4-Medicine-Medical Treatments-Medical Testing

medical testing

If people have diseases, tests {medical testing} have probabilities {sensitivity, test} of finding diseases. If people do not have diseases, tests have probabilities {specificity, test} of indicating no diseases. Diseases have probabilities {prevalence, disease} in populations. Prevalence is typically less than one per thousand. Probability that people have disease if tested positive is prevalence times sensitivity divided by one minus specificity: p * se / (1 - sp).

actuarial method

Survival-function estimates {life table estimate, actuarial method} for grouped data, for example grouped by time interval, is number surviving at end divided by number at beginning minus half number censored for each interval, multiplying interval probabilities {actuarial method, test}.

attributable risk

Risk in people exposed to factor, minus risk in people not exposed, measures number of factor-caused outcomes {attributable risk}.

bias in measurement

Non-random quantities {bias, measurement} {measurement bias} can include selecting non-randomly {selection bias}, failing to account for hidden factors {confounding bias}, measuring with non-random tools, or having goals.

Cox regression

Statistical methods {Cox regression} {proportional hazards model} can analyze survival data as multiple regression, for quantitative data, or multiple logistics, for qualitative data. Surviving also depends on treatment weights Cn and prognostic variables Xn. Proportional hazard model is: ln(l(t)) = C0(t) + C1*X1 + C2*X2 + ... + Cn*Xn.

definitive cure

For same age and sex, cured-patient survival rate can be similar to healthy-people survival rate {cure}. Age-corrected survival divides actual survival in each interval by survival for healthy people of same age and sex. Curve can become horizontal {point of definitive cure} {definitive cure point}.

efficacy

treatment effectiveness {efficacy, treatment effectiveness}|.

exposure

People have disease risk {exposure, risk}| when factor is present.

factor of study

Studies have quantifiable independent variables {factor, study}.

hazard function

Patients have probability functions {hazard function} of failing to survive for some years or past an age.

hypothesis of study

Hypotheses {hypothesis, study} typically state that two treatments are no different in outcome. Studies can be only descriptive.

incidence

Populations can have new cases over times {incidence, population}. New cases divided by population measures probability {incidence rate} that people will have disease during that time.

modification by factor

Third variables can affect relation between factor and outcome {modification, study}.

odds ratio

Probabilities {odds ratio} that people who have disease also have factor approximates relative risk, if risk is less than 1/100.

outcome

Studies have quantifiable dependent variables {outcome, study}.

prevalence

number with disease or factor divided by number in population {prevalence, population}.

relative risk

Factor-strength measures {relative risk} can be ratio between risk when factor is present {exposure, factor} and risk when factor is absent.

reliability of test

Repeated measurements can have small range, with no oscillations or trends {reliability, study}.

research question

Disease studies {research question} can determine number of people affected, typical stages {natural history, disease stages}, outcomes {prognosis, disease}, causes {etiology, disease}, or treatment effectiveness {efficacy, treatment}. Studies often compare two treatments.

risk in testing

If factor is present, outcome has probability {risk, study}.

risk factor

If factor is present, outcome risk {risk factor} can increase.

sample of population

Regions and groups have populations {reference population} {source population}. Source-population subsets {sample frame} can be about sex, age, or other variable. Studies are about random reference-population subsets {sample, study} that have similar sample frames.

survival function

Over time, people have decreasing survival probability {survival function}| {survival analysis}. Survival-function estimates for ungrouped data, for example, individual patients, multiply probability of surviving interval by probability of surviving next interval, for all intervals {Kaplan Meier Survival Curve} {product limit}. Kaplan-Meier curve falls rapidly between 70% and 30% surviving and ends below 50% survival. Survival-function estimates for grouped data, for example, grouped by time interval, are number surviving at end divided by number at beginning minus half number censored for each interval, multiplying interval probabilities {life table estimate, survival} {actuarial method, survival}.

tests

Tests {log rank test} can have null hypothesis that there is no difference in survival between two groups. Mortality rate in one group is typically always higher than mortality rate in another group, and mortality-rate ratio can stay constant over time {proportional hazards}. If ratio is high enough, difference in groups is significant. Tests {stratified log-rank test} can compare two groups if there is another variable. Tests {generalized Wilcoxon test} can give more weight to early deaths.

validity of test

Tests can correctly check if hypothesis is true or false {validity, study}. Studies can use unbiased measurements {internal validity}. Studies can use random samples {external validity}.

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Date Modified: 2022.0225