Course overview, the diagnostic process, and measures of interobserver agreement

Required Reading:

1. EBD FM -- Contents and Preface
2. EBD 1 -- Introduction: understanding diagnosis and diagnostic testing
3. EBD 2 -- Reliability and measurement error

Optional Reading:

1. Using Stata to calculate Kappa

Note/Slide Files: Lec 1 Overview diagnosis kappa_17Sep08.ppt (214 KB)

Assignment:
1. Read Preface, Chapter 1 and Chapter 2 of Evidence-Based Diagnosis (EBD). 2. Be prepared to discuss problems from Chapter 1.

Review of Chapter 1 problems and "Kappa Game"

Assignment:
For next week's section: EBD Chapter 2 #1,2,3,5.

Assignment Files: KAPPA GAME DATA COLL FORM11Sep08.doc (79 KB)

Dichotomous tests

Required Reading:

1. EBD 3 -- Dichotomous tests

Review of Chapter 2 problems on measures of interobserver agreement

Assignment:
Due in NEXT WEEK's (10/2) section: EBD Chapter 3, Problems 1 - 4, 7, 8. (#7 and #8 are not in the PDFs, only in the Word document.)

Assignment Files: Chapter 3 Problems (Do 1-4, 7, 8).doc (111 KB)

Multilevel and continuous tests

Required Reading:

1. EBD 4 -- Multilevel and continuous tests

Note/Slide Files: MulilevelAndContinuousTests_10-02-2008 MAK.ppt (1190 KB)

Review of Chapter 3 problems on dichotomous tests

Assignment:
No class next week, 10/9. Due in section in two weeks, 10/16, Chapter 4 #1,3,4,6.

Studies of Diagnostic Tests

Required Reading:

1. EBD 5 -- Critical appraisal of studies of diagnostic tests

Note/Slide Files: StudiesOfDxTEsts15Oct08b.ppt (357 KB)

Review of Chapter 4 problems on multilevel and continuous tests

Assignment:
Due in next week's (10/23) section: EBD Chapter 5, #1,2,3,6.

Screening tests

Required Reading:

1. EBD 6 -- Screening Tests

Note/Slide Files: ScreeningTests_Part1_Marmor.ppt (3355 KB) ScreeningTests_Part2_Marmor.ppt (2503 KB)

Review of Chapter 5 problems on studies of diagnostic tests

Assignment:
Due in next week's (10/30) section: EBD Chapter 6 #1,#2,#4,#5.

Combining tests and prognostic tests

Required Reading:

1. EBD 7 -- Prognostic Tests and Studies
2. EBD 8 -- Multiple Tests and multivariable decision rules

Note/Slide Files: KohnMultipleTestsPrognosticTests_10-30-2008.ppt (1190 KB)

Review of Chapter 6 problems on screening tests

Assignment:
Ch 7 #1, #2, #3 AND Ch 8 #1, #2. Due Nov 6.

Quantifying the benefits and harms of treatments

Required Reading:

1. EBD 9 -- Quantifying the treatment effects using randomized trials

Optional Reading:

1. Marketing Medicines with Research (Narrated PowerPoint Presentation by TBN)

Note/Slide Files: KohnRBTsQuantifyingTreatmentEffects11_6_2008.ppt (3496 KB)

Review of Chapter 7 problems on prognostic tests and Chapter 8 problems on combining tests

Assignment:
Chapter 9 #1,2,3,6. Due 11/13/08.

Alternatives to randomized trials for estimating effects of tests and treatments

Required Reading:

1. EBD 10 -- Alternatives to randomized trials for estimating treatment effects

Note/Slide Files: AltToRCTs 13Nov08.ppt (2462 KB)

Review of Chapter 9 problems on quantifying the benefits and harms of treatments

Assignment:
Chapter 10 #1, #2, #4. Due 11/20/2008

Reminder: Submit final exam problems to Tom and Michael by Monday 11/24/2008.

What do P-values and confidence intervals really mean?

Required Reading:

1. EBD 11 -- Understanding P-values and confidence intervals

Optional Reading:

1. Browner WS, Newman TB. Are all significant P-values created equal? The analogy between diagnostic tests and clinical research. JAMA 1987;257:2459-63
2. Davidoff, F. Standing statistics right side up. Annals of Internal Medicine 1999; 130: 1019-1021
3. Goodman, S. Toward evidence-based medical statistics. 1: The P value fallacy. Annals of Internal Medicine 1999; 130: 995-1004
4. Goodman, S. Toward evidence-based medical statistics. 2: The Bayes factor. Annals of Internal Medicine 1999; 130: 1005-1013
5. Newman, T. If almost nothing goes wrong, is almost everything all right? JAMA 1995; 274: 1013

Note/Slide Files: Understanding P- values and CI 20Nov08.ppt (146 KB)

Review of Chapter 10 problems on alternatives to randomized trials for estimating effects of tests and treatments

Assignment:
Chapter 11 #1, #2, #3, #5. Due 12/4/2008.

Reminder: Final Exam question submission deadline -- 11/24 at 2 pm.

Challenges for Evidence-based Diagnosis and Course Review; Distribute final exam

Required Reading:

1. EBD 12 -- Challenges for evidence-based diagnosis
2. EBD -- Index
3. ANSWERS to all problems in the text

Optional Reading:

1. Newman, TB. The Power of Stories over Statistics.BMJ. 2003;327(7429):1424-7
2. Video of TBN Stories and Statistics talk at Fermilab (Requires RealVideo)
3. Newman TB, Maisels, MJ. Less Aggressive Treatment of Neonatal Jaundice and Reports of Kernicterus: Lessons About Practice Guidelines. Pediatrics 200;105:242
4. Newman TB, Johnston BD, Grossman DC. Effects and costs of requiring child-restraint systems for young children traveling on commercial airplanes.Arch Pediatr Adolesc Med. 2003 Oct;157(10):969-74
5. Bishai D. Hearts and Minds and Child Restraints on Airplanes. Arch Peds Adol Med 2003;157:953
6. Merenstein D. Winners & Losers. JAMA 2004;291:242-5

Note/Slide Files: Challenges for EBM3Dec2008.ppt (1679 KB)

Review of Chapter 11 problems on P-values and confidence intervals

Assignment:
Final Exam. Due 12/11 at 8:45 am.

Final Exam Files: ClinEpiFinal2008_NoAnswers3Dec08.doc (910 KB)

examination review