Chapter 13 Evaluation and Diagnosis Research Methods and Data.pptVIP

Copyright ? 2011 Wolters Kluwer Health | Lippincott Williams Wilkins Copyright ? 2011 Wolters Kluwer Health | Lippincott Williams Wilkins Chapter 13Evaluation and Diagnosis: Research Methods and Data Analysis Chapter Overview Health care providers use a variety of diagnostic procedures, including laboratory testing, diagnostic imaging, physical examination, interviewing, and observation. Patient interviews and the performance of physical examination procedures are the primary tools available to those evaluating an individual seeking care. Overview of the diagnostic continuum and the differences between research into diagnostic testing and prevention or treatment strategies. Define and decrease investigational bias. Concepts of sensitivity and specificity. Calculation of sensitivity and specificity values, and likelihood ratios. Positive and negative prediction values. Understand and interpret receiver-operator characteristic (ROC) curves. Physical Examination Procedures  Observation, interview, and the performance of physical examination procedures are the primary methods available during the injury evaluation process. Observation guides the opening questions in an interview with a patient. Through observation and interview, the list of diagnostic possibilities shrinks, and one or two conditions emerge as the most likely culprits of the patient’s complaints. The clinician can then select physical examination procedures that will help confirm or refute the existence of the suspect conditions. Research into the performance of diagnostic tests differs from research into, for example, prevention efforts and treatment outcomes. In studies of diagnostic procedures, comparison to another group of patients or subjects is unnecessary. These studies require that the results of the diagnostic test of interest be compared to the results of an established standard. Clinical Research Improving Patient Evaluation Challenge in health care: maximize benefit to the