PHEP 341 Quiz 1-4 (Midterm)

An outbreak of salmonella occurred following a company picnic. There were 590 people at the company picnic. Officials from the health department determined that out of 127 people who at vanilla ice cream 122 were diagnosed with salmonella. What is the Attack Rate of vanilla ice-cream?

122 / 127 x 100= 96.06%

At the end of a prospective cohort study, a researcher calculated that the incidence rate of skin cancer was 0.000437 per every 1 person-year How should we interpret this rate if we multiply it by 100,000?

43.7 cases per 100,000

A question about Case Fatality Rate or Case Fatality % A stroke (i.e. cerebral vascular accident) is a disruption of blood flow through the brain. There are two general types of stroke, embolic (due to a clot), or hemorrhagic (due to a rupture of a brain artery). In 2018 there were 795,000 strokes in the United States. Of these, 120,000 were hemorrhagic in nature. Of the 120,000 people diagnosed with a hemorrhagic stroke, 45,000 died due to their stroke. Given this information, what is the Case Fatality % for hemorrhagic stroke?

45,000/120,000 x 100 = 37.5%

Negative Predictive Value Formula

TN/(TN+FN) D / (C+D)

Specificity Formula

TN/(TN+FP) D / (B+D)

Sensitivity Formula

TP/(TP+FN) A / (A+C)

Positive Predictive Value Formula

TP/(TP+FP) A / (A+B)

IRB approval for Human Subjects Research is required by Federal Law. True or False

True - 45 C.F.R. 46.101(a) - This a Federal Law that MUST be followed (Ignorance is NOT an excuse)

Early theories of disease transmission included the workings of witchcraft, demons, gods, comets, and earthquakes. True or False

True: Early theories were based upon anecdotal observation, which often relied upon mysticism

Use the list of number 7 numbers below to answer the following question: 1, 1, 1, 3, 4, 5, 20 What is the mode? a. 1 b. 3 c. 20 d. 5

a. 1

The ____________________ is the nation's premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services a. Behavioral Risk Factor Surveillance System (BRFSS) b. Surveillance, Epidemiology, and End Results (SEER) c. National Health and Nutrition Examination Survey (NHANES) d. Federal Bureau of Investigation - Uniform Crime Report

a. Behavioral Risk Factor Surveillance System (BRFSS)

In sub-Saharan Africa, Malaria is considered? a. Endemic disease b. Epidemic disease c. Pandemic disease d. None of these are correct

a. Endemic disease

This person turned medicine away from mysticism and religion, and towards observation and reason: a. Hippocrates b. John Snow c. Louis Pasteur d. Fracastoro

a. Hippocrates

The MEDLINE (PubMed) database, indexes which of the following? a. Journal Articles (i.e. Biomedical Literature) b. National Cancer Registry c. Vital Statistics (Births, Deaths, Marriages) d. FBI Crime Data

a. Journal Articles (i.e. Biomedical Literature)

This person proposed a germ theory of diseases, supporting that living microorganisms are the cause of disease: a. Louis Pasteur b. Fracastoro c. John Snow d. Hippocrates

a. Louis Pasteur

The numerator of an Incidence Rate (Incidence Density) includes: a. Only New Cases (i.e. people who developed the outcome of interest) b. Both new and non-cases

a. Only New Cases (i.e. people who developed the outcome of interest)

Randomly selecting names from a hat, where everyone had an equal probability of being selected is an example of: a. Simple Random Sampling b. Convenience Sampling c. Stratified Random Sampling d. Cluster Sampling

a. Simple Random Sampling

The denominator of an Incidence Rate (Incidence Density) includes: a. Total Person-Time At Risk (e.g. 1,000 person-years) b. The total number of people followed (e.g. 25 people)

a. Total Person-Time At Risk (e.g. 1,000 person-years)

The Statistic we use to measure the Reliability (Repeatability / Precision) of a screen test is: a.KAPPA b.Sensitivity c.Specificity

a.KAPPA

Immunization against Measles, so that you could NEVER catch Measles, is which type of prevention a.Primary b.Secondary c.Tertiary

a.Primary

From a Public Health perspective what are the three types of prevention? a.Primary, Secondary, and Tertiary b.Validity, Reliability, and Precision c.Primary, Immunizations, and Diet d.Sensitivity, Specificity, and Reliability

a.Primary, Secondary, and Tertiary

Which of the following public health domains is considered the foundation of public health? a. Health Behavior b. Epidemiology c. Anthropology d. Health Policy

b. Epidemiology

Recently the media reported that the rate of Covid-19 deaths for Florida was 17.21 per 10,000 residents compared to Vermont which was 4.1 per 10,000. The media then speculated that Floridians were reckless in their response to Covid-19. From an epidemiological perspective, what would you want to know before comparing these rates? a. I would want to know why every person in Florida has been so reckless in their response to Covid-19 b. I would want to know if these rates were age adjusted. Covide-19 mortality is strongly associated with older age and the only fair way to compare two or more rates is to adjust for age. c. The media report has everything I need to know to draw numerous conclusions.

b. I would want to know if these rates were age adjusted. Covide-19 mortality is strongly associated with older age and the only fair way to compare two or more rates is to adjust for age.

Measures of Central Tendency include: a. Mode, Median, and Standard Deviation b. Mean, Median, and Mode c. Mean, Median, Standard Deviation d. Mode, Standard Deviation, and Variance

b. Mean, Median, and Mode

Mammograms, used to screen for breast cancer annually in all women over age 40 is which type of screening? a.Primary b.Secondary c.Tertiary

b.Secondary

The accuracy of a screening test can be measured by Sensitivity and Specificity. We call the accuracy of a screening test, its ____________: a.Reliability b.Validity

b.Validity

In Public Health we collect and use data to: a. Evaluate programs only b. Test hypothesis only c. Evaluate programs and policies, as well as create and test hypotheses d. Compare crude mortality rates between different geographic areas (e.g. states, countries)

c. Evaluate programs and policies, as well as create and test hypotheses

The ____________________ is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations. a. Behavioral Risk Factor Surveillance System (BRFSS) b. Surveillance, Epidemiology, and End Results (SEER) c. National Health and Nutrition Examination Survey (NHANES) d. Federal Bureau of Investigation - Uniform Crime Report

c. National Health and Nutrition Examination Survey (NHANES)

Covid-19 is considered a(n)? a. Endemic disease b. Epidemic disease c. Pandemic disease d. None of these are correct

c. Pandemic disease

Use the list of number 7 numbers below to answer the following question: 1, 1, 1, 3, 4, 5, 20 What is the median? a. 1 b.4 c.3 d.19

c.3

`Screening test programs are most efficient when? a.Targeted at high at-risk populations b.When the burden of False Positives is deemed acceptable c.Answers A and B are both correct d.They are highly diagnostic

c.Answers A and B are both correct

What are the 3 Core Functions of Public Health? a. Endemic, Epidemic, and Pandemic b. Epidemiology, Policy Development, and Health Behavior c. Equity, Social Justice, and Environmental Health d. Assessment, Policy Development, and Assurance

d. Assessment, Policy Development, and Assurance

What are the two methods we can age adjust a crude rate? a. Specific and Crude Age Standardization b. Indirect and Crude Age Standardization c. Crude and Standard Age Standardization d. Direct and Indirect Age Standardization

d. Direct and Indirect Age Standardization

How did Doll and Hill improve public health? a. They created the Clean Air and Clean Water Acts b. They found that tobacco smoke causes genetic mutations in the lung which can lead to lung cancer c. They showed that Cholera was caused by contaminated water d. They observed an association between cigarette smoking and lung cancer

d. They observed an association between cigarette smoking and lung cancer

Which of the following does epidemiology study? a. Environmental exposures b. Infectious diseases c. Chronic diseases d. Injuries e. All the above (and many more)

e. All the above (and many more)

Please use the following information to answer the question below. Please note, this question is unrelated to the question directly above: The SMR in an occupation cohort is 2.5 The mortality rate in the general population is 210 per 100,000 What is the Indirect Age Adjusted mortality rate for the occupational cohort?

(2.5 x 210) = 525 per 100,000

Please use the following information to answer the question below: The observed number of deaths in an occupational cohort was 618. The expected number of deaths given the general population was 206. Which of the following is the correct Standardized Mortality Ratio (SMR)?

618/206 = 3.0

n 2019 there were a total of 2,854,838 deaths in the United States. The top 3 causes were of death were: Heart Disease: 659,041 Cancer: 599,601 Accidents (unintentional injuries): 173,040 What proportion of these deaths were due to Heart Disease?

659,041 / 2,854,838

A prospective cohort study followed 500 people over a 7-year follow-up period. At the start of the study no one had a diagnosis of hypertension (high blood pressure). At the end of the study 83 people had a diagnosis of hypertension. The total person-time of follow-up was 2,900 person-years. What is the incidence rate (incidence density) for hypertension in this study?

83/2900 x 1000 = 28.62 cases per 1000

Suppose the Standardized Mortality Ratio (SMR) for bush pilots is 3.50. How should you interpret this SMR?

Bush pilots have an observed number of deaths 3.5 times higher compared to their expected number of deaths

Incidence and Prevalence measure the same thing and are terms that can be used interchangeably. True or False

False: Incidence measures new cases, while prevalence measures existing cases

What does specificity tell you?

If you DO NOT have the disease, what is the probability that the screening test will correctly determine that you do not have the disease?

What does sensitivity tell you?

If you have the disease, what is the probability that the screening test will correctly tag you having the disease?

What does NPV tell you?

You do not know whether you have the disease or not. You've just tested negative for the disease by a screening test. What is the probability that you are disease free given the negative screening test

What does PPV tell you?

You do not know whether you have the disease or not. You've just tested positive for the disease by a screening test. What is the probability that you actually have the disease given the positive screening test