What is survival curve? what things do you have to consider?
- % surviving patients v time
- assess outcome (death y/n) and time to outcome
What is right centered data?
underestimating survival time if you include patients (as dead) if you dont have their outcome data at the time
What is kaplan meier estimator?
way of doing survival curve
drop in surival each time you have an event (step function); notch each time you have a censored observation
How do you assess statistical significance between 2 survival curves?
Log-rank test
more sensitive to later differences
null is no difference
Managing HBOC? vs non HBOC
- mostly BSE at 18, biannual CBE, annual MRI at 25 (40 normal)
- tamoxifen and mastectomu
-prophylactic BSO at 35-40; if no BSO, biannual pelvic exam and transvag u/s at 30-35; oral contraceptives
what is response rate of placebo?
25%
consent v assent
children cannot give consent only assent (have to say YES)
Types of controls in study design (3)
- historical
- positive (other drug)
- negative (placebo)
4 types of cost effectiveness analyses?
- Cost-minimization: only compare costs; or med in different setting
- Cost effectiveness analysis (CEA): natural units, most common, average (cost/effect) v incremental (diff in cost/effect)
- Cost utility analysis (CUA): QALY
- Cost benefit analysis: net benefit (>0 is good); benefit to cost ratio (>1 is good); compare benefit in dollars
Sensitivity analysis?
see how much your cost analysis are off if your assumptions are off
4 bioethical principles
- benficience
- nonmaleficence
- autonomy
- justice
Continuu of psychooncology distreess
normal adjustement (anticipatory grief, depression) adjustment disorder (more severe, still normal) Psych disorder
3 types of psychotherapy for pychooncology
- cognitive behavior therapy (CBT)- most common (IID annd solve problems) (all or nothing thnking, should) (motivation behavior)
- Acceptance and committment therapy (ACT)
- Cognitive processing therapy (CPT): PTSD; devo awareness
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AFRAM
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ETHNIC
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