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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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Presentation Transcript
who are we
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
Who are you?
  • Breakdown of ≈ 36 participants
thursday morning
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

book will be here tomorrow
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.

thursday afternoon
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

evidence based medicine
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.

basic evidence based diagnosis
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

advanced evidence based diagnosis
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

diagnosis vs test utilization

Diagnosis vs. Test Utilization

Diagnosis: Assigning a name to the patient’s illness

Test Utilization: Using tests to guide a treatment decision

diagnosis vs test utilization1
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