Type of Clinically Stable with Can be used

Epidemiologic useful? changing w/ tests that

al parameter prevalence? have > 2
possible
results?
Sensitivity No Yes No
/Specificity
Predictive Yes No No
values
Likelihood Yes Yes Yes
ratios

Standardized Mortality Ratio (SMR)

Represents an adjusted measure of the
overall mortality
Typically used in occupational
epidemiology
Mortality is typically adjusted for age
(less commonly for gender, race and
other factors)
The standard population is used for
comparison
SMR = Observed number of deaths
Expected number of deaths
Expected number of deaths calculated
using age-specific rates of death in the
standard population
Observed number of deaths is exposed
is x times higher than in the standard
population

How does one decide on which measure of

central tendency to use:
Continuous data that are normally
distributed mean is the best choice
Ordinal data or continuous data that are
highly skewed median is the best
choice
o Ordinal data can be ordered in a
logical fashion
Nominal data mode or describing the
frequency of proportion of subjects in
each category is best

Net Clinical Benefit = Benefit to harm ratio

Or clinical usefulness of a medication is a
measure of its benefit versus its harm
E.g. significant clinical improvement in
pxs with untreatable cancer might result
in a favorable benefit to harm ratio (net
clinical benefit) despite substantial
toxicity of the medication

Intention-to-treat analysis in RCT

Participants in trials should be analyzed
in the groups to which they were
randomized, regardless of whether they
received or adhered to the allocated
 intervention and regardless of whether
they withdrew from treatment
Holds that the randomization is of
paramount importance, deviation from
the original randomized groups can
contaminate the treatment comparison
Performed to avoid the effects of
crossover and drop-out

Placebo effect
Phenomenon whereby a patients
symptoms are alleviated by an otherwise
ineffective treatment
Most likely since the individual expects
that the treatment will work

Time-to-event data analysis

Analysis of follow-up studies and clinical
trials
This type of analysis is called survival
analysis
Accounts not only for the number of
events in both groups, but also for the
timing of the events

Postmarketing Surveillance
Practice of monitoring the safety of
medication or devices after they have
been released on the market
Clinical trials often have short follow-up
times, underrepresented populations,
and too few participants to detect rare
and serious side effects