Term
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Definition
- Fundamental to understanding reasoning under uncertainty
- Mathematical expression of chance
- Medical reasoning is reasoning under uncertainty |
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Term
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Definition
- Must make use of available [uncertain] information to make decisions
- Knowing the information is absolutely useless without knowing how uncertain it is
-All information is uncertain to some extent |
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Definition
Can’t have disease and not have disease at the same time (example: can’t be pregnant and not pregnant simultaneously)
Usually a problem when considering more than 2 possibilities |
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Term
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Definition
| all possible options are included in the set |
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Term
| Examples of Diagnostic Tests |
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Definition
Depending on situation:
- Electrical signals (EKG, EEG, etc.)
- Imaging (X-rays, CT scans, etc.)
- Sounds (stethoscope, ultrasound, Doppler, etc.)
- Tissue (biopsies, Pap smears, etc.)
- Observations (rashes, gait, endoscopy, etc.)
- “test” might even be a specific question – “Does this happen when you do XYZ?” |
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Term
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Definition
- The probability of a positive test given the presence of a disease
- Does the test find what it is supposed to?
- AKA: True Positive Rate (TPR) |
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Term
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Definition
- The probability of a negative test in the absence of a disease
- Is a negative test really negative?
- AKA: True Negative Rate (TNR) |
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Term
| Positive Predictive Value |
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Definition
| The probability of having a disease given a positive test |
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| Negative Predictive Value |
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Definition
| The probability of not having a disease given a negative test |
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Term
| Definition of Evidence Based Medicine |
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Definition
Conscientious and judicious use of current best
research evidence in combination with clinical
expertise and patient values applied to the
management of individual patients. |
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Term
| Evidence based medicine (from chart in class) |
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Definition
| is at the intersection of Best External Evidence, Individual Clinical Expertise and Patient Values & Expectations |
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Term
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Definition
Cohort studies identify a group of patients who are already taking a particular treatment or have an exposure, follow them forward over time, and then compare their outcomes with a similar group that has not been affected by the treatment or exposure being studied.
Cohort studies are observational and not as reliable as randomized controlled studies, since the two groups may differ in ways other than in the variable under study. |
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Term
| Randomized Controlled Trials |
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Definition
Randomized controlled clinical trials are carefully planned experiments that introduce a treatment or exposure to study its effect on real patients. They include methodologies that reduce the potential for bias (randomization and blinding) and that allow for comparison between intervention groups and control (no intervention) groups.
A randomized controlled trial is a planned experiment and can provide sound evidence of cause and effect. |
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Term
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Definition
Systematic Reviews focus on a clinical topic and answer a specific question.
An extensive literature search is conducted to identify studies with sound methodology. The studies are reviewed, assessed for quality, and the results summarized according to the predetermined criteria of the review question. |
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Term
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Definition
| thoroughly examines a number of valid studies on a topic and mathematically combine the results using accepted statistical methodology to report the results as if it were one large study. |
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Term
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Definition
| are systematic errors that predispose one's thinking in favor of a certain viewpoint over other viewpoints |
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Definition
| The tendency to search for or interpret information in a way that confirms one's preconceptions, while ignoring information that does not support the preconceptions. |
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Definition
| — the tendency to reject new evidence that contradicts an established paradigm. |
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Definition
| Occurs when clinicians judge the probability of disease based on how closely the patient's findings fit classic manifestations of a disease without taking into account disease prevalence |
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Term
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Definition
Our estimate of the probability of an event is influenced by the ease with which we remember similar events
We remember dramatic, atypical, or emotion-laden events more easily |
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Term
| Anchoring and Adjustment Bias |
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Definition
| Occur when clinicians steadfastly cling to an initial impression even as conflicting and contradictory data accumulate |
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Term
| Clinical practice guidelines (CPGs): |
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Definition
| “systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances”(1). Are based on evidence and published by authoritative groups. |
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Term
| Clinical decision support (CDS) systems |
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Definition
| provide clinicians, staff, patients, and other individuals with knowledge and person-specific information, intelligently filtered and presented at appropriate times, to enhance health and health care |
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Term
| Clinical Decision Support Interventions |
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Definition
| – Preventive care, Diagnosis, Planning or implementing treatment, gollow-up management, Hospital provider efficiency, Cost reductions and improved patient convenience |
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Term
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Definition
- Is an HL7/ANSI Standard
+Current version is 2.7
- Arose from the need to make medical knowledge available for decision making at the point-of-care
- Makes the knowledge and logic explicit
- Allows sharing within and between institutions
- Standardizes the way medical knowledge is integrated into health information systems |
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Term
| Medical Logic Module (MLM) |
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Definition
- Maintenance – Metadata about the MLM
- Library
- Knowledge |
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Term
| CDS Dashboards: How do they work? |
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Definition
1. Summarizes user’s performance for key indicators or metrics
2. Compares user’s performance with other users or reference benchmarks |
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Term
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Definition
1. Speed is everything
2. Anticipate needs and deliver in real time
3. Fit into the user’s workflow
4. Little things can make a big difference (usability)
5. Recognize that physicians will strongly resist stopping
6. Changing direction is easier than stopping
7. Simple interventions work best
8. Ask for additional information only when necessary
9. Monitor
10.Manage and maintain |
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