EPID 309 Midterm
About how long was it between the discovery of penicillin and the widespread use of it?
15 years
A study of 78 cases of disease X were identified from a state registry. A total of 120 control subjects were then recruited from random-digit dial procedure. 6 cases had been exposed, compared to only 3 controls. How much more likely were cases to report an exposure than controls?
3.25 times more likely
In a clinical trial investigating at the efficacy of Mohs surgery to remove cancers the best control would be:
A sample from the population of individuals receiving standard care
______ have _____ values and may be represented by ___________.
Categorical data, finite, contingency tables
Which factor below is NOT considered to be a component of socio-economic status:
Ethnicity
A new treatment for a chronic disease affecting millions of Americans is developed that prolongs survival with the disease. Which of the following will occur?
Incidence will remain the same, but prevalence will increase
The systematic and continuous gathering of information about the occurrence of diseases and other health phenomena is known as:
Public health surveillance
Gradual changes in the frequency of diseases over a long periods refer to:
Spatial Clustering
When calculating a Pearson Correlation Coefficient (r), you get a large negative value (-0.89). This means that:
The exposure is strongly negatively associated with the outcome
A new technique for screening of autism has led to earlier detection of the disorder among white boys. As a result:
The reported prevalence will increase
Ecological studies are best characterized by
The use of aggregated data
In addition to disease data, the Notifiable Disease Surveillance System also collects data on risk factors.
false
The term epidemiologic transition describes a shift in the patterns of high infant mortality and high birth rates to low birthrates and longer life expectancy.
false
Use of a double blind study design can help reduce
information bias.
An endemic disease is one which
is habitually present in a community, geographic area, or population group
A ____ enables a reader to detect trends in the data, often time trends.
line graph
When the value of one variable increases and the value of another variable decreases, the association is:
negative
If a cross-sectional study demonstrated a strong positive association between age of child when weaned and maternal age, it would most likely be based on:
none of the other answers listed
When information about the study outcome is collected in the future, this is known as a
prospective study
A research team is analyzing the association between leukemia and exposure to benzene among factory workers. They use the population of Allentown PA for their study, which has a population of 10,000 people. Out of this, a total of 1,000 factory workers are recruited into the study (653 males and 347 females). In this sample, 13 individuals have leukemia. A total of 263 of the participants are exposed to benzene in the workplace; 9 of them have leukemia. Using these data,
they calculate an Odds Ratio and conclude that there is a positive association where cases are more likely to report exposure to benzene.
The lowest dose at which a particular response occurs is known as the:
threshold
Contact with a disease-causing factor or the amount of the factor that affects a group of individuals is referred to as exposure.
true
Examples of continuous variables are height and weight.
true
Primary prevention involves the prevention of disease before it occurs.
true
The Ecological Fallacy is
when you assume the results of population level associations apply to individuals
The ecological fallacy is:
when you assume the results of population level associations apply to individuals.
When calculating a Pearson correlation coefficient (r), you get a large positive value (8.9). This means that:
you did the math wrong
A study of 39 cases of disease X were identified from a state registry and an equal number of control subjects were then recruited from random-digit dial procedure. 5 cases had been exposed, compared to only 6 controls. How much more likely were cases to report an exposure than controls?
0.81 times as likely
A group of 728 women from the UA campus were recruited to participate in a research study to determine the risk of developing depression. At the beginning of the study, 38 women were diagnosed as depressed. Over the course of a year, an additional 23 women were diagnosed with depression (3 in October, 15 in November and 5 in December). Over the year, 3 deaths among these women were attributed to depression. The likelihood that a UA woman will develop depression in a year is:
5%
A ___ is a type of graph that shows the frequency of cases for categories of a categorical (discrete) variable.
Bar graph
Which of the following is a good index of the severity of a short-term, acute disease:
Case-fatality rate
_____ have _____ values and may be represented by ___________.
Continuous data, infinite, scatter plots
HIPAA was primarily enacted into law for the privacy and protection of health information.
False
Histograms are useful for portraying categorical data.
False
All of the following are considered vital events EXCEPT:
Graduation
The web of causation model specifies a type of causal relationship that is:
Multifactorial
An epidemiologist is asked to comment on the association between microcephaly and Zika.
She evaluates the data presented in the literature and discusses what studies are showing about how Zika and microcephaly may be causality associated.
A population is defined as all of the inhabitants of a given country or area considered together.
True
A primary difference between registries and surveillance is
cases know they are part of a registry, but not necessarily a surveillance
Researchers interested in understanding the association between helmet use and injury severity survey students on the UA campus with respect to bicycle safety and injury sustained. The study design was:
Cross-sectional
You would like to assess the effectiveness and efficiency in delivering health services through your clinic. After selecting a 10% sample of all patient visits during the past six months, you are able to characterize the patient population utilizing your clinic in terms of age, sex, race, method of referral, diagnostic category, daily patient load, clinic staff work schedules. This study is:
Cross-sectional
A new treatment for a chronic disease affecting millions of Americans is developed that hastens (speeds) the recovery from disease. Which of the following will occur?
Incidence will remain the same, but prevalence will decrease
You don't have to worry about external validity in:
None of the above. You have to worry about external validity in all study designs.
Your Public Health internship preceptor at Pima County Health Department asks you to collect background data on cancer rates for the US. You start by going to:
SEER
An example of a categorical variable is eye color
True
A team of researchers hypothesizes that climate exposure causes obesity. College students were chosen who either did or did not have BMI > 30. They were compared on whether they exercised indoors or outdoors. This kind of study is:
case control
Researchers hypothesize that older students are more effective learners. They assemble groups of students from UA Gen Ed courses and collect demographic and academic information. This kind of study is
cross sectional
Increases and decreases in the frequency of a disease within a year or over a period of several years are known as:
cyclic trends
In the 18th and 19th centuries, childbed fever was a significant cause of maternal mortality. During the years 1764 through 1861, there were 23 outbreaks in a Dublin hospital. During one of these outbreaks 19 of 63 women who delivered at this hospital become infected. Fourteen of the infected women died from the infection. What was the maternal mortality rate?
222 per 1000
In the 18th and 19th centuries, childbed fever was a significant cause of maternal mortality. During the years 1764 through 1861, there were 23 outbreaks in a Dublin hospital. During one of these outbreaks 19 of 63 women who delivered at this hospital become infected. Fourteen of the infected women died from the infection. What was the incidence of childbed fever during this outbreak?
302 per 1000
In the 18th and 19th centuries, childbed fever was a significant cause of maternal mortality. During the years 1764 through 1861, there were 23 outbreaks in a Dublin hospital. During one of these outbreaks 19 of 63 women who delivered at this hospital become infected. Fourteen of the infected women died from the infection. What was the case fatality rate?
74%
An abrupt drop in mortality rates due to a specific disease from one year to the next is most likely due to:
A change in the International Classification of Disease (ICD) system
Random assignment of subjects to study groups helps to control for:
Biases due to confounding
A researcher is interested in understanding how lethal (deadly) SARS in Southern China was in 2002-3. Which of the following would be most appropriate for answering this question?
Case Fatality Rate
To answer the question "what proportion of cases die from the disease" you should calculate the
Case-Fatality rate
A study that follows women recruited from university health services for 15 years after graduation to detect an association between tanning bed use and skin cancer rates:
Cohort Study
Researchers interested in understanding the association between helmet use and injury severity survey students on the UA campus with respect to bicycle safety and injury sustained. The study design was:
Cross-sectional study
The number of live births during a specified period such as a year per the resident population during the midpoint of the year is the:
Crude Birth Rate
Repetitive, predictable, or regularly occurring increases and decreases in the frequency of a disease within a year or over a period of several years are known as:
Cyclic trends
Dr. Melanoma was born in 1971 and is still alive. Which of these events occurred during her life time?
Discovery of HIV & Smallpox eradication
Researchers compare the prevalence of obesity and the average walk-ability scores of Tucson and Phoenix. What type of study design did they use?
Ecological
A vaccine that provided immunity to smallpox was created by ___ in ___.
Edward Jenner, late 1700s
The occurrence in a community or region of cases of an illness, specific health behavior, or other health related events clearly at the level of normal expectancy is known as a(n):
Epidemic
A graphic plotting of the distribution of cases by time of onset is a(n):
Epidemic curve
A cross-sectional study allows the demonstration of a time sequence.
False
Continuous data can be converted to categorical data, and vice versa.
False
In epidemiology, person variables include secular trends
False
One of the main purposes of descriptive epidemiology is to test research hypotheses.
False
Syndromic surveillance is a database for the collection of information about a disease.
False
The Behavioral Risk Factor Surveillance System (BRFSS) is an example of syndromic surveillance.
False
Cohort studies are preferred by epidemiologists because they are:
Good for assessing incidence
Stanley Studiesalot was born in 1995 and is still alive. Which of these events occurred during his life time? (There may be more than one correct answer. You need to select all of them for credit.)
HPV vaccination became available & West Nile virus introduced into the USA
A type of graph that is used to display the frequency distribution for grouped categories of a continuous variable is a ____.
Histogram
The most important advantage of cohort studies is:
It allows us to determine both the relative risk and the attributable risk
The English anesthesiologist who linked cholera outbreaks to contaminated water and innovated several of the key epidemiological methods that remain valid and in use today was:
John Snow
In a case-control study of sudden infant death syndrome (SIDS), you believe that maternal smoking is an important risk factor. Your cases were recruited from Arizona using Death Certificates. Of the following, the best controls would be
Non-SIDS infant deaths in Arizona
In a case-control study of prostate cancer, you believe that smoking is an important risk factor. Your cases were recruited from UMC prostate cancer patients using a provide administered survey. Of the following, the best controls would be:
Non-prostate cancer patients at UMC
Grandpa Aedes was born in 1908 and died in 1995. Which of these events occurred during his lifetime? (There may be more than one correct answer. You need to select all of them for credit.)
Polio eradication
The term that indicates cases of disease that occur in a specific geographic region is:
Spatial Clustering
For which of the following criteria do epidemiologists need to observe the cause before the effect?
Temporality
Hill's criteria of causality include which of the following:
Temporality Strength All of the answers listed(C) Dose-response
Which of the following disease outbreaks occurred between 1346 and 1352 and claimed up to 1/3 of the population of Europe
The Black Death
Robert Koch (1843-1910) is famous for his work in support of the germ theory by isolating the causative agents for both anthrax and tuberculosis. Which of the following is NOT one of Koch's postulates?
The association between the organism and the disease must be consistently observed across populations, places, circumstances and times.
The incidence rate of a disease is eight times greater in women than in men, but the prevalence rates show no sex differences. The best explanation is that:
The case-fatality rate for this disease is greater for women
A research team is analyzing the association between leukemia and exposure to gasoline by pumping gas. They use the population of Allentown PA for their study, which has a population of 10,000 people. Out of this, a total of 5,000 participants are recruited into the study (2568 males and 2432 females). In this sample, 14 individuals have leukemia. A total of 4583 of her participants regularly pump gas; 11 of them have leukemia. Using these data:
They calculate a Relative Risk and decide there is a protective effect where pumping gas was associated with a decreased likelihood of leukemia.
Incidence measures the frequency of new disease occurring in the population.
True
Tertiary prevention is directed toward the later stages of pathogenesis and involves programs for restoring the patient's optimal functioning.
True
The overriding question that epidemiologists ask is whether a particular exposure is causally associated with a given outcome.
True
A classic ethical dilemma in biomedical research is the:
US Public Health Service Syphilis Study, Tuskegee AL
An abrupt increase in incidence rates due to a specific disease in one country from one year to the next is most likely due to:
a change in reporting requirements
The Arizona Developmental Disabilities Surveillance Program seeks to determine the prevalence of autism spectrum disorders among children age 8 in Maricopa County. The team goes out to schools and clinics and reviews records of the children. What kind of surveillance system do they use?
active surveillance
