Section 230, Row F, G, H Seats 1-8

Who are we?

Michael Kohn, Emergency Medicine Tom Newman, General Pediatrics Mark Pletcher, General Internal

Medicine George Sawaya,

Obstetrics/Gynecology John Stein, Emergency Medicine Josh Galanter, Pulmonary/Critical Care

Who are you?

Breakdown of ≈ 36 participants

First Name Last Name Degree Specialty City

Christian Apfel MD, PhD Anesthesiology San Francisco

Nicole Appelle MD Internal Medicine San Francisco

Arpi Bekmezian MD Pediatrics San Francisco

Dennis Bleakley MD Internal Medicine Claremont

Christopher Carpenter MD, MSC Emergency Medicine Wildwood

Maria Carriedo-Ceniceros MD Family Practice Bonita

George Cembrowski MD Lab Medicine Edmonton

Chatkanok Dumavibhat MD Cardiology Bangkok

Miranda Dunlop MD Internal Medicine San Francisco

Victor Ettinger MD Endocrinology/Diabetes Bakersfield

Nola Hylton PhD Radiology San Francisco

Adam Jung MD, PhD Radiology Mill Valley

Renata Kiefier MD Pediatrics San Francisco

Kurt Landauer MD Family Practice Minocqua

Eugene Lee MD, MPH Internal Medicine San Francisco

Alan Levin MD, JD Pathology Incline Village

Andrew MichaelsMD, FACC,

FAHA Cardiology Eureka

Cecily Miller MPH Infectious Disease San Francisco

First Name Last Name Degree Specialty City

Pauline Mysliwiec MD Gastroenterology San Francisco

Tim Nicholls MD Pediatrics Berkeley

Godfrey Oakley MD, MSPM Pediatrics Atlanta

Matthew Olsen DO Internal Medicine Seattle

Luke Perkocha MD Pathology San Francisco

Cody Reeves MD Anesthesiology Nevada City

Max Robinowitz MD None Bethesda

Saad Shakir MD Psychiatry and Neurology Los Gatos

Ruth Shelton-Pryor MD Family Practice Vallejo

Alvin Silva MD Radiology Scottsdale

Jutta Skogberg MD Occupational Medicine Espoo

Thomas Steffen MD Family Practice Decatur

Sara Swenson MD Internal Medicine San Francisco

Daniel Theodoro MD, MSCI Emergency Medicine Saint Louis

Kara Timmins PA-C Hospital Medicine Syracuse

Anastasia Toles MD, MPH Internal Medicine San Francisco

Andrea Wickremasinghe MD PediatricsSan Francisco

Antonio Westphalen MD Radiology San Francisco

Evidence-Based Medicine Level

EBM Level Count %

Advanced 5 25%

Intermediate 11 55%

Beginner 4 20%

Responded 20  

No Response 15  

Total 35  

Familiar with Threshold Model -- C/(C+B)?

Threshold Model Count  

NO 16 67%

YES 8 33%

Responded 24  

No Response 11  

Total 35  

Familiar with ARR and NNT = 1/ARR?

ARR and NNT Count %

NO 7 29%

YES 17 71%

Responded 24  

No Response 11  

Total 35  

Interest in Screening

Interest In Screening (vs. Diagnosis and

Prognosis) Count %

High 6 25%

Intermediate 9 38%

Low 9 38%

Responded 24  

No Response 11  

Total 35  

Thursday Morning

9:15-9:55 Dichotomous Tests (Tom)9:55-10:35 Multilevel and Continuous

Tests (Michael)10:35-10:45 Break (Confirm small group

assignments and locations.)10:45-12:30 Small Groups12:30-1:30 Buffet Lunch

Book will be here tomorrow

If you won’t be here tomorrow or you plan to use the book tonight, we have a few copies.

Thursday Afternoon

1:30-2:15 Studies and Systematic Reviews of Diagnostic Test Accuracy (Tom)

2:15-3:00 Prognostic and Genetic Tests (Mark)

3:00-3:45 Combining Tests (Michael)3:45-4:00 Break4:00-6:00 Small Groups6:00 Meet in 6702 to head to Giants game

Evidence Based Medicine

I. Diagnosis: How to evaluate a test and then use it to estimate the probability that a patient has a given disease.

II. Treatment: How to determine if a treatment is beneficial in patients with a given disease, and if so, whether the benefits outweigh the costs and risks.

Basic Evidence-Based Diagnosis

Evaluate and compare dichotomous tests using sensitivity and specificity

Update pre-test probability of disease using LR(+) and LR(-).

Checklist for evaluating studies of diagnostic test accuracy

Advanced Evidence-Based Diagnosis

Determining and using likelihood ratios for the results of non-dichotomous tests

Understanding biases in studies of diagnostic tests and predicting their effect on study results.

Combining results of multiple tests allowing for non-independence of tests

Diagnosis vs. Test Utilization

Diagnosis: Assigning a name to the patient’s illnessTest Utilization: Using tests to guide a treatment decision

Diagnosis vs. Test Utilization

Should we do a test to diagnosis a disease with no effective treatment? SLUBI Voiding cystourethrogram (VCU) for

vesicoureteral reflux (VUR) Should we do a test to distinguish

between two diseases with the same treatment? Kidney biopsy in child with nephrotic

syndrome

Dichotomous Tests (Tom)