A recent meta-analysis of studies of the utility of the Mallampati score in the prediction of a difficult airway found that it had a sensitivity of 60% and a specificity of 70%.
a) Outline what is meant by meta-analysis and the factors that ensure a high quality conclusion from the process. (10 marks)
b) Explain what is meant by sensitivity and specificity as applied to the interpretation of the Mallampati data given above. (6 marks)
c) Rank the levels of scientific proof used to grade medical evidence. (4 marks)
Pass Rate 72.8% It was anticipated that candidates would find this subject matter to be difficult. Surprisingly the question generated the highest overall pass rate, and the majority of candidates scored in excess of the pass mark. Weak candidates were unable to indicate how a high quality conclusion can be ensured from a meta- analysis or to interpret the data for Mallampati studies in a meaningful way.
(a) What are the main types of studies that must be done on a drug in order to obtain marketing authorisation (formerly called a product licence) from the Medicines and Healthcare products Regulatory Agency (MHRA)? (25%) (b) Define what is meant by ‘a double blind randomised controlled trial with adequate power’, and explain the reasons for these methods? (50%) (c) Under what circumstances might an observational study be an acceptable method of investigation?(15%)
Question11 Critical care/management of airway problem/tracheostomy