Exam III Review

Researchers develop a set of standard criteria for classifying whether a person has a particular disease, syndrome, or health condition. It is a working definition that researchers have agreed upon as the basic unit of study. a. Case Definition b. Common Source Outbreak c. Surveillance d. Epidemiologic Triad e. Screening

a. Case Definition

Abstract BACKGROUND: Mammographic screening alone has historically missed a certain fraction of malignancies. Retrospective reviews of mammograms following a subsequent screening have identified malignancies missed on first test. Breast density is a marker for elevated cancer risk. It is also associated with a higher risk of interval breast cancer, which is cancer detected between screening tests. This review's purpose was to estimate benefits and risks of subsequent breast ultrasound in women with dense breast tissue and negative mammographic screening results. METHODS: A systematic search and review of studies was conducted for research involving mammography and breast ultrasound to screen for breast cancer. The search was conducted between 1/2000-8/2008. Sources included PubMed, DARE, and Cochrane databases. Study inclusion and exclusion criteria were prospectively determined. The Oxford evidence classification system for diagnostic studies was used for determining evidence levels. The following parameters were extracted or constructed: biopsy rate, cancer yield for breast ultrasound alone, positive predictive value (PPV) for biopsy, and carcinoma identification rate by breast density. The reference standard was histological confirmation. RESULTS: The literature search identified no randomized controlled trials or previously published systematic reviews. Six cohort studies of intermediate level of evidence (3b) were found. Two of the studies were found to include adequate subject follow-up with negative or benign findings. Subsequent breast ultrasound after negative mammographic screening permitted diagnosis of primarily invasive carcinomas in 0.32% of women in breast density type categories 2-4 (employing the American College of Radiology, ACR, definitions). Mean identified tumor size was 9.9 mm, of which 90% had negative lymph node status. A majority of detected cancers occurred in mammographically dense breast (ACR types 3 and 4). Biopsy rates were in the range 2.3%-4.7%, with PPV of 8.4-13.7% for those biopsied due to positive ultrasound, which meant about one third of the PPV of biopsies were due to mammography. LIMITATIONS: The study populations included wide age ranges. The application to women age 50-69 years, as proposed for mammographic screening, could result in lesser benefit. Additional validation studies are encouraged to employ a consistent assessment system, such as BI-RADS, and to report not only PPV, but also sensitivity, specificity, and negative predictive value. CONCLUSION: Subsequent breast ultrasound in women with mammographically dense breast tissue (ACR 3 and 4) increases detection of small, otherwise occult, breast cancers. Adverse impact for women in this intermediate risk group is the potential for an increased biopsy rate. In this study, what was the reference standard diagnostic modality? a. Confirming the finding by histology b. Confirming the finding by following women until mastectomy or death c. There was no standard of reference. d. Confirming the finding with CT e. Confirming the finding through mammogram

a. Confirming the finding by histology

__________ is a measure of the relative odds of a positive diagnosis for those with the condition versus those free of the condition. It is calculated by dividing the positive likelihood ratio by the negative likelihood ratio. a. Diagnostic odds ratio b. Likelihood ratio c. Posttest probability d. Area under the curve e. Youden's index

a. Diagnostic odds ratio

What terminology is defined as the study of diseases in populations and the evaluation of interventions at a population level, as a method of solving the problems of diseases in individuals? a. Epidemiology b. Biomedical research c. Endemic d. Evidence-based practice e. Public health

a. Epidemiology

The SuperStatin Package Insert in Appendix A of the textbook is for a drug that is clinically indicated for the treatment of: a. Hyperlipidemia. b. Diabetes. c. Depression. d. Hypertension. e. Osteoporosis.

a. Hyperlipidemia.

According to an article by Ashley Welch, published online for CBS News, ""Scientists from the FDA estimate that if 8,000 people took the highest valsartan dose (320 mg) from the recalled batches daily for four years, there may be one additional case of cancer over the lifetimes of those 8,000 people."" Welch A. FDA expands valsartan blood pressure medication recall. 2018 Aug 7. [Internet]. Accessed from https://www.cbsnews.com/news/blood-pressure-medication-recall-valsartan-fda/ The quote above is an example of what type of biostatistic? a. NNH b. Specificity c. Prevalence d. NPV e. It is not an example of a biostatistic at all.

a. NNH

The sensitivity of a new diagnostic tool was reported to be 92% (95% CI, 88 to 96). Considering the information provided by the confidence interval, identify the correct statement regarding the sensitivity scores. a. Ninety-five percent of the time, the sensitivity scores fell between the range of 88% and 96%. b. There is an 8% chance that the true value for sensitivity is outside the range of 88% and 96%. c. Ninety-two percent of the sensitivity scores fell between the range of 88% and 96%. d. One hundred percent of the sensitivity scores fell between the range of 88% and 96%. e. Ninety-five percent of the sensitivity scores were 92%

a. Ninety-five percent of the time, the sensitivity scores fell between the range of 88% and 96%.

What biostatistics is the event rate among those exposed to a factor divided by the event rate among those not exposed to the same factor? a. Relative Risk b. Absolute Risk c. Attack Rate d. Odds Ratio e. Relative Risk Reduction

a. Relative Risk

What procedures are used to identify early signs and symptoms of a disease or health problems associated with a population at risk for a specific disease or event. a. Screening b. Disease Surveillance c. Epidemiologic Triad d. Web of Causation e. Case Definition

a. Screening

________ is the ability of a test to be negative given the person does not have the disease a. Specificity b. Gold standard c. PPV d. NPV e. Sensitivity

a. Specificity

A/an __________ is the diagnostic test that is normally used in clinical practice and serves as the basis of comparison for a new diagnostic test in a study a. reference standard b. usual diagnostic care c. laboratory test d. standard of care e. sensitive test

a. reference standard

A study designed to determine if the harms associated with a new intervention were significantly less than usual care is referred to as a/an: a. superiority trial. b. study of harm. c. tertiary prevention trial. d. relative risk study. e. nonequivalence study.

a. superiority trial.

A odds ratio (OR) greater than 1.0 means: a. the odds are increased b. Cannot be determine, An OR cannot be above 1.0. c. the odds are the same d. the odds are decreased e. the intervention was harmful to the treatment group.

a. the odds are increased

__________ is/are a set of standardized criteria for classifying individuals as having a specific disease or condition. a. Assessment b. Case definition c. Diagnosis d. Risk factors e. Spectrum

b. Case definition

_________ is the level of a test assigned to designed the result as positive. a. Inclusion criteria b. Diagnostic cutoff c. Indication d. Positive predictive value e. Sensitivity

b. Diagnostic cutoff

The _______ provides science-based, 10-year national objectives for improving the health of all Americans. For three decades, the program has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors, empower individuals to make informed health decisions, and measure the impact of prevention activities. a. World Health Organization Global Health Program b. Healthy People initiative c. US Department of Health and Human Services d. Health for America e. US Preventive Services Task Force

b. Healthy People initiative

A/An _____ is when a provider prescribes a medication for the first time to see how the drug works a. case study b. N of 1 trial c. illegal prescribing practice d. micro clinical trial e. non-random single person cohort

b. N of 1 trial

__________ are findings that are applicable to other diagnoses and indicate the patient does not have the diagnosis of interest. They help rule out items in the differential. a. Negative cases b. Pertinent negatives c. Contraindications d. Differential diagnoses e. Indications

b. Pertinent negatives

Ink pens and sticky notes with a drug company's logo and/or the name of the drug prominently displayed on them would be examples of what category of PhRMA gift? a. Moderately priced item b. Reminder item c. Non-reportable item d. Expensive item e. Reportable item

b. Reminder item

_____ is a website sponsored by drug manufacturers that connects patients with pharmaceutical assistance programs. a. Drugs.com b. RxAssist c. Meds4U d. FDA e. PhRMA Help

b. RxAssist

Of the four statistics PPV, NPV, sensitivity, and specificity, which can be computed using a 2x2 contingency table? a. Only specificity can be computed with a 2x2 contingency table. b. Sensitivity, specificity, NPV, and PPV can all be computed with a 2x2 contingency table. c. Only NPV and PPV can be computed with a 2x2 contingency table, not sensitivity or specificity. d. Only sensitivity and specificity can be computed with a 2x2 contingency table, not PPV or NPV. e. Only PPV can be computed with a 2x2 contingency table.

b. Sensitivity, specificity, NPV, and PPV can all be computed with a 2x2 contingency table.

__________ is the range of disease states among individuals who comprise the population in which the diagnostic test will be used. a. Risk factors b. Spectrum of disease c. Symptom algorithm d. Disease classification e, Youden's index

b. Spectrum of disease

What does a RR of 10.5 mean? a. Those with the disease have a 10.5 greater odds of having the exposure of interest in their history than those without the disease. b. The event rate in the population exposed to the risk factor is 10.5 times higher than the event rate in the population not exposed to the risk factor. c. The relative risk is 10.5 times higher for the unexposed population than for the exposed population. d. There is a 10.5 times decrease in disease risk among the unexposed population. e. The risk of disease is essentially equal between the exposed and the unexposed populations.

b. The event rate in the population exposed to the risk factor is 10.5 times higher than the event rate in the population not exposed to the risk factor.

__________ is defined as procedures concerned with the remedial treatment or prevention of diseases. a. Outcomes b. Therapeutics c. Adherence d. Efficacy e. Interactions

b. Therapeutics

What is the primary role of an IRB in a prevention research study? a. To define the primary outcome measure b. To approve the study protocol c. To write the article for publication d. To report the results to the medical community e. To describe the indications and contraindications

b. To approve the study protocol

In the package insert for a medication by the brand name SuperStatin, the manufacturer reports the drug should not be administered to anyone with active liver disease. This is an example of: a. a complication. b. a contraindication. c. a side effect. d. a case definition. e. a serious adverse event.

b. a contraindication.

The FDA uses FAERS as: a. a database of results of phase 1 studies before medications are allowed to enter further phases of research. b. a database of adverse events and medication errors to monitor the safety of products after they are approved by FDA. c. a database of all of the studies of harm related to a specific medication or biologic treatment. d. a database of studies funded by the federal government related to medications or biologics. e. a database of head-to-head comparisons of treatments using the same class of medication or biologic.

b. a database of adverse events and medication errors to monitor the safety of products after they are approved by FDA.

Typhoid fever was contracted by individuals exposed to Salmonella typhi from Mary Mallon who was employed as a cook. This situation is an example of: a. case definition. b. common source outbreak. c. disease surveillance d. .epidemiologic triad. e. screening.

b. common source outbreak.

An unanticipated problem that arises from having a diagnostic procedure is called a/an a. contraindication b. complication c. side effect d. indication e. harmful effect.

b. complication

The __________ show(s) the range within which two treatments may differ and still be deemed to be substantially equivalent. a. interaction range b. equivalence margin c. noninferiority range d. 25th and 75th percentiles e. box-and-whisker plot

b. equivalence margin

A differential diagnosis is defined as: a. collecting data from the patient through a history and physical exam b. making a determination of a disease from two or more choices c. using pertinent negatives d. conducting laboratory tests for diagnostic purposes e. collecting data from imaging.

b. making a determination of a disease from two or more choices

A ________ is a conversation in which the pharmaceutical sales representative (PSR) aims to identify a prescriber's objections or concerns related to the use of the product (e.g., medication or medical device). The goal of the PSR is to provide FDA- and corporate-approved messages that identify solutions to the provider's concerns, for the sake of the provider's patients. a. conference presentation b. sales call c. continuing education session d. paid lunch meeting e. clinical briefing

b. sales call

The usual practice by clinicians in the community or region is known as: a. defensive medical practice b. standard of care c. specificity d. sensitivity e. gold standard.

b. standard of care

A randomized controlled trial reports that 2% of the patients in the active treatment group had a heart attack vs. 3% of the patients in the placebo group. What would be the absolute risk reduction? a. 0.5 b. 0.33 c. 0.01 d. 0.95 e. 0.1

c. 0.01

In an isolated community of 23,000 people, there was an outbreak of E. Coli associated with a vegetable grown at a farm in the area. Health statistics for the community showed that at any time, approximately 2 residents in the community were living with an E. Coli infection. During the outbreak, 202 new cases of E. Coli infection were documented. Based on these data, what was the incidence rate of E. Coli infection in the community during the outbreak? a.0.00009% b. 0.099 c. 0.88% d. 0.013 c. 0.5

c. 0.88%

__________ is the degree to which patients are able to sustain a treatment regimen according to how it was prescribed. a. Compliance b. Cooperation c. Adherence d. Observance e. Consent

c. Adherence

City dwellers live in run down high-rise apartment buildings where the water is of questionable quality and heat is sparse during the winter months. The high crime rate in the area has caused local businesses to close or relocate to another part of the city, including the local grocery store. People who live in this area cannot afford to have cars and rely on bus transportation. City parks are miles away, and the neighborhood is not safe to walk. What categories of social determinants of health are represented in this scenario? a. Economic stability b. Language and literacy c. Built environment d. Social context e. Health and health care

c. Built environment

What epidemiologic activity involves tracking the number of people afflicted with a particular illness? a. Case Definition b. Common Source Outbreak c. Disease Surveillance d. Epidemiologic Triad e. Screening

c. Disease Surveillance

_________ is a statistic that shows the ratio over time of the relative risk in one group against the relative risk in another group for a given outcome of interest. a. Attributable risk ratio b. Odds ratio c. Hazard ratio d. Risk ratio e. Absolute risk ratio

c. Hazard ratio

________ is a field focusing on the interplay of human behavior and the environment related to health outcomes, problems of disease, and disease control. This field addresses the spatial context of health-related issues, specifically the location of disease occurrence and contributing environmental factors. a. Ethnography b. Epidemiology c. Medical geography d. Health demography e. Public health

c. Medical geography

What are exposures, attributes, or behaviors associated with (but not the cause of) a given outcome of interest and that can be controlled? a. Risk factors b. Morbidities c. Modifiable Risk Factors d. Non-modifiable Risk Factors e. Relative Risks

c. Modifiable Risk Factors

__________ is the percentage likelihood an individual has a disease or condition before the diagnostic test results are received. a. Odds ratio b. Odds c. Pretest probability d. Likelihood ratio e. Area under the curve

c. Pretest probability

__________ are actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability, or if none of these is feasible, retarding the progress of disease and disability. a. Treatments b. Self-help activities c. Prevention strategies d. Adherence programs e. Compliance monitoring devices

c. Prevention strategies

__________ determine(s) the difference between prevalence and pretest probability. a. Relative risk b. Diagnostic odds c. Risk factors d. Sensitivity e. Diagnostic cutoff

c. Risk factors

__________ is/are end points that are evaluated but not the specific focus of the intervention. a. Indications b. WOMAC Scale c. Secondary outcome measures d. Side effects e. Minimal clinically important differences

c. Secondary outcome measures

What theory posits that there is no singular reason for the occurrence of a disease and a compendium of factors predisposes an individual to meet criteria for a particular case definition? a. Point-source Outbreak b. Syndemic c. Web of Causation d. Period Prevalent e. Disease Surveillance

c. Web of Causation

A __________ covers all body systems and collects information on the patient's entire health status, including items such as, but not limited to, past medical/surgical history, medications, and family and social history. a. wellness exam b. systematic interview c. complete history d. motivational exam e. standard exam

c. complete history

A/an __________ determines if two interventions are similar enough to be deemed essentially equivalent. a. noninferiority trial b. superiority trial c. equivalence trial d. nonequivalence trial e. nonsuperiority trial

c. equivalence trial

According to the information provided in the textbook for this course, the US Office of the Inspector General found in 2003 _____ are likely to result in prescriptions or purchases of medical devices or treatments used for patients. a. no type of gifts b. only expensive gifts c. even small gifts and educational projects d. only educational projects e. moderate to expensive gifts

c. even small gifts and educational projects

A reference standard test to which new diagnostic tests are compared in diagnostic research studies is also known as a: a. sensitivity b. definitive diagnostic practice c. gold standard d. PPV e. standard of care

c. gold standard

The term __________, in the con of healthcare, is defined as, "mutual or reciprocal action or influence." a. complication b. side effect c. interaction d. compliance e. serious adverse event

c. interaction

According to a meta-analysis by Baker et al (2003), discussed in the textbook for this course, pharmaceutical sponsored drug trials resulted in: a. consistent outcomes of the comparator medications against placebo. b. superior outcomes of placebo as compared to the company's drug. c. more favorable outcomes for the company's drug compared with comparator medications. d. similar outcomes for the company's drug as compared with other medications. e. consistently superior outcomes of the comparator medications against the pharmaceutical's medication.

c. more favorable outcomes for the company's drug compared with comparator medications.

Based on the following data table, calculate the effect of asbestos exposure in terms of relative risk reduction or relative risk increase. Select the statement that correctly reports the resulting statistics. a. Relative risk of malignant mesothelioma decreases 100% with exposure to asbestos. b. Relative risk of malignant mesothelioma increases 50% with exposure to asbestos. c. Relative risk of malignant mesothelioma increases 50% with exposure to asbestos. d. Relative risk of malignant mesothelioma increases 100% with exposure to asbestos. e. Relative risk of malignant mesothelioma decreases 100% with exposure to asbestos.

d. Relative risk of malignant mesothelioma increases 100% with exposure to asbestos.

The excessive use of diagnostic procedures to avoid medical malpractice is known as:__________ are findings that are applicable to other diagnoses and indicate the patient does not have the diagnosis of interest. They help rule out items in the differential. a. standard of care b. specificity c. sensitivity d. defensive medical practice.

d. defensive medical practice

The amount and frequency of administering a treatment is referred to as: a. prescription. b. technique. c. route. d. dosage. e. medium.

d. dosage.

A __________ is designed to collect information about a specific problem and differentiate between critical and non-critical causes. It covers only the relevant body systems, past medical/surgical history, medications, family history, and social history a. prevention encounter b. wellness exam c. medical exam d. focused history e. motivational interview

d. focused history

In diagnostics research, the test/tool/procedure of interest and being studied is referred to as the: a. gold standard b. spectrum test c. definitive diagnostic tool d. index test e. neo-diagnosis.

d. index test

Absorption through the skin is an example of the __________ of administration of a treatment. a. form b. course c. method d. mode e. dosage

d. mode

City dwellers live in run down high-rise apartment buildings where the water is of questionable quality and heat is sparse during the winter months. The high crime rate in the area has caused local businesses to close or relocate to another part of the city, including the local grocery store. People who live in this area cannot afford to have cars and rely on bus transportation. City parks are miles away, and the neighborhood is not safe to walk. The social determinants of health in the scenario are examples of: a. precipitating factors. b. predisposing factors. c. non-modifiable risk factors. d. modifiable risk factors. e. pandemic risk factors.

d. modifiable risk factors.

A/An __________ is a diagram that displays the scales of three or more variables side by side as parallel lines and is used to estimate posttest probability. a. odds ratio chart b. parallel diagnosis diagram c. side-by-side chart d. nomogram e. Youden's index

d. nomogram

A/An _____ must be included in the box with any prescribed medication. It provides information about the proper use and prescribing of the medication. a. receipt b. advertisement c. patient handout d. package insert e. practice guideline

d. package insert

The nursery rhyme, Ring Around the Rosie, is said to be about the plague, which killed up to a half of the population of Europe and Asia over four years. The plague is an example of a/an: a. endemic b. epidemic c. .incidence. d. pandemic. e. syndemic.

d. pandemic.

Endpoints that are intended to be directly impacted by the study intervention are called: a. clinical indications. b. minimally clinical important differences. c. principal effects. d. primary outcome measures. e. adverse events.

d. primary outcome measures.

PSRs usually present studies that a. show the medication compared in a head-to-head trial with another current medication known to be effective for the condition of interest. b. show only information about the medication without any comparison at all. c. show all of the medications in the same class that are used to treat the condition of interest. d. show the medication in a positive light while comparing it with placebo or an infrequently used medication with a higher side-effect profile. e. show the positive effects of medication but conceal the adverse effects of it.

d. show the medication in a positive light while comparing it with placebo or an infrequently used medication with a higher side-effect profile.

Which of the following would be a patient-centered outcome that matters in a study of Type II Diabetes? a. Fasting plasma glucose level b. Cholesterol level c. Blood pressure d. Vision loss e. Heart rate

d. vision loss

Which of the following is not a requirement for obtaining a position as a pharmaceutical sales representative (PSR)? a. Years of successful sales experience b. Cumulative GPA of 3.0 or higher c. Completion of a rigorous interview process d. A thorough background check e. A master's or doctorate degree

e. A master's or doctorate degree

__________ is/are any undesirable experience that is observed during a clinical trial and associated with the use of a medical product in a patient. a. Contraindications b. Secondary effects c. Harm d. Interactions e. Adverse events

e. Adverse events

Which of the following healthcare professionals does not need an understanding of pharmaceuticals and their appropriate use in patient care? a. Physicians b. Nurses c. Pharmacists d. Physical therapists e. All of the listed professionals need to know about pharmaceuticals.

e. All of the listed professionals need to know about pharmaceuticals.

Epidemiology studies determine the: a. prevalence of diseases in populations. b. exposure risk of groups with and without diseases c. .etiology of diseases. d. prevalence of diseases in populations and exposure risk of groups with and without diseases. e. All of these are correct.

e. All of these are correct.

Studies of treatment may use which of the following methodologies? a. Randomized controlled trial b. Case-control c. Cross-sectional study d. Cohort e. All of these are correct.

e. All of these are correct.

__________ is the technique used for performing a treatment. a. Treatment administration b. Preference of intervention c. Style of treatment d. Manner of intervention e. Method of administration

e. Method of administration

According to a study by Linde et al (2016), the use of acupuncture as a treatment for episodic migraine will produce one resolved (pain free) migraine after treating four individuals. What type of biostatistic does that result represent? a. Prevalence b. NNH c. NPV d. Specificity e. NNT

e. NNT

_______ refers to determining the factors that predispose someone to a specific disease. a. Etiology b. Disease classification c. Differential diagnosis d. Surveillance e. Risk identification

e. Risk identification

A health care team set a goal of preventing the development of diabetes among patients with risk factors for diabetes who were overweight, but not obese, and who had pre-diabetes. Their program involved enrolling patients in a clinic-based education program with monthly meetings that included physical activities and meal preparation. What type of prevention does this program represent? a. Primary prevention of type 2 diabetes b. Tertiary prevention of type 2 diabetes c. Primary prevention of obesity d. Secondary prevention of obesity e. Secondary prevention of type 2 diabetes

e. Secondary prevention of type 2 diabetes

_________ is when researchers select populations that are clinically inappropriate for their study of a diagnostic test. a. Population bias b. Dimension bias c. Selection limitation d. Sampling limitation e. Spectrum bias

e. Spectrum bias

A medication by the brand name SuperStatin includes a report in its package insert under the Precautions section that a known symptom sometimes experienced by patients is muscle pain. In some instances, rhabdomyolysis has occurred. This is an example of: a. an adverse event of special interest. b. a serious adverse event. c. Cohen's Kappa. d. a case definition. e. a side effect.

e. a side effect.

Studies of __________ explore adverse consequences of therapies, the natural progression of disease, or the complications and interactions between interventions. a. treatment b. prevention c. epidemiology d. pharmaceuticals e. harm

e. harm

Research on pharmaceutical marketing has shown: a. healthcare professionals are less susceptible to the effects of advertising than patients. b. the majority of promotions by drug companies are targeted at patients, rather than healthcare professionals. c. most patients are only minimally susceptible to television advertising. d. radio is equally effective as television in causing patients to request advertised medications. e. marketing does effect the prescribing decisions made by healthcare professionals.

e. marketing does effect the prescribing decisions made by healthcare professionals.

A study designed to show the experimental treatment to not be substantially worse than the control treatment is referred to as a/an: a. study of harm. b. interaction trial. c. relative risk study d. relative harm study. e. noninferiority trial.

e. noninferiority trial.

A positive likelihood ratio (LR+) greater than 1 means that a: a. diagnostic test is more specific than it is sensitive and has a higher NPV than PPV b. positive diagnostic test is less likely to be associated with patients who have the disease c. negative diagnostic test is more likely to be associated with patients who have the disease d. negative diagnostic test is less likely to be associated with patients who have the disease e. positive diagnostic test is more likely to be associated with patients who have the disease

e. positive diagnostic test is more likely to be associated with patients who have the disease

Which of the following is a database that provides evidence-based guidelines for screening and prevention? a. webmd.com b. clinicaltrials.gov c. fda.gov d.Mayo Clinic Staff e. uspreventiveservicestaskforce.org

e. uspreventiveservicestaskforce.org

As discussed in the textbook, the following statement was included in the drug information for the medication tolterodine: Tolterodine is a competitive muscarinic receptor antagonist. Both urinary bladder contraction and salivation are mediated via cholinergic muscarinic receptors. In the anesthetized cat, tolterodine shows a selectivity for the urinary bladder over salivary glands; however, the clinical relevance of this finding has not been established. Select the statement that represents the appropriate action for a prescribing provider to take when a patient using this medication reports experiencing dry mouth. a. The provider should recognize the drug's reported selectivity for receptors in the bladder was not sufficiently tested and discuss with the patient the possibility of using a different medication. b. The provider should have the patient get in contact with the pharmaceutical company to report the symptom so it can be tracked. c. The provider should contact the FDA to report the symptom that appears to be associated with this medication. d. The provider should prescribe a mouth wash that has a medication in it that treats dry mouth. e. The provider should recommend the patient drink more water to counteract the dry mouth symptoms the patient is experiencing.

a. The provider should recognize the drug's reported selectivity for receptors in the bladder was not sufficiently tested and discuss with the patient the possibility of using a different medication.

A drug advertisement includes the following statement: "Our drug lowers the risk of heart attack by 36%." This number is most likely derived from which of the following? a. The relative risk reduction b. Odds ratio c. The number needed to harm d. The number needed to treat e. Sensitivity

a. The relative risk reduction

A low prevalence condition will result in a mathematical ________ in NPV. a. increase b. decrease c. null effect d. equivalency e. There is no association.

a. increase

The contraindications section of a drug's package insert would contain information regarding: a. patients who should avoid using the drug. b. patients who would most benefit from using the drug. c. clinical trials related to the drug's efficacy. d. the class of the medication. e. clinical uses of the drug.

a. patients who should avoid using the drug.

The primary goal of the PSR's interaction with physicians and other healthcare providers is to: a. provide FDA- and corporate-approved messages related to pharmaceuticals that identify potential solutions for a provider's patients. b. provide a wide range of health-related strategies for physicians to try with their patients. c. provide unbiased information about a company's specific group of pharmaceuticals. d. meet sales goals established by the manufacturer. e. treat patients with the most effective available interventions.

a. provide FDA- and corporate-approved messages related to pharmaceuticals that identify potential solutions for a provider's patients.

What theory explains disease outbreak in terms of the relationships and interactions between the host, the agent, and the environment? a. Case Definition b. Common Source Outbreak c. Disease Surveillance d. Epidemiologic Triad e. Screening

d. Epidemiologic Triad

A randomized controlled trial of heart attack prevention reports that only 2% of the patients in the active treatment group had a heart attack vs. 3% of the patients in the placebo group. What would be the relative risk reduction? a. 0.5 b. 0.95 c. 0.1 d. 0.33 e. 0.01

d. 0.33

A randomized controlled trial reports that 2% of the patients in the active treatment group had a heart attack vs. 3% of the patients in the placebo group. What would be the number needed to treat? a. 10 b. 1000 c. Impossible to calculate d. 100 e. 1

d. 100

Studies of harm generally use which of the following methodologies? a. Randomized controlled trial b. Prospective randomized cross-over studies c. Prospective case series d. Case-control study e. All of these are correct.

d. Case-control study

What type of comparisons are most often made in the research included in a pharmaceutical package insert? a. There are no research articles referenced within package inserts. b. Only research performed in the last ten years c. Head to head trials comparing the medication with all others of the same class and indication d. Comparison of the medication with placebo e. Systematic reviews

d. Comparison of the medication with placebo

Which of the following terms is best defined as "the ability of an intervention to produce the desired or beneficial effect"? a. Indication b. Clinically important difference c. Interaction d. Efficacy e. Adherence

d. Efficacy