PHP 405 CDC training (Final Assessment)

Using 2005 data, health district staff determined that the population in Kitsap County, Washington, has a median age of 37.2 years. 9% of residents live in poverty, 4.2% are unemployed, and 12 percent have no health insurance. The teen birth rate is 9/1000, and the infant mortality rate is 6.2/1000. This example illustrates which one of the following uses of epidemiology in public health? A. Targeting intervention programs B. Community health assessment C. Screening D. Evaluation of intervention programs E. Disease outbreak investigation F. Surveillance

(B) Community health assessment

Between April 30 and May 17, as part of routine surveillance, 32 cases of hepatitis were reported to the district health department in Ogemaw County, Michigan (an unusually high number in this county for such a short time period). The health department determined that the illness was most common among boys 15-19 years old (16 cases) and boys 10-14 years old (12 cases). Additionally, more than 90% of the ill people had recently eaten at the West Branch Bakery. Health department personnel determined that consumption of glazed donuts at the bakery exposed residents to hepatitis. This example illustrates which one of the following uses of epidemiology in public health? A. Community health assessment B. Screening C. Targeting intervention programs D. Evaluation of intervention programs E. Disease outbreak investigation

(E) Disease outbreak investigation

In an effort to prevent child abuse and neglect, new mothers were enrolled in a support program shortly after delivery if they had any of the following factors that indicated they may be at high risk for this problem: single parenthood, ambivalence to pregnancy (sought termination, no prenatal care), and personal experience of physical domestic violence or childhood abuse. Participants received home visit by the program's staff for the first 12 months of an infant's life, with extensive program services offered and implemented according to the individual mother's needs. This example illustrates which one of the following uses of epidemiology in public health? A. Community health assessment B. Disease outbreak investigation C. Evaluation of intervention programs D. Surveillance E. Screening F. Targeting intervention programs

(F) Targeting intervention programs

Epidemiology can be divided into two types. Select the correct two types. A. Analytic and descriptive B. Academic and descriptive C. Categorical and continuous D. Analytical and definitive

A. Analytic and descriptive

A cohort study is a type of: A. Analytical epidemiology B. Descriptive epidemiology

A. Analytical epidemiology

Relative risk is a measure of association that: A. Can help measure the degree to which an exposure is associated with an outcome of interest. B. Is of little use in determining the degree to which an exposure causes an outcome. C. Often proves a causal relationship, since correlation is virtually the same as causation. D. Is only useful in case-control studies.

A. Can help measure the degree to which an exposure is associated with an outcome of interest.

A local nursing home has reported of 20 cases of influenza to the local health department during the past month. Which measure would you use to estimate the extent of the influenza outbreak? A. Category-specific crude rate B. Median C. Age-adjusted rate D. Crude rate

A. Category-specific crude rate

You and your colleagues hope to reduce coronary heart disease (CHD), and you want to know what you can hope to accomplish with your new smoking cessation campaign. You determine that the population attributable risk due to smoking is 4.7/1000. Select the statement that best expresses what you can hope to accomplish through your smoking cessation campaign. A. If the prevention program is completely effective, you could reduce CHD by 4.7/1000 in the population. B. If the prevention program is completely effective, you could reduce CHD by 4.7/1000 among smokers. C. If the prevention program is completely effective, you could reduce CHD by 4.7% in the population. D. If the prevention program is completely effective, you could reduce CHD by 4.7/1000 among non-smokers.

A. If the prevention program is completely effective, you could reduce CHD by 4.7/1000 in the population.

Select the correct statement. A. Prevalence is the number of all events or cases in a population during a specified time period. B. Prevalence is the number of all new events or cases in a population at a specified time. C. Prevalence is used to evaluate burdensome diseases. D. Prevalence data are only collected every five years.

A. Prevalence is the number of all events or cases in a population during a specified time period.

Fifty residents of a small town were identified with E. coli infections. An investigation of 25 of these patients and 40 well residents of the same town revealed that many of the patients had eaten spinach from the local market in the week before the onset of illness. Of the control subjects, fewer had eaten spinach in the same time period. The information on patients and controls is displayed in a 2x2 table. Select the correct statement. A. Since this is case-control data, relative risk cannot be directly, but can be estimated using an odds ratio. B. We can calculated relative risk directly from this table. C. An odds ratio is not useful in this case because it cannot prove that the spinach is the cause of the outbreak. D. An odds ratio can be calculated from this table, but it is not a useful estimate of relative risk.

A. Since this is case-control data, relative risk cannot be directly, but can be estimated using an odds ratio.

Select the correct statement. A. Small number of events may cause rates to fluctuate greatly from year to year. B. Aggregation small numbers of events causes the resulting rates to fluctuate. C. Rates based on small numbers are of limited use because they change from year to year. D. When grouping data, it is possible to increase the specificity of the information.

A. Small number of events may cause rates to fluctuate greatly from year to year.

Select the correct statement below. A. The mean can be influenced by outliers. B. The median is a measure of frequency. C. The median can be influenced by outliers. D. The mean is a measure of frequency.

A. The mean can be influenced by outliers

In 2004 in King County, 14 women and 27 men died of viral hepatitis. Select the statement below that best expresses a conclusion you can draw from the information. A. The ratio of men to women dying of viral hepatitis is roughly 2 to 1. B. The category-specific rate of men to women dying of viral hepatitis is three times as high for men. C. Women are two times more likely than men to die of viral hepatitis. D. Viral hepatitis is a major factor in the King County death rate.

A. The ratio of men to women dying of viral hepatitis is roughly 2 to 1.

Age-adjusted rates: A. are useful when comparing communities with differing age distribution. B. Contribute little to community health assessment work. C. Cannot be used to compare populations with different age distributions. D. Are useful for getting accurate counts of cases.

A. are useful when comparing communities with differing age distribution.

Select the correct statement. A.Overlapping confidence intervals indicate a statistically significant difference in the rates being compared. B. If a difference is statistically significant, it means the difference is likely to be the result of chance. C. When comparing rates be sure you are comparing the same type of rate. D. A single rate by itself has no meaning.

A.Overlapping confidence intervals indicate a statistically significant difference in the rates being compared.

Which of the following is a true statement about 2x2 tables? A. 2x2 tables are rarely used in epidemiology. B. 2x2 tables are used to record and analyze relationships between exposures and outcomes. C. 2x2 tables show how the rates of disease in a population change over time. D. 2x2 tables are useful for proving an association between an exposure and a disease.

B. 2x2 tables are used to record and analyze relationships between exposures and outcomes.

Summary measures of frequency are used with: A. Data that are continuous. B. Data that are categorical. C. Data that are generated only by primary research. D. Data that are only from surveys.

B. Data that are categorical.

A case series is a type of: A. Analytical epidemiology B. Descriptive epidemiology

B. Descriptive epidemiology

The influenza strain is now causing significant numbers of human illnesses, so a vaccine has been developed. To test the vaccine, a group of volunteers were randomly given either the influenza vaccine or a placebo (injection with no vaccine). Blood specimens were obtained, and both groups were observed for signs and symptoms, such fever and pain at the injection site. This study is a form of: A. Case-control study B. Experimental study C. Cohort study D. Descriptive epidemiology

B. Experimental study

Trend tests: A. Include statistical procedures such as the confidence interval. B. Indicate if there is significant change over time C. Cannot be used to indicate if a change over time is statistically significant D. Measure the rate of change in a chronological series of rates

B. Indicate if there is significant change over time

In a case-control study: A. It is usually unnecessary to use a 2 x 2 table. B. It is possible to estimate the relative risk using an odds ratio. C. We can calculate the relative risk directly from a 2 x 2 table. D. The incidence of the disease in the population is the same as the incidence of disease in the study subjects.

B. It is possible to estimate the relative risk using an odds ratio.

A case control study is: A. Prospective B. Retrospective

B. Retrospective

Select the correct statement. A. A p value greater than 0.05 suggests that an increase in rates is not just random variation. B. The p value is a test of the statistical significance of a rate. C. A p value less than 0.05 indicates a statistically difference in rates. D. The p value can be calculated on only continuous data.

C. A p value less than 0.05 indicates a statistically difference in rates.

You are examining the results of a vaccine efficacy trial from the 1950s. You find that the incidence of polio among unvaccinated persons was 57/100,000, and the incidence among vaccinated individuals was 16/100,000, for an attributable risk 41/100,000. Select the statement below that best expresses this attributable risk. A. Of unvaccinated individuals, 41% contracted polio. B. Unvaccinated individuals were 41 times as likely to develop polio as vaccinated persons. C. Among unvaccinated individuals, the rate of polio that was due to their being unvaccinated was 41/100,000. D. Attributable risk of polio was 57 cases per 100,000 fewer among vaccinated individuals.

C. Among unvaccinated individuals, the rate of polio that was due to their being unvaccinated was 41/100,000.

Which of the following is a reason why it might be important to consider attributable risk in public health practice? A. Since attributable risk is a ratio, it can be useful in determining what proportion of funds to allocate to a particular program. B. Attributable risk can tell us if exposure causes a disease, which is useful in outbreak investigations. C. Attributable risk tells us an absolute number of cases that could be prevented. D. Attributable risk can be estimated using an odds ratio, which is useful when interpreting the results of case-control studies.

C. Attributable risk tells us an absolute number of cases that could be prevented.

A new strain of influenza has been identified by the Centers for Disease Control and Prevention (CDC). The signs and symptoms of the first 100 human illnesses were described in the Morbidity and Mortality Weekly Report. This epidemiology study is a: A. Cohort study B. Ecological study C. Case series D. Case-control study

C. Case series

After several million doses of influenza vaccine were given, about 20 people with an unusual paralysis were reported. Some of the people received influenza vaccine prior to their paralysis, but it was not known if this was coincidental or if the influenza vaccine caused the paralysis. To investigate further, a group of people with the paralysis was identified. Then a similar group of people were selected who did not have the paralysis. Both groups were interviewed to identify exposures, including influenza vaccination. This study is a type of: A. Experimental study B. Cohort study C. Case-control study

C. Case-control study

After the vaccine was distributed for use, it was given at a nursing home. Of 200 residents, 100 decided to receive the vaccine, and 100 decided not to receive the vaccine. Subsequently, an influenza outbreak occurred in the nursing home. The local health department investigated the vaccinated group and unvaccinated groups to determine whether they developed influenza. This study is a form of: A. Case-control study B. Experimental study C. Cohort study D. Case report

C. Cohort study

Select the correct statement below. A. Age-Adjusted rates always reflect the actual count of events. B. Age-adjusted rates account for difference in population locations C. Crude rates do not account for the underlying age differences between communities. D. Crude rates take into account the underlying age differences in population.

C. Crude rates do not account for the underlying age differences between communities.

Eight pairs of small Oregon communities were assigned to received either a school-based adolescent tobacco use program or the school-based program plus a community program. In each of the next five years, 7th and 9th grade students in these communities were surveyed about tobacco and other substance use. Surveys during years two and five indicated that the prevalence of smoking was significantly lower in the community intervention communities. This example illustrates which one of the following uses of epidemiology in public health? A. Community health assessment B. Disease outbreak investigation C. Evaluation of intervention programs D. Surveillance E. Screening F. Targeting intervention programs

C. Evaluation of intervention programs

Select the correct statement A. Incidence rates give the number of all the events or cases in a population. B. Incidence is used to measure how a health condition has developed. C. Incidence rates give the number of new cases or events in a population during a specified time. D. In incidence rates, the data for the cases and the population of concern must be drawn from the same specific time but can be from different places.

C. Incidence rates give the number of new cases or events in a population during a specified time.

Which of the following is used to determine if overlapping confidence intervals are statistically significant? A. Behavioral indicator rate B. Mortality rate C. P value

C. P value

Epidemiology will often stratify their analysis by race because: A. Race may suggest underlying biological differences. B. Race is readily available in most datasets. C. Race is a marker for social, economic, and political factors that affect health and health disparities. D. Race categories accurately reflect individuals' self-identification.

C. Race is a marker for social, economic, and political factors that affect health and health disparities.

Fertility rates are: A. The number of births compared to infant mortality rates. B. The number of lives births in a specific area per year C. The number of live births per 1000 women of childbearing age in a given time period D. The number of births in a given year per 1000 population

C. The number of live births per 1000 women of childbearing age in a given time period

Select the correct statement below. A. We cannot infer the probable cause of a health event using the methods of analytic epidemiology. B. Descriptive epidemiology is the most commonly used branch of epidemiology in public health research. C. We cannot infer the cause of a health event using the methods of descriptive epidemiology. D. We can use methods of descriptive epidemiology to confirm causation.

C. We cannot infer the cause of a health event using the methods of descriptive epidemiology.

Select the correct statement. A. Smaller confidence intervals indicate less precision and stability. B. Two observed rates are said to be significantly different statistically if their confidence intervals overlap. C. We use confidence intervals t measure the randomness associated with a rate D. The 95% confidence interval means there is more than 5% probability that any observed difference in the rates is the result of chance.

C. We use confidence intervals t measure the randomness associated with a rate

Your funders for a smoking cessation campaign are interested in the potential effect of the campaign on the incidence of coronary heart disease in the population as a whole. You calculate that the population attributable risk percent is 21.3%. Select the statement below that best expresses amount of disease to be reduced. A. 21.3 cases of coronary heart disease per year could be eliminated from the population if smoking were eliminated. B. Smoking causes coronary heart disease in about 21.3% of non-smokers. C. About 21.3% of the incidence of coronary heart disease among smoker could be eliminated if the campaign were completely effective. D. About 21.3% of the incidence of coronary heart disease in the population as a whole could be eliminated if the campaign were completely effective in eliminating smoking.

D. About 21.3% of the incidence of coronary heart disease in the population as a whole could be eliminated if the campaign were completely effective in eliminating smoking.

You are investigating tuberculosis in the US. You find that although the incidence rate of tuberculosis among US-born individuals is 2.3 per 100,000, the incidence rate among foreign-born individuals is 21.9 per 100,000, for a relative risk of 10.5 associated with being foreign-born. Select the statement below that best expresses this relative risk. A. Foreign- and US-born individuals in the US are almost equally likely to contract tuberculosis. B. US-born individuals are 10.5 times as likely to contract tuberculosis as foreign-born individuals. C. Foreign-born individuals in the US are 10.5% less likely to contract tuberculosis than US-born individuals. D. Foreign-born individuals are 10.5 times as likely to contract tuberculosis as US-born individuals.

D. Foreign-born individuals are 10.5 times as likely to contract tuberculosis as US-born individuals.

You are in charge of determining the cause of a salmonella outbreak in your jurisdiction. To estimate the relative risk for several possible exposures, you calculate their odds ratios and reveal an odds ratio of 5 for exposure to frozen chicken breasts from a particular supplier in the area. You conclude that: A. The chicken is the cause of the outbreak, because of the high odds ratio associated with eating it. B. The chicken is not causing the outbreak, because an odds ratio of 5 is fairly low. C. The cause of the outbreak is probably the way that supplier processed the chicken. D. More investigation is necessary to determine whether the chicken is the cause of the outbreak.

D. More investigation is necessary to determine whether the chicken is the cause of the outbreak.

Select the correct statement. A. Incidence and prevalence are used for similar purposes B. Incidence rates are useful when assessing the burden of disease in a community C. Incidence and prevalence are statistical tests of trends D. Prevalence rates are useful when assessing the burden of disease in a community.

D. Prevalence rates are useful when assessing the burden of disease in a community.

Select the correct statement below. A. Rate cannot be used to determine the burden of diseases in a given population. B. Rate express the size of the population relative to events that occur to persons at risk of an event. C. Rates cannot be used to estimate risk. D. Rates can be used to compare the risk of health events across different groups of people, places, and time.

D. Rates can be used to compare the risk of health events across different groups of people, places, and time.

Cases in the Metropolitan Atlanta Congenital Defects Program are identified through ongoing active search and review of newborn and pediatric hospital records, and through birth certificates, death certificates, fetal death certificates, pathology reports, autopsy records of cytogenetic laboratories. This program provides reports on rates of birth defects to local and state officials on a regular basis. This example illustrates which one of the following uses of epidemiology in public health? A. Community health assessment B. Disease outbreak investigation C. Evaluation of intervention programs D. Surveillance E. Screening F. Targeting intervention programs

D. Surveillance

A baby's heel is pricked to obtain a few drops of blood for laboratory testing for signs of phenylketonuria (PKU). Usually, the baby's blood specimen is sent to a state public health laboratory for testing, and finding are sent to health care professional responsible for the infant's care. If there are abnormal laboratory results, the baby needs more extensive and precise testing to see if he or she does have PKU. This example illustrates which one of the following uses of epidemiology in public health? A. Community health assessment B. Disease outbreak investigation C. Evaluation of intervention programs D. Surveillance E. Screening F. Targeting intervention programs

E. Screening