Core Knowledge, Scholarship, and Professionalism
Scope
This domain tests evidence-based practice, study design interpretation, and professional conduct in pediatric gastroenterology.
Concepts
- Evidence appraisal: distinguish sensitivity, specificity, positive predictive value, and likelihood ratios; understand how prevalence affects PPV.
- Study designs: randomized controlled trials, cohort studies, case-control, and cross-sectional; recognize bias (selection, recall, confounding).
- Guideline adherence: use consensus guidelines for celiac, IBD, and GERD; avoid low-value testing.
- Professionalism: informed consent, assent in minors, confidentiality, and conflict-of-interest disclosure.
- Quality improvement: PDSA cycles, audit, and feedback to improve outcomes.
Traps
Candidates confuse sensitivity with PPV-PPV depends on prevalence. Another trap: assuming a statistically significant result is clinically meaningful. Beware recommending screening tests without evidence of benefit.
Worked example
A celiac serology study reports sensitivity 95% and specificity 95% in a high-prevalence population; PPV is high there but falls in low-prevalence screening populations. Interpret accordingly.
Rule of thumb
Sensitivity rules out; specificity rules in. PPV depends on prevalence. Evidence before eminence.