Advanced Professional Practice and Research
Advanced professional practice questions test the NMAA scope of practice, supervision and delegation, quality improvement, research methods, and biostatistics.
Core rules
- NMAA practice occurs under the supervision of an authorized nuclear medicine physician; know which tasks require direct versus general supervision under state and institutional policy.
- Quality improvement uses PDSA cycles, tracked indicators, and documented corrective actions.
- Human-subject research requires institutional review board (IRB) approval and informed consent before enrollment.
- Diagnostic test statistics: sensitivity = TP/(TP+FN); specificity = TN/(TN+FP); positive predictive value depends on prevalence.
Worked example
A new tracer is compared with a gold standard in 200 patients: TP = 80, FN = 20, TN = 90, FP = 10. Calculate sensitivity and specificity. Reasoning: sensitivity = 80/(80+20) = 0.80, or 80%; specificity = 90/(90+10) = 0.90, or 90%. PPV = 80/(80+10) = 0.89, but PPV changes with prevalence; sensitivity and specificity are intrinsic to the test at a given threshold.
Traps
- Using PPV as if it were independent of disease prevalence.
- Starting research data collection before IRB approval.
- Assuming all NMAA tasks may be performed without direct physician supervision.