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| compare levels of exposure and disease in several populations |
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| des. a group of individual with disease |
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| des. exposure / or disease status in a pop. |
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| compare exposure histories in people with disease (case) and without (control) |
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| compares rates of new (incident) disease in people with different exposure history or follow a population forward in time to look for incident diseases |
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| compares outcome in participants assigned to an intervention or control group |
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| seek to understand how individuals and communities perceive and make of the world and their expiriences |
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| case series, cross-sectional, ecological |
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| case control, experimental, cohort |
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| the inigma( not analytical not descriptive) |
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| ask about past exposures? |
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| asks about current status? |
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| case series and case control focus on individuals with what? |
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| cohort focuses on what on idividuals? |
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| select participatns who represent a population at one point in time |
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| select participants who reprent a pop. in multiple points in time |
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| to describe a new perspective on a topic that can be supported by the existing literature |
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| compare the findings of previous studies on a well-defined topic |
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| systematic review goal and designed to do what? |
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| compare the findings of previous studies on a well-defined topic, minimize bias |
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| to summerize previous findings using pooled statistics |
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| narrative review intended to? |
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| convey a perspective and not compile faccts |
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| systematic search strategy, read each study, asses quality and comparability, extract statistical result, combine stat. results |
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| Narrative is objectie or sub? |
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| less objective, more subjectiev |
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| other names for ecological study |
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| aggregate or correlational |
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| ecological study uses population level data to... |
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| look for associations b/w two or more group characteristics |
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| proportion of each population with a particular charact. or the average value of the variable in the population |
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| Pearson correlation coef. |
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| used to calculate the correlation (r) |
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| spearman rank order correlation |
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| variable that assign rank to responses or that have order catergories |
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| "doers the rate of asthma tend to be higher in cities with higher levels of air pollution?" example of what study? |
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| data for ecological doesnt have what? |
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| time order/ time sequence |
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| no association b/w exposure and outcome |
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| scatterplot for eco. demonstrates |
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| association, NOT CASUALITY |
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| all points fall neatly on a line |
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| mild correlation or moderate |
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| points are not exactly linear but a line for trend can be drawn |
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| correlation is weak or non existent |
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| points appear to be randomly placed and no obvious line can be drawn |
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| if higher levels of exposure are linked to lower rates of disease the slope is? |
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| Parametric def. and plot line |
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pearson; CONTINUOUS, assumes normality, homescedasticity, linearity, and independence
(univariate analysis can confirm these assumptions) |
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| non parametric def. and data plot |
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| spearman; makes no assumption, rank based |
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| cross sectional ecological |
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| purely descriptive, one point in time |
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| descriptive and analytical beginning of temporal classification (follows up) |
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| association b/w 2 or more variables which shows how strong correlation is without indication direction |
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| 0 for no corr. to 1 perfect corr. |
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| determines if 2 or more related items for a survey measures various features of the same thing. INTERNAL CONSISTENCY |
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| cronbachs alpha and kuder richardson formula 20 (KR20) ARE para or non? |
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cron;parametric and KR20; non para
both measures of internal consistancy |
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| knowing exposure and disease rates by age group in pop |
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| age distributions are known but age specific rates of exposure / disease are NOT |
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| incorrect attribution of population level associations to individuals |
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| phenomenology, grounded theory, ethnography, focus groups, consesus methods, program evaluation |
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grounds itself in introspective
(ask group their lived experience) |
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| more structured then phenom. and aimed to establish theory |
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| chinatown expir. studying people, culture.. |
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must use a "protocal" to help drie the meeting
CANT BE GENERALIZED but great for extracting salient variables |
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| what qualitative design is great for extracting salient variables |
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| what qualitative design is a good method to check for validity |
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| program evaluation main purpose |
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| to identify what is working wel and what can improve |
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| cross sectional participants must be representative of |
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| cross sectional cannot show that an exposure... |
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| prevelency study is a ____ survey |
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| develop hypothesis, identify and study subgroup, avoid selecting sample by (blood pressure status..) |
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| used for describing communites, asses pop. needs, evaluate programs, establish baseline data prior to start of longitudinal study |
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| design has no time element and CANT infer casuality |
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| observation analytical which designs? |
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| analytical that manipulates the variable |
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| analytical that DOES NOT manipulate the variable |
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| RCT & QET -->INTERVENTIONS |
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timing of data collection
(retrospective) |
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| leads to prevention or risk factor/disease, leads to quant. (framingham heart study) |
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| analytical research (premordial & primary) |
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dropout rate
30% but you want no more than 10% |
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| a task of classification sequenses (time series data) for given categories |
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| Do you have temporal classific. in case control |
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| study conducted retrospectively and why (look up) |
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| best study design to identify risk factor or rare disease |
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| selection of ___ can be difficult to execute and should be choosen from the same population as cases |
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| used to identify likely risk factors in case controls |
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| why are cases and controls matched? |
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| to make as comparable as possible |
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| controls are called what in case controls? |
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| referent groups or study base |
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| what does it mean that the data is in the aggregate? |
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| exposure and outcomes are in the form of proportion of population with particular charact. or average value of variable in population |
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| ecological design is important to have comparable data why? |
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| key to sucess is identifying a data source that contains comparable material to examine relationship b/w exposure rates and disease rates |
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| probability of finding a case in a time frame relates to mortality risk |
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| where can you get controls in case control study |
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| friends and relatie of cases, hospital/clinic, general pop |
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| in case control, asking if participants are case or control clearly can prevent it |
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| cases and controls have dif. memories of the past |
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| measure of association that readers will expect to be reported for a case control. odds of exposure in case to odds of exposure in control |
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| odds ratios greater than 1 |
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| if odds of exposure are same fo cases and controls |
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| what designs calculate direct risk? |
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| cohort and experimental bc starting at disease free |
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| why are results pullesd towards a null in cohort? |
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| discordant exposure histories provide what? |
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| whether exposure is likely to be risky |
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| compares incidence rate among exposed and non exposed |
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| attributable risk (cohort) |
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| comparing new diseases in exposed and non exposed members |
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# of new cases of disease in a pop. during specified time
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total # of person in pop whore were at risk at the time |
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| exposed participants are more examined then un exposed |
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| absolute difference in incidence rate |
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| excess risk or attributable risk |
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| how are groups in cohort designs set up? |
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| few exposure many outcomes |
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| longitudinal cohort studies |
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| follow a group of indiv. forward in time but dont recruit them based on exposure status but instead memebership in well defined pop. |
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| 4 components of exp. study |
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| manipulations of IV, temporal classification, proper comparison groups and random assingment |
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| temporal classification in exp. study |
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| follow subjects over a period of time |
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| what allows to explore cause and effect and infer casuality at highest standard in experimental study? |
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| the four components; manip. of IV, temporal class, proper comparison group and random assignment |
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| GOLD standard for infer casuality |
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| why is exp. the gold standard for infering casuality? |
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| may provide only reliable basis for evaluatign efficacy and safety for new treatment |
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| lack control group or RANDOM allocation/selection |
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| has control group and random selection |
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| assigning participants particular outcome? |
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| participants change behavior for the better |
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researcher assigns partici. first to active and then control
then other participants to control first then active.
introduce washout period between |
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| true test of effectiveness in experimental study |
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| defining intervention ROXO |
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r=random assingment
o=oberservation/measurement
x=experimental treatment
__(blank space)= control condition |
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| defining outcomes in experimental study; types of sucess? |
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superiority; intervention is better than control
noinferiority; int. is not worse
equivalence; int. is equal |
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| value that can hopefully serve as a reliable substitute for disease (blood pressure) |
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| placebo controlled vs. true controlled |
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placebo; active pill and inactive pill are given
true controlled; new therapy and existing therapy are given |
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| participants and some team member dont know whether the part. are taking control or active |
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| participant and researcher dont know |
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| includes double blind and info is also withheld from staticians analyzing the data |
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| randomization of experimental types |
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| simple and block and statified |
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| simple randomization (exp) |
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| coin toss, random generator |
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| assigns groups of people like communities, schools |
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| asings individ. within certain subgroups (males females, age group) |
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| ethical consideration for experimental designs |
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| equipose (unsure of which meds work better), distributive justice; dont exploit low income, and respect for person |
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| ___ use measures of association to examine impact of assigned exposure on the likelyhood of having a favorable or not, outcome |
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| ___ use measures of association to examine impact of unassigned exposure on incidence of disease |
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| proportion of ind. in control group who experience unfavorable outcome who could have been ok if in active group |
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| number needed to treat NNT |
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| expected number of people who would have had unfavor. outcome |
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| more effective intervention |
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| ideal for real world efficacy |
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| treatment received approach |
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| ideal for real world effectiviness |
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| treatment assigned approach |
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| proportion of people who have a disease and test positive |
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| propor. of people who dont have disease and test negaitve |
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| positive predic. value PPV |
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| those who test positive and have disease |
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| kappa statistic can measure |
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| strenghts, weakness, opportunities, strengths |
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structure decision making process where parti. engage in rounds of questionares, sharing responses.
goal is to move panel of experts closer to agreement |
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| measure, sample, and analyze properly |
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| measure, analyze, sample properly |
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| random error results in increase chance of |
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| systematic error increases chance that |
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| your findings dont reflect "truth b/w variable" |
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| how do well structured designs keep error low |
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| post positivism and constructivism |
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tendency to generalize, more positivistic, more deduction
variable are non spurious (non truth) temp. truth
ex. men eat apples, apples are red, men eat red apples |
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inductionist, seeking to completely undertand
ex. why does this man eat red apples? |
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| participation in research should be voluntary |
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| benefits and burdens of research are fair |
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| institutional review boards; protect human subjects, protect researchers from liability, protect researchers by preventing them from engaging in harm |
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1. exemption 2. expedited review 3. full review
steps! |
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| fair procedure and distribution of benefits and burdens |
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A PRIORI
means justify the ends
ends ONLY if means are just |
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POSTERIORI
ends justify mean |
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| similarities and diferences between cases |
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