This document discusses various types of bias that can occur in research studies. It defines bias as an unknown or unacknowledged error created during the research process. Some key biases discussed include selection bias, measurement bias, confounding, and publication bias. The document emphasizes the importance of research design features like randomization and blinding to help reduce bias.
Bias, confounding and causality in p'coepidemiological researchsamthamby79
A brief description of three issues (Bias, Confounding and Causality) commonly encountered while performing pharmacoepidemiological research. A big THANK YOU to Mr. Strom and Mr. Kimmel.
Este documento descreve os mecanismos reguladores da tensão arterial, incluindo sensores como os seios carotídeos e corpos carotídeos, e efetores como o sistema nervoso central, músculo vascular, endotélio, eixo renina-angiotensina-aldosterona, vasopressina, endotelina e peptídeo natriurético auricular. Estes mecanismos trabalham em conjunto para regular a pressão arterial através de respostas a estímulos de pressão, químicos e neuro-hormonais.
This document discusses bias and validity in clinical research. It defines clinical epidemiology as the study of health-related states and events in populations to control health problems. It describes how epidemiologic studies compare outcomes like disease rates between exposed and unexposed groups. Validity is important, with internal validity indicating good construct free from bias/errors, and external validity showing generalizability. Bias and confounding can threaten validity and lead to erroneous associations if not avoided or controlled for.
Amy Oppenheimer is an expert in workplace investigations and bias elimination. She discussed various types of unconscious biases that can impact investigations including implicit biases, confirmation bias, priming effects, and anchoring. Studies show biases can influence how questions are asked, witness memory, hiring decisions, and how evidence is interpreted. To reduce bias, investigators should consider alternative explanations, multiple suspects, and replace initial intuitions with deliberative thinking. Eliminating bias requires awareness of cognitive shortcuts and actively considering how perspectives and assumptions may be influencing judgments.
Regulação da Pressão Arterial a Longo PrazoCarlos Alves
A regulação da pressão arterial a longo prazo envolve mecanismos que mantêm a pressão arterial dentro de uma estreita faixa através de ajustes no volume de sangue. Os principais mecanismos incluem o sistema renina-angiotensina-aldosterona, a vasopressina, a hormona natriurética auricular, a transferência de líquidos e a resposta de stress-relaxamento dos vasos sanguíneos.
The document discusses randomized controlled trials (RCTs), which are considered the gold standard for evaluating causal relationships. It describes key aspects of RCTs such as randomization methods, blinding, allocation concealment, study populations, interventions, follow-up, and outcome assessment. RCTs follow a strict protocol and involve randomly allocating participants into study and control groups to receive different interventions/exposures. The results are then compared to determine the effectiveness of the new treatment or exposure being tested.
This document discusses various types of bias that can occur in research studies. It defines bias as an unknown or unacknowledged error created during the research process. Some key biases discussed include selection bias, measurement bias, confounding, and publication bias. The document emphasizes the importance of research design features like randomization and blinding to help reduce bias.
Bias, confounding and causality in p'coepidemiological researchsamthamby79
A brief description of three issues (Bias, Confounding and Causality) commonly encountered while performing pharmacoepidemiological research. A big THANK YOU to Mr. Strom and Mr. Kimmel.
Este documento descreve os mecanismos reguladores da tensão arterial, incluindo sensores como os seios carotídeos e corpos carotídeos, e efetores como o sistema nervoso central, músculo vascular, endotélio, eixo renina-angiotensina-aldosterona, vasopressina, endotelina e peptídeo natriurético auricular. Estes mecanismos trabalham em conjunto para regular a pressão arterial através de respostas a estímulos de pressão, químicos e neuro-hormonais.
This document discusses bias and validity in clinical research. It defines clinical epidemiology as the study of health-related states and events in populations to control health problems. It describes how epidemiologic studies compare outcomes like disease rates between exposed and unexposed groups. Validity is important, with internal validity indicating good construct free from bias/errors, and external validity showing generalizability. Bias and confounding can threaten validity and lead to erroneous associations if not avoided or controlled for.
Amy Oppenheimer is an expert in workplace investigations and bias elimination. She discussed various types of unconscious biases that can impact investigations including implicit biases, confirmation bias, priming effects, and anchoring. Studies show biases can influence how questions are asked, witness memory, hiring decisions, and how evidence is interpreted. To reduce bias, investigators should consider alternative explanations, multiple suspects, and replace initial intuitions with deliberative thinking. Eliminating bias requires awareness of cognitive shortcuts and actively considering how perspectives and assumptions may be influencing judgments.
Regulação da Pressão Arterial a Longo PrazoCarlos Alves
A regulação da pressão arterial a longo prazo envolve mecanismos que mantêm a pressão arterial dentro de uma estreita faixa através de ajustes no volume de sangue. Os principais mecanismos incluem o sistema renina-angiotensina-aldosterona, a vasopressina, a hormona natriurética auricular, a transferência de líquidos e a resposta de stress-relaxamento dos vasos sanguíneos.
The document discusses randomized controlled trials (RCTs), which are considered the gold standard for evaluating causal relationships. It describes key aspects of RCTs such as randomization methods, blinding, allocation concealment, study populations, interventions, follow-up, and outcome assessment. RCTs follow a strict protocol and involve randomly allocating participants into study and control groups to receive different interventions/exposures. The results are then compared to determine the effectiveness of the new treatment or exposure being tested.
General Research Design Issues in PsychologyGrant Heller
This document provides an overview of key concepts in research design and methodology. It discusses the scientific attitude, theories of proof and scientific progress, research questions, variables, conceptual models, reliability and validity, research designs (fixed vs. flexible), and threats to validity. The document emphasizes developing testable hypotheses from theoretical frameworks and choosing appropriate research strategies and methods to answer specific research questions.
This document discusses several key aspects of research and statistics:
1. It emphasizes that reliable evidence generally comes from multiple studies and research teams, and the totality of evidence matters most.
2. Statistics are useful for determining whether differences or associations are likely due to chance or represent real effects, but numbers can be easily manipulated.
3. Several types of biases and errors can influence research, decision making, memory, and social judgments. Rigorous methodology is important to produce high quality, accurate research and publications.
Randomization is a key process in clinical trials that assigns participants to treatment groups in a way that limits bias. It aims to balance groups so they are similar in all ways except for the intervention received. Common randomization methods include coin tossing, random number tables, and computer generation of sequences. Block and stratified randomization can help produce balanced groups with comparable characteristics. Blinding of participants, investigators, and assessors is important to prevent biases from influencing outcomes. Inclusion and exclusion criteria define who can participate in a clinical trial based on factors like age, sex, disease characteristics, and medical history.
This document discusses assessing risk of bias in studies included in systematic reviews. It defines bias as systematic error that can vary in direction and magnitude. The Cochrane Risk of Bias tool is recommended for assessing bias in domains such as selection bias, performance bias, detection bias, attrition bias, and reporting bias. Assessments involve describing the risk of bias and making a judgment of low, high, or unclear risk. Summary assessments of risk of bias are made within and across studies.
The document discusses identifying and avoiding bias in writing. It provides examples of biased language to avoid, such as using gendered pronouns to refer to all people or reinforcing racial, age, or occupational stereotypes. It recommends using specific, uncharged language and considering how word choice could affect different groups.
Clinical research methodology involves understanding different study types and choosing the appropriate one to investigate research questions. The main types are observational (cross-sectional, case-control) and interventional (cohort, randomized controlled trial). Observational studies can show associations but not causation due to limitations like bias and confounding. Interventional studies like randomized controlled trials can establish causation by minimizing biases through randomization and blinding. Well-designed clinical trials systematically plan the hypothesis, participants, interventions, outcomes, sample size, controls, analysis and interpretation of results to accurately assess interventions.
Thorough study of Experimental Errors occurred during experimentation using different experimental techniques.
A clear picture about techniques for error measurement is given in the presentation.
This document discusses different types of error and bias that can occur in epidemiological studies. It defines random error as occurring due to chance and resulting in imprecise measures, while systematic error or bias results in invalid measures that are not true. Types of bias discussed include selection bias, information bias, and confounding. Selection bias can arise from how cases and controls are selected, while information bias occurs when exposure or disease status is incorrectly classified. The document emphasizes the importance of reducing both random and systematic errors to obtain valid study results.
This document discusses different types of epidemiological studies, with a focus on experimental studies and randomized controlled trials (RCTs). It describes the key features of RCTs, including that they: (1) involve randomly allocating subjects into study and control groups to receive or not receive an intervention, (2) aim to control for confounding factors through randomization, and (3) are considered the gold standard for evaluating interventions due to their ability to minimize bias. The document outlines the basic steps in conducting an RCT, from developing a protocol to randomization, intervention, follow-up, assessment and analysis. It also discusses types of RCTs and their importance in evaluating treatments, prevention, risk factors and more.
This document is a CME tracker for Javier Rodriguez Vera listing the CME activities he has completed from January 2012 through December 2012. It shows that he earned a total of 52.25 credits. The activities covered topics such as glucose-lowering therapy in chronic kidney disease, assessing treatment response in PAH, biomarker-guided heart failure therapy, management of joint bleeding in hemophilia, incorporating new approaches to hyponatremia management, and more. Each activity is listed with its title, provider, date participated, and credits earned.
This study analyzed the legibility of epicrisis reports for 108 deceased patients in the department of internal medicine at a hospital in Portugal in 2002. The reports were written by 13 different doctors, with only 6 being typewritten and fully legible. 30 reports (27.77%) had some degree of illegibility, though only 1 was fully unclear. No reports were completely illegible. Legibility defects were slightly higher for patients with shorter average stays of 5 days or less before death. The study concludes that introducing electronic epicrisis reports could help address legibility issues, and that staffing levels on weekends did not influence mortality or report quality.
This study aimed to understand the magnitude and characteristics of infectious diseases among patients admitted to the internal medicine ward of a Portuguese hospital over one month. A total of 25 out of 73 patients admitted during the study period had infectious diseases, representing 41 infectious episodes. The most common infections were urinary tract infections (44%) and pneumonia (29%). The majority (83%) of cultures grew pathogens, most commonly E. coli (21%), Pseudomonas aeruginosa (11%), and fungi (11%). Infections increased patient mortality by 10% and length of stay by 3.5 days compared to other patients. Pressure ulcers accounted for 12% of infections and were all hospital-acquired. Empiric antibiotic therapy was ineffective in
1) The study assessed the appropriateness of 174 patient admissions to an internal medicine ward in Portugal using the prospective Appropriateness Evaluation Protocol (AEP).
2) They found that 17.7% of admissions were inappropriate, similar to other studies in the Iberian Peninsula. The most common reason for appropriateness was intravenous therapy.
3) Patients admitted on weekends had significantly longer hospital stays than those admitted on weekdays, possibly due to lack of elective care on weekends.
This study analyzed 30 patients admitted to a hospital in southern Portugal between 1998-2003 with spotted fever. Spotted fever is endemic to the Mediterranean region and transmitted by ticks. The average age was 43 years and 70% were male. Most cases occurred between June-August. Rural environments and contact with dogs were identified as risk factors. The most common symptoms were fever (100%) and rash (90%). Half of patients developed hepatitis and 40% thrombocytopenia. Doxycycline treatment was started early in 93% of patients and all patients recovered well with an average hospital stay of 5.9 days. The study concludes that spotted fever is common in the region likely due to rural areas, treatment with doxycy
Este estudo avaliou a adequação de 72 admissões hospitalares num serviço de medicina interna em Portugal utilizando o Protocolo de Avaliação da Apropriação (AEP). 20,8% das admissões foram consideradas inadequadas, principalmente para exames ou tratamentos que poderiam ter sido realizados em ambulatório. O AEP é uma ferramenta útil para avaliar a utilização de recursos e melhorar a eficiência dos hospitais.
Adequaçao do Internamento num Serviço de Medicina INterna Utilizando o AEP. A...Javier Rodriguez-Vera
Este artigo avalia a adequação das admissões e estadias hospitalares de pacientes internados em uma enfermaria de medicina interna utilizando a versão concorrente do Appropriateness Evaluation Protocol (AEP). Os resultados mostraram que todas as admissões foram consideradas adequadas, com a necessidade de terapia endovenosa sendo o critério mais comum. No entanto, 27,3% das estadias foram consideradas inadequadas de acordo com o AEP.
El estudio evaluó la adecuación de ingresos y estancias en un servicio de medicina interna utilizando la versión concurrente del AEP. Se encontró que un 15.3% de los ingresos y un 33% de las estancias fueron inadecuados, siendo las causas más frecuentes agilizar estudios ambulatorios e esperar resultados de pruebas, respectivamente. El estudio proporciona información sobre el uso de recursos que puede ayudar a mejorar la eficiencia.
Reingreso hospitalario como indicador de la calidad asistencialJavier Rodriguez-Vera
RODRIGUEZ-VERA, F. J.; ALCOUCER DIAZ, M. R.; MARIN FERNANDEZ, Y. y PUJOL DE LA LLAVE, E. An. Med. Interna (Madrid). 2002, vol.19, n.5, pp. 66-67. ISSN 0212-7199.
Inadecuación de ingresos y estancias hospitalarias en una seción de digestivoJavier Rodriguez-Vera
Este estudio evaluó la inadecuación de ingresos y estancias en la sección de digestivo de un hospital durante enero y febrero de 2000 utilizando el protocolo de evaluación de adecuación. El 15.7% de los pacientes no cumplían criterios de ingreso y la causa más común fue la necesidad de realizar estudios de forma rápida. La estancia media fue de 6.11 días y el 28.57% de las estancias inadecuadas se debió a procedimientos que podrían haberse realizado de forma externa. El estudio conclu
General Research Design Issues in PsychologyGrant Heller
This document provides an overview of key concepts in research design and methodology. It discusses the scientific attitude, theories of proof and scientific progress, research questions, variables, conceptual models, reliability and validity, research designs (fixed vs. flexible), and threats to validity. The document emphasizes developing testable hypotheses from theoretical frameworks and choosing appropriate research strategies and methods to answer specific research questions.
This document discusses several key aspects of research and statistics:
1. It emphasizes that reliable evidence generally comes from multiple studies and research teams, and the totality of evidence matters most.
2. Statistics are useful for determining whether differences or associations are likely due to chance or represent real effects, but numbers can be easily manipulated.
3. Several types of biases and errors can influence research, decision making, memory, and social judgments. Rigorous methodology is important to produce high quality, accurate research and publications.
Randomization is a key process in clinical trials that assigns participants to treatment groups in a way that limits bias. It aims to balance groups so they are similar in all ways except for the intervention received. Common randomization methods include coin tossing, random number tables, and computer generation of sequences. Block and stratified randomization can help produce balanced groups with comparable characteristics. Blinding of participants, investigators, and assessors is important to prevent biases from influencing outcomes. Inclusion and exclusion criteria define who can participate in a clinical trial based on factors like age, sex, disease characteristics, and medical history.
This document discusses assessing risk of bias in studies included in systematic reviews. It defines bias as systematic error that can vary in direction and magnitude. The Cochrane Risk of Bias tool is recommended for assessing bias in domains such as selection bias, performance bias, detection bias, attrition bias, and reporting bias. Assessments involve describing the risk of bias and making a judgment of low, high, or unclear risk. Summary assessments of risk of bias are made within and across studies.
The document discusses identifying and avoiding bias in writing. It provides examples of biased language to avoid, such as using gendered pronouns to refer to all people or reinforcing racial, age, or occupational stereotypes. It recommends using specific, uncharged language and considering how word choice could affect different groups.
Clinical research methodology involves understanding different study types and choosing the appropriate one to investigate research questions. The main types are observational (cross-sectional, case-control) and interventional (cohort, randomized controlled trial). Observational studies can show associations but not causation due to limitations like bias and confounding. Interventional studies like randomized controlled trials can establish causation by minimizing biases through randomization and blinding. Well-designed clinical trials systematically plan the hypothesis, participants, interventions, outcomes, sample size, controls, analysis and interpretation of results to accurately assess interventions.
Thorough study of Experimental Errors occurred during experimentation using different experimental techniques.
A clear picture about techniques for error measurement is given in the presentation.
This document discusses different types of error and bias that can occur in epidemiological studies. It defines random error as occurring due to chance and resulting in imprecise measures, while systematic error or bias results in invalid measures that are not true. Types of bias discussed include selection bias, information bias, and confounding. Selection bias can arise from how cases and controls are selected, while information bias occurs when exposure or disease status is incorrectly classified. The document emphasizes the importance of reducing both random and systematic errors to obtain valid study results.
This document discusses different types of epidemiological studies, with a focus on experimental studies and randomized controlled trials (RCTs). It describes the key features of RCTs, including that they: (1) involve randomly allocating subjects into study and control groups to receive or not receive an intervention, (2) aim to control for confounding factors through randomization, and (3) are considered the gold standard for evaluating interventions due to their ability to minimize bias. The document outlines the basic steps in conducting an RCT, from developing a protocol to randomization, intervention, follow-up, assessment and analysis. It also discusses types of RCTs and their importance in evaluating treatments, prevention, risk factors and more.
This document is a CME tracker for Javier Rodriguez Vera listing the CME activities he has completed from January 2012 through December 2012. It shows that he earned a total of 52.25 credits. The activities covered topics such as glucose-lowering therapy in chronic kidney disease, assessing treatment response in PAH, biomarker-guided heart failure therapy, management of joint bleeding in hemophilia, incorporating new approaches to hyponatremia management, and more. Each activity is listed with its title, provider, date participated, and credits earned.
This study analyzed the legibility of epicrisis reports for 108 deceased patients in the department of internal medicine at a hospital in Portugal in 2002. The reports were written by 13 different doctors, with only 6 being typewritten and fully legible. 30 reports (27.77%) had some degree of illegibility, though only 1 was fully unclear. No reports were completely illegible. Legibility defects were slightly higher for patients with shorter average stays of 5 days or less before death. The study concludes that introducing electronic epicrisis reports could help address legibility issues, and that staffing levels on weekends did not influence mortality or report quality.
This study aimed to understand the magnitude and characteristics of infectious diseases among patients admitted to the internal medicine ward of a Portuguese hospital over one month. A total of 25 out of 73 patients admitted during the study period had infectious diseases, representing 41 infectious episodes. The most common infections were urinary tract infections (44%) and pneumonia (29%). The majority (83%) of cultures grew pathogens, most commonly E. coli (21%), Pseudomonas aeruginosa (11%), and fungi (11%). Infections increased patient mortality by 10% and length of stay by 3.5 days compared to other patients. Pressure ulcers accounted for 12% of infections and were all hospital-acquired. Empiric antibiotic therapy was ineffective in
1) The study assessed the appropriateness of 174 patient admissions to an internal medicine ward in Portugal using the prospective Appropriateness Evaluation Protocol (AEP).
2) They found that 17.7% of admissions were inappropriate, similar to other studies in the Iberian Peninsula. The most common reason for appropriateness was intravenous therapy.
3) Patients admitted on weekends had significantly longer hospital stays than those admitted on weekdays, possibly due to lack of elective care on weekends.
This study analyzed 30 patients admitted to a hospital in southern Portugal between 1998-2003 with spotted fever. Spotted fever is endemic to the Mediterranean region and transmitted by ticks. The average age was 43 years and 70% were male. Most cases occurred between June-August. Rural environments and contact with dogs were identified as risk factors. The most common symptoms were fever (100%) and rash (90%). Half of patients developed hepatitis and 40% thrombocytopenia. Doxycycline treatment was started early in 93% of patients and all patients recovered well with an average hospital stay of 5.9 days. The study concludes that spotted fever is common in the region likely due to rural areas, treatment with doxycy
Este estudo avaliou a adequação de 72 admissões hospitalares num serviço de medicina interna em Portugal utilizando o Protocolo de Avaliação da Apropriação (AEP). 20,8% das admissões foram consideradas inadequadas, principalmente para exames ou tratamentos que poderiam ter sido realizados em ambulatório. O AEP é uma ferramenta útil para avaliar a utilização de recursos e melhorar a eficiência dos hospitais.
Adequaçao do Internamento num Serviço de Medicina INterna Utilizando o AEP. A...Javier Rodriguez-Vera
Este artigo avalia a adequação das admissões e estadias hospitalares de pacientes internados em uma enfermaria de medicina interna utilizando a versão concorrente do Appropriateness Evaluation Protocol (AEP). Os resultados mostraram que todas as admissões foram consideradas adequadas, com a necessidade de terapia endovenosa sendo o critério mais comum. No entanto, 27,3% das estadias foram consideradas inadequadas de acordo com o AEP.
El estudio evaluó la adecuación de ingresos y estancias en un servicio de medicina interna utilizando la versión concurrente del AEP. Se encontró que un 15.3% de los ingresos y un 33% de las estancias fueron inadecuados, siendo las causas más frecuentes agilizar estudios ambulatorios e esperar resultados de pruebas, respectivamente. El estudio proporciona información sobre el uso de recursos que puede ayudar a mejorar la eficiencia.
Reingreso hospitalario como indicador de la calidad asistencialJavier Rodriguez-Vera
RODRIGUEZ-VERA, F. J.; ALCOUCER DIAZ, M. R.; MARIN FERNANDEZ, Y. y PUJOL DE LA LLAVE, E. An. Med. Interna (Madrid). 2002, vol.19, n.5, pp. 66-67. ISSN 0212-7199.
Inadecuación de ingresos y estancias hospitalarias en una seción de digestivoJavier Rodriguez-Vera
Este estudio evaluó la inadecuación de ingresos y estancias en la sección de digestivo de un hospital durante enero y febrero de 2000 utilizando el protocolo de evaluación de adecuación. El 15.7% de los pacientes no cumplían criterios de ingreso y la causa más común fue la necesidad de realizar estudios de forma rápida. La estancia media fue de 6.11 días y el 28.57% de las estancias inadecuadas se debió a procedimientos que podrían haberse realizado de forma externa. El estudio conclu
Lo que nunca se ve: resúmenes de estudios enviados para presentación en Congr...Javier Rodriguez-Vera
Not all the studies sent for presentation to a Congress are accepted. Although less selective than a journal, an abstract has to comply with criteria of quality and scientific interest. As higher the number of abstracts sent, more rigurous the selection becomes.
Este documento estudia la relación entre la comorbilidad crónica de los pacientes y la duración de sus estancias hospitalarias. Analizó los registros médicos de 117 pacientes y calculó su índice de comorbilidad de Charlson. Encontró que los pacientes con mayor comorbilidad tuvieron estancias más largas, especialmente debido a más días de estancia adecuados, probablemente para estabilizar sus condiciones. Además, detectó que el 11% de las estancias fueron inadecuadas, una tasa menor que otros estudios simil
SADEMI 2001 (Abstract of non accepted study): Factores estructurales que dete...Javier Rodriguez-Vera
This is the case: I found interesting to analyze if there were another factors not related with the requirements of acute care causing innappropriateness. Results showed facts, from my perspective, not appropriate to be changed.
This abstract was accepted, the Director Medicine making despective comments about importance, pertinence and Interest of the study. During the Congress, it was a study calling the attention of many assistens. My boss (Director of Medicine and friend), mantained his position: it´s a "cute" study to be presented on a regional meeting, but that´s all. the study was published as an original article on the Journal of the Royal Society of Medicine, presenting a high individual impact factor. Chiefs can also be wrong.
Este documento contiene información personal de Francisco Javier Rodríguez-Vera, incluyendo su nombre, lugar de trabajo en el Hospital Juan Ramón Jiménez de Huelva como médico interno, dirección, códigos postales y correo electrónico.
Este documento evalúa el uso de la versión concurrente del Protocolo de Evaluación de la Adecuación (AEP) en un servicio de medicina interna para evaluar la adecuación de ingresos y estancias. El estudio encontró que el 15.3% de los ingresos y el 25.97% de las estancias fueron inadecuados, principalmente debido a la espera de resultados de pruebas e interconsultas. La conclusión es que el AEP puede identificar la sobreutilización de recursos y que agilizar pruebas y colaboración entre especial
Este documento evalúa el uso de la versión concurrente del Protocolo de Evaluación de la Adecuación (AEP) en un servicio de medicina interna para evaluar la adecuación de ingresos y estancias. El estudio encontró que el 15.3% de los ingresos y el 25.97% de las estancias fueron inadecuados, principalmente debido a la espera de resultados de pruebas e interconsultas. La conclusión es que el AEP puede identificar la sobreutilización de recursos y que agilizar pruebas y colaboración entre especial
Este documento contiene un protocolo de estudio de pluripatología para un paciente. Recopila datos personales del paciente como nombre, edad, sexo y número de historia clínica. También incluye información sobre ingresos hospitalarios previos, categorías de patologías crónicas, comorbilidades según la escala de Charlson y detalles sobre la continuidad asistencial tras el último alta hospitalaria.