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FoPC Year 2 > The Use Of Data > Flashcards

The Use Of Data Flashcards

1
Q

What % of people consult their GP about their health concerns?

A

20%

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2
Q

What % of people who consult their GP are passed on to secondary care/ get an Ix done?

A

3%

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3
Q

What’s the difference between diagnosis, disease and illness?

A

Disease=symptoms
Diagnosis=signs
Illness=ICE and experience

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4
Q

The medical and non-medical factors affecting the uptake of care

A 
Medical:
New symptoms 
Visible symptoms 
Increasing severity
Duration
Non-medical:
Crisis 
Peer pressure
Patient beliefs 
Expectations 
Social class
Economic 
Psychological 
Environmental
Cultural 
Ethnic
Age 
Gender 
Media
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5
Q

What’re the 3 main aims of epidemiology?

A

Description
-to describe the amount and distribution of disease in human population

Explanation
To elucidate the natural history and identify aeitological features for the disease

Disease control
To provide the basis one which preventive measures, public health practices and therapeutic strategies can be used

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6
Q

What differences in groups can epidemiology point out?

A

Aetiological clues (what causes the problem)
The scope for prevention
The identification of high risk or priority groups in society

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7
Q

How may the study group be defined?

A

Age/sex/location

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8
Q

Who does clinical medicine deal with?

A

The individual patient

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9
Q

What does epidemiology deal with?

A

Populations

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10
Q

What’s the ratio to do with disease and risk?

A

Events/population at risk

The risk part is crucial. It means that everyone in the denominator must have the possibility of entering the numerator. And conversely those people in the numerator, must have come from the denominator population

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11
Q

Incidence vs prevalence

A

Incidence=the number of new cases of a disease in a population in a specified period of time

Prevalence=is the number of people with a specific disease at a single point in time or a defined period of time

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12
Q

What is the relative risk and the ratio to work it out?

A

A measure of the strength of an association between a suspected RF and disease under study

RR=incidence in an exposed group/incidence of disease in an unexposed group

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13
Q

Sources of epidemiological data

A 
Mortality data
Hospital and clinical activity statistics
Reproductive health statistics 
Infectious disease stats 
Cancer stats
Accident stats
GP morbidity stats
Health and household stats
Drug misuse databases
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14
Q

What is health literacy?

A

It is about people having the knowledge, skills, understanding and confidence to use health information, to be active partners in their care and to navigate health and social care system

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15
Q

What’s the CHA2DS2-VASc score used for?

A

Estimating the risk of stroke in patients with non-rheumatic AF

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16
Q

What’re NAOCs and why do they appeal to patients?

A

Novel anticoagulants

Newer drugs that don’t require regular blood tests like warfarin

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17
Q

Downside of NOACs?

A

Not easily reversed like warfarin is (with vit K) in the event of bleeding
Relatively expensive

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18
Q

HAS-BLED score is used for what?

A

The risks of bleeding for patients on anticoagulants

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19
Q

What’re the 6 steps in making SIGN guidelines?

A

1) identify questions
2) search for evidence
3) look at the evidence
4) make judgements and recommendations
5) publish the guidelines
6) advertise guidelines

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20
Q

What’re descriptive studies?

A

The describe the amount and distribution of a disease in a given population
May look at the disease alone or examine one or more factors (exposures) thought to be linked to the aetiology

Doesn’t provide definite conclusions about disease causation but gives clues to possible risk factors and candidate aetiologies

Follow the time, place, person framework

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21
Q

What are are descriptive epidemiological studies useful in?

A

Identifying emerging public health patterns
Signalling the presence of effects worthy of further investigation
Assessing the effectiveness of prevention and control measures
Assessing the needs for health services and service planning
Generating hypotheses about disease aetiology

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22
Q

Do descriptive epidemiological studies test hypotheses?

A

No

23
Q

What’re cross sectional studies

A

Observations are made at a single point in time

Conclusions are drawn about the relationship between diseases and other variables of interest in a defined population

24
Q

One positive and one negative about cross sectional studies

A

Provides results quickly

Impossible to infer causation

25
Q

What’re case controlled studies?

A 
2 groups of people are compared 
The cases (those with the disease) and those who are the control (those without the disease)
26
Q

What data is essential in case control studies?

A

Determining if each individual has been exposed to the suspected aetiological factor(s)

27
Q

How are clues to what elevates/reduces the disease risk found in case control studies?

A

The average exposure to the aetiological factors

28
Q

what’s a cohort study?

A

Baseline data is gathered from a group without the disease and that same group is then followed till they do develop the disease

29
Q

How are the subgroups of cohort studies determined?

A

According to original exposure status

30
Q

What do cohort studies allow for?

A

The calculation of cumulative incidence, allowing for differences in follow up time

31
Q

How are the results of cohort studies normally expressed?

A

Relative risks, with confidence intervals or p values

The comparison of those who were exposed and those who were not and the number of each group which go on to become diseased or those who remain not diseased

32
Q

What is the definitive method of assessing any new treatment in medicine

A

Randomised control trial

33
Q

What’re the 2 groups in a randomised control trial?

A

An intervention (study) group and the control

34
Q

Which group in a randomised control trial is the change made to?

A

The intervention group (eg a suspected causative factor is removed or neutralised)

35
Q

Name the types of analytical studies

A

Cross sectional
Case control
Cohort

36
Q

Descriptive vs analytical studies

A

Descriptive studies focus on detailed investigative studies of individuals to improve disease knowledge whereas analytical studies focus on testing hypothesises by selection and comparison of groups

37
Q

What’re the 6 factors that must be considered when interpreting results?

A 
Standardisation
Standardised mortality ratio
Quality of data
Case definition 
Coding and classification
Ascertainment
38
Q

What is standardisation?

A

A set of techniques used to remove/adjust for the effects of differed in age or any other confounding variables when comparing two or more populations

39
Q

What’s an age-sex standardised rate?

A

It represents what the unstandardised or crude rate would’ve been if the population had had the same proportion of females and males and of people in different age groups as the standard population

40
Q

What’s an SMR?

A

A standardised mortality ratio
The figure for a standard reference in Scotland is taken to be 100 in SCO and the standardised death rate for the study is expressed as a % of 100
So 120 means 20 more than than should be expected

41
Q

What is ascertainment?

A

Data completion

42
Q

Why is case definition relevant?

A

Deciding whether or not all individuals have the same disease of interest or not as different people in different places may have different definitions of the same thing

43
Q

What is bias?

A

The trend in collection, analysis, interpretation, publication or review in data that are systematically different from the truth

44
Q

Name the 5 types of bias that may affect epidemiological studies

A 
Selection
Info
Follow up
Systematic error
Publication bias
45
Q

When does selection bias occur?

A

When a study sample isn’t truly representative of the whole study population

46
Q

When does information bias occur?

A

Systemic errors in monitoring exposure or disease
Eg a researcher who was aware of the case or control groups may encourage patients to think harder about past symptoms than one in a ransomised control trials

47
Q

What’s a follow up bias?

A

One group of subjects is followed up more assiduously than another to measure disease incidence or other relevant outcomes
Eg if 2 people moved address or failed to respond to the questionnaire sent out be the researchers and the one had more effort to to trace them

48
Q

What’s a systematic error?

A

A form of measurement bias where there is a tendency for measurements to always fall on one side eg an instrument is calibrated wrong

49
Q

How can a publication bias arise?

A

Occurs when positive results have a greater chance of being published than negative results even if the study quality is poorer in the positive result one

50
Q

What’s a confounding factor?

A

A factor which independently influences the relationship with the disease and exposure so skews the results

51
Q

Name 3 common confounding factors

A

Age
Sex
Social class

52
Q

What’re the criteria for causality?

A 
Strength of association 
Consistency 
Specificity
Temporality
Biological gradient 
Biological plausibility 
Coherence 
Analogy 
Experiment
53
Q

What’s the only absolute criterion for causality?

A

Temporality

54
Q

What’s temporality?

A

Whether the info about cause and effect were gathered at the same time

FoPC Year 2 (4 decks)

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