative hypothesis?
Some relationship between factor and outcome
40
What would occur if the study result indicated the null hypothesis was correct and the reality is that the null hypothesis is correct?
Correct result - there is no relationship
41
What would occur if the study results indicated the alternative hypothesis was correct but the reality was that the null hypothesis was correct?
Type 1 error (α) - False positive error. α is probability of making a type I error. α = you sαw a difference that did not exist
42
Wha twould occur if the study results indicated the null hypothesis was correct but th ereality was that the alternative hypothesis was correct? How would you reduce this error?
Type II error (ß) - False negative error ß is probability of making a type II error. Reduced by increasing sample size, precision of measurement
43
When would you accept the null hypothesis in: a) mean difference b) odds ratio and relative risk c) CIs between 2 groups
a) H0 not rejected when CI for a mean difference between 2 variables includes 0 b) odds ratio or relative risk includes 1 c) if CIs between 2 groups overlaps = H0 accepted
44
What is the t-test used for?
checks difference between _mean_ of 2 groups **_T_**ea is **_mean_**t for 2
45
What is ANOVA used for?
checks differences between means of 3 or more groups
46
What is Chi-square used for
checks differences between 2 or more percentages or proportions of _categorical_ outcomes (not mean values) e.g. chi square used to measure PERCENTAGE of MEMBERS of 2 different ethnic groups rather than comparing the MABP between 2 different ethnic groups
47
What is the pearson correlation coefficient?
"Can I draw a line graph to represent the data?" - r is between -1 and +1 Closer to 1 is stronger linear correlation. +1 is positive correlation. -1 is negative correlation. 0 is no correlation.
48
What is primary, secondary, tertiary and quaternary disease prevention?
**_P_**rimary - **_P_**revent disease occurrence e.g. vaccine **_S_**econdary - **_S_**creening early for diseaes **_T_**ertiary - **_T_**reatment to reduce disability from disease Quaternary - Identify patients at risk of unnecessary treatment
49
Who is medicare for?
medicare for \>65, \<65 with disabilities and those with end stage renal disease
50
Who is medicaid for?
Medicaid for people with v low incomes
51
What are the 4 parts of medicare?
Part _A_ - Hospit**_a_**l insurance Part _B_ - **_B_**asic medical **_b_**ills Part _C_ - Parts a and b delivered by approved private **_c_**ompanies Part _D_ - Prescription **_d_**rugs
52
What is the concept of autonomy?
respect patients as individuals to create conditions necessary to make self informed decisions and to honour their decisions
53
What is the concept of beneficence?
duty to act in the patient's best interest.
54
What is the concept of Justice?
Treat the patients fairly and EQUITABLY. Not necessary equally
55
What does informed consent require?
* Disclosure of info about disease and treatment * Ability to understand * Ability to make ones own decisions * Freedom from coercion or manipulation
56
What situations do not require parental consent?
* Sex (contraception, STIs, pregnancy) * Drugs (addiction) * Rock and roll (emergency/trauma)
57
What are advance directives?
Instructions given by a patient in anticipation of the need for a medical decision
58
What is an oral advancce directive?
Incapacitated patient's prior oral statements commonly used as a guide
59
What is a living will?
Describes treatments the patient wishes to recieve or not recieve if they lose decision making capacity
60
What is a medical power of attorney?
Patient designates an agent to make medical decisions in the event that they lose decision making capacity
61
What is a surrogate decision maker
If patient loses capcity and has not prepared an advance directive, surrogates who knew the patient must determine what the patient would have done spouse \> adult children \> parents \> adult siblings \> others
62
What is an Apgar score? What do the scores mean?
Appearance, Pulse, Grimace, Activity, Respiration Assessment of newborn vital signs following labour via a 10 point scale evaluated at 1 minute and 5 minutes. \>7 is good, 4-6 = assist and stimulate, \<4 = resus
63
Define low birth weight. What are the risks?
\<2500g. risks of sudden infant death syndrome and mortality
64
What are the motor milestones of a 0-12 month baby?
* **_P_**rimitive reflexes disappear * **_P_**osture - lifts head up prone (1mo) --\> rolls and sits (by 6 mo) --\> crawls (by 8 mo) --\> stands up (by 10 mo) --\> walks (12-18 months) * **_P_**icks - passes toys hand to hand (by 6 mo), Pincer grasp (by 10) * **_P_**oints to objects (by 12 mo) ****_P_**arents** **_S_**tart **_O_**bserving **_C_**hild **_R_**earing **_W_**orking **_D_**ont **_F_**orget, theyre still **_L_**earning!
65
What are the social milestones of a 0-12 mo baby?
* Social smile (by 2 mo) * Stranger anxiety (by 6 mo) * Separation anxiety (by 9 mo) Parents ****_S_**tart** Observing Child Rearing Working Dont Forget, theyre still Learning!
66
What are the verbal/cognitive milestones of a 0-12 mo baby?
* Orients - first to voice (by 4 mo), then to name and gestures (by 9 mo) * Object peramnence (by 9 mo) * Oratory - says mama and dada (by 10 mo) Parents Start ****_O_**bserving** Child Rearing Working Dont Forget, theyre still Learning!
67
What are the motor milestones of a 12-36 mo baby?
* Cruises - takes first steps (by 12mo) * Climbs stairs (by 18 mo) * Cubes stacked - number = age (yr) x 3 * Cultured - feeds self with fork and spoon (by 20 mo) * Kicks ball (by 24 mo) Parents Start Observing ****_C_**hild** Rearing Working Dont Forget, theyre still Learning!
68
What are the social milestones of a 12-36 mo toddler?
* Recreation - parallel play (play next to each other but independently) * Rapprochement - moves away from and returns to mother (by 24 mo) * Realisation - core gender identitiy formed (by 36 mo) Parents Start Observing Child ****_R_**earing** Working Dont Forget, theyre still Learning!
69
What are the verbal/cognitive milestones of a 12-36 mo toddler?
* Words - 200 words by age 2, 2 word sentences Parents Start Observing Child Rearing ****_W_**orking** Dont Forget, theyre still Learning!
70
What are the motor milestones of a 3-5 yr old?
* Drive - tricycle (3 wheels at yr 3) * Drawings - copies line or circle, stick figure (by yr 4) * Dexterity - hops on one foot (by yr 4), uses buttons or zippers and grooms self (by yr 5) Parents Start Observing Child Rearing Working ****_D_**ont** Forget, theyre still Learning!
71
What are the social milestones of a 3-5 yr old?
* Freedom - comfortably spends part of day away from mother (by 3 yr) * Friends - coop play, has imaginary friends (by 4 yr) Parents Start Observing Child Rearing Working Dont ****_F_**orget, theyre still** Learning!
72
What are the verbal/cognitive milestones of a 3-5 yr old?
Language - 1000 words by age 3 (3 zeroes), uses complete sentences (by yr 4) Legends - can tell detailed stories (by yr 4) Parents Start Observing Child Rearing Working Dont Forget, theyre still ****_L_**earning!**
73
What sexual changes occur in elderly men?
Slower erection / ejaculation Longer refractory period Sexual interst does not decrease
74
What sexual changes occur in elderly women?
Vaginal shortening, thinning, dryness Sexual interest does not decrease
75
What is presbycusis?
Sensorinerual hearing loss due to destruction of hair cells at cochlear base
76
What is the no. 1 cause of death in: a) \<1 b) 1-14 yo c) 15 - 34 yo d) 35-44 yo e) 45-64 yo f) 65+
a) congenital malformations b) accidents c) accidents d) accidents e) cancer f) heart disease
77
What is the no. 2 cause of death in: a) \<1 b) 1-14 yo c) 15 - 34 yo d) 35-44 yo e) 45-64 yo f) 65+
a) preterm birth b) cancer c) suicide d) cancer e) heart disease f) cancer
78
What is the no. 3 cause of death in: a) \<1 b) 1-14 yo c) 15 - 34 yo d) 35-44 yo e) 45-64 yo f) 65+
a) SIDS b) congenital malformations c) homicide d) heart disease e) accidents f) chronic resp disease

High Yield General Principles (2 decks)

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