Clinical decision making

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Board Exam ClinicalDecisionSupport (CDS) Flashcards on Clinical decision making, created by Michael Riben on 08/10/2013.
Michael Riben
Flashcards by Michael Riben, updated more than 1 year ago
Michael Riben
Created by Michael Riben over 10 years ago
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Question Answer
how do you calculate the expected value? [Prob*value of win] + [prob*value of lose]
What is expected Utility function of value and also risk aversion, personal pref
What are sources of Decision Bias? diagnostic inference, blois funnel, making decision based on opinion is subject to predictable patterns of bias
What is availability Bias? overestimation of the probability of unusual events because of recent or memorable instances
What is Representative Bias ? overestimating rare disease by matching patients to typical picture of that disease
What is anchoring Bias? Failure to adjust probability of a disease or outocme based on new information akin to premature closure
What is a value induced bias Overestimate of the probability of an outcome based on value associated with outcome i..e not wanting to miss brain tumor
What do sum of all probabilities for a situation equal to? 1
What are conditional probabilities Probability of X given y p(X|Y)
What are conditional probabilities Probability of X given y p(X|Y)
what is a Cost effective analysis Value of outcome nodes becomes units of cost instead of the values used in our example (life = 1, death = 0)
What is time trade off? choose between X time in state of illness vs. Y time in state of perfect health
What is the standard gamble? choose between X time in state of illness vs. therapy with known risk of cure or death
What is the incremental cost/effectiveness Ratio? ICER = (C1-C2)/(E1-E2) measure of change in cost with change in unit of effectiveness (usually the QALY)
What is the incremental cost/effectiveness Ratio? ICER = (C1-C2)/(E1-E2) measure of change in cost with change in unit of effectiveness (usually the QALY)
What is sensitivity? Equal to True Positive Rate = TP/(TP+FN)
What is Specificity ? Equal to True Negative Rate - TN/(FP+TN)
What is sensitivity out or snOUT? sensitivity test allows you to rule a condition out . you want to minimize false negative so you can trust a negative test
What is spIN Specifity tests allow you to rule condition in, minimize false positives so you can trust a positive test
What is the Positive Predictive value? Characteristic of test in context of condition and dependent on prevalence of a condition in population PPV = TP/(TP+FP)
What is negative predictive Value? Characteristic of test in context of condition and dependent on prevalence of a condition in population NPV = TN/(TN+FN)
What is negative predictive Value? Characteristic of test in context of condition and dependent on prevalence of a condition in population NPV = TN/(TN+FN)
What do Sensitivity and Specificity of test assume? Assume you know the disease state and it is used to determine if test performs as tested
What does PPV and NPV assume? Assumes you know the test results and your trying to determine the disease state
What is a useful way to remember S, Sp, PPV, and NPV? s= given a known disease,what is probability of a positive test Sp= Given the patient doesn't have disease, what is the probability of negative test? PPV- Given a positive test, what is probability of patient having disease NPV= given a negative test, what is probability patient doesn't have disease
What is prevalence of disease? TP+FN/Total #
What is prevalence of disease? TP+FN/Total #
What is the Receiver Operating Characteristics? Graph of sensitivity vs. 1-specificity (TPR vs FPR)
What is the area under curve in a ROC curve --> Allows to compare different tests to determine which is better at distinguishing disease from normal ( a higher under care is betteR)
What is the relative risk? RR = prob (Disease|Exposure)/ P(disease|no Exposure)
Bayes theorem Probability of disease given a pos test = prob of positive test given disease (sensitivity) multiplied by Prob of disease (prior prob) devided by prob of positive test (
What are Odds? Odds X = P(X)/1 - P(X)
what does Post test odds =? Pre-test odds X Likelihood Ratio
What is the Positive Likelihood Ratio? LR+= sensitivity/1-Specificity = TPR/FPR
What does negative Likelihood ratio ? LR- = 1-sensitivity/Specificity = FNR/TNR
What is the Fagan Nomogram Allows you to determine the post-test probabiltiy given the pre-test probability (prevalence) and the positive Likelihood ratio
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