EBM Exam 1 Flashcards

Question

Maternal mortality

Answer 1

death of woman while pregnant or w/in 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management

Answer 2

rate of infant death during first 28 days after live birth

Answer 3

number of infant deaths in first yr of life for every 1,000 live births

Answer 4

probability per 1,000 that a newborn baby will die b/f reaching age 5

Answer 5

how long a person is expected to live, based on yr of birth, current age, and other factors

Answer 6

number of healthy yrs a person is expected to live at birth by subtracting the yrs of ill health

Answer 7

estimating the avg time a person would have lived had he or she not died prematurely

Answer 8

measure of the value of health outcomes

Answer 9

sum of the years of life lose due to premature mortality in the pop and the yrs lost due to disability

Answer 10

stable across populations with different baseline risks and are, for instance, useful when combining the results of different trials in a meta-analysis

Answer 11

Relative risks: when prospective cohort studies or RCTs are conducted Odds ratios: used for case-control studies b/c we do not know the true incidence of a disease/outcome

Answer 12

IS THERE BIAS? did the study measure what it claimed to test? how accurate is the study? is there bias (systematic error)?

Answer 13

are the results of the study valid for the pop studied?

Answer 14

are the results of the study valid for the larger pop? are they generalizable?

Answer 15

HOW PRECISE ARE THE RESULTS? do you get similar results if you measure more than once? is the study precise in measurement?

Answer 16

test/retest reliability repeatability and reproducability precision of measure

Answer 17

Sample size too small Volunteers used Inclusion and exclusion criteria too select

Answer 18

Efficacy: determine whether an intervention is successful under IDEAL circumstances Effectiveness: determine whether an intervention is successful under REAL WORLD clinical settings

Answer 19

``` Measurement or info bias --recall bias --ascertainment bias Intervention bias Attrition bias ```

Answer 20

were the predictor and outcome variables measured accurately? - -recall bias: participants may not remember past events - -ascertainment bias: researchers or participants have knowledge of who is receiving the intervention, lack of blinding

Answer 21

did the authors select an unusually high dose for the comparison drug?

Answer 22

loss to follow-up b/c too many people drop out, lack of intention-to-treat analysis

Answer 23

conclusions about indv are based only on analyses of group data

Answer 24

people who know they are being studied may modify their behavior or feelings

Answer 25

true effect is due to an unmeasured variable that affects the results, lack of randomization to intervention and control groups

Answer 26

Case control: outcome --> exposure Cohort: exposure --> outcome Cross-sectional: snapshot at one time period AKA prevalence/frequency survey *all are analytic (observational, primary)

Answer 27

Cannot calculate relative risks or attributable risks b/c no pop denominator *cohort study: can calculate incidence rates, relative risks, attributable risks

Answer 28

``` P: pop I: intervention C: comparison O: outcome T: time ```

Answer 29

Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations

Answer 30

Peer review is the critical assessment of manuscripts submitted to journals by experts who are not part of the editorial staff

Answer 31

``` Follow-up Randomizaiton Intention-to-treat Similar baseline Blinding Equal treatment Equivalence to your pt **validity of research ```

Answer 32

``` Feasible Interesting Novel Ethical Relevant ```

Answer 33

``` Problem Patient/population Intervention Comparison Outcomes ***clear clinical question in systematic review ```

Answer 34

Fixed effects model: any difference found among study results due to chance Random effects model: difference b/w study results due to chance and other effects --popular when interventions thought to be more variable Bayesian Meta-Analysis

Answer 35

Quickly visualize the results of individual | studies and possibly for pooled data

Answer 36

``` Quickly shows the amount of contribution of individual studies to the outcome sample size is proportional to circle size ```

Answer 37

bias unlikely: dots to left and right of zero | bias likely: dots to right of zero

Answer 38

reporting bias true heterogeneity data irregularities chance

Answer 39

Patients in studies (differences in gender, age range, disease state) Interventions (drug vs. placebo, drug A vs drug B) Outcomes (death, inc chance of MI) Clinical research design of indiv studies

Answer 40

Mantel-Haentszel Chi-Square test Breslow-Day Test Cochran's Q Test I^2 statistic

Answer 41

Pos: mean and median to the RIGHT of the mode Normal: mean, median, mode are the same Neg: mean and median to the LEFT of the mode

Answer 42

``` mean = 0 SD = 1 ```

Answer 43

measures the degree to which observation varies from predicted

Answer 44

Student's T test: continuous data Chi-squared test: categorical data and proportions ANOVA: comparing means of 2 or more pops

Answer 45

the intervention being studies has NO EFFECT

Answer 46

incorrectly concluding that an effect exists when it does not (errouneous REJECTION OF NULL HYPOTHESIS) **worry more about type I errors

Answer 47

failing to recognize an effect that truly exists (erroneous ACCEPTANCE OF THE NULL HYPOTHESIS)

Answer 48

prob of making a type I error

Answer 49

prob of making a type II error

Answer 50

inc sample size

Answer 51

prob of obtaining the observed results if the null hypothesis is true

Answer 52

prob of finding an effect if it truly exists (1-beta)

Answer 53

determining the plausible range of values for a parameter of interest in a pop or experimental group - -point estimate - -CI

Answer 54

wider CI to inc degree of confidence

Answer 55

Mean of sample means should be the SAME as the mean of the whole pop SD of the sample means should be LESS THAN the SD of the pop

Answer 56

measures the degree to which exposure to a risk factor or a treatment changes the odds of experiencing an outcome

Answer 57

maximum acceptable loss of efficacy

Answer 58

adjust p values when doing multiple hypothesis testing | alpha = 0.05/# hypotheses tested rather than alpha = 0.05

Answer 59

how reliably does the test pick up disease when present? to calculate, only consider pts known to have disease neg result on highly sensitie test rules out disease

Answer 60

does this test avoid false-pos? to calculate, only consider pts who do not have the disease pos result on a highly specific test rules in disease

Answer 61

based on prior research, clinical/biochemical reasoning, or other first principles precisely defined in study protocol

Answer 62

even if highly statistically significant, not proof of association or causality --to be convincing, findings must be both improbable and have a plausible explanatory mechanism

Answer 63

``` more than 2 groups F statistic (variance b/w and within groups) If have more variance b/w groups than within the groups, you will get a bigger F statistic which will be more likely to be stat sig ```

Answer 64

when longitudinal data collected | --each person has repeated measures of the dependent variable

Answer 65

Therapy: involve experimental intervention by researcher --compare groups based on treatment Prognosis: observational --look for associations b/w variables

Answer 66

``` normally distributed dependent variable ratio or interval level data measures are independent usually used to examine means (t tests, ANOVA) --sometimes difference in variance ```

Answer 67

make NO assumptions about normal distribution more conservative than parametric used for analysis of medians and proportions used for ranked data used for nominal or ordinal data

Answer 68

nonparamentric test when assumptions for t test don't hold ranks scores from lowest to highest ranks analyzed as though they were original observations null hypothesis: means of the ranks are equal

Answer 69

independent: predictor dependent: outcome

Answer 70

in drug studies, what is the largest, most effective dose w/o serious side effects?

Answer 71

Poisson (count dependent variable) Logistic (dichotomous dependent variable) Cox proportional hazards analysis (survival analysis)

Answer 72

predicting a binary (dichotomous outcome) predicts the probability of the outcome variable regression coefficients can be transformed into odds ratios w/ CI used for multivariate analysis

Answer 73

the relationship b/w an independent variable and the dependent variable is conditional upon a second independent variable

Answer 74

used with survival analysis x axis: exposures y axis: percent of event-free subjects

Answer 75

CI width inc as sample size dec | --seen in survival curve as people die off

Answer 76

censored observations Kaplan-Meier curves plot timing of events Cox proportional hazard analysis for multivariate analysis based on regression analysis

Answer 77

logistic regression | OLS regression

Answer 78

Prevalence: tells dr the prior prob of the disease | Diagnostic test: alters the disease prob estimate

Answer 79

``` sensitivity and specificity remain constant PPV inc NPV dec **inc true pos **inc false neg ```

Answer 80

method to find best cut point used to compare tests --test is best when has greater area under the curve --best cut point is at the top of the curve

Answer 81

increases number of false pos

Answer 82

Cut down Annoyed (others) Guilty Eye opening

EBM Exam 1 Flashcards

(108 cards)