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Jason's Cardiovascular Block > Pop Health and Ethics for Cardiovascular Block > Flashcards

Pop Health and Ethics for Cardiovascular Block Flashcards

(65 cards)

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1
Q

Doctors are allowed to act in ways others are not. What is that called?

A

Social permissions

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2
Q

3 special situations for doctors

A
  1. Power over patient
  2. privileged position in society, professional autonomy/self regulation
  3. reinforced by law
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3
Q

So why do we need ethics again? Two reasons:

A
  1. protect and respect patients

2. counter negative aspects of culture of medicine (the hidden curriculum)

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4
Q

do not cause or allow harm is called

A

Non-maleficence

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5
Q

Beneficence is:

A

provide help, do good

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6
Q

how to you respect someone’s autonomy?

A

get informed consent

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7
Q

how to you respect privacy?

A

confidentiality

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8
Q

Two tenants of informed consent

A

Informed

Voluntary choice

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9
Q

Doctors discussing a case, why is it NOT a breach of confidentiality?

A

Necessary good for the patient

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10
Q

3 ethically difficult situations:

A
  1. inadvertent breach of confidentiality
  2. patient non-consent (if anesthetized
  3. inappropriate procedure (miscommunication)
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11
Q

Feeling unsure what is right to do is called:

A

Moral confusion

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12
Q

Feeling unable to to what you know is right

A

Moral distress

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13
Q

Moral distress is:

A

feeling compelled to do what you think is wrong

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14
Q

Moral confusion is:

A

not sure what’s right or wrong

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15
Q

How to deal with moral confusion and distress?

A
  1. talk to peers
  2. advice from staff
  3. get more information
  4. acknowledge own feelings
  5. consider further action
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16
Q

How should you talk about patients? (3 ways)

A
  1. non-identifying
  2. purpose to learn
  3. respectfully
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17
Q

What’s the cause and effect study design called?

A

analytical

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18
Q

what is a cross-sectional design?

A

observational descriptive

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19
Q

what are clinical trials?

A

interventional analytical

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20
Q

what are case-control and cohort studies?

A

observational analytical

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21
Q

example of a descriptive observational?

A

Case study/series, ecological, cross-sectional

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22
Q 
Which of the following are longitudinal?
cohort
cross-sectional
case-control
Case series/reports
clinical trials
ecological
A

Cohort and clinical trials

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23
Q 
Which of the following are non-longitudinal?
cohort
cross-sectional
case-control
Case series/reports
clinical trials
ecological
A

ecological
cross-sectional
case-control
Case series/reports

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24
Q

What does non-longitudinal mean?

A

no follow-up, usually only one encounter

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25
is cross sectional analytical?
Nope, descriptive
26
is there follow up in a cross sectional study?
No.
27
Data from cross sectional study collected via?
questionniares, examiniations, investigations
28
what's the main purpose of a cross sectional?
make associations and hypothesis generating. kinda sucks at causality cause no temporal aspect
29
Case-control is?
comparing previous exposure status of someone who had it vs. someone who didn't have it but they are both similar characteristic people. age. sex.
30
What is case-control useful for studying?
rare outcomes
31
key output of odds ratio is for what study design?
Case control
32
odds ratio is an approximation of what?
relative risk?
33
2 main features of cohort study?
1. longitudinal | 2. follow-up of subjects
34
what kind of data collected for cohort study?
incidence data
35
output for cohort study?
relative risk
36
Retrospective cohort study?
can research established cohorts for other things that you have good data for
37
disadvantages of cohort study?
1. not good for rare outcomes | 2. expensive, hard to organize
38
Example of how you can establish a cohort study with 'routine' clinical care?
RMH stroke service data collection
39
Active outcome follow-up
explicit surveillance
40
passive outcome follow up
database, retrospective
41
2 Bias types:
1. selection bias | 2. info/measurement bias
42
what is the 'worried well'
people who are willing to participate are usually better than those who might now or can't and are more open
43
how to minimize selection bias? 2 ways
1. representative sample | 2. case and control from same source
44
information bias is?
systematic differences in the way the info was collected esp. variability/subjectivity
45
eg. of measurement bias?
tight BP cuff on obese people
46
Minimize info bias? 2 ways
1. standardized tools | 2. objective assessment
47
confounding variable?
independently changes outcome at exposure
48
how to minimize confounding?
in the design of the study, not analysis
49
Most clinical trials involve what groups?
a control group | intervention group
50
What's the 'gold standard' for causality?
clinical trials
51
How to reduce confounding variables?
Randomization
52
how do you deal with information bias?
blinding/masking
53
Selection bias (cross-over in parallel) is what?
sick subjects stop drug control switches to drug or vice versa healthier ppl stay on drug cause less side effects
54
How to deal with cross-over?
assume subjects remained in randomized group
55
Intention-to-treat Analysis involves what?
underestimates treatment effect because cross over would introduce overlap which is ignored
56
Hazard
continuously updated instantaneous rate
57
When do you use hazard?
longitudinal studies
58
Survival analysis is?
avoidance of the event
59
What's Hazard ratio?
like RR, but applies to WHOLE period of time so HR of 0.5 would mean that the probability of outcome in control is HALF that of other group any ANY GIVEN TIME in the study.
60
Risk/Rate reduction is measured in two ways:
relative | absolute
61
Numer needed to treat is:
how many people needed to undergo intervention to prevent outcome in one
62
Equation for NNT?
NNT = 1/ absolute risk/rate
63
What the point of NNT anyways?
marks the efficiency of the intervention
64
NNT affected by what?
Relative effect | underlying likelihood of outcome
65
Number needed to harm is?
if interventions increase risk/rate of outcome

Jason's Cardiovascular Block (15 decks)

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