User Khanh Nguyen

Course Advanced Epidemiology and Biostatistics

Test Exam 2
Started 3/24/20 9:11 AM
Submitted 3/24/20 10:39 AM
Status Completed
Attempt 19.446 out of 25.002 points   0.778
Score
Time 1 hour, 28 minutes out of 1 hour and 30 minutes
Elapsed
Instruction Please answer all the questions. Select the best answer
s for each question. 

Tuesday, March 24, 2020 10:40:05 AM PDT

Question 1

      All of the following are criteria for a confounding variable except: 

a third variable that is related to exposure

a third variable that is related to outcome
a third variable that provides valuable information and should be analyzed

a third variable that is not an intermediate between exposure and outcome

Question 2

The extent to which a specific health care treatment, service, procedure, program, or other
intervention produces a beneficial result under ideal controlled conditions is its:

Effectiveness
Efficiency

None of the above

Effect modification
Efficacy

Question 3

1.     The sensitivity and false negative results are:

Not inversely
 related

Not related

None of the
above

Inversely
related

Question 4

The extent to which a specific health care treatment, service, procedure, program, or other
intervention does what it is intended to do when used in a community-dwelling
population is termed its:

Efficacy
Efficiency

None of the above

Effect modification
Effectiveness

Question 5

A random sample of middle age sedentary males was selected from four census tracts, and
each man was examined for coronary artery disease. All those having the disease were
excluded from the study. All others were randomly assigned to either an exercise group,
which followed for a two-year program of systematic exercise, or to a control group, which
had no exercise program. Both groups were observed semiannually for any difference in
incidence of coronary heart disease.

Case control

Cohort

Cross-sectional

Randomized control
design

Question 6

What type of study design is considered to be the ‘gold standard’ in assessing causality?

 Cohort

Case-
control

Experimen
tal

Ecological

Question 7

What is beneficence?
Participants right to self-determination
Performance of some good
Protection from physical and psychological harm and exploitation
Freedom to control their own actions

Question 8

If on a group of 457 patients, for a risk factor we calculated a Relative Risk RR= 12.74, the
possibility of developing the disease being investigated is:

Very small when exposed to the factor 

Lower in the exposed than in the unexposed, RR

being less than 100

The same in the case of exposure in the case of non-

exposure 

Very high when exposed to the factor 

Question 9

Number of new cases per population at risk in a given time period is a definition of which of
the following?

Incidence
 Prevalenc
e

Odds
ratio

Relative
risk

Question 10

A case control study is characterized by all of the following except:

Assessment of past exposure may be biased

It is relatively inexpensive compared with most other

epidemiologic study design

Incidence rates may be computed directly

Definition of cases may be difficult

Patient with the disease are compared with persons without the
disease

Question 11

What type of research examines the quality and effectiveness of healthcare and nursing services?
Survey

None of the
above

Outcomes

Evaluation

Question 12

A major problem resulting from the lack of randomization in a cohort study is

The possibility that a factor that led to the exposure, rather than the exposure itself, might
have caused the disease
 Planned crossover is more likely
The possibility that a greater proportion of people in the study may have been exposed

The possibility that a smaller proportion of people in the study may have been exposed

That, without randomization, the study may take longer to carry out

Question 13

Which of the following is related to a case control study

The units of analysis are groups. This can be referred to as an Ecological Comparison Study.
None of the above

Allowance of the direct observation of risk. The exposure factor is well defined and can
study exposures that are uncommon in the population. The temporal relationship
between factor and outcome is known.

Are used very commonly in environmental epidemiologic research. An example may be possible
health effects of exposure to electromagnetic fields.
Question 14

Why is selection of an appropriate design for a research study important?

The design provides a blueprint or diagram that appears in the concept map.
If there is no design, critique is impossible.

If the design is an incorrect one, the researcher will examine variables and their interactions
in a way that does not answer the research question.
If the design is appropriate, the researcher can eliminate error.
Question 15

Which phase of a clinical trial requires an experimental design?

IV

III

II

I
Question 16

What is the best measure to estimate the percent of children with no otitis media that have
normal otoscope examination?
Predicted value
positive

Risk

Predicted value
negative

Specificity

Sensitivity

Question 17

Which indicator answers the following question from the patients: “Given that I have a positive
test, what is my chance that I have the disease?”  

Predicted value
negative

None of the above

Specificity

Predicted value
positive

Sensitivity

Question 18

The overall odds ratio for the association between breast cancer and smoking status is 2.0
(95% confidence interval=1.3-3.6).

What would you conclude about smoking status?

None of the above

Smoking is a protective factor for

breast cancer

Smoking is a risk factor for breast

cancer

Smoking is not related to breast

 cancer

Question 19

All of the following are potential benefits of a randomized clinical trial, except:

Assignment of the next subject cannot be predicted
The likelihood that the study groups will be comparable is increased

The therapy that a subject receives is not influenced by either conscious or

subconscious bias of the investigator

Self-selection for a particular treatment is eliminated

The external validity of the study is increased

Question 20

What is justice?
Participants right to self-determination
Right to fair treatment
Protection from physical and psychological harm and exploitation
Freedom to control their own actions
Question 21

What is the dependent variable (outcome) in the research question “Is the quality of life of nursing
home residents affected by their functional ability”?
None of the above

Nursing home
residents

Functional ability

Quality of life

Question 22

Which of the following is an approach to handling confounding?

Adjustment
 Stratification

All of the above

Group
matching

Individual
matching

Question 23

The best index (indices) for concluding that an early detection program for breast cancer truly
improves the natural history of disease, 10 years after its initiation, would be:
Improved long-term survival rates for breast cancer patients (adjusted for lead time)

A smaller proportionate mortality for breast cancer 10 years after initiation of the early
detection program compared to the proportionate mortality prior to its initiation

A decrease in incidence of breast cancer

A decrease in the prevalence of breast cancer

None of the above

Question 24

The strength of an association is one of the criteria for evaluating the cause and effect
relationship between an exposure and outcome. Which of the following is a measure of the
strength of association?
None of the above

Incidence rate among the exposed

Cumulative incidence among the exposed

Odds of disease among exposed relative to the prevalence of exposure in

 the source population

The ratio of odds of exposure among cases to the odds of exposure among
the non-cases

Question 25

Reliability is the degree to which an instrument measures what it is supposed to measure

Not applicable

None of the
above

True

False

Question 26

What is the drawbacks of the ecologic study?

Mass screening is defined as the standards of care, anyone that could at risks should be
screened for exposure.

Are used very commonly in environmental epidemiologic research. An example may be

possible health effects of exposure to electromagnetic fields.

The ecologic fallacy and imprecise measurement of exposure.

None of the above

Question 27

1.     It has been suggested that physicians may examine women who use oral contraceptives
more often or more thoroughly than women who do not. If so, and if an association is
observed between phlebitis and oral contraceptive use, the association may be due to:

Recall bias

Surveillance bias
Selection bias

Non response
bias
 Interviewer bias

Question 28

1.     In general, screening should be undertaken for diseases with the following feature(s):

Diseases with a natural history that can be altered by medical intervention

Diseases with a low prevalence in identifiable subgroups of the population

Diseases for which case-fatality rates are low

Diseases that are readily diagnosed and for which treatment efficacy has been shown
to be equivocal in evidence from a number of clinical trials

Question 29

1.     Which of the following is not an advantage of a prospective cohort study?

It usually costs less than a case-control study

Precise measurement of exposure is possible
Incidence rates can be calculated
Recall bias is minimized compared with a case-control study
Many disease outcomes can be studied simultaneously
Question 30

All of the following are important criteria when making causal inferences except:
Consistency with existing
knowledge

Strength of association

Dose-response relationship

Predictive value

Consistency of association in
 several studies

Question 31

Investigators conducted a retrospective cohort study to investigate outbreak gastroenteritis

in California. Use the results of the following table to answer the following questions:  What
is the likely food (s) that cause(s) this outbreak?     

Food Ate Did not  eat

Ill We AR Ill we AR RR
ll ll
Chick 35 17 67. 1 22 43. 1.5
en 3 7 6

Potat 50 12 80. 1 35 22. 3.6

o Salad 6 0 2
Spina 25 10 71. 2 30 40. 1.8
ch 4 0 0
Salad 15 11 57. 1 12 57. 1.0
7 6 1
Fruits 8 30 21. 6 18 25. 0.8
1 0
Potato
salad, spinach, and
chicken

Fruits and Spinach

Chicken

Salad and potato salad

and fruits

Spinach and potato

salad

Potato salad

Question 32

The Belmont Report articulated broad principles on which standards of ethical conduct in
research are based. Which is not considered an ethical principle for protecting study participants
in the report?
Beneficence
Informed consent
Justice
Respect for human dignity
Question 33
 In the following research question, what is the independent (exposure) variable?
Can diabetics on oral antiglycemic medications achieve better control of blood sugar, as measured by
Hgb A1C, if they are taught to meditate and do this on a daily basis?
None of the above

Oral antiglycemic medications

Meditation
Hgb A1C
Question 34

1.     Residents of three villages with three different types of water supply were asked to
participate in a survey to identify cholera carriers. Because several cholera deaths had
occurred recently, virtually everyone present at the time underwent examination. The
proportion of residents in each village who were carriers was computed and
compared. What is the proper classification for this study?

Case control
study

Cohort study

Cross-sectional
study

Experimental
study

None of the
above

Question 35

All of the following are measures of process of health care in a clinic except:

None

Proportion of patients whose bill is reduced because of

financial need

Proportion of patients advised to stop smoking

Proportion of patients in whom blood pressure is

measured
 Proportion of patients whose height and weight are
measured

Question 36

In a case-control study of the relationship of radiation exposure and thyroid

cancer, 50 cases admitted for thyroid cancer and 100 “controls” admitted
during the same period for treatment of hernias were studied.  Only the cases
were interviewed, and 20 of the cases were found to have been exposed to x-
ray therapy in the past, based on the interviews and medical records.  The
controls were not interviewed, but a review of their hospital records when they
were admitted for hernia surgery revealed that only 2 controls had been
exposed to x-ray therapy in the past.

Based on the description given above, what source of bias is least likely to be present in this
study?
Bias due to use of different methods of ascertainment of exposure in
cases and controls

Selection bias for exposure to x-ray therapy in the past

Bias due to controls being non-representative of the non-diseased
population

Recall bias

Bias due to loss of subjects from the control group over time