Presentation on theme: "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."— Presentation transcript:
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
First NameLast NameDegreeSpecialtyCity ChristianApfelMD, PhDAnesthesiologySan Francisco NicoleAppelleMDInternal MedicineSan Francisco ArpiBekmezianMDPediatricsSan Francisco DennisBleakleyMDInternal MedicineClaremont ChristopherCarpenterMD, MSCEmergency MedicineWildwood MariaCarriedo-CenicerosMDFamily PracticeBonita GeorgeCembrowskiMDLab MedicineEdmonton ChatkanokDumavibhatMDCardiologyBangkok MirandaDunlopMDInternal MedicineSan Francisco VictorEttingerMDEndocrinology/DiabetesBakersfield NolaHyltonPhDRadiologySan Francisco AdamJungMD, PhDRadiologyMill Valley RenataKiefierMDPediatricsSan Francisco KurtLandauerMDFamily PracticeMinocqua EugeneLeeMD, MPHInternal MedicineSan Francisco AlanLevinMD, JDPathologyIncline Village AndrewMichaels MD, FACC, FAHACardiologyEureka CecilyMillerMPHInfectious DiseaseSan Francisco
First NameLast NameDegreeSpecialtyCity PaulineMysliwiecMDGastroenterologySan Francisco TimNichollsMDPediatricsBerkeley GodfreyOakleyMD, MSPMPediatricsAtlanta MatthewOlsenDOInternal MedicineSeattle LukePerkochaMDPathologySan Francisco CodyReevesMDAnesthesiologyNevada City MaxRobinowitzMDNoneBethesda SaadShakirMDPsychiatry and NeurologyLos Gatos RuthShelton-PryorMDFamily PracticeVallejo AlvinSilvaMDRadiologyScottsdale JuttaSkogbergMDOccupational MedicineEspoo ThomasSteffenMDFamily PracticeDecatur SaraSwensonMDInternal MedicineSan Francisco DanielTheodoroMD, MSCIEmergency MedicineSaint Louis KaraTimminsPA-CHospital MedicineSyracuse AnastasiaTolesMD, MPHInternal MedicineSan Francisco AndreaWickremasingheMDPediatricsSan Francisco AntonioWestphalenMDRadiologySan Francisco
Evidence-Based Medicine Level EBM LevelCount% Advanced525% Intermediate1155% Beginner420% Responded20 No Response15 Total35
Familiar with Threshold Model -- C/(C+B)? Threshold ModelCount NO1667% YES833% Responded24 No Response11 Total35
Familiar with ARR and NNT = 1/ARR? ARR and NNTCount% NO729% YES1771% Responded24 No Response11 Total35
Interest in Screening Interest In Screening (vs. Diagnosis and Prognosis)Count% High625% Intermediate938% Low938% Responded24 No Response11 Total35
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 If you wont be here tomorrow or you plan to use the book tonight, we have a few copies.
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 I. Diagnosis: How to evaluate a test and then use it to estimate the probability that a patient has a given disease. II. 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 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 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: Assigning a name to the patients illness Test Utilization: Using tests to guide a treatment decision
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
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