Upgrade to remove ads
Busy. Please wait.
Log in with Clever
or

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever
or

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Medical Stats

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
        Help!  

Term
Definition
Clinical Trial   Planned experiment on human beings which is designed to evaluate the effectiveness of 1 or more forms of treatment  
🗑
Experiment   Series of observations made under conditions controlled or arranged by the investigator  
🗑
Treatment   A pharmaceutical drug or medical treatment (surgery, diet, counselling), or method of organising/delivering health care (education leaflet, phone app)  
🗑
Classification   Systematic arrangement by purpose or phase in drug development  
🗑
Phase I trial   Looks into pharmakinetics of a drug (absorption, metabolism) and toxicity (drug safety). finding maximum tolerated dose.  
🗑
Phase II trial   Initial clinical investigation. Dose finding study. Work out dose and dose schedules and early indication of efficacy  
🗑
Phase III trial   Aim of full scale evaluation, efficacy of a new experimental treatment compared to a standard therapy or placebo, acting as a control  
🗑
Phase IV trial   Effectiveness. Post marketing surveillance for info on long term effects and uncommon side effects.  
🗑
Effect   Difference between what happened to a patient as a result of the treatment vs what would have happened without the treatment  
🗑
Efficacy   The true biological effect of a treatment  
🗑
Effectiveness   Effect of a treatment when widely used in general practice.  
🗑
Efficiency   The time and cost related economics of a treatment.  
🗑
Research Protocol   Formal written document outlining the research plan for a clinical trial  
🗑
Control group's Purpose   Give a yard stick as to what may have happened in absence of experimental treatment. Needed in phase III trials  
🗑
Use of control group in Phase III trials   As investigator/patients expectations and enthusiasm of trial inclusion may affect judgement and outcomes. Some open & uncontrolled trials yeilded spurious results.  
🗑
Gold standard of trial design   Randomised, controlled and double-blinded trial.  
🗑
Randomisation   Treatments assigned according to chance (often equal).  
🗑
Aim of Randomisation   To yield treatment groups that are comparable in terms of extreneous factors.  
🗑
Purpose of Randomisation   Avoid bias due to differences in clinical & demographic characteristics. To support the independence assumption underlying many statistical procedures  
🗑
Simple Randomisation   independent random treatment allocation with fixed probability  
🗑
Pros of simple randomisation   easy to implement can do analysis via standard statistical methods  
🗑
Cons of simple randomisation   likely to get uneven treatment group numbers esp in small samples doesnt ensure balance over confounders (e.g. age and disease severity)  
🗑
Block randomisation   Restricted randomisation that works by balancing participant numbers in each group.  
🗑
Block randomisation method   Choose a block at random and assign patients accordingly. Want to keep block sizes short to prevent incomplete blocks (as may be fixed/randomly varying)  
🗑
Block size   A multiple of the number of treatments  
🗑
Cons of block randomisation   Assignment may become known if blocking factor revealed statistical methods often presume simple randomisation  
🗑
Pros of block randomisation   Has balance. max difference is b/2 for blocks of size b  
🗑
Stratified randomisation   Uses block randomisation in each stratum to aid between group comparability (balance) over important characteristics.  
🗑
Pros of stratified randomisation   Overcomes imbalance with regards to important factors in small samples Increases efficacy and reduces potential bias  
🗑
Cons of stratified randomisation   no. of strata may limit usefulness Complicates proceedings  
🗑
Adaptive randomisation - Minimisation   A non random treatment allocation where allocation probabilities adjusted according to patient imbalance  
🗑
Minimisation Purpose   Balance between treatment groups with regard to important prognastic factors.  
🗑
Minimisation Method   Use simple randomisation when groups are balanced. When imbalanced, allocates next patient to treatment so imbalanced minimised via minimisation score.  
🗑
Weighted minimisation   Weighting in favour of treatment which would minimise imbalance  
🗑
Purpose of Blinding/Masking   Avoid bias due to differences in treatment outcome (conscious or unconscious)  
🗑
Single-blind trial   Patient not know which treatment is being received  
🗑
Double-blind trial   Neither patient nor physician knows treatment allocation. GOLD standard.  
🗑
Triple-blind trial   double-blind plus monitoring group & data analyst don't know which group receives experiences & which control.  
🗑
Open trial   All are knowledgable about treatment allocation.  
🗑
Double-dummy   Compares 2 active treatments with different appearances  
🗑
Blind alternative   Incorporate blind assessment or conceal treatment allocation until patient entered into trial  
🗑
Cons of blind trial   More complex as need independent monitoring committee to deal with ethical aspects & trial termination  
🗑
Ethical Issues in clinical trials   can you obtain informed consent? Should you try to continue until investigators convinced 1 better or until entire medical community convinced?  
🗑
Ethical issues regarding placebos   Is it ethical if an effective existing treatment is known to exist  
🗑
Declaration of Helsinki   Set of ethical principles regarding human experimentation. For medical community. By WMA. Is a cornerstone document on human research ethics. Not legally binding.  
🗑
Governance arrangement for NHS research ethics committees   Describes what REC's should be like and when their review is needed  
🗑
Example of a complication of clinical trials   Non adherence to protocol - missing follow up visits, not completed full course of treatment  
🗑
Intention to treat set   Analyse as randomised, regardless of adherence. To look at effectiveness.  
🗑
Per Protocol set   Analysis based upon adherers only. To look at efficacy.  
🗑
Cons of per protocol set   Can introduce bias when groups of patients no longer have similar characteristics.  
🗑
When to use intention to treat set   In superiority trials where want to avoid over optimistic estimates  
🗑
Endpoint   Quantative measurement implied or required by the trial objectives. Is determined in each study subject.  
🗑
Hard endpoint   Preferred. Well defined and reliable. No subjectivity. Objectively measured.  
🗑
Soft endpoint   Difficult to define and subjective measures.  
🗑
Student's T-test   Comparison of 2 independent group means. Parametric method.  
🗑
Assumptions of student's T-test   Normality of data and equality of variances across comparison groups.  
🗑
Order of methodology for student's t-test   state research hypothesis (no diff and diff in difference in group means) estimate D = mean(T) - mean(C) Compute test statistic under H0. T = (mean(T)-mean(C)-0)/SE(estimate D) SE(estimate D) = S*sqrt(1/N(T) + 1/N(C)) S depend on underlying variance.  
🗑
S^2 (pooled variance estimate) in student's T-test if common underlying variance   1/(n-2) * (sum from 1 to N(T) of (each value in T - mean(T))^2 + sum from 1 to N(C) of(each value in C - mean(C))^2  
🗑
S^2 (pooled variance estimate) in student's T-test if S(T) and S(C) are sample standard deviations   ((N(T) -1)*S(T)^2 + (N(C) - 1)*S(C)^2/(N - 2)  
🗑
Confidence interval for student's T-test   T is compared to t-distribution with N-2 degrees of freedom & inference based on if |T| >= t dist (N-2,1 - alpha/2) D +- t dist (N-2, 1 - alpha/2)  
🗑
Point Estimate   Observed difference in group means D = mean(T) - mean(C)  
🗑
Interpretation if confidence interval for true difference spans zero   there is no statistically significant difference between groups so cannot reject null hypothesis  
🗑
Inference for p value   Calculate alpha for T value. if p < alpha = 0.05. Then is statistically significant  
🗑
Pro of confidence intervals   More informative as can assess plausible range of effect size  
🗑
Welch's test   An approximate test if assume non-constant variance  
🗑
Mann-whitney test   Non parametric alternative to student's T-test  
🗑
1-sample Paired t-test   Test based on within-pair differences  
🗑
Paired t-test method   Compute mean of within-pair diffs standard deviation of diffs Sd = sum of squares of differences between diffs and mean diff standard error of mean of diffs SE(D) = Sd/sqrt(n) Compute T under H0. T = D/SE(D)  
🗑
Paired t-test confidence interval   Compare T to t-distribution under n-1 degrees of freedom D +- t(n-1,1-alpha/2)*SE(D)  
🗑
p_1 and p_2 in binary response data   success probabilities for treatment and control groups in binary response data  
🗑
Risk Difference   Difference between risk of an outcome between group 1 and 2. p1 - p2. a/(a+c) - b/(b+d)  
🗑
Relative Risk   Compare risks for 2 groups. p1/p2. (a/(a+ c))/(b/(b+d)). treatment 1 RRx risk of outcome being observed than treatment 2.  
🗑
Disease odds   ratio of success to failure. p_i/(1-p_i)  
🗑
Odds ratio   Measure of association between outcome and exposure. p1/(1-p1) / p2/(1-p2) = ad/bc. treatment 1 ORx more likely to be exposed to outcome than treatment 2.  
🗑
When does odds ratio equal relative risk?   When the occurrence of outcome is less than 10%.  
🗑
Binary data confidence intervals   theta +- z(1-alpha/2)*SE(theta) where theta is risk difference, log of relative risk or log of odds ratio.  
🗑
Standard error for Risk difference BINARY   sqrt(p1(1-p1)/n1 + p2(1-p2)/n2). p1 = a/(a+c) and p2 = b(b+d). n1 = a+c. n2 = b + d  
🗑
Standard error for log of Relative Risk BINARY   sqrt(1/a - 1/(a+c) + 1/b - 1/(b+d)) DONT FORGET TO ANTILOG THE INTERVAL  
🗑
Standard error for log of Odds Ratio BINARY   sqrt(1/a + 1/b + 1/c + 1/d) DONT FORGET TO ANTILOG THE INTERVAL  
🗑
Parallel group design   Different groups of patients are studied in parallel. Estimate of treatment effects is based upon between subject comparisons.  
🗑
What inference test to use for parallel group design?   2 independent samples t-test  
🗑
Paired design   Patient recieves both treatments. Then estimate of treatment effect based on within subject comparison  
🗑
What inference test to use to paired design   1-sample t-test on within subject differences  
🗑
Crossover Design   Patient recieves sequence of treatments. Order determined by randomisation. Treatment effect based on within-subject comparisons  
🗑
Treatment Periods   times treatments are administered  
🗑
Pros of cross-over design   Patients act as own control as uses within-subject comparisons - eliminates between patient variation. Smaller sample size required for same no of observations Same degree of precision in estimation with fewer observations  
🗑
Cons of cross-over design   Inconvinience to patients as multiple treatments mean longer time under observation Patients may withdraw Treatment effect not constant over time (p-by-t interaction) Carry over effect Analysis more complex - may be systematic diffs between periods  
🗑
Carry over effect   Persistence of treatment applied in one period in a subsequence period of treatment  
🗑
How to deal with carry over effect   Wash out period  
🗑
Wash out Period   Period in trial during which effect of treatment given previously believed to disappear.  
🗑
When are cross-over trials useful?   Chronic diseases that are relatively stable Single dose trials of biological equivalence rather than long term trials Drugs with rapid and reversible effects  
🗑
AB/BA design   A 2 treatment x 2 period cross over trial.  
🗑
Simple analysis for a cross over design with no period effect   Use paired t-test  
🗑
Assumptions underlying use of paired t-test   Normally distributed differences Unbiased - that E(d) is the true treatment effect  
🗑
Factors that may cause differences to not be distributed at random about true treatment effect   period effect period by treatment interaction carry over effect patient by treatment interaction patient by period interaction  
🗑
When is a treatment effect estimate unbiased   If expectation of estimate is the estimate.  
🗑
Why do you need adequate sample sizes?   ethics budget constraints time constraints trial should be large enough to give reliable answer to research question  
🗑
P value   Probability, p, of obtaining test result at least as extreme as that observed assuming H0 is true  
🗑
Size of test   Given by alpha, usually alpha = 0.05  
🗑
When p value less than alpha?   Reject H0 and conclude data is inconsistent with null.  
🗑
Type I error rate   alpha, probability of rejecting H0 given H0 is true (saying theres a diff when theres not)  
🗑
Type II error rate   beta, probability of failing to reject H0 when H1 true (saying no diff when there is a diff)  
🗑
Power of test   1 - beta, probability of rejecting H0 when H1 is true (correctly saying is a diff)  
🗑
What does power of a test depend on?   the statistical test being used size of test (alpha) variability of observations (sigma^2) H1 (size of diff 'triangle')  
🗑
What does symbol triangle* represent?   The clinically relevant difference in a gauss test per say  
🗑
One & two sample one sided gauss test   Used to determine sample size  
🗑
Epidemiology   Study of distributions and determinants of disease in human populations  
🗑
What are descriptive studies used for?   Generating research hypotheses and resource allocation Gaining info regarding disease frequency in populations Info on distributions - age, geography, time, etc  
🗑
Disease Determinants aka risk factors   Factors precipitating disease (biological or enviro or social)  
🗑
Target population   Population about which we wish to draw inferences for  
🗑
Study population   Population from which data is collected  
🗑
Generalisability   Whether can use study population results to draw accurate conclusions about target pop  
🗑
Factors affecting study sample choice   generalisability of results trading off with availability and cost opportunistic sample is readily identifiable and likely to be cooperative Preference is a random sample of target population  
🗑
Routinely collected data   A source for data in epidemiological studies. E.g. hospital data bases, birth/death registers, census data)  
🗑
Sources for data in epidemiological studies   routinely collected data data purposely collected by investigators via surveys and follow up  
🗑
Purpose of routinely collected data   vital to monitor public health and health planning can use to investigate possible associations between routinely available attributes and rate of indecence from a particular disease  
🗑
Con of routinely collected data   May be of limited quality - subject to regional variation and often dont contain required individual level info.  
🗑
Limits of routinely collected data   Coverage - difficult to define morbidity so incomplete coverage Accuracy - diagnosis of cause of death and illness can be wrong Availability - confidential safe guards may limit data availability  
🗑
Reasons for incomplete coverage of routinely collected data   Inconsistent reporting of infectious diseases by practitioners and cancer registers may miss non hospital cases  
🗑
Disease Iceberg   moving down it, cases increase but severity decreases died, hospital, GP, self report, population screening  
🗑
Incidence (I) of disease   number of new cases of disease within a specified time period  
🗑
Prevalence (P) of disease   number of existing cases of disease at particular point of time. Probabiity of disease prior to seeing test result. (a+c)/N  
🗑
Calculation for incidence of disease   number of develop disease in specified time period / sum of length of time in which each person in population is at risk for  
🗑
Calculation for prevalence of disease   number with disease at time t / number in population at risk at time t  
🗑
Person-time of observation   Total observation time. Often express as person-years. Used for incidence rates.  
🗑
Purpose of prevalence measures   better for descriptive studies than analytical, suggests possible causes  
🗑
Purpose of incidence measures   Better to study as can establish sequence of events. Not susceptible to bias by survival  
🗑
Cumulative Incidence Risk   Alternative measure of disease occurance. Calculate: number of people who get disease in specified period / number of people free of disease at beginning of period. Is the risk of developing a disease.  
🗑
Crude mortality rate   number of deaths in a specified time period divided by average population at risk in period, multiplied by length of study period  
🗑
How to assess utility of a diagnostic test   Apply test to a number of individuals where true disease status known (based on GOLD standard)  
🗑
Sensitivity   Errors in testing. Proportion of truly diseased persons in tested population who are identified as diagnosed by screening test. P(T|D) (prob of pos test given diseased). a/(a+c)  
🗑
Specificity   Proportion of truly non diseased who are identified as so by screening test. P(bar(T)|bar(D)). d/(b+d)  
🗑
Positive Predictive Value PPV   Proportion truly diseased of those testing positive. Probability of diseased after a positive test. P(D|T). a/(a+b)  
🗑
Negative Predictive Value NPV   Proportion not diseased of those testing negative. P(bar(D)|bar(T)). Probability of not diseased after a negative test. c/(c+d)  
🗑
High cut off value   More specific test  
🗑
Low cut off value   More sensitive test  
🗑
Intermediate cut off value   Smaller overall errors. Need to balance high sensitivity and low specificity.  
🗑
Receiver Operating Characteristic curve   Plot of sensitivity against (1-specificity) for various cut off points. Cut off choice is top-left-most plot on curve.  
🗑
PPV using sensitivity, prevalence and specificity   (sens x prev)/((sens x prev) + (1 - spec)(1-prev))  
🗑
NPV using sensitivity, prevalence, specificity   (spec x (1-prev))/((spec x (1- prev))+((1-sens) x prev))  
🗑
Likelihood Ratio   Used to make therapeutic decisions regarding tests. P(T|D)/P(T|bar(D)) = sens/(1-spec). Test informative if value high. Is the ratio of posterior disease odds after pos test to prior disease odds, so tells how much odds of disease increase after pos test.  
🗑
Weight   Relative importance to give to sensitivity  
🗑
When to give high weight to sensitivity?   If disease high threatening and treatment has few side effects. (dont want false negatives).  
🗑
When to give high weight to specificity?   If disease not serious and treatment has many side effects. (dont want false positives)  
🗑
How to maximise weight with respect to study   Choose w = number of positive samples/total number of samples. Want to maximise M = w x sens + (1-w) x spec. 1-w is weight of spec.  
🗑
How to maximise weight with respect to population criterion   w = number with disease in population / total population size. Which is disease prevalence.  
🗑
Screening test   Test for particular disease given to population at risk who are asymptomatic  
🗑
Criteria for disease screening   Natural history of disease should be well understood should be an important health issue test should be acceptable to population there should exist a suitable screening test  
🗑
Why must be careful in disease screening   As truly diseased population likely to be small so many disease free will test positive  
🗑
Observational studies   Investigator role is passive so exposures not manipulated  
🗑
Intervention studies   Investigator role is active. Groups exposed to intervention of interest (eg treatment). Are experimental studies (clinical trials)  
🗑
Why are intervention studies the gold standard in terms of causality   can handle confounding with randomisation and exposure known to preceed disease.  
🗑
ethical Issue with intervention studies   rarely acceptable to force exposures on people  
🗑
Cross-sectional studies   surveys also feature but only to give info for snapshot in time - are less useful. Can only use to measure prevalence.  
🗑
Most common observational studies   cohort and case studies.  
🗑
Cohort study   Most useful observational study in disease causes. Tracks 2 or more groups forward from exposure to outcome. classify according to exposures. exposure vs non exposure rows and outcome vs non outcome columns  
🗑
Pros of cohort study   Strongest evidence for causal r.ship as exposure known to preceed outcome Can measure risk, incidence rate & survival time can examine many events after 1 exposure maintain temporal sequence best way to ascertain incidence & natural disease history  
🗑
Rationale of cohort studies   Follow cohorts through time - record disease occurrance and compare exposure groups with respect to disease outcome- then interpret  
🗑
Cons of cohort studies   large & costly selection bias loss to follow up confounding variables exposure can change in study period  
🗑
Case control study   Case & control groups defined & selected according to disease status. Look back in time to ascertain each person's exposure status  
🗑
Pros of case control study   efficient in terms of time and money (if exposure frequency not too low) can study rare diseases  
🗑
Cons of case control study   choosing control group can lead to selection bias obtaining exposure history so may have recall bias  
🗑
Risk difference for cohort studies (binary exposure)   p1 - p0. a/(a+b) - c/(c+d)  
🗑
Relative risk for cohort studies (binary exposure)   p1/p0. (a/(a+b)/c/(c+d)).  
🗑
Disease odds in cohort studies. binary exposure   p/1-p. Ratio of success to failure  
🗑
Odds ratio in cohort studies. binary exposure.   Compares exposed and not exposed groups. p1/(1-p1) / p0/(1-p0) = ad/bc  
🗑
In case control studies - estimate disease odds ratio not disease risk...   p1/(1-p1) / p0/(1-p0)  
🗑
Disease odds ratio   similar to odds ratio if disease is rare.  
🗑
Exposure odds for cases (D)   P(E|D)/P(bar(E)|D)  
🗑
Exposure odds for controls (bar(D))   P(E|bar(D))/P(bar(E)|bar(D))  
🗑
Exposure odds ratio   Ratio of 2 exposure odds. Equal to disease odds ratio. ad/bc  
🗑
How to increase precision of estimate of disease odds ratio?   More controls.  
🗑
A confounder   3rd variable associated with exposure of interest. Independently associated with risk of disease. partially or fully explains relationship between E and D.  
🗑
Consequences of confounders   Creates a false relationship between E and D Masks true relationship between E and D  
🗑
Design based approaches to control confounding   Randomisation (balance over potential confounders) Restriction (Limit participation to individuals similar in relation to confounders) Matching (select controls to be similar to cases in terms of confounders)  
🗑
Analysis based approaches to control confounding   Stratification Standardisation (control confounding using external pop to adjust for age, gender etc) Multivariate analysis/regression models (include confounding variable in model)  
🗑
Stratification (in analysis based approach to control confounding)   Examine exposure-disease associations within strata of confounding variable. Estimate pooled estimate of association measure, adjusting for confounding effect.  
🗑
Mantel-haenszel estimate   Estimate of association between outcome and exposure after adjusting for confounding. Estimates a common odds ratio so use log in confidence interval  
🗑
Standard error for mantel-haenszel   very long. sum(a+d/n x ad/n)/2xsum(ad/n)^2 + same for bc + sum((a+d/n x ad/n)+(same for bc))/2sum(ad/n)sum(bc/n)  
🗑
If odds ratio confidence interval spans 1 for mantel-haenzel   association between exposure and outcome not significant at 5% level  
🗑
If reduction in odds ratio from joint odds ratio to individual in mantel-haenzel is small   The degree of confounding is small  
🗑
Unstratified matching in case control studies   Choose controls randomly  
🗑
Stratified matching in case control studies   Match controls to cases according to confounding variable. May be group or individual matching.  
🗑
Rationale of matched case control study   Eliminate confounders by design  
🗑
Pros of matching in case control study   control confounders by elimination gain in efficiency minimises selection bias  
🗑
Cons of matching in case control study   More complex study design cant study effect of matching variables on outcome of interest overmatching (matching variable linked to exposure not disease)  
🗑
Maximum likelihood estimate of exposure odds ratio in matched case-control study   b/c. standard error is log of estimate = sqrt(1/b + 1/c)  
🗑
Standardisation   process aimed at removing confounding by choosing a standard population with known distribution of confounders  
🗑
Direct standardisation   disease rates in population of interest are applied to standard population counts  
🗑
Indirect standardisation   disease rates in standard population applies to population of interest  
🗑
Direct standardised event rate   expected event rate in standard population, if age-specific event rates in study population prevailed  
🗑
How to adjust event rate for age   category specific event rates for each population being compared will be applied to a single standard population  
🗑
Direct age standardised event rate per 1000   1000/total size of standard pop x sum of ((observed number of events in ith age group of study population/size of ith age group of study population)x size of ith age group of standard population)  
🗑
Person years   average population size x study length  
🗑
When to use indirect standardisation of event rates   when age specific rates aren't available for population of interest  
🗑
Methods of indirect standardisation of event rates   Produce standardised event ratio (SER) or standardised mortality rate (SMR)  
🗑
SMR   O/E. where O is total number of observed events in all age groups of study population and E is sum of (observed number of events in ith age gorup of standard population / size of ith age group of standard population) x size of ith age group of study pop  
🗑
Requirement for direct standardised rates   need age specific rates for all population studies  
🗑
Requirement for indirect standardised rates   need total number of cases observed  
🗑
Standardised incidence / mortality rate   ratio of 2 indirectly standardised rates  
🗑
Pro of indirect standardised rates   More stable in case of small numbers of events  
🗑
Con of indirect standardised rates   Need age specific rates for standard population  
🗑
Survival analysis   data analysis in the form of time from some well defined time origin to occurrence of some event or endpoint.  
🗑
Examples of time origins for survival analysis   time of trial entry or diagnosis time  
🗑
Time-to-event data   can be time to death or time to failure of prosthetic etc  
🗑
Positive event example in time-to-event data   hospital discharge  
🗑
Adverse event example in time-to-event data   Death  
🗑
Neutral event example in time-to-event data   Cessation of breast feeding  
🗑
Lifetime random variable   time-to-event rate is random variable T  
🗑
Why can't apply time-to-event data to standard methods of analysis   Event times are positive continuous, typically skewed, and subject to censoring  
🗑
When does censoring occur?   if endpoint not observed  
🗑
Right censoring   event time greater than last follow up time  
🗑
Left censoring   Event time before time of last follow up but is unknown  
🗑
Interval censoring   event time falls in a specified interval  
🗑
Reasons for right censoring   period of observation end prior to event occurrence loss to follow up completing event precludes further follow up - eg death event may not be inevitable (eg pregnancy)  
🗑
Why one treatment may have more censoring at the end than other   results in increased survival  
🗑
Why does period of observation time vary between patients?   patients accrued sequentially over time and followed up to fixed date so period of observation varies between patients  
🗑
Assumption of survival analysis when acru patients over time   Prognosis doesn't depend on entry time to study  
🗑
Aims of survival analysis   model survival times for a group & make predictions assess effects of covariates on survival compare survival distribution for 2 or more groups  
🗑
The functions of interest when summarising survival data   Survivor function & hazard function  
🗑
Survival time of individual i   observation of a non negative r.v. T  
🗑
Distribution function of T   F(t)  
🗑
Probability density function of T   f(t)  
🗑
Link between Distribution and pdf of T   F(t) = integral (from 0 to t) of f(s) ds = P(T <= t). f(t) = d/dt F(t)  
🗑
Survivor function   Probability an individual survives to time t. S(t) = P(T>t) = 1 - F(t) = integral (from t to infinity) f(s) ds. Monotone decreasing function S(0) = 1  
🗑
Link between pdf and survivor function   f(t) = -d/dt S(t)  
🗑
Hazard function   specify instantaneous rate of failure at T=t given survival to time t. h(t) = f(s)/S(t). RATE not probability  
🗑
How to approximate probability an individual who survived to time t will experience event in interval (t,t+delta*t)   h(t)*delta*t  
🗑
Cumulative/integrated hazard function   H(t) = integral (from 0 to t) of h(u) du. Probability of failure at time t given survival until time t  
🗑
Decreasing hazard function   Clinically less likely, such as in risk after organ transplantEs  
🗑
Emperical survivor function   estimate of survivor function. hat(S)(t). Step function with steps at observed failure times.  
🗑
Kaplan-meier estimate   Estimates survivor function. first step in presence of censored data. Is the product limit estimator  
🗑
event times and number in sample at risk at each event time and number who fail at this time notation   t_j and n_j and d_j  
🗑
Estimated probability of survival through interval j in kaplan meier survivor function   p_j = (n_j - d_j)/n_j) = 1 - d_j/n_j  
🗑
Assumptions for kaplan-meier estimate   independence of event times  
🗑
Kaplan meier estimator   S(t) = multiplication of all p_j's for k=r+1 subintervals  
🗑
Kaplan-meier when no censoring   emperical survivor estimator  
🗑
Greenwood's formula   for estimated variance. S(t)^2 x sum of (d_j/(n_j(n_j - d_j)))  
🗑
Make a smoother plot for survivor function estimate   More data and more distinct failure times  
🗑
End point of the kaplan-meier estimator curve   the estimated survival % at t years  
🗑
Why can't use t-test to compare group means in survival distribution?   Because of censoring  
🗑
Log-rank test   formal comparison of 2 groups survival distribution. Can compare more than 2 groups.  
🗑
Informal comparison of 2 groups survival distribution   Use Kaplan-meier curve  
🗑
Cox proportional hazards model   commonly used to flexibly model covariate effects on the hazard function.  
🗑


   

Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
 
To hide a column, click on the column name.
 
To hide the entire table, click on the "Hide All" button.
 
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
 
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.

 
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how
Created by: Rebeka
Popular Math sets