EPID309: Final Exam Possible Questions
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 likely were cases to report an exposure compared with controls? a. .81 times as likely b. .86 times as likely c. .90 times as likely d. .83 times as likely
a. .81 times as likely
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 likely were cases to report and exposure compared with controls? a. 3.25 times as likely b. 1.23 times as likely c. 3.07 times as likely d. 1.75 times as likely
a. 3.25 times as likely
In the 18th and 19th centuries, childbed fever was a significant cause of maternal mortality. During the years 1764 through 1861m there were 23 outbreaks in a Dublin hospital. During one of these outbreaks, 19 of 63 women who delivered at this hospital became infected. Fourteen of the infected women died from this infection. What was the incidence of childbed fever during this outbreak? a. 302 per 1,000 b. 74% c. 826 per 1,000 d. 222 per 1,000
a. 302 per 1,000
A case-control study can be completed in a relatively short period of time. a. True b. False
a. True
A retrospective study is one in which the researcher obtains information about participants exposures in the past. a. True b. False
a. True
An ecological study does NOT provide information to conclude an exposure is a cause of disease. a. True b. False
a. True
An example of a categorical variable is eye color. a. True b. False
a. True
Birth is considered a vital event. a. True b. False
a. True
Contact with a disease-causing factor or the amount of the factor that affects a group of individuals is referred to as exposure. a. True b. False
a. True
Incidence measures the frequency of new disease occurring in the population. a. True b. False
a. True
Registries can be used to select patients for case-control studies a. True b. False
a. True
Tertiary prevention is directed toward the later stages of pathogenesis and involves programs for restoring the patient's optimal functioning. a. True b. False
a. True
The overriding question that epidemiologists ask is whether a particular exposure is causally associated with a given outcome. a. True b. False
a. True
The primary principle to be followed in identifying an appropriate control group is that controls should be a sample of the population that gave rise to the cases, and if a member of the control group had the disease being studied, they would have been identified as a potential case for the study. a. True b. False
a. True
When conducting a case-control study, researchers enroll participants based on disease status. a. True b. False
a. True
An abrupt increase in incidence rates due to a specific disease in only one U.S. state from one year to the next is most likely due to: a. a change in reporting requirements b. a change in the International Classification of Disease (ICD) system c. incorrect listing of cause fo death by physician on the death certificate d. all of the answers listed
a. a change in reporting requirements
An abrupt drop in mortality rates due to a specific disease from one year to the next is most likely due to: a. a change in the International Classification of Disease (ICD) system b. all of the answers listed c. incorrect listing of cause of death by the physician on the death certificate d. incorrect coding assignment by the hospital coders according to the International Classification of Disease (ICD) system
a. a change in the International Classification of Disease (ICD) system
Comparing persons with symptomatic versus asymptomatic Chlamydia infection to identify predictors is an example of: a. analytical epidemiology b. surveillance c. evaluation d. descriptive epidemiology
a. analytical epidemiology
An epidemiologist wants to determine if the recent outbreak of salmonella in Gilbert, Arizona resulted from eating a Los Favoritos Burritos. She composes a sample by taking 20 people from Gilbert who have salmonella. She decided to match each of them with another person who is equivalent in respect to age and gender but does not have Salmonella. Each of the 40 participants are asked about any recent visits to Los Favoritos. This study design is: a. case-control study b. experimental study c. ecological study d. cross-sectional study
a. case-control study
Some of the passengers on a cruise ship developed a gastrointestinal illness compatible with norovirus. Testing for this pathogen is not readily available in any nearby island or, where available take several days to get results. As an epidemiologist, you are called on board to investigate this possible outbreak, your case definition should include at a minimum: a. clinical criteria (symptoms) b. that nationally agreed standard case definition for disease reporting c. clinical features (symptoms), plus the exposure(s) you most suspect d. all suspected cases
a. clinical criteria (symptoms)
__________ have ____________ values and may be represented by _____________. a. continuous data, infinite, scatter plots b. categorical data, finite, dose response curves c. categorical data, infinite, contingency tables d. continuous data, finite, contingency tables
a. continuous data, infinite, scatter plots
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: a. cross-sectional b. case-control c. randomized trial d. cross-sectional study
a. cross-sectional
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. This study design was: a. cross-sectional study b. case-control study c. ecological study d. cohort study
a. 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: a. crude birth rate b. fetal mortality rate c. perinatal fertility rate d. general fertility rate
a. crude birth rate
What is not an ethical consideration in epidemiology research? a. ensuring all who need treatment receive it b. maintaining public trust c. respecting and meeting obligations of communities d. minimize risks and informed consent
a. ensuring all who need treatment receive it
A graphic plotting of the distribution of cases by time of onset is a(n): a. epidemic curve b. threshold curve c. dose-response curve d. multimodal curve
a. epidemic curve
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 control would be: a. non-SIDS infant deaths in Arizona b. the baby's own birth certificate information c. SIDS deaths in New Mexico d. non-SIDS infant deaths matched by maternal smoking status
a. non-SIDS infant deaths in Arizona
A researcher is interested in assessing the current burden of smoking in a population of college aged individuals. Which of the following measures of morbidity would be most appropriate in answering this question? a. prevalence b. age-adjusted incidence c. case fatality rate d. age specific incidece
a. prevalence
The systematic and continuous gathering of information about the occurrence of diseases and other health phenomena is known as: a. public health surveillance b. chronic disease surveillance c. syndromic surveillance
a. public health surveillance
Case-control studies are best characterized by a. starting with a group of cases b. describing individual cases or a series of cases c. use of aggregate data d. starting with a group who were exposed
a. starting with a group of cases
Ecological studies are best characterized by a. the use of aggregated data b. starting with a group of exposed individuals c. starting with a group of cases d. the inclusion of ecological or environmental data
a. the use of aggregated data
A research team is analyzing the association between eczema and exposure to river water from swimming. They use the population of Pittsburgh, PA for their study, which has a population of 100,000 people. Out of this, a total of 50,000 participants are recruited into the study (27,000 males and 23,000 females). In this sample, 200 individuals have eczema. A total of 15,830 of the participants regularly swim in the river; 110 of them have eczema. Using this data: a. they calculate an Odds Ratio and decide there is a positive association between eczema and river water, where cases were more likely report swimming in the water b. they calculate an Odds Ratio and decide there is a protective association between eczema and river water, where cases were more likely to report swimming in the water c. they calculate a Relative Risk and decide there is a protective effect where swimming in the river was associated with a decreased likelihood of eczema d. they calculate a Relative Risk and decide there is a positive association, where swimming in the river was associated with an increased likelihood of eczema
a. they calculate an Odds Ratio and decide there is a positive association between eczema and river water, where cases were more likely report swimming in the water
The lowest dose at which a particular response occurs is known as the: a. threshold b. correlation coefficient c. transition dose d. mode
a. threshold
In epidemiology, the key part of an analytic study is: a. use of an appropriate comparison group b. publication in a peer-reviewed journal c. statistical analysis using regression d. laboratory confirmation of the diagnosis
a. use of an appropriate comparison group
The ecological fallacy is: a. when you assume results of population level associations apply to individuals b. Interpreting the results of an ecological study as causal c. collecting data from research from the population as a whole instead of from individuals d. using data from vastly different groups in an ecologic study
a. when you assume 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: a. You did the math wrong b. none of these answers are correct c. the exposure is strongly associated with the outcome d. the exposure causes the outcome
a. you did the math wrong
In the 18th and 19th centuries, childbed fever was a significant cause of maternal mortality. During the years 1764 through 1861m there were 23 outbreaks in a Dublin hospital. During one of these outbreaks, 19 of 63 women who delivered at this hospital became infected. Fourteen of the infected women died from this infection. What was the maternal mortality rate? a. 737 per 1,000 b. 222 per 1,000 c. 74 per 100 d. 30%
b. 222 per 1,000
A case-control study is useful for the investigation of rare exposures. a. True b. False
b. False
Analytic epidemiology involves describing the occurrence of disease in populations. a. True b. False
b. False
Histograms are useful for portraying categorical data. a. True b. False
b. False
In 1980, the case fatality rate was about 5 per 1 million persons. a. True b. False
b. False
In addition to disease data, the Notifiable Disease Surveillance System also collects data on risk factors. a. True b. False
b. False
In an ecological study, exposure and disease measurements are known for individuals. a. True b. False
b. False
In the United States, birth statistics are collected for tax purposes and do not include enough information to be helpful to epidemiologists. a. True b. False
b. False
Incidence is the number of instances of a particular health condition/illness occurring within a population. a. True b. False
b. False
Participants are selected for a case-control study based on their exposure status a. True b. False
b. False
Syndromic surveillance is a database for the collection of information about a disease. a. True b. False
b. False
The Behavioral Risk Factor Surveillance System (BRFSS) is an example fo syndromic surveillance. a. True b. False
b. False
The decrease in the case fatality rate in the 1950s was probably due to decreased population at the end of WWII (ended in 1945). a. True b. False
b. False
Your public health internship at Pima County Health Department asks you to collect background data on cancer rates for the U.S. You start by going to: a. ADDMnet b. SEER c. NHANES d. BRFSS
b. SEER
A classical ethical dilemma in biomedical research is the: a. case definition change of Valley Fever in Arizona in 2009 b. U.S. Public Health Service Syphilis Study, Tuskegee, AL c. London Cholera Outbreak in 1850 d. Smallpox eradication in Somalia, 1977
b. U.S. Public Health Service Syphilis Study, Tuskegee, AL
Which of the following is a good index of the severity of a short-term, acute disease: a. 5-year survival b. case fatality rate c. none of the other answers listed d. cause-specific death rate e. crude death rate
b. case fatality rate
Investigators in Arizona conducted a study to compare measles-mumps-rubella (MMR) vaccine history among 4,469 children without these disorders. This is an example of which study design? a. cohort b. case-control c. ecological d. clinical trial
b. case-control
A study that follows women recruited from University Health Services for 15 years after graduation to detect an association between training bed use and skin cancer rates: a. ecological study b. cohort study c. cross-sectional study d. case-control study
b. cohort study
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, and clinic staff work schedules. This study is: a. case-control b. cross-sectional c. cohort d. randomized intervention study
b. cross-sectional
If one is concerned with being able to generalize study results to a different population they are speaking about the study's a. internal validity b. external validity c. confounding d. selection bias
b. external validity
All fo the following are considered vital events except: a. marriage b. graduation c. divorce d. death
b. graduation
The most important advantage of cohort studies is: a. it is easy to build up a control group b. it allows us to determine both the relative risk and the attributable risk c. it allows one to take advantage of existing records and data it is cheap and provides a quick answer
b. it allows us to determine both the relative risk and the attributable risk
The web of causation model specifies a type of causal relationship that is: a. coherent b. multifactorial c. specific d. consistent
b. multifactorial
When the value fo one variable increases and the value of another variable decreases, the association is: a. positive b. negative c. continuous d. none of the answers listed
b. negative
To answer the question "what proportion of cases die from the disease" you should calculate the: a. cause-specific death rate b. proportional mortality rate c. case fatality rate d. crude death rate
b. proportional mortality rate
An activity that takes place to prevent the progression of disease is: a. primary prevention b. secondary prevention c. tertiary prevention
b. secondary prevention
Case control studies are best characterized by a. starting with a group who were exposed b. starting with a group of cases c. describing individual cases or a series of cases d. use of aggregate data
b. starting with a group of cases
A new technique for screening of autism has led to earlier detection of the disorder among white boys. As a result: a. there will be no change in reported incidence of prevalence b. the reported prevalence will increase c. there is not enough information provided d. the reported incidence will decrease
b. the reported prevalence will increase
Disadvantages of case-control studies include all except which of the following? a. representativeness of cases and controls may be unknown b. they can be used to study low-prevalence conditions c. they provide indirect estimates of risk d. measurements of exposure may be inaccurate
b. they can be used to study low-prevalence conditions
An epidemic curve has _____________ on the x-axis and _____________ on the y-axis. a. incidence; CFR b. time (usually in days); cases (counts) c. incidence; time (usually in days) d. time (usually in weeks); prevalence (point prevalence)
b. time (usually in days); cases (counts)
About howl long was it between the discovery of penicillin and the widespread use of it? a. 3 years b. 50 years c. 15 years d. it was immediately adopted
c. 15 years
The smallpox vaccine was created by ________________ in ______________. a. Ramazzini, late 1600s b. Sir Percival Pott, late 1700s c. Edward Jenner, late 1700s d. John Snow, mid 1850s
c. Edward Jenner, late 1700s
What is step 6 of creating a concept map, as per the YouTube link? a. update your map to reflect better understanding b. use arrows, symbols, and colors to show relationships c. analyze and improve your map d. brainstorm what you know about the identified main topic
c. analyze and improve your map
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 in answering the question? a. incidence rate b. period prevalence c. case fatality rate d. late fetal mortality rate
c. case fatality rate
A study was conducted in a nursing home to examine the association of hand-washing and gastro-enteritis. Residents with the disease were recruited and others from the nursing home without the disease were subsequently selected. This kind of study is known as: a. cross-sectional study b. ecological study c. case-control study d. cohort study
c. case-control study
In the investigation of an epidemic of a fatal disease such as SARS, the most appropriate measures to describe the frequency of death from the disease is the: a. mortality rate b. incidence rate c. case-fatality rate d. proportional mortality ration
c. case-fatality rate
A study that examines the incidence of developmental delays among residents of Flint, Michigan based on water source (Hint: in 2014 Flint water switched its source to the Flint River which has failed corrosion control and this the aging pipes caused lead to leach into the water supply) is known as: a. cross-sectional study b. case-control study c. cohort study d. ecological study
c. cohort study
Researchers compare the prevalence of obesity and the average walk-ability scores of Tucson and Phoenix. What type of study design did they use? a. case-series b. case-control c. ecological d. cohort
c. ecological
On average there are 7 cases of plague a year in the U.S. In 2015, there were 2 cases in AZ, 4 in CO, 4 in NM, and one each in CA, UT, GA, and Mi. The best word to describe plague in the U.S. is a. eradicated, because plague does not represent a significant burden in the U.S. b. temporal , because cases usually occur from later spring to early fall c. endemic, because it is expected that cases will happen each year d. pandemic, because cases occur in more than one state
c. endemic, because it is expected that cases will happen each year
A researcher is interested in knowing how many new cases of the measles developed at St. Theresa's Elementary School in April 2001. Assuming no children enrolled during that month (all children were followed for the entire month), which measure of morbidity would be most appropriate in answering the question? a. CFR b. prevalence c. incidence d. PMR
c. incidence
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? a. incidence will increase, but prevalence will remain the same b. incidence will remain the same, but prevalence will increase c. incidence will remain the same, but prevalence will decrease d. both incidence and prevalence will decrease
c. incidence will remain the same, but prevalence will decrease
A researcher is interested in recording the number of individuals in a particular geographic region, who have a common cold at some point during the month of February 2001. Which of the following measures of morbidity would be most appropriate in answering this question? a. incidence b. PMR c. prevalence d. case fatality rate
c. prevalence
A group of women with stage I breast cancer were recruited and randomized to receive either lupenctomy alone or lupenctomy with breast radiation. The women were then followed for 5 years to determine if there were any differences in breast cancer recurrence and survival. This study is called: a. case-control study b. ecological study c. randomized controlled study d. cross-sectional study
c. randomized controlled study
For which of the following criteria do epidemiologists need to observe the cause before the effect? a. biological gradient b. coherence c. temporality d. consistency
c. temporality
When calculating a Pearson correlation coefficient (r), you get a large negative value (-.89). This means that: a. the exposure prevents the outcome b. none of the answers are correct c. the exposure is strongly negatively associated with the outcome d. you did the math wrong
c. the exposure is strongly negatively associated with the outcome
Asthma prevalence is on the rise in Arizona. A recent cross-sectional study among a group of 160 grade school boys living near Speedway were asthmatic compared with 17 per 100 (15 of 90) who lived further. The researchers attributed this increased prevalence of asthma to exposure to exhaust by proximity to Speedway. The relative risk of asthma for those exposed to Speedway is: a. there is not enough information to calculate this rate b. (15/160)/(45/160)=.09/.28=.33 b. (45/70)/(15/90)=.643/.167=3.86 c. (15/90)/(45/70)=.167/.643= .26 d. (45/160)/(15/160)= .28/.09= 3
d. (45/160)/(15/160)= .28/.09= 3
In the 18th and 19th centuries, childbed fever was a significant cause of maternal mortality. During the years 1764 through 1861m there were 23 outbreaks in a Dublin hospital. During one of these outbreaks, 19 of 63 women who delivered at this hospital became infected. Fourteen of the infected women died from this infection. What was the case fatality rate? a. 302 per 100 b. 61% c. 22% d. 74%
d. 74%
An abrupt increase in incidence rates due to a specific disease in only one U.S. state from one year to the next is most likely due to: a. incorrect listing of cause of death by the physician on the death certificate b. a change in the International Classification of Disease (ICD) system c. all of the answers listed d. a change in reporting requirements
d. 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? a. rapid ascertainment b. syndromic surveillance c. passive surveillance d. active surveillance
d. active surveillance
Hill's criteria of causality include which of the following: a. temporality b. dose-response c. strength d. all of the answers listed
d. all of the answers listed
A _______________ is a type of graph that shows the frequency of cases for categories of a categorical (discrete) variable. a. dose response curve b. pie chart c. histogram d. bar graph
d. bar graph
A primary difference between registries and surveillance is a. cases know they are part of surveillance but not necessarily of a registry b. registries are limited to infectious diseases, while surveillance is limited to chronic diseases c. registries are limited to chronic diseases, while surveillance is limited to infectious diseases d. cases know they are apart of a registry, but not necessarily part of surveillance
d. cases know they are apart of a registry, but not necessarily part of surveillance
_____________ have _______________ values and may be represented by __________________. a. continuous data, finite, contingency tables b. continuous data, infinite, pie charts c. categorical data, finite, dose response curves d. categorical data, finite, contingency tables
d. categorical data, finite, contingency tables
An epidemiologist wants to evaluate the association between skin cancer incidence and the risk factors such as sun exposure. He decided to compare skin cancer rates in Costa Rica to skin cancer rates in Norway. He hypothesized that Costa Rica, being closer to the equator and receiving relatively larger amounts of UV radiation from sunlight exposure would have significantly higher skin cancer incidence rates. This study design is a. experimental study b. cross-sectional study c. case-control study d. ecological study
d. ecological study
A type of graph that is used to display the frequency distribution for grouped categories of a continuous variable is _______________. a. pie chart b. line graph c. bar graph d. histogram
d. histogram
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? a. incidence will increase, but prevalence will remain the same b. incidence will remain the same, but prevalence will increase c. both incidence and prevalence will decrease d. incidence will remain the same, but prevalence will decrease
d. incidence will remain the same, but prevalence will increase
A new treatment for chronic disease affecting millions of Americans is developed that prolongs survival with disease. Which of the following will occur? a. incidence will remain the same, but prevalence will decrease b. incidence will increase, but prevalence will remain the same c. both incidence and prevalence will decrease d. incidence will remain the same, but prevalence will increase
d. incidence will remain the same, but prevalence will increase
Improved therapy of childhood leukemia has considerably lengthened the average survival time. There has, however, been no change in incidence. What has this done to the prevalence rate of the disease? a. can't tell from the information b. decreased it c. no change d. increased it
d. increased it
The epidemiological approach is distinguished from the clinical approach by: a. its concern with specific signs and symptoms b. its use of clinical data such as temperature readings c. none of the above d. its focus on the population
d. its focus on the population
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 provider administered survey. Of the following, the best controls would be: a. prostate cancer patient at the Northwestern Hospital b. the patient's own record before the development of cancer c. smoking status matched non-prostate cancer patients d. non-prostate cancer patients at UMC
d. non-prostate cancer patients at UMC
Used in case-control studies, a type of indirect measure of the association between frequency of exposure and frequency of outcome is known as the: a. attributable risk b. population risk difference c. all of these are correct d. odds ratio
d. odds ratio
Subjects are classified according to their exposure to a factor of interest and then are observed over time to document the incidence of disease in what type of study? a. retrospective cohort study b. cross-sectional study c. case-control study d. prospective cohort study
d. prospective cohort study
When information about the study outcome is collected in the future, this is known as a: a. retrospective study b. ecological study c. cross-sectional study d. prospective study
d. prospective study
The incidence rate of a disease is eight times greater in women than men, but the prevalence rates show no sex differences. The best explanation is that: a. risk factors for developing the disease are more common in women b. the crude all-cause mortality rate is greater in women c. the case-fatality rate for this disease is greater for women d. the duration of this disease is shorter in men
d. the duration of this disease is shorter in men
