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85 Cards in this Set
- Front
- Back
What term does the state pertain to? "As randomized, so analyzed" |
Intent to Treat |
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What is the difference between Relative Risk and Odds Ratio |
RR: proportion; compares an event in relation to all the events Odds Ratio: ratio of ratios; compares events with non events |
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What 3 criteria must be present in experimental research? |
1. cause must precede effect 2. cause and effect must be correlated 3. correlation cant be explained by another variable |
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T/F
Compliant subjects usually have better outcomes than non-compliant subjects regardless of treatment |
True |
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Describe a Cohort Study |
Prospective |
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Describe a Case Control Study |
retrospective |
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Describe Efficacy and Effectiveness in RCTs |
Efficacy refers to those that received treatment Effectiveness refers to those who were offered treatment
Efficacy excludes non-compliers |
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Describe internal and external validity |
Internal: Did it make a difference?
External: Can it be applied |
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Describe the 'last assessment point carried forward' technique |
Used for non-compliant data, take the last assessment point before they dropped out and carry it forward to each assessment check point |
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What are the two ways of dealing with non-compliers? |
1. implement strategies to minimize withdrawal 2. report lost data in a flow diagram |
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Describe the psychological theory of the placebo |
It's not the treatment that works, it's the belief that it will work
Irving Kirsch Anti-depressant study |
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Which study discussed in class emphasizes the subjective nature of pain |
Talbot, 2000 Wisdom Teeth |
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Describe the process-of-treatment theory |
showing attention and care for the patient triggers physical reactions that reduce stress and promote healing |
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what is the gold standard study for epidemiology work? |
Cohort |
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What is the key feature of a cohort study? |
time |
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What are the 2 types of epidemiological study designs and their subcategories? Define each. |
Descriptive: Cross Sectional (look at the mean difference) and Ecological (existing data sets; compare/contrast rate of disease in specific popn) Analytical: Case-Control and Cohort (individuals with disease are selected and their exposure is traced back in time) |
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Is a cross sectional design prospective or retrospective? |
retro. |
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Is a case control design prospective or retrospective? |
retro. |
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Is a cohort design prospective or retrospective? |
pro. |
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What is the limitation of the cross sectional design? |
outcome measured at a single time point |
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What are 3 limitations of an ecological design? |
Levelof analysis is the population rather than the individual. Unableto control for the effects of other factors that could obscure the relationship
Only useful at testing initial hypotheses about exposure |
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The Morris et al Occupational Physical Activity Study is an example of __________ study design. |
Ecological. |
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The Paffenbarger et al. Harvard Alumni study (PA and heart attack levels) is an example of ________ study design. |
Cohort. |
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The Fish Oil study was a ________ design |
Cohort. |
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What are the pros and cons of a cohort study? |
Pros: Temporal sequence, multiple effects Cons: time, money, loss to follow up, rare disease |
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An odds ratio calculation is used in ______ study |
case control and cohort |
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incidence rate and relative risk calculations are used in _______ study. |
cohort |
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What does an odds ratio of 0.30 mean? |
There is a 70% reduced risk in the disease |
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What are the pros and cons of a case control study? |
Pros: valid estimate of exposure disease, $ Cons: temporal sequencing not ideal, recall bias, recruit control participants |
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What are the equations for Relative risk and Odds Ratio? |
RR=[(a/a+b)/(c/c+d)] Odds Ratio=[(a/c)/(b/d)] |
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What are the 3 criteria for experimental research? |
1. Cause must precede effect 2. cause and effect must be correlated 3. Correlation cannot be explained by another variable |
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What are the 4 phases of a clinical trial? |
1. Small number of patients; emphasis on how drug should be given (dose, frequency) 2. Proof of principle: safety and how well it works 3. Large number of patients; compare to the current standard (RCT) 4. Large number of patients; drug already being marketed; Evaluate long term side effects, risks and benefits |
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What is the difference between effectiveness and efficacy? |
Effective--> on those offered Efficacy--> on those who receive it |
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What is the difference between internal and external validity? |
Internal: did the treatment make a difference External: can it be applied |
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What is the process of treatment theory? |
Showing attention, and care to a patient triggers a physical reaction in the body that promotes healing |
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What is the Hawthorne effect? |
Subjects improve their behavior in response to their awareness of being observed |
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Pygmalion effect "self-fulfilling prophecy" |
the greater the expectation placed upon people, the better they perform |
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What is Relative Risk? |
the dif btw event rates in relative terms |
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How do we calc RRR |
ARR/control |
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How do we calc ARR? |
Treatment-Control |
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What is Absolute Risk? |
The actual difference in event rates |
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How do we calc NNT? |
1 or 100/ ARR |
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What is the event rate? |
the # of people experiencing an event as a proportion of the # of people in the population |
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What are two ways to collect qualitative data? |
Analytical narrative: Short interpretive description Narrative vignette: Detailed description that conveys a sense of holisticmeaning |
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What is trustworthiness? |
quality achieved in a study when the datacollected generally are applicable, consistent, and natural Is the study competently conducted? |
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What are the 4 techniques for determining trustworthiness? |
1. Triangulation: need three sources of data 2. Consensual Validation: isthe process of achieving mutual agreement between analysts relative to finalorder of each quote and theme 3. Reliability Check: have someone work backwards—theindependent analyst proceeds sequentially to categorize the quotes into theappropriate lower order levels and themes 4. Data Saturation: occurs when the researcher is nolonger hearing or seeing new information |
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What is the gold standard for measuring PAEE in the free-living environment? |
Doubly Labelled Water (DLW) |
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What is the most accurate (objective) measurements of PA and Body composition? |
Actical and iDEXA |
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How do you calc effect size? |
(Mean of exp-mean of control)/ SD of control |
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Describe the relationship btw effect size, sample size and power |
as ES increases, N decreases for the same power |
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How does changing the P value influence sample size? |
Reducing the P value means we need to increase our sample size |
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What does an alpha of .05 mean? |
there is a 5% chance that the data is due to random variability, and a 95% chance that it is not. |
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What does a power of .8 mean? |
If the study was conducted again, there is an 80% chance that the same result would be found. |
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What are the equations for eta and omega? |
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What is the coefficient of determination? |
one variable can predict a % of the scores from the other variable |
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Define moderation and mediation |
Moderation: Underwhat conditions does X relate to Y? (A third variable) Mediation: Whydoes variable X relate to Y under some conditions but not others? |
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What is a type 1 error |
reject the null when the hypothesis is True (There is no difference but we think there is) |
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What is a type 2 error |
Not reject the null when the hypothesis is False (There is a difference but we think there isn't) |
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Define effect size. |
ES is meaningfulness. It deals the with strength and magnitude of the finding |
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Define Power |
Poweris the probability of rejecting the null hypothesis when the null hypothesis isfalse (e.g., detecting a real difference) |
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Define Coefficient of Determination |
The coefficient of determinationindicates the portion of total variance in one measure that can be explained,or accounted for, by the variance in the other measure (% of overlap) |
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Advantages (4) and disadvantages (2) of a case-study |
Advantages -Emphasis on helping -In-depth analysis of how the variables affect each other -More informative -$ Dis. -External validity -Opportunity for bias |
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What does equivocal mean? |
not clear cut |
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What type of study was used for the Rifle Shooter? |
Case Study |
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what is the difference btw a case study and a single subject design? |
Case study uses one person, single subject design uses a small number of people |
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What are the advantages (6) and disadvantages of a single subject design? |
Advantages -Focus on measurement of consistency acrosstrials -Small n -ID within and btw subject changes Everyone receives the intervention -Not hampered by statistical assumptions -Emphasis on socialvalidation Dis. |
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What is the key feature of a Single Subject Design? |
ongoing assessment for consistency |
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How do you calculate inter-observer reliability? |
dividethe smaller total of the dependent variable by one observer by the larger totalrecorded by the second observer and then multiply by 100 |
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Describe the 3 types of single subject designs |
1. Replication Reversal (ABAB): Light switch; turn treatment on and off 2. Multiple Baseline: Baseline gets progressively longer 3. Alternating Treatment: Compares more than one treatment intervention |
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Why is visual analysis of data advantageous? |
if it’s large enough to see it’s likely to be significant |
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WHat are 3 statistical tests used in Single Subject Designs? |
1. Split Method: Atrend line is made in the baseline and then extended into the interventionperiod.Comparethe proportion of data points above and below the line across the two phases. 2. Two SD method:calculatevariability around the mean, 2points above the SD in the treatment phase indicates a change in performance. 3. Trend (Time Series Analysis): Compare slopes of line of best fits |
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Epidemiological research is _________ not _______ |
Observational not experimental |
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Epidemiology research is used to provide the scientificbackbone for public health endeavors, including: |
Magnitude of the problem risk factors allocate resources monitor prevention strategies |
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Descriptive vs Analytical |
D: general observations of disease relationship to demographics A: test specific hypotheses using purely observational methods |
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What study was the first time epidemiology was used to link levels of PA to disease? |
Harvard Alumni, Paffenbarger et al Examining activity levels and rates of heart attacks |
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Clinical Trial |
test whether one health care interventionis superior to another |
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Selection Bias |
Occurswhen groups are formed on some basis other than random assignment. Thus, whentreatments are administered, because the groups were different to begin with-->rivalhypothesis that differences are due to the initial selection biasesrather than treatment |
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How do we deal with withdrawl in an ITT analysis |
- Designtrial to minimize withdrawal -Accuratelyreport withdrawal -Analyticapproaches (lastobservation carried forward, other imputation techniques) canbe used to reduce, but not remove the effect of withdrawal |
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Hawthorne effect |
Feeling of being studied=perform better |
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Pygmalion Effect |
greater the expectation placed upon people, the better they perform |
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Expectancy Bias |
refersto the experimenters’ or researchers’ anticipating that certain participantswill perform better |
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How do you calc RRR |
1-(treated/untreated) Or ARR/control |
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How do you calc ARR |
treated-untreated |
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How do you calc NNT? |
1 or 100/ ARR |
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Statistical Sign. Clinical Sign. |
Stat: is this difference likely to be real (not due to chance) Clinic: is this difference likely to meet the measurement criteria |