Biostatistics/Health Delivery

What does an Odds Ratio of 4.0 compared to 1.0 indicate about disease risk?

The first group has a 400% higher chance of having the disease compared to the second group.

What is Relative Risk (RR) in cohort studies?

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

Define Specificity in diagnostic testing.

Specificity rules in and identifies true negatives.

What does Sensitivity in diagnostic testing indicate?

Sensitivity rules out and identifies true positives.

What does NNT stand for and what does it signify?

Number needed to treat; it is the number of patients that need to be treated to prevent one additional bad outcome.

How is Attributable Risk Percent (ARP) calculated?

ARP = (RR - 1)/RR.

What is the purpose of conducting a Failure Mode and Effects Analysis?

To find solutions to potential problems before they arise.

What is a Control Chart Analysis used for?

To monitor a variable over time and identify potential issues when points fall outside control limits.

What does the Hawthorne Effect refer to?

Changes in behavior by participants when they know they are being observed.

What is the Null Hypothesis (H0)?

It states that there is no association between the disease and the risk factor.

What does a Type I error indicate?

It occurs when we wrongly reject the null hypothesis, claiming there is an association when there isn’t.

What does the term 'power' refer to in hypothesis testing?

The probability of correctly rejecting the null hypothesis.

What is the significance of a p-value less than 0.05?

It indicates statistical significance, suggesting that results are unlikely to have occurred by chance.

What is Phase I of clinical trials focused on?

Testing safety and dosage in a small number of healthy subjects.

Explain what a Likelihood Ratio is in context of diagnostic tests.

It indicates the extent to which a test result is correct, with LR+ being sensitivity/(1-specificity) and LR- being specificity/(1-sensitivity).

What does 'matching' achieve in studies?

It prevents confounding by ensuring comparison groups are similar in key characteristics.

When there is no impact on future prognosis for genetic testing for children, when should they be tested?

Testing should be deferred until they reach the age of consent or exhibit symptoms.

What is the most effective intervention for sign-out safety?

Having a standardized template

What is one way to improve adherence to isolation precautions?

Having strategically placed visual aids

When an association remains statistically significant even after adjusting for factors, why is that?

It’s likely there are some other factors that weren’t able to be accounted for

Should a patient want to be an organ donor after death, what are contraindications to organ donation?

incurable or metastatic malignancy, sepsis, transmissible spongiform encephalopathies (e.g., Creutzfeldt-Jakob disease), and cardiac arrest that occurred before brain death,

What are signs of dementia that warrant hospice care?

Signs of dementia that warrant hospice care include significant cognitive decline, inability to perform daily activities, and worsening overall health status.

What are the tests for diagnosing brain death?

Tests for diagnosing brain death include clinical examinations to assess coma, absence of brainstem reflexes, and apnea testing.

Under HIPAA, who can receive patient information without the patient’s consent?

Certain healthcare providers, legal representatives, and public health authorities.

What is the hierarchy of next-of-kin?

Starts with the spouse, followed by adult children, parents, siblings, and other relatives.

What describes a bundled payment model of insurance?

A fixed payment that covers all services related to a treatment or episode of care, encouraging cost efficiency and coordinated care.

What is the goal of resource stewardship?

To optimize resource use while ensuring high-quality patient care, reducing unnecessary testing

What additional precautions should be taken for patients who develop multi drug resistant bacteria?

Isolation to a single occupancy room

When should the ethics committee be consulted?

When there is a difference of opinion between the family and the medical team over life-sustaining measures in a patient with established brain death, for instance

What are gifts that are unacceptable?

Gifts that could influence clinical decision-making or compromise professional integrity, such as expensive items or personal favors.

What describes alert fatigue?

A decline in attention or responsiveness to alarms due to an overwhelming number of alerts.

What are scenarios where confidentiality is waived?

1. Patient explicitly waives right to privacy

2. Diseases that must be reported, like STI, HIV, TB

3. Patient is a danger to oneself or others

4. Abuse

5. Penetrating wounds

Informed consent should always be obtained, but there are situations where it’s not required to obtain informed consent. What are they?

1. Emergency situations where treatment is necessary to prevent harm or death

2. Patients are unable to provide consent due to incapacitation

What are situations in which minors do not need parental/guardian consent?

1. Treatment for sexually transmitted infections

2. Emergencies

3. Substance abuse treatment

If a surrogate’s decision endangers the life of the patient, such as refusing emergency life-saving treatment, what is done?

Proceed to treatment

What situations would be life-threatening should there be refusal of treatment?

1. Refusal of emergency surgery

2. Denial of critical medication