Swartz Chapter 28 Flashcards

Data collection is primarily the product of what?

A. History and physical examination

B. Laboratory testing

C. Imaging studies

D. Differential diagnosis

Which component contributes most to the clinical database?

A. Laboratory studies

B. History

C. Imaging studies

D. Pathology

Approximately what proportion of the database may come from the history?

A. 10–20%

B. 30–40%

C. 70–75%

D. 90–100%

What does data processing primarily involve?

A. Ordering medications

B. Performing procedures

C. Obtaining consent

D. Clustering clinical data

Data processing integrates history, examination, and what additional information?

A. Labs and imaging

B. Insurance status

C. Billing records

D. Family income

Which principle favors the simplest unifying diagnosis?

A. Hickam dictum

B. Occam's razor

C. Bayes theorem

D. Metacognition

Occam's razor attempts to explain multiple findings with what?

A. Several unrelated diseases

B. No diagnosis

C. One diagnosis

D. Laboratory error

What does a clinical problem list summarize?

A. Medications

B. Laboratory abnormalities only

C. Surgical history

D. Conditions affecting health

A problem list may include which domains?

A. Physical, mental, social, personal

B. Physical findings only

C. Mental diagnoses only

D. Social problems only

A finding supporting a suspected diagnosis is called what?

A. Pertinent negative

B. Pertinent positive

C. False positive

D. Incidental finding

Absence of an expected diagnostic finding is called what?

A. Pertinent positive

B. False negative

C. Pertinent negative

D. Screening failure

What is bias in diagnostic reasoning?

A. Perfect objectivity

B. Random laboratory error

C. Statistical significance

D. Prejudiced inclination

Laboratory results generally contribute approximately what proportion to problem-list development?

A. Less than 10%

B. About 50%

C. About 75%

D. More than 90%

Sensitivity is also called what?

A. False-positive rate

B. True-positive rate

C. True-negative rate

D. False-negative rate

Sensitivity asks what proportion of diseased patients do what?

A. Test negative

B. Remain asymptomatic

C. Test positive

D. Have false positives

Sensitivity is calculated using which patient group?

A. Only healthy patients

B. Entire population

C. Only test-positive patients

D. Patients with disease

What is the formula for sensitivity?

A. TP/(TP + FN)

B. TN/(TN + FP)

C. TP/(TP + FP)

D. TN/(TN + FN)

A highly sensitive test minimizes which result?

A. False positives

B. False negatives

C. True negatives

D. True positives

Specificity is also called what?

A. True-positive rate

B. False-negative rate

C. True-negative rate

D. Positive predictive value

Specificity asks what proportion of nondiseased patients do what?

A. Test positive

B. Develop disease

C. Become symptomatic

D. Test negative

Specificity is calculated using which patient group?

A. Patients without disease

B. Patients with disease

C. Test-positive patients

D. Entire population only

What is the correct formula for specificity?

A. TP/(TP + FN)

B. TN/(TN + FP)

C. TP/(TP + FP)

D. TN/(TN + FN)

A highly specific test minimizes which result?

A. False negatives

B. True positives

C. False positives

D. True negatives

A useful diagnostic test generally has what positive likelihood ratio?

A. Near zero

B. Equal to zero

C. Less than one

D. Greater than one

A useful diagnostic test generally has what negative likelihood ratio?

A. Close to zero

B. Greater than ten

C. Equal to one

D. Greater than one

How likely a test result is in a patient with the disease compared with a patient without the disease is called _____ _____.

The positive likelihood ratio is calculated how?

A. Specificity/sensitivity

B. FN rate/TN rate

C. Sensitivity/(1 − specificity)

D. PPV/NPV

The positive LR can also be expressed as what?

A. TN rate/FN rate

B. FP rate/TP rate

C. PPV/NPV

D. TP rate/FP rate

What does a positive likelihood ratio greater than 1 do?

A. Favors disease

B. Rules out disease

C. Proves disease

D. Excludes testing

As LR+ increases, evidence for disease generally does what?

A. Weakens

B. Strengthens

C. Remains unchanged

D. Becomes negative

An LR+ very close to 1 provides what?

A. Strong confirmation

B. Strong exclusion

C. Little diagnostic information

D. Perfect sensitivity

What is the formula for negative likelihood ratio?

A. Sensitivity/specificity

B. Specificity/sensitivity

C. PPV/NPV

D. (1 − sensitivity)/specificity

The negative LR can also be expressed as what?

A. FN rate/TN rate

B. TP rate/FP rate

C. FP rate/TP rate

D. TN rate/FN rate

As LR− approaches zero, evidence against disease generally does what?

A. Weakens

B. Strengthens

C. Becomes irrelevant

D. Favors disease

An LR equal to 1 has what diagnostic effect?

A. Strongly confirms disease

B. Strongly excludes disease

C. Does not change odds

D. Proves disease

_____ odds × Likelihood ratio = _____ odds

Likelihood ratios are useful for converting pretest odds into what?

A. Sensitivity

B. Specificity

C. Prevalence

D. Posttest odds

Positive predictive value (PPV) describes the probability of which of the following?

A. The patient actually has the disease given that the test result is positive
B. The test will be positive given that the patient has the disease
C. The test will be negative given that the patient does not have the disease
D. The patient does not have the disease given that the test result is negative

What is the formula for positive predictive value?

A. TP/(TP + FN)

B. TP/(TP + FP)

C. TN/(TN + FN)

D. TN/(TN + FP)

Negative predictive value (NPV) describes the probability of which of the following?

A. The test will be positive given that the patient has the disease
B. The test will be negative given that the patient does not have the disease
C. The patient does not have the disease given that the test result is negative
D. The patient has the disease given that the test result is positive

What is the formula for negative predictive value?

A. TP/(TP + FN)

B. TP/(TP + FP)

C. TN/(TN + FN)

D. TN/(TN + FP)

Which test characteristics depend strongly on disease prevalence?

A. Predictive values

B. Sensitivity only

C. Specificity only

D. Likelihood ratios only

As disease prevalence increases, positive predictive value generally does what?

A. Decreases

B. Increases

C. Remains fixed

D. Becomes zero

As disease prevalence increases, negative predictive value generally does what?

A. Increases

B. Remains fixed

C. Decreases

D. Becomes 100%

Pretest probability refers to disease probability at what time?

A. After treatment

B. After biopsy

C. After final diagnosis

D. Before test results

In an unselected population, pretest probability may approximate what?

A. Disease prevalence

B. Sensitivity

C. Specificity

D. Likelihood ratio

How is disease prevalence calculated?

(____ + ____ )/____ ____

Which patients are included in the numerator for disease prevalence?

A. TP and FP

B. TN and FN

C. TP and FN

D. FP and TN

What does Bayes theorem calculate?

A. Test sensitivity

B. Disease incidence

C. False-positive rate

D. Conditional probabilities

What is a conditional probability?

A. Probability given another event

B. Initial probability

C. Probability without evidence

D. Random sampling error

What is a prior probability?

A. Probability after testing

B. Probability before new evidence

C. Probability after treatment

D. Probability after diagnosis

What is a posterior probability?

A. Initial probability

B. Disease prevalence

C. Revised probability after evidence

D. Laboratory sensitivity

Bayesian reasoning updates prior probability using what?

A. No additional information

B. Only prevalence

C. Only specificity

D. New evidence

What does metacognition mean?

A. Thinking about one's thinking

B. Memorizing diagnostic criteria

C. Ordering more tests

D. Avoiding uncertainty

Metacognition can help clinicians identify what?

A. Only laboratory errors

B. Cognitive biases

C. Only medication errors

D. Only imaging artifacts