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EBM > General Definitions > Flashcards

General Definitions Flashcards

1
Q

Accuracy

A

How close to the actual value

Aka validity

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2
Q

Precision

A

How reproducible are the results

Aka reliability

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3
Q

Sensitivity

A

how many people with the disease will have a positive test?

=true positives / those with disease

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4
Q

Specificity

A

How many people without the disease will have a negative test

=(true negatives) / (those without disease)

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5
Q

Pre-test probability

A

Probability you have the disease before test is done

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6
Q

Post-test probability

A

Probability that you have the disease after test results have been received

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7
Q

Predictive value of positive test

A

Chance that the positive result is correct

=(true positives) / (all positive tests)

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8
Q

Predictive value of negative test

A

Chance that negative result is correct

= (true negatives) / (all negative tests)

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9
Q

Threshold concept

A
  1. TESTING THRESHOLD: How sure must I be that individual does NOT have illness in order to feel comfortable not treatingn them?
  2. TREATMENT THRESHOLD: How sure must I be that individual DOES have illness in order to feel comfortable treating?
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10
Q

PICO

A

Patients
Intervention
Comparison
Outcome

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11
Q

Likelihood ratio

A

Ratio between likelihood of a particular test result in those patients with the disease to the likelihood of the same test result in those without the disease

Can have likelihood ratios for positive and negative tests

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12
Q

Likelihood ratio for positive test

A

(Likelihood positive test in diseased) / (likelihood positive test in healthy)

Sensitivity / (1-specificity)

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13
Q

Likelihood ratio for a negative test

A

(Likelihood of a negative test in diseased) / (likelihood of negative test in non-diseased)

(1-sensitivity) / specificity

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14
Q

Criteria for a reasonable screening test

A
  1. Substantial burden of suffering from the suspected disease
  2. Test is a fairly good predictor of the presence or absence of the disease
  3. Finding and treating the disease early leads to a better outcome than treating after symptoms appear
  4. Benefits of screening outweigh the harm
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15
Q

EBM definition

A

Integration of the best research evidence with our clinical expertise and our patient’s unique values and circumstance

Should be patient centric

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16
Q

Perfect study type for diagnosis and prognosis questions

A

Large prospective cohort with 100% capture of information and no loss to follow up

Diagnosis using a gold standard
Prognosis: everyone starting at a well-defined time in their illness

17
Q

Perfect study for intervention/exposure questions

A

Large RCT with 100% adherence and followup, blinding, and similar patients

18
Q

P-value

A

Probability of finding level of association when the null hypothesis is true, due completely to chance

Above p-value–>cannot reject the null hypothesis because association could be due to chance

Below p-value–>significant difference does exist; reject the null hypothesis

19
Q

Confidence interval

A

Estimate of the precision of the results and statistical significance

20
Q

Type I (alpha) error

A

Reject null hypothesis when the different is not significant

21
Q

Type II error

A

Accept null hypothesis when there is a statistically significant difference

22
Q

Internal validity

A

How well an experiment is done so that it avoids confounding variables

Degree to which results found can be attributed to the independent variable and not other confounding factors

23
Q

External validity

A

How well can the study results be generalized

24
Q

Common flaws associated with observational studies

A

Confounding by indication: does drug kill you or is drug prescribed to sicker ppl?

Selection bias: ppl get selected to have surgery because their physician thinks they can handle it

Recall bias

Ascertainment bias

25
Q

Problems associated with RCTs

A

Expensive and time-consuming

Inadequate power

Randomization/concealment issues

Inadequate blinding/placebo

Adherence, cross-over
Intention to treat vs. per-protocol

Early stopping for benefit or harm

26
Q

Crossover RCT

A

If you have groups A and B assigned to two different treatments, plan for these two groups to switch between treatments at some point in the study

Increases the power

27
Q

Cluster RCT

A

Randomize groups and look at differences between groups, instead of individuals

28
Q

Non-inferiority RCT

A

See that a drug/treatment is no worse then what is currently used

29
Q

Per-protocol analysis

A

Comparing treatment groups that only include patients who completed the treatment originally allocated

Does NOT include intended to treat

30
Q

Bench/animal research best for hypothesis…

A

Hypothesis generating

31
Q

Case series research best for hypothesis…

A

Hypothesis generating

Points out new threats (i.e. Zika)

32
Q

Case series research best for hypothesis…

A

Hypothesis generating and testing

33
Q

Retrospective cohort study best for hypothesis…

A

Generating or testing

34
Q

Prospective cohort study best for hypothesis…

A

Generating or testing

35
Q

Big data studies best for hypothesis…

A

Testing or generating

36
Q

RCT best for hypothesis…

A

Testing

37
Q

Systematic review best for hypothesis…

A

Testing

EBM (3 decks)

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