@julian_stevenson Having 2 clozes for this made sense in my opinion. C1 tested ‘How long must antipsychotic use continue following symptom resolution if the symptoms originally lasted longer than 6m or delusional disorder?’, C2 tested ‘In what cases must antipsychotic treatment continue for ≥2y following resolution of psychotic symptoms?’
@mohsenz22 @Stapedius @pembrolizumab @braviboron
Yes, it made sense from a normal Anki design perspective, but I removed the second cloze to reduce card burden for what I believe is a low-yield card. My thinking was that for highly-motivated psych-keen people, the increased difficulty of the single card would be no problem.
I also rewrote the card for clarity.
I plan to do the same for the other similar card. This reduces total cards from 4 to 2.
Happy to keep them as 4 separate cards if others think it is necessary.
It would also be great if you could add source links please @mohsenz22
Well improved @julian_stevenson
My only concern would be that because it’s a long card it can be a bit too easy to remember the format of the card, instead of the content.
If it’s possible, it could be better covered with a small number of Q&A cards with all the information in the extra. Thoughts @Stapedius
@julian_stevenson These are some good points and I agree that it’s low yield and probably not worth all the fuss but my concern is that the user will be facing a bunch of blanks rather than a question cueing a particular principle:
Continue antipsychotics […] following symptom resolution if psychotic symptoms originally lasted longer than […] or if the patient has [psychiatric illness]
One might easily recall this when they first see the card but down the line, the blast of blanks can be overwhelming. This is complicated by the presence of a related card questioning treatment duration if psychosis lasted <6 months, if that one is edited to one cloze like this one, it’d look like this:
Cease antipsychotics after […] following symptom resolution if symptoms of psychosis last less than […]
Sure ‘longer than’ and ‘last less than’ will clue you in on which card you’re seeing but it becomes a game of fill in the blanks rather than actually recalling the fact/statement. My edit of nid:1723095981793 caused a similar issue and I believe the way I did it deprecated the card’s quality a bit.
I agree with @braviboron in that there might be a bigger benefit in making a small number of Q&As.
These notes test multiple concepts as I see it:
Continue antipsychotics for a period of time after symptom remission (duration of treatment is the key principle).
The duration of additional time is at least either 1 or 2 years based on the clinical features of longer initial symptom duration/delusional disorder/etc.
One alternative approach would be to rewrite the two cards into one with two clozes with hybrid Q&A format, as follows.
“Antipsychotic treatment should be continued for at least {{c1::1 or 2 years::duration}} after remission of symptoms, depending upon what factors?
{{c2::Treat for ≥2 years for delusional disorder, schizoaffective disorder or whenever the original duration of symptoms exceeded 6 months. Otherwise ≥1 year.}}”
That would still keep total card burden at 2.
Does that seem better?
I anticipate that the deck will get to 15K+ cards so am mindful of keeping it as low as possible whilst still being comprehensive.
I also recall that this issue is an area of active research in psychiatry so there is uncertainty around it.
On your point about card burden - the number of cards doesn’t really matter, it’s the difficulty of cards that makes the burden. E.g. even if you broke 1 difficult card into 15 easier cards it would be less work overall for a learner, because the easier cards will very quickly increase the time between seeing it, whereas difficult cards will have to be seen much more often. @julian_stevenson
Haven’t actually looked at this particular card so no comments on that rn
This is pretty good but I fear it might break MIP a little, though I may be wrong. Personally, I think a bigger deck with fewer leeches is better than a smaller deck with more cards that are prone to become leeches. I think your rewording of the card + keeping both clozes was pretty good. @julian_stevenson
@mrvhyte Completely agree with this. For some high-yield concepts, I think it’s acceptable to break the minimum information principle and make the card a bit chunky with several items to remember if it’s absolutely necessary but for lower-yield stuff the burden of difficulty isn’t worth it just to reduce the number of cards.
Also agree that we should try to reduce avoidable leeches.
In this case, I believe that inclusion of the concepts from both paired cards together aids comprehension.
I could further finesse it as follows, although it still may sound a little long and clunky.
“Antipsychotic treatment should be continued for at least either {{c1::1 or 2 years::duration}} after resolution of psychotic symptoms, depending upon what factors?
{{c2::Treat for ≥2 more years for delusional disorder, schizophrenia or whenever the original duration of psychotic symptoms exceeded 6 months. Otherwise treat for ≥1 additional year.}}”
Does that sound adequate?
I think this is reasonable @julian_stevenson
However if it were up to me I would just have this as two separate cards. One being high/medium yield:
For how long should antipsychotic treatment should be continued for, after resolution of psychotic symptoms?
{{c1::1 or 2 years::duration}}
Then the following card is supplementary and is low yield or beyond med school:
In which circumstances should antipsychotic treatment be employed for ≥2 more years following symptom resolution?
{{c1::Delusional disorder, schizophrenia or whenever the original duration of psychotic symptoms exceeded 6 month}}
Extra: Typically ≥1 additional year following symptom resolution is indicated
@julian_stevenson I think this is much better than the current wording