Patient worth with Dr. Hollingsworth
Term for when the measure of association between a variable and an observed effect is modified by another variable.
What is... Effect Modification
This leads to outcome stratifications in a sample set. For example, outcomes of drug tolerance due to smoking. It is different than a confounding variable, as a confound is causative.
What is the core ethical principle that physicians are obligated to respect patients as individuals (truth-telling confidentiality), create conditions necessary for autonomous choice (informed consent), and honor their preference in accepting or not accepting medical care?
What is... Autonomy
A graphic representation of event probability (y-axis) vs. length of time (x-axis). Useful for displaying "time-to-event" data. Outcomes examined may include any event but frequently includes mortality.
What is... a Kaplan-Meier Curve
A type of insurance plan in which patients are restricted to a limited panel (except for emergencies) is the most affordable and requires a referral from a primary care provider.
What is... a Health Maintenance Organization
The study of how people process and document the human experience.
What is... the Humanities
A medical error analysis that takes a retrospective approach. It is applied after a failure event to prevent a recurrence.
What is... a Root Cause Analysis
Methods: uses records and participant interviews (5 whys approach, fishbone/cause-and-effect diagrams, process maps) to identify all the underlying problems (process, people, environment, equipment, materials, management) that led to an error.
A mother and her 12-year-old daughter were in a car crash, and both are in desperate need of a blood transfusion in the ED. The family are devout Jehova's Witnesses.
As the attending physician, you need to determine if it is ethically responsible to provide a life-saving treatment to either of the patients. Which patient do you decide receives the transfusion?
Who is... the daughter
Retrospectively compares a group of people with disease to a group without disease. Looks to see if the odds of prior exposure or risk factors differ by disease state.
What is... a Case-Control Study
The ability for a patient to be psychologically and legally capable of making a particular healthcare decision.
What is... Decision-Making Capacity
Capacity is determined by a physician for a specific healthcare-related decision (right to refuse medical care).
Competency is determined by a judge and usually refers to more global categories of decision-making (legally unable to make ANY healthcare decision).
Who said, "For me, an area of moral clarity is: you're in front of someone who's suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, and you act"?
Who is... Paul Farmer
Term for when the measure of association between a variable and an observed effect is modified by another variable.
What is... Effect Modification
This leads to outcome stratifications in a sample set. For example, outcomes of drug tolerance due to smoking. It is different than a confounding variable, as a confound is causative.
The special ethical (fiduciary) duty to act in the patient's best interests. It may conflict with autonomy an informed patient has the right to decide what is best for society.
What.. is Beneficence
If 5/10 people are exposed to radiation and are diagnosed with cancer, and 1/10 people not exposed to radiation are diagnosed with cancer, the RR is ______.
What is... 5
RR is the risk of developing a disease/risk in the unexposed group
Medicare and Medicaid originated from an amendment to what law?
What is... the Social Security Act of 1935
Medicare is available to patients at the age of 65 and after, patients younger than 65 with certain disabilities, and those with end-stage renal disease. You care for the elderly.
Medicaid is a joint federal and state health assistance program for people with limited income and/or resources. You aid the disadvantaged.
What is the name of the free hospital that Patch, Carin, and Truman established together (and it still exists)?
What is the... The Gesundheit Institute
Any unexpected occurrence involving death or serious harm to the patient or the risk there of.
What is a sentinel event?
Compare this with:
Never event: An event that should never occur (i.e. wrong site/wrong side surgery).
Negligence: Failure to meet expected standard of care (i.e. not reviewing pathology report of cancer diagnosis).
Medical error: Any deviation from process of care.
A 15-year-old, female patient comes in to see a provider for STI testing. They are concerned about new bodily changes. What treatments/results MUST be discussed with the minor's parents?
What is... abortion
The physician does NOT have to disclose STI testing results, but they
A type of analysis where all subjects are analyzed according to their original, randomly assigned treatment. No one is excluded. Attempts to avoid bias from attrition, crossover, and nonrandom noncompliance may dilute the true effects of intervention.
What is... Intention To-Treat Analysis
What category of disease prevention is regular blood pressure measurements?
What is... Secondary Prevention
Secondary disease prevention is aimed at early detection of disease so as to reduce morbidity and mortality.
According to the humoral theory there are four bodily fluids: blood, yellow bile, black bile, and ______, that determine a person's temperament.
What is... Phlegm
What does the "S" stand for in the PDSA cycle?
What is... Study
Process improvement model to test changes in real clinical settings.
Plan - define problems and solution
Do - test new processes
Study - measure and analyze data
Act - integrate new processes into the workflow
What stage of the transtheoretical model of change is a patient in if they are in denial or ignorant of a problem (i.e. substance use disorder)?
What is … precontemplation?
The six stages of the transtheoretical model of change are:
1. Precontemplation: Denial or ignorance of problem
2. Contemplation: Awareness, but ambivalence, to problem
3. Preparation: Preparing to change behavior
4. Action: Taking action to change behavior
5. Maintenance: Maintaining the behavioral change
6. Relapse: Falling back into old behavior
A type of selection bias where cases and/or controls selected from hospitals (bedside bias) are less healthy and have different exposures.
What is... Berkson Bias
Also, it's good to know...
Attrition Bias: participants lost to follow-up have a different prognosis than those who complete the study.
Convenience Sampling: patients are enrolled on the basis of ease of contact.
What is the #1 most common cause of death of patients over the age of 65?
What is... Heart Disease
#1 Heart Disease
#2 Cancer
#3 Respiratory Disease (Chronic Lower)
Who said, "Instead of guiding students who tend to see medicine as a career or business endeavor into areas of medicine where such perspectives are widely accepted, we should instead ask those students to reflect on what will bring them not just a paycheck but also meaning and purpose in their life of medicine?
Who is... Dr. Piemonte