MKSAP 17 General Internal Medicine Questions And Answers Rated A+.
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MKSAP 17 General Internal Medicine
MKSAP 17 General Internal Medicine Questions And Answers Rated A+.
What % of the U.S. gross domestic product is spent on health care? - correct answer.18%
What are the 5 steps of the High Value Care Framework? - correct answer.1. Understand the benefits, harms, and relative costs of t...
MKSAP 17 General Internal Medicine
Questions And Answers Rated A+.
What % of the U.S. gross domestic product is spent on health care? - correct
answer.18%
What are the 5 steps of the High Value Care Framework? - correct answer.1.
Understand the benefits, harms, and relative costs of the interventions that you are
considering
2. Decrease or eliminate the use of interventions that provide no benefits and/or may be
harmful
3. Choose interventions and care settings that maximize benefits, minimize harms, and
reduce costs (using comparative effectiveness and cost-effectiveness data)
4. Customize a care plan with patients that incorporates their values and addresses
their concerns
5. Identify system level opportunities to improve outcomes, minimize harms, and reduce
health care waste
What is an experimental study? - correct answer.a study in which subjects and
interventions are determined at the study outset, and investigators and subjects are
often blinded to the intervention to minimize biased outcomes
What are the 3 different types of experimental studies? - correct answer.1. Randomized
controlled trial (subjects are randomly allocated to a treatment group or a control group)
2. Cluster randomized trial (subjects are randomized by clusters (e.g., nursing unit)
rather than as individuals)
3. Quasi-experimental design (review of data collected before and after an intervention)
What are the strengths and weaknesses of a Randomized controlled trial? - correct
answer.Strengths: strongest design for determining causation
,Weaknesses: expensive, time consuming, not practical for many clinical situations
limited follow up duration
limited number of outcomes that can be assessed
limited generalizability
What are the strengths and weaknesses of a Cluster randomized trial? - correct
answer.Strengths: same as for RCT's
can be used if randomization of patients if not ethical or feasible
Weaknesses: same as for RCTs
challenging to analyze
What are the strengths and weaknesses of a Quasi-experimental design? - correct
answer.Strengths:can be used if randomization of patients is not ethical or feasible
Weaknesses: patients not randomized
What are the key threats to validity in a Randomized controlled trial? - correct answer.if
randomization is ineffective
if data are not analyzed according to initially assigned group
if key individuals are aware of group assignment (not blinded)
if follow-up is incomplete
What are the key threats to validity in a Cluster randomized trial? - correct
answer.same as for RCTs
if analysis does not account for clustering
What are the key threats to validity in a Quasi-experimental design? - correct answer.if
no adjustment for possible confounding
What is an observational study? - correct answer.a study that does not employ
interventions or patient assignment to groups; alternatively, researchers compare two or
more naturally existing groups
these studies are often less rigorous than experimental studies, thus reducing the ability
to draw causal inferences
,advantages include the capacity to utilize natural practice settings and to involve
patients with wider ranges of illnesses and exposures
a disadvantage of observational studies is that they are more subject to confounding
and bias than experimental studies
What are the 4 different types of observational studies? - correct answer.1. Cohort
study (studies outcomes of groups using observed assignment; example is a study that
examines the rates of type 2 DM among patients with high socioeconomic status versus
patients with low socioeconomic status)
2. Case-control study (compares past exposures in patients with and without disease)
3. Cross-sectional study (determines prevalence of disease (e.g., survey studies)
4. Case series (describes the characteristics of a group (or series) of patients (or
cases))
What is the difference between a prospective cohort study and a retrospective cohort
study? - correct answer.a study in which patients are observed for outcomes going
forward in time, whereas retrospective cohort studies look at patients histories, often
after an outcome has occurred
prospective cohort studies are often more rigorous than retrospective cohort studies
because they reduce bias by selecting patients and statistical methods priori
the standard outcome measure for a cohort study is relative risk
What are the strengths and weaknesses of a cohort study? - correct answer.Strengths:
able to detect associations, but these are not always cause-effect relationships
able to study multiple outcomes over a long period of time
large sample size
Weaknesses:requires complicated statistical techniques to minimize confounding
prospective designs can be expensive and take many years before results are available
What is an example of a case control study? What is the standard estimate of risk in
case control studies? - correct answer.example: patients with and without type 2 DM,
could be compared with respect to exposure to high-calorie, fast-food diets
odds ratio is the standard estimate of risk
, What are the strengths and weaknesses of a case-control study? - correct
answer.Strengths: useful for rare diseases or exposures
inexpensive
Weaknesses: high risk for bias
high risk for confounding
cannot assess incidence/prevalence
What are the strengths and weaknesses of a cross-sectional study? - correct
answer.Strengths: can be completed quickly
inexpensive
Weaknesses: may result in misleading information
provides information on only one point in time
high risk for bias
What are the strengths and weaknesses of a case series? - correct answer.Strengths:
hypothesis generating
observations may be useful in designing a study to evaluate possible explanations or
causes for the observed findings
Weaknesses: high risk for bias
cannot infer causation
What are the key threats to validity in a cohort study? - correct answer.selections bias
in cohort
bias in measurement of exposures and outcomes
if important confounders not accounted for
What are the key threats to validity in a case control study? - correct answer.selection
bias, especially in controls
measurement bias, especially recall bias
What are the key threats to validity in a cross sectional study? - correct
answer.selection bias, response bias
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