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Analytical Methods Of Healthcare Leaders - D
Questions And Correct Answers
In conversations with her patients, a physical therapist notices that patients who are on Workman's Compensation and have supportive supervisors, eager for them to return to work, have more positive outcomes in rehabilitation than those patients whose supervisors have a negative attitude toward their employee's injury: insisting they not return to work until they are at 100% because if anything less they are "useless to the job". What type of test could the therapist use to see if these two factors have a measurable relationship? Linear regression Data analysts at a large metropolitan hospital need to determine risk factors associated with readmission within 30 days via the hospital's emergency room among patients with COPD. The variables of interest include age, gender, race/ethnicity, insurance status, and family support. Which statistical technique should be used? Regression analysis Several community health centers across a rural state are gathering data on their pre-diabetic patients and using A1c levels as a baseline measurement to include patients in a research project. Three different interventions will be applied. One group of patients will receive a special diet to follow; the second group will work with physical therapists on a regular exercise program; the third group will follow the diet and engage in the exercise. Which statistical test will be appropriate to use to determine which treatment is most effective in controlling pre-diabetes? ANOVA
A hospital CFO is analyzing the cost benefits of using the patient reminder system, which was implemented over a year ago, to see if the automated system results in less missed appointments ("no-shows"). She is comparing quarterly reports from this past year on volume of patients who did not show up to their appointments, to the volume of patients of the previous year, who did not show up to their appointments, to see if the automated system has proven effective. She is considering other variables as she reviews the data, but is primarily analyzing the number of "no-show" patients from last year's quarterly reports to this year's. time series There are two standard treatments for children with ADHD who display a specific set of characteristics. One treatment is a cognitive behavioral intervention, and the other is a dietary and biomedical intervention. Both treatments have equally strong clinical evidence supporting their efficacy. A researcher proposes a comparison of the two interventions to determine which is preferable. The children will be randomized to one of two groups: half of the children will receive the cognitive behavioral intervention and the other half of the children will receive the dietary and biomedical intervention. Which test is appropriate to determining the preferable treatment? Cross-sectional The vice president, CMO, and Operations Team collected data on resources used by patients who have undergone coronary bypass and the length of stays for a defined population of patients who received CABG surgery. Since the raw data is complex to discuss and evaluate, the team will use descriptive statistics to analyze the data to support their decisions for recommendations. Which of the following descriptive statistics could prove the most useful? The mean (average) length of stay and The mean number of providers seeing each patient each day
Is a set of large-scale surveys of families and individuals, their medical providers, and employers across the United States. The Medical Expenditure Panel Survey (MEPS) Data mined from billing/ coding departments, many organizations use software or services to facilitate their process. Health Payment Systems Data Is an agency of the U.S. Department of Health and Human Services. It is the primary Federal agency for improving health care to people who are geographically isolated, or economically or medically vulnerable. Health Resources and Services Administration (HRSA) Financial health is critical to any organization. Managing financial data ensures adequate resources for long and short term goals, and sound financial planning. Accounts Receivable and cost data Catheter associated urinary tract infection is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney CAUTI Medical complications due to infection impact patient recovery, often resulting in thousands of dollars in additional cost; data also beneficial for improvement in infection control processes. Post-op infection rate Central Line Associated Blood Stream Infection CLABSI Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS The Affordable Care Act (ACA) added a section to the Social Security Act establishing the Hospital Program. It requires CMS to reduce payments to hospitals with excessive ________________. This was implemented back in 2012. Readmissions Used as an indicator for measuring the quality in health care. Affects clinical outcomes, patient retention, and medical malpractice claims. Patient Satisfaction Surveys
Division of Department of Health and Human Services (DHHS). Is responsible for developing healthcare policy in the U.S., and administering Medicare program and federal portion of Medicaid program. Centers for Medicare and Medicaid Services (CMS) Contains patient-identifiable information such as patient demographics, dates of hospitalization or other types of encounters, health record number (medical record number) and physician. Master Patient Index (MPI) May be used in research studies where there are two or more groups to compare. ANOVA (analysis of variance) test Determine if an association exists between two categorical variables. Chi-square test Is designed to test if two population variances are equal. The ratio of the two variances is compared. If they are equal, the ratio of the variances will be 1. F-test Includes units of equal size, such as IQ results. There is no zero point. An example is time: Time is measured in 24 hours in each day; the time between each hour is the same, 60 minutes. Interval data Can be measured as a frequency or percentage, and the mean of these data cannot be calculated. In healthcare might include demographic information about patients. The word means "pertaining to a name." Nominal Data The word means to "put in order." It can be measured as a frequency, and the mean of ordinal data is often calculated. In healthcare might include patient satisfaction surveys using a Likert scale. Ordinal Data Is used with interval and ordinal scale data and determines the extent to which a change in one variable tends to be associated with a change in another. Pearson's Correlation Test
development. The best practice guidelines will be used across the entire regional system. Which type of database would be used to gather and analyze data for the reports needed? data warehouse A hospital is onboarding a new cardiothoracic surgeon who is moving from a different state to join their physician team. Which data source will be used to ensure the credentials and background of this physician? NPDB (National Practitioner Data Bank) You are working on a report for the quality improvement manager to identify Hodgkin's Lymphoma rates in the state as they compare to your rural area. Which data source would provide valid data for your report? Cancer Registry Also called cross-sectional. Analyzes data collected from a subset of patients at a specific point in time. Prevalence Study Forecasts outcomes, consequences, effects, costs. Analyzes existing data to make prediction. Predictive Study Investigates one person, one organization, one group in depth. Non-participant observational. Case Study Data gathered on same subjects over a lengthy period of time. Longtitudinal Study A QI Team gathered data on all of the organization's patients with Medicare, who received total hip arthroscopy in 2017. They will survey these patients to determine the effectiveness of the surgery on quality of life and functional abilities. What type of study is this? Prevalence Study Draws conclusions about a larger population based on data from a sample. Inferential Statistics
The researchers recruited 80 physicians (44 men and 36 women) and 113 nurses (10 men and 103 women) for a total sample of 193. Approximately 71% of participants were female, 69% were Caucasian, 11% were African American, 6% were Hispanic, 10% were Asian, and 4% identified as Other. The average age of the healthcare providers was 44 years (range: 22-75), and the average years of professional experience was 15 years (range: 1-47). A majority of the healthcare professionals lived in Florida (N = 148). This is an example of what type of statistics? Descriptive Statistics The value is in the name or label. Types of cancers (breast, skin, lung, etc.) Categorical Variables It obscures the effect of another variable, the researcher may initially believe the variable will have an influence on the research, but findings show it does not. As a researcher, you may not be able to control its influence on the result of the research, but you should have an awareness that it is impacting your results and do not allow it to skew your data. Confounding Variable Also known as an interval variable. There is a meaningful difference between values. An example is body temperature. Continuous variable Also called a binary variable. Occurs in one of two possible states. For example, male or female. The patient has cancer or does not have cancer. Dichotomous variable Order matters, but not the difference between the values. Example: Likert Scale, which is subjective. Another example is birth order. Children are ranked according to the order in which they are born, but years between each child may vary. Ordinal variable Single table database. Cannot merge, must cut and paste. Good for storage of information. Similar to Excel spreadsheet. Flat File database
Error In research, this principle is the right for a person to participate as a human subject, or not. In healthcare, it refers to a patient having the right to make their own choices, unless they have been legally deemed unable to do so. Autonomy Is a concept which concerns the welfare of a research participant, but can also apply to treatment of patients. The opposite term, "maleficence" describes opposing the welfare of a research participant. You may also see a term, "malfeasance" which is intentional conduct outside the law. Beneficence This principle requires loyalty, fairness, truthfulness, advocacy, and dedication to patients (and others). It involves an agreement to keep promises, to keep a commitment, and is based on the virtue of caring. This principle would include patient advocacy. Fidelity Is the process of predicting outcomes and needs to create systems and models with the highest financial and operational safety and efficiency; it can be used to determine potential use of services and patient demand, or to expand service lines and markets. Forecasting Defined as "differences in the incidence, prevalence, mortality, and burden of diseases"; frequently seen in subpopulations based on socioeconomic status, geography, race, ethnicity, sexual orientation, or special needs. Health disparities In research, it pertains to the fair selection of research participants. This is the ideal distribution of risks and benefits when conducting clinical research and recruiting volunteer research participants to participate in clinical trials. One example that we see in the U.S. of the principle of justice is that in our country, when a citizen turns 65 years of age, he or she is eligible for Medicare, no matter who they are or their socioeconomic level. Justice
The purpose of _______________ is to determine the relationship between several independent or predictor variables and a dependent variable. Multiple regression Relies on mathematical algorithms to predict the probability of an outcome. Predictive modeling When used in the healthcare environment, it provides a ____________ score (probability) for each patient or groups of patients, in order to determine, inform, and influence organizational processes that pertain to large numbers of individuals. Predictive analytics Is a tool to plot the frequency and number of cases and is useful to identify areas of high variance. Histogram Reflects how close a sample mean is to the true population mean. This calculation is essential for identifying variation that is a result of chance. The standard error Measures the distance along the x-axis of a normal distribution measured in units of standard deviation. The ___________ is a unit that can simplify the measurement of variation. The z-score A quality improvement manager in Alaska is comparing data at her facility on enrollment of patients using Medicaid and CHIP, from before the passage of the Affordable Care Act to current data on Medicaid and CHIP enrollment. Statistical modeling A hospital CFO in California is examining reimbursement data from their five- hospital system to compare which hospital is incurring debt from healthcare services to patients using Medicaid and CHIPS. Statistical modeling A hospital in Colorado is launching an initiative to decrease the use of their emergency department by the homeless population who uses Medicaid for their healthcare, by sending mobile healthcare units into certain sections of their
She decides to call him back at the end of her eight-hour work day, as she tells herself that his call is most likely unnecessary and unimportant. Nonmaleficence and Beneficence The chief medical officer of emergency services is investigating the number of gunshot victims seen in their emergency department in the past two years, for their hospital. What type of database should be used to locate this data? Trauma registry A group of speech pathologists from several facilities within the same large healthcare system are doing a research study on children who stutter. They want to share their audio files across their interoperable databases as they work on this study together. Object-Oriented Database A clinical research associate is comparing data on her study patients and their response to a clinical trials drug for patients with fibromyalgia. They were enrolled six months ago. She is comparing data from when they were first enrolled in the study, to today. What type of database is she using? Research Identified The actual probability that an event will occur. Absolute risk The difference in the chance of an event between the treatment and control groups. Absolute risk reduction A probability distribution based on the occurrence of a particular outcome based on n independent yes/no events. Binomial distribution The theory which predicts that the frequency distribution of the means of samples drawn from any population will approach the normal distribution. Central limit theorem
An expression of the range of values between which the population mean is believed to be found. Confidence limits Tables that display frequency data for nominal scale data. Contingency tables A technique for establishing differences between means of two related samples. Paired t test Rejecting the null hypothesis when it is true. Type I error Not rejecting the null hypothesis when it should be rejected. Type II error A test that is similar to the paired t test. A non-parametric test A measure of how many standard deviations an individual case is from the mean. z score A phenomenon or thing that relates to the individual or objects under study that varies. Variable longitudinal cohort study. Studies a cohort of individuals that share a common exposure factor to determine its influence on the development of a disease, and are compared with another group of equivalent individuals that were not exposed to the factor. Retrospective Study a method for systematically combining pertinent qualitative and quantitative study data from several selected studies to develop a single conclusion that has greater statistical power. Meta-analysis you would use all types of information to build your research report: published articles written by thought leaders; documents and artifacts containing information and data useful to your report; chart review could be in the form of graphs or visuals with data, or you may use medical charts to review.
Demographic Statistic using chance methods to assign subjects to a study. Example: you are interested in surveying patients to determine their use of the new patient portal. You distribute the survey to the first 200patients who come in for clinic services. Randomized Statistic summarizes a population (the entire group you are interested in investigating) Parameter Sequence of data taken at equally spaced point - in time. Example trending data month to month Time series Analysis Analyzing data that comes from a specific point in time Cross-sectional research The applicants or data is chosen by chance. Randomized control trial or study Test before you apply an intervention to obtain the baseline. Then you apply the intervention. Then you test again to identify the change. Pre & post-test Analyze data that comes from a specific point in time Cross-Sectional Research Chosen by Chance Randomized Control Trial or Study Categorical Data This type of data names categories. It may use numbers by the value is in the category. For example: Cancer Type (Not Stage), Units in the Hospital, or the M0150 OASIS Question. Qualifies as Qualitative Data. Nominal Data Categorical Data
This type of data buts the category in an order. There is order and sequence to this data. The value is not only in the category, but the order. For example: The pain scale, or the Stages of Cancer. Qualifies as Qualitative Data. Ordinal Data Numbers Data This type of data qualifies as quantitative data. This data includes numbers that are not discrete - it is continuous data that can fall in a range or threshold. For example: Body temperature, height, or weight. Interval Data This only includes only one paired t-test Examining relationship between a dependent variable (the outcome), and one or more independent (the predictor) variable. Aims to find the best fitting line that minimized the difference between the predictive value & the actual value of the dependent variable. It helps us understand how one thing (called the "dependent variable," like ice cream sales) might be influenced by another thing (called the "independent variable," like temperature). It's like figuring out how changes in one thing might cause changes in another. Linear Regression The outcome Dependent Variable The predictor Independent Variable
