HSC 404 final

75%

A cohort Study was conducted to investigate the association between coffee consumption and anxiety in a population-based sample of adults. Cohort Study Data for Coffee Use and Anxiety Anxiety Coffee Use Yes No Total Yes 1,000 9,000 10,000 No 500 19,500 20,000 The etiologic fraction is:

4

A cohort Study was conducted to investigate the association between coffee consumption and anxiety in a population-based sample of adults. Cohort Study Data for Coffee Use and Anxiety Anxiety Coffee Use Yes No Total Yes 1,000 9,000 10,000 No 500 19,500 20,000 The RR of anxiety associated with coffee use is:

50%

A cohort Study was conducted to investigate the association between coffee consumption and anxiety in a population-based sample of adults. Cohort Study Data for Coffee Use and Anxiety Anxiety Coffee Use Yes No Total Yes 1,000 9,000 10,000 No 500 19,500 20,000 The population etiologic fraction is:

0.075

A cohort Study was conducted to investigate the association between coffee consumption and anxiety in a population-based sample of adults. Cohort Study Data for Coffee Use and Anxiety Anxiety Coffee Use Yes No Total Yes 1,000 9,000 10,000 No 500 19,500 20,000 The risk difference is:

The prevalence of virus X infection is higher among the hospital patients than among blood donors.

A new antibody test detects serum antibodies against virus X (sensitivity 99%, specificity 90%). When applied in a group of hospitalized patients diagnosed as having virus X infections, the test is found to have a positive predictive value of 85%. When used to screen a group of healthy blood donors for virus X infections, the test is found to have a positive predictive value of 30%. Which of the following best explains this difference between the positive predictive values?

Lower the cut point below 50 units.

A new blood test has been developed to screen for disease Z. Researchers establish 50 units as a cut point above which a test is considered positive and thereby indicative of disease. The test manufacturers determine that the test's sensitivity is unacceptably low. However, the manufacturers are not concerned with the specificity and do not want the cost of the test to rise. How can they improve the sensitivity of the test?

81

A new screening test for Lyme disease is developed for use in the general population. The sensitivity and specificity of the new test are 60% and 70%, respectively. Three hundred people are screened at a clinic during the first year the new test is implemented. Assume the true prevalence of Lyme disease among clinic attendees is 10%. The number of false positives is:

18.2%

A new screening test for Lyme disease is developed for use in the general population. The sensitivity and specificity of the new test are 60% and 70%, respectively. Three hundred people are screened at a clinic during the first year the new test is implemented. Assume the true prevalence of Lyme disease among clinic attendees is 10%. The predictive value of a positive test is:

can transmit the infection to others

A person with an inapparent infection:

70%

A screening examination was performed on 250 persons for Factor X, which is found in disease Y. A definitive diagnosis for disease Y among the 250 persons had been obtained previously. The results are charted below: RESULTS OF DIAGNOSIS TEST RESULTS Disease Present Disease Absent Positive for Factor X 40 60 Negative for Factor X 10 140 The specificity of this test is expressed as:

80%

A screening examination was performed on 250 persons for Factor X, which is found in disease Y. A definitive diagnosis for disease Y among the 250 persons had been obtained previously. The results are charted below: RESULTS OF DIAGNOSIS TEST RESULTS Disease Present Disease Absent Positive for Factor X 40 60 Negative for Factor X 10 140 The sensitivity of this test is expressed as:

a case of unnecessary workplace disease that serves as a warning signal

A sentinel health event refers to

Diagnostic test

A test that determines whether disease is actually present is a:

all of the above

According to The Association of Schools of Public Health, competencies in epidemiology to be achieved by Master of Public Health degree candidates in public health include:

Of those dying of lung cancer who smoke, 80% of those deaths are attributed to their smoking, assuming a causal association exists.

An attributable-risk percent of 80% was calculated for the association between smoking and lung cancer death. Which of the following provides the best interpretation of this statistic?

Improve the likelihood that the two groups will be comparable with regard to known and unknown confounding factors.

An epidemiologic experiment is performed in which one group is exposed to a suspected factor and the other is not. All individuals with an odd hospital admission number are assigned to the second group. The main purpose of this procedure is to:

28.2%

An outbreak of salmonellosis occurred after an epidemiology department luncheon, which was attended by 485 faculty and staff. Assume everyone ate the same food items. Sixty-five people had fever and diarrhea, five of these people were severely affected. Subsequent laboratory tests on everyone who attended the luncheon revealed an additional 72 cases. The attack rate of salmonellosis was:

5/60

An outbreak of salmonellosis occurred after an epidemiology department luncheon, which was attended by 485 faculty and staff. Assume everyone ate the same food items. Sixty-five people had fever and diarrhea, five of these people were severely affected. Subsequent laboratory tests on everyone who attended the luncheon revealed an additional 72 cases. The ratio of severe cases to other clinically apparent cases was:

47.4%

An outbreak of salmonellosis occurred after an epidemiology department luncheon, which was attended by 485 faculty and staff. Assume everyone ate the same food items. Sixty-five people had fever and diarrhea, five of these people were severely affected. Subsequent laboratory tests on everyone who attended the luncheon revealed an additional 72 cases. The virulence of salmonellosis was: Note: "Virulence = the ratio formed by the total number of individuals with overt infection divided by the total number of infected cases."

7.7%

An outbreak of salmonellosis occurred after an epidemiology department luncheon, which was attended by 485 faculty and staff. Assume everyone ate the same food items. Sixty-five people had fever and diarrhea, five of these people were severely affected. Subsequent laboratory tests on everyone who attended the luncheon revealed an additional 72 cases. The virulence of salmonellosis was: Note: "Virulence = the ratio formed by the total number of individuals with overt infection divided by the total number of infected cases."

asbestosis, malignant mesothelioma, and lung cancer

Asbestos exposure has been associated with:

(A+C/A+B+C+D) − (C/C+D)

Assuming that the sample table is for a cohort study, define the population risk difference or population attributable risk: SAMPLE 2 BY 2 TABLE Outcome Total Factor + − + A B A + B − C D C + D Total A + C B + D A + B + C + D

all of the above

Career roles for epidemiologist include:

Multiphasic screening

Drs. Poke and Jab (2014) conducted an employee health program that used 5 screening tests at the same time to detect diseases among workers. Which type of program is this?

True

Education in epidemiology can be obtained via special summer session programs and online programs.

all of the above

Examples of social incongruity include:

childhood leukemia risk

Exposure to electric and magnetic fields has been linked to

Attributable risk

If it is accepted that an observed association is a causal one, an estimate of the impact that a successful preventive program might have, can be derived from:

Bias due to loss of subjects from control groups over time.

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, what source of bias is least likely to be present in this study?

Selection bias: survival bias

In a study to determine the incidence of a chronic disease, 150 people were examined at the end of a three-year period. Twelve cases were found, giving a cumulative risk of 8%. Fifty other members of the initial cohort could not be examined; 20 of these 50 could not be examined because they died. Which source of bias may have affected the study?

Retrospective cohort

It has been suggested that occupational exposure to benzene in the petroleum industry increases the risk of developing leukemia. The levels of benzene to which workers in this industry have been exposed were high from 1940 to 1970, but since 1970 have been significantly reduced. What kind of study design, using petroleum workers, would provide the most useful information on whether benzene affects incidence rates of leukemia in this industry? You may assume that records of individual worker assignments to jobs involving benzene exposure have been maintained by the industry.

An apparently lower survival rate among persons screened compared to an unscreened group.

Lead time bias is best described as:

good health status may be a factor for selection into a job.

One must use care in interpreting occupational differences in morbidity and mortality because:

social support

Personal behavior and lifestyle factors in health do NOT include:

Case control studies.

Recall bias is most likely to occur in:

stage of recovery

Selye's concept of the general adaptation syndrome did NOT include:

attributable risk

Several studies have found that approximately 85% of cases of lung cancer are due to cigarette smoking. This measure is an example of:

All of the above

Social epidemiology deals with the health effects of:

all of the above

Sociocultural influences on health include:

Host

Someone suggests immunization as a means of reducing disease, specifically the feared UJ (uderlinger jacamoodi). What part of the disease cycle is he or she trying to affect?

all of the above

Surgeons at Hospital A report that the mortality rate at the end of a one-year follow-up after a new coronary bypass procedure is 15%. At Hospital B, the surgeons report a one-year mortality rate of 8% for the same procedure. Before concluding that the surgeons at Hospital B have vastly superior skill, which of the following possible confounders would you examine?

endemic

The Centers for Disease Control and Prevention published an article concerning the high rate of foot fungal disease in New Orleans. The article explains that there has been a high rate of foot fungal disease in New Orleans for decades. Foot fungal disease in New Orleans is best described as:

True

The Epidemiology Monitor is a newsletter that lists employment opportunities in national and international locations.

Inter-judge reliability

The degree of agreement among several trained experts refers to:

False

The field of epidemiology is restricted to only 30 specializations.

A, B and C

The most important methodological problems in the measurement of life events are:

The relative risk of the disease in exposed individuals versus unexposed individuals. The prevalence of the exposure in the population.

The population etiologic fraction is a measure of the proportion of the disease rate in a population attributable to the exposure of interest. This measure of effect is influenced by:

The case fatality rate of the Pox must be high.

The public health officer from Long Beach complains to you about the dreaded Pacific Pox. The health officer says, "If people catch the Pox, they suddenly get the urge to dance in the sand and fall dead on the beach within the hour." There are no survivors to interview so you deduce:

Avoid observer and interviewee bias.

The purpose of a double-blind study is to:

Portal of entry

The site where a disease agent enters the body is the:

Standardized protocol for structured interviews.

The strategy which is not aimed at reducing selection bias is:

coronary heart disease

The type A behavior pattern is hypothesized to be a risk factor for:

Agent, host, and environment

What factor(s) comprise the epidemiologic triangle?

none of the above

When assessing a positive relationship between alcohol consumption and oral cancer using a case-control study, increasing the sample size of the study will result in which of the following? A lower p value A greater odds ratio A smaller 95% confidence interval A higher disease prevalence

Bacterial Infections

Which of the following conditions would not be likely to be considered a Western or way-of-life disease?

Blinding

Which of the following is not a method for controlling the effects of confounding in epidemiologic studies?

Interviewer bias

Which of the following is not a type of selection bias in cohort studies:

Radon

Which of the following is the leading source of radiation?

an occurrence that might cause readjustments in people's activities

Which of the following statements describes a stressful life event?

Goodness of fit between the characteristics of the person and environment

Which of the following statements describes the person-environment fit model?

Virulence

With respect to a hypothetical rabies investigation conducted among veterinary workers (Dr. Spot, 2003), researchers found that rabies was almost always fatal. This finding refers to:

Is a factor associated with physical activity and heart disease.

You are investigating the role of physical activity in heart disease and suggest that physical activity protects against having a heart attack. While presenting these data to your colleagues, someone asks if you have thought about confounders such as factor X. This factor X could have confounded your interpretation of the data if it: