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Section 230, Row F, G, H Seats 1-8

Section 230, Row F, G, H Seats 1-8. Who are we?. Michael Kohn, Emergency Medicine Tom Newman, General Pediatrics Mark Pletcher, General Internal Medicine George Sawaya, Obstetrics/Gynecology John Stein, Emergency Medicine Josh Galanter, Pulmonary/Critical Care. Who are you?.

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Section 230, Row F, G, H Seats 1-8

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  1. Section 230, Row F, G, H Seats 1-8

  2. Who are we? • Michael Kohn, Emergency Medicine • Tom Newman, General Pediatrics • Mark Pletcher, General Internal Medicine • George Sawaya, Obstetrics/Gynecology • John Stein, Emergency Medicine • Josh Galanter, Pulmonary/Critical Care

  3. Who are you? • Breakdown of ≈ 36 participants

  4. Evidence-Based Medicine Level

  5. Familiar with Threshold Model -- C/(C+B)?

  6. Familiar with ARR and NNT = 1/ARR?

  7. Interest in Screening

  8. Thursday Morning 9:15-9:55 Dichotomous Tests (Tom) 9:55-10:35 Multilevel and Continuous Tests (Michael) 10:35-10:45 Break (Confirm small group assignments and locations.) 10:45-12:30 Small Groups 12:30-1:30 Buffet Lunch

  9. Book will be here tomorrow If you won’t be here tomorrow or you plan to use the book tonight, we have a few copies.

  10. Thursday Afternoon 1:30-2:15 Studies and Systematic Reviews of Diagnostic Test Accuracy (Tom) 2:15-3:00 Prognostic and Genetic Tests (Mark) 3:00-3:45 Combining Tests (Michael) 3:45-4:00 Break 4:00-6:00 Small Groups 6:00 Meet in 6702 to head to Giants game

  11. Evidence Based Medicine Diagnosis: How to evaluate a test and then use it to estimate the probability that a patient has a given disease. Treatment: How to determine if a treatment is beneficial in patients with a given disease, and if so, whether the benefits outweigh the costs and risks.

  12. Basic Evidence-Based Diagnosis Evaluate and compare dichotomous tests using sensitivity and specificity Update pre-test probability of disease using LR(+) and LR(-). Checklist for evaluating studies of diagnostic test accuracy

  13. Advanced Evidence-Based Diagnosis Determining and using likelihood ratios for the results of non-dichotomous tests Understanding biases in studies of diagnostic tests and predicting their effect on study results. Combining results of multiple tests allowing for non-independence of tests

  14. Diagnosis vs. Test Utilization Diagnosis: Assigning a name to the patient’s illness Test Utilization: Using tests to guide a treatment decision

  15. Diagnosis vs. Test Utilization • Should we do a test to diagnosis a disease with no effective treatment? • SLUBI • Voiding cystourethrogram (VCU) for vesicoureteral reflux (VUR) • Should we do a test to distinguish between two diseases with the same treatment? • Kidney biopsy in child with nephrotic syndrome

  16. Dichotomous Tests (Tom)

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