Public Health Flashcards
What is evidence based medicine?
The clinician as expert must bring clinical setting, patient preference and best evidence together to make the best choice.
What are the 6 steps for practising EBM?
The patient
The question
The resources
The evaluation
The patient
Self evaluation
What does PICO stand for
Patient
Intervention
Comparison
Outcomes
What is the GD for therapeutic studies
Randomised control trial
How do you critically appraise an articulate?
1) is it valid? (Free of bias)
2) are the results statistically and clinically significant?
3) can I apply there results to my practice?
Phases of diagnostic research
Phase 1: do normal and diseased pts have different test results?
Phase 2: are pts with certain test results more likely to have the disorder than patients with other test results? (Sensitivity and specificity)
Only if these are promising
Phase 3:amount pts in whom it is clinically sensible to suspect the disorder, does the test result distinguish those with and without
Phase 4: Do patients who undergo the diagnostic test fare better than whose who do not?
What is sensitivity
Test+/+ disease
Specificity
Test -/disease -
Positive predictive value
The probability that if the pt tests positive, they actually have the disease
Negative predictive value
The probability that if the patient tests negative, that they really are negative
What influences the PPV and NPP
Prevalence
Likelihood ratio positive
Sensitivity/(1-specificity)
What is a threshold with regards to diagnostic testing?
The diagnostic process is to gather information until a certain threshold is reached, then you can either send home or treat.
What is validity?
Is the result representative of the truth?
Is the study free of bias?
How does NNT (number needed to treat) help us?
It tells us about the clinical significance
