NR569 Differential Diagnosis in Acute Care Midterm Exam Most
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Evaluation and Management (E/M) codes
Evaluation and management (E/M) coding involves the use of CPT codes
ranging from 99202-99499. These represent services by a provider in which
the provider is either evaluating or managing a patient's health.
Evidence-Based Medicine
- The conscientious, explicit, judicious and reasonable use of modern, best
evidence in making decisions about the care of individual patients.
PICOT question
- A mnemonic derived from the elements of a clinical research question - Patient,
Intervention, Comparison, Outcome and Time. The PICOT process begins with a
case scenario, and the question is phrased to elicit an answer.
Sensitivity
Sensitivity refers to a test's ability to designate an individual with a disease as positive.
- A sensitive test correctly identifies patients do who have the disease in
question. Tests with high sensitivity are ideal screening tests to discover as many
patients as possible with the disease, frequently a tradeoff of increased false
positive results.
**Confirmatory testing may require a more specific test.**
,Sensitivity Formula
- To calculate sensitivity the number of patients who do have the disease and
test positive (true positive = TP) is divided by all who have the disease,
including those who falsely test negative (false negative = FN)
- TP/(TP + FN)
Specificity
- Specificity refers to the ability of testing to recognize patients who do not have the
disease.
- For example, D-Dimer has high sensitivity and will be positive in most
cases of PE; however, this comes at the cost of a high false positive rate
due to low specificity. A confirmatory, more specific, imaging test may be
required to make the diagnosis.
Specificity Formula
- To calculate specificity, the number of patients who test negative and do not
have the disease (true negative = TN) is divided by the total number without the
disease, including those who falsely test positive (false positive = FP).
- TN/(TN + FP)
SPIN & SNOUT
SPecific test rule IN disease (SPIN) while SeNsitive tests rule OUT disease (SNOUT).
, Positive Predictive Value (PPV)
- Positive Predictive Value (PPV) reports the probability that a patient has
the disease after testing positive for it. Positive predictive value is
markedly dependent on the
prevalence of the disease in question.
- TP/(TP + FP)
Negative Predictive Value (NPV)
- Negative predictive value (NPV) describes the probability that a patient does
not have the disease following a negative test result. Both positive and
negative predictive values are dependent on the prevalence or pretest
probability prior to testing.
- TN/(TN + FN)
Pretest Probability
Pretest probability percentage represents them probability of a specific
pathology for a patient prior to initiating further diagnostic testing. Pretest
probability may be the
prevalence of the disease in question in the population. At any point in the
diagnostic work up, the clinician may pause and estimate the prevalence or
pretest probability of disease in light of what information is known about the
patient. The pretest probability of clinical gestalt is frequently delineated as low,
intermediate, and high probabilty.
Recent Exam Actual Complete Real Exam Questions And
Correct Answers (Verified Answers) Already Graded A+ ||
Guaranteed Success!! Newest Exam | Just Released!!
Evaluation and Management (E/M) codes
Evaluation and management (E/M) coding involves the use of CPT codes
ranging from 99202-99499. These represent services by a provider in which
the provider is either evaluating or managing a patient's health.
Evidence-Based Medicine
- The conscientious, explicit, judicious and reasonable use of modern, best
evidence in making decisions about the care of individual patients.
PICOT question
- A mnemonic derived from the elements of a clinical research question - Patient,
Intervention, Comparison, Outcome and Time. The PICOT process begins with a
case scenario, and the question is phrased to elicit an answer.
Sensitivity
Sensitivity refers to a test's ability to designate an individual with a disease as positive.
- A sensitive test correctly identifies patients do who have the disease in
question. Tests with high sensitivity are ideal screening tests to discover as many
patients as possible with the disease, frequently a tradeoff of increased false
positive results.
**Confirmatory testing may require a more specific test.**
,Sensitivity Formula
- To calculate sensitivity the number of patients who do have the disease and
test positive (true positive = TP) is divided by all who have the disease,
including those who falsely test negative (false negative = FN)
- TP/(TP + FN)
Specificity
- Specificity refers to the ability of testing to recognize patients who do not have the
disease.
- For example, D-Dimer has high sensitivity and will be positive in most
cases of PE; however, this comes at the cost of a high false positive rate
due to low specificity. A confirmatory, more specific, imaging test may be
required to make the diagnosis.
Specificity Formula
- To calculate specificity, the number of patients who test negative and do not
have the disease (true negative = TN) is divided by the total number without the
disease, including those who falsely test positive (false positive = FP).
- TN/(TN + FP)
SPIN & SNOUT
SPecific test rule IN disease (SPIN) while SeNsitive tests rule OUT disease (SNOUT).
, Positive Predictive Value (PPV)
- Positive Predictive Value (PPV) reports the probability that a patient has
the disease after testing positive for it. Positive predictive value is
markedly dependent on the
prevalence of the disease in question.
- TP/(TP + FP)
Negative Predictive Value (NPV)
- Negative predictive value (NPV) describes the probability that a patient does
not have the disease following a negative test result. Both positive and
negative predictive values are dependent on the prevalence or pretest
probability prior to testing.
- TN/(TN + FN)
Pretest Probability
Pretest probability percentage represents them probability of a specific
pathology for a patient prior to initiating further diagnostic testing. Pretest
probability may be the
prevalence of the disease in question in the population. At any point in the
diagnostic work up, the clinician may pause and estimate the prevalence or
pretest probability of disease in light of what information is known about the
patient. The pretest probability of clinical gestalt is frequently delineated as low,
intermediate, and high probabilty.
