Quiz 3

Question 1

what are the three pathways you can take as a provider when making a medical decision?

Answer 1

1. wait and see
2. obtain more info-order a new test
3. initiate immediate Tx

Question 2

no fault errors

Answer 2

errors due to masked or unusual presentations of disease or due to patient errors (uncooperative, deceptive)

Question 3

system-related errors

Answer 3

technical failure and equipment problems, organizational flaws

Question 4

what are the three types of errors that contribute to either failure to diagnose or misdiagnosis?

Answer 4

1. system-related errors
2. no fault errors
3. cognitive errors

Question 5

cognitive errors

Answer 5

faulty knowledge, data gathering and/or synthesis

Question 6

paternalist decision-making

Answer 6

provider decides, most common w/ lower educational and SES

Question 7

what are the 3 types of decision making?

Answer 7

1. paternalist (9%)
2. shared (61%)
3. consumerist (30%)

Question 8

shared decision-making

Answer 8

provider and patient deliberate, more common w/ higher education and SES

Question 9

consumerist decision-making

Answer 9

patient decides

Question 10

premature closure and how it relates to diagnosis

Answer 10

example in class was about how specialists often diagnose what is familiar

Question 11

misleading details

Answer 11

often present in patient history, can lead to misdiagnosis

Question 12

what do you need to consider given a positive test result?

Answer 12

tests are not “yes” or “no”, need to consider the result a probability of a condition now that the test is positive.

Question 13

shot gunning

Answer 13

ordering multiple tests (often in ED setting) because of uncertainty, lack of time, etc.

Question 14

what factor did we discuss in class as affecting prevalence?

Answer 14

setting (example family practice setting vs. specialty setting)

Question 15

discuss test performance curve when differentiating test results in a severe illness

Answer 15

curves only overlap a little bit

Question 16

discuss test performance curve when differentiating test results in a disease of lower severity

Answer 16

curves have a higher area of overlap

Question 17

when should you order a test?

Answer 17

when patients w/ and w/o the target condition cannot be distinguished w/o the test

Question 18

pre-test probability

Answer 18

prevalence of a disease in a defined pop. (TP+FN)/total

Question 19

pre-test odds

Answer 19

odds of disease before performing a test

prevalence/(1-prevalence)

Question 20

sensitivity

Answer 20

ability of a diagnostic test to correctly ID the presence of a condition. If high, avoids false positives (good at ruling OUT). Conditional probability of a positive test if the patient has the condition.
TP/(TP+FN)

Question 21

specificity

Answer 21

ability of a test to judge that subjects do not have a condition. Conditional probability of a negative result when patient do NOT have disease. If high, avoids false negatives .
TN/(TN+FP)

Question 22

PPV

Answer 22

probability of having the target condition given a positive test result. Depends on prevalence of the disease in the tested pop.
TP/(TP+FP)

Question 23

NPV

Answer 23

probability of not having the target condition given a negative test result.
TN/(TN+FN)

Question 24

post-test probabilty

Answer 24

probability of a disease after a positive test result:
post-test odds/(post -test odds +1)

probability of a disease after a negative test result:
post-test odds/(post-test +1)

***yes I know those are the same equations, I double checked in the reading

Question 25

post-test odds

Answer 25

odds of a disease after a test result

after a positive test result:
pretest odds x positive likelihood ratio

after a negative test result:
pretest odds x negative likelihood ratio

Question 26

positive likelihood ratio

Answer 26

the amount of certainty gained after a positive test result

sensitivity/(1-specificity)

Question 27

negative likelihood ratio

Answer 27

the amount of certainty gained after a negative test result

(1-sensitivity)/specificity