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02/07/2013

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Term
Categorical data
Definition
data that can be divided into groups
-race, sex, age education status
Term
Nominal data
Definition
divided into qualitative categories or groups
-male/female, black/white, urban/surburban/rural, red/green
-no implication of order or ratio
Term
Dichotomous data
Definition
-nominal data that falls into only two groups
Term
Ordinal data
Definition
-can be placed into meaningful order
-i.e. 1st, 2nd, 3rd
-no info about size of interval
-can't determine difference btwn 1st and 2nd, 2nd and 3rd etc
Term
Interval data
Definition
-can be placed in meaningful order
-have meaningful intervals btwn items
-i.e. Celsius scale
Term
Ratio data
Definition
-can be placed in meaningful order
-have meaningful intervals btwn items
-have an absolute zero--> meaningful ratios do exist (i.e. weight, time, bp, pulse rate)
Term
What is normal (Gaussian) distribution?
Definition
-symmetrical, bell-shaped curve
-mean=median=mode
Term
For Gaussian distributions, what data proportions are contained within +/- 1 SD?
Definition
68%
Term
For Gaussian distributions, what data proportions are contained within +/- 2 SD?
Definition
95%
Term
For Gaussian distributions, what data proportions are contained within +/- 3 SD?
Definition
99.7%
Term
What is a Z score?
Definition
-how many SDs a point lies above or below the mean of distribution= converted into a %
Term
What is the equation to calculate a z score?
Definition
Z= (x-mean)/SD
Term
What is a z score curve?
Definition
-area under the curve from Z score to end of the curve
Term
What is the actual number of SDs for 95% of data?
Definition
-area under the curve on one side= 0.025
-Z score= 1.96
Term
What is the actual number of SDs for 90% of data?
Definition
-area under the curve for .05
-1.65
Term
What is a positively (right) skewed non-Gaussian distribution?
Definition
-Mean> median> mode
-elongated tail at the right; more data in the right tail than would be expected in a normal distribution
Term
What is a negatively (left) skewed non-Gaussian distribution?
Definition
-Mean< median< mode
-elongated tail at the left; more data in the left tail than would be expected in a normal distribution
Term
Discrete vs. continuous data
Definition
-discrete- can only take certain values and none in between (ex. # of patients in a hospital census, # of syringes used in one day)
-continuous- may take any value (typically between certain limits); most biomedical variables are continuous (i.e. weight, height, age, BP); however, reporting the vales reduces them to a discrete variable
Term
What is the level of significance, alpha?
Definition
-probability level at which it is decided that the null hypothesis is incorrect
-< 0.05= difference between the groups is significant- null hypothesis is incorrect
->0.05= difference between the groups isn't significant- null hypothesis is correct.
Term
What is statistical significance?
Definition
-probability that the events were unlikely to have occurred by chance (i.e. p< 0.05= likelihood of results having occured by chance is 0.05 or less)
-does NOT make result truly significant
Term
When is the Chi square (x^2) test used?
Definition
-used for testing hypotheses about nominal scale data
-Test of proportions- whether the proportions of observations falling in different categories differ significantly from proportion that would be expected by chance.
-compares percents or proportions (not mean values)
Term
When is the Student's t test used?
Definition
-T score= estimated standard error used to find a statistic; must be used when making inferences about means that are based on estimates of population parameters rather than on population parameters themselves
- 1+ comparisons (i.e. 1+ groups being compared)
Term
When is ANOVA used?
Definition
-Total variability- variability resulting from known differences btwn groups; ordinary random variability within each group that is to be expected in any set of data caused by sampling error, individual differences between patients, etc
-Compare variance- F ratio= (variance between groups)/ (variance w/in group)
-1 comparison (ie. between two sample means, or between sample man and hypothesized population mean.
Term
When do you use Wilcoxon rank-sum?
Definition
-used when comparing two related samples, matched samples, or repeated measurements on a single sample to assess whether their population means rank differ
-used as alternative to Student's T test when population can't be assumed to be normally distributed
-interval scale data
Term
When do you use Manten-Haenzel?
Definition
used for repeated tests of independence
Term
When do you use Mann-Whitney?
Definition
-used to assess wheter 1 or 2 samples of independent observation tends to have larger values than the other.
-ordinal data
-distributions sufficiently far from normal and for sufficiently large samples
Term
When do you use Kruskal-Wallis?
Definition
-used when there is 1 nominal variable and 1 measurement variable, and measurement variable doesn't meet assumption of ANOVA
-NO assumptions about normality
-Ranke data
Term
What is a "non-inferiority" trial?
Definition
-primary objective is response to investigational product is not clinically inferior to a comparative agent (active or placebo control)
Term
What is a "1 tailed analysis"?
Definition
-alternative hypothesis is directional (aka, specifies that the population mean lies in a particular direction with respect to null hypothesis.
-more powerful than two tailed analysis
-used w/ "non-inferiority" clinical trials
Term
What is a "2 tailed analysis"?
Definition
-alternative hypothesis is nondirectional (aka, population mean not equal to X, but didn't specify whether above or below)
Term
Do "non-inferiority" trials primarily use 1-tailed or 2-tailed analysis?
Definition
1-tailed
Term
Randomized trial
Definition
-gold standard for clinical trial
-tests efficacy of various types of intervention within a patient population
-subjects randomly allocated to receive one or the other treatment
Term
Cohort study
Definition
-focus on factors related to disease development
-aka "which factors can cause disease?"
-some people exposed to risk factor for disease
-"follow-up" study or "longitudinal" study
Term
Case-control study
Definition
-compares people with disease and those without
-looks to identify possible independent variables that cause disease
-aka "how did I get this disease and the other person didn't?"
Term
What are some advantages to a case-control study?
Definition
-performed quickly and cheaply
-require comparatively few subjects
-allow multiple potential causes of disease
Term
What are some disadvantages to a case-control study?
Definition
-bias about history based on presence of disease
-undiagnosed/asymptomatic cases missed
-comparable control group difficult to assemble
-control group is based on researcher's judgment
-cannot determine rate or risk of disease
-no cause-effect relationship
Term
Cross-sectional survey
Definition
-surveys entire population
-assesses proportion of people with certain disease
-aka "how many people in Kentucky have disease X?"
Term
Disadvantages of cross-sectional survey
Definition
-likely to over-represent chronic disease and under-represent acute disease
-may be unstable for acute disease (few people suffering from it at the time of survey)
-people with certain disease may leave community, be institutionalized
Term
Odds ratio
Definition
-ratio of the odds that a case was exposed: odds that control was exposed
-OR = (case exposed to risk)/(control exposed to risk)
-must be used when analyzing case-control data
Term
Risk ratio
Definition
-relative risk
-(incidence of disease among people exposed)/(incidence of disease among people not exposed)
Term
Relative risk reduction
Definition
1-risk ratio
Term
Confidence Interval
Definition
-difference between upper and lower confidence limits
-mean +/- (z score*SD)
Term
Bias
Definition
-problem with study design
-study consistently errs in a particular direction
Term
Lead time bias
Definition
overestimation of survival duration among screen-detected cases (vs. those detected clinically) when survival is measured from diagnosis
Term
Length bias
Definition
overestimation of survival duration among screening-detected cases caused by relative excess of slowly-progressing cases
Term
Recall bias
Definition
exposure status measurement relies on patient report
-patients can be poor historians
Term
Selection bias
Definition
unintended systematic difference between study groups
Term
Confounding
Definition
variables that contribute differently and inextricably to the 2 groups
-this is why you need random assignment
Term
Causation
Definition
observed association due to causal relationship
-measured via randomized clinical trial or cohort study
-can't be measured via observational study
Term
Type 1 (a) error
Definition
"false positive"
-accepting the alternative (or experimental) hypothesis when it's wrong
-probability Type 1 error will be made = a = p
Term
Type 2 (B) error
Definition
"false negative"
-rejecting the alternative (or experimental) hypothesis when it's true
-probability Type 2 error will be made = B
Term
Define "power"
Definition
probability that false null hypothesis will be rejected
- 1-B
Term
How do you increase the power analysis?
Definition
-increase sample size
-increase a
-increase size of difference between sample mean and hypothesized population mean
-decrease sampling error
Term
If p > 0.05, what should you look for
Definition
-see if they did a power analysis to prevent "type 2 error"
Term
How do you calculate "number needed to treat" in "positive" clinical trials?
Definition
NNT= 1/ARR = 100/[(risk with usual care)-(risk with new tx)]
Term
Sensitivity
Definition
-ability to detect people who DO have disease
-rule OUT people who don't (snOUT)
= [TP / (TP + FN)] x 100
Term
Specificity
Definition
-ability to detect people who do not have disease
-rule IN people who do (spIN)
= [TN / (TN + FP)] x 100
Term
False positive
Definition
-number of people tested positive when disease is actually absent
-Type 1 error
Term
False negative
Definition
-numer of people tested negative when disease is present
-Type 2 error
Term
Positive predictive value
Definition
-proportion of positive results that are truly positive
PPV = TP / (TP + FP)
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