EBM Review Questions

(C) Open-labeled clinical trial

1. Over 1 year, a study is conducted to assess the antileukemic activity of a new tyrosine kinase inhibitor in patients with chronic myeloid leukemia in blast crisis. All patients enrolled in the study are informed that they would be treated with the tyrosine kinase inhibitor. They are assigned to successive dose cohorts of 300 to 1000 mg/day of the drug. Six to eight patients are assigned to each dose. Treatment efficacy is determined based on the results of complete blood counts and bone marrow assessments conducted regularly throughout the study. This study is best described as which of the following? (A) Case-control study (B) Crossover study (C) Open-labeled clinical trial (D) Randomized clinical trial (E) Single-blind, randomized, controlled trial

A. Interval

10. Intelligence tests would be considered what type of data? A. Interval B. Dichotomous C. Nominal D. Ordinal E. Ratio

B. Skewed left (negative)

11. Which way is the data skewed looking at this graph? (There is a straight line then it is curved on the R of the graph) A. Skewed right (positive) B. Skewed left (negative)

A. Skewed right (positive)

12. A data set has a median of 13 and a mean of 20. Which way would the data be skewed? A. Skewed right (positive) B. Skewed left (negative)

A. Accepts the null hypothesis

13. A cancer researcher is studying to see if a new chemotherapy drug is effective. After examining the data she determines that difference in outcomes is due to chance. This means she: A. Accepts the null hypothesis B. Rejects the null hypothesis C. The p-value is <0.5

C. 7.6-9.8

14. A clinical trial examined whether or not a new study improved fatigue in cancer patients. The result was an improved stamina score of 8.6 p<0.05. Which confidence interval represents the stamina score with the p value? A. 3.2-4.9 B. 5.4-7.3 C. 7.6-9.8 D. 9.9-12.5

E. Student's t-test

15. You are looking to compare mean survival rates for those treated at LSU Health Shreveport and LSU Health New Orleans. What test would you use? A. ANOVA B. Chi-square test C. Cox Proportional Hazard D. Paired t-test E. Student's t-test

D. 99.8%

16. Scores on the USMLE in 2013 formed a normal distribution. A student received a score that was three standard deviations above the mean. Her score was better than what percentage of students who took the exam? A. 68% B. 84% C. 95% D. 99.8%

D. Sampling fraction

17. You are going to conduct a study comparing the quality of life of female and male breast cancer patients while undergoing chemotherapy. What statistical method would you use to make sure males are represented adequately in a sample? A. Convenience sampling B. Fisher's sampling C. Sampling random patients D. Sampling fraction

C. Outbreak

18. In the 50 states and the District of Columbia as of September 21, 2016, the Laboratory confirmed LOCALLY acquired cases (not from travel) of the Zika virus disease have only occurred in Florida. According to the CDC definitions, what epidemiological term does this represent? A. Endemic B. Epidemic C. Outbreak

B. Epidemic

19. What epidemiological term describes the current 2017-2018 Influenza season, which has had significant higher levels of infection and for a longer period of time than normal? A. Endemic B. Epidemic C. Outbreak

(D) Crossover study

2. A study is designed to evaluate the feasibility of acupuncture in children with chronic headaches. Sixty children with chronic headaches are recruited for the study. In addition to their usual therapy half the patients are treated with acupuncture three times a week for 2 months. After a period of no intervention (wash-out), the other half of the patients are treated with usual therapy and the other group gets the acupuncture three times a week for 2 months. Which of the following best describes this study design? (A) Case-control study (B) Case series (C) Cohort study (D) Crossover study (E) Randomized clinical trial

A. Endemic

20. Syphilis is very prevalent in the Shreveport-Bossier area. Knowing this it might be considered that Syphilis in Shreveport-Bossier is: A. Endemic B. Epidemic C. Outbreak

B. It increases If the progression is slowed then more people will be living with the disease so the prevalence will increase

23. A new treatment has been discovered that helps prevent the progression of Prostate cancer. What does this do to the prevalence of prostate cancer in a population? A. It decreases B. It increases C. It doesn't change

B. It increases - It increases because there are less people to possibly have the disease. Try 200/1000 = 0.20 when you reduce the denominator to 800 it goes up 200/800 = 0.25

24. What happens when women with hysterectomies are excluded from the denominator of calculations for the incidence of uterine cancer? A. It decreases B. It increases C. It doesn't change

C. 0.09

25. A group of researchers is studying a new disease in a city of 20,000. After obtaining medical records, it is determined that 3,500 people have the disease. Over the next 5 years, another 1500 people develop the disease. What is the incidence of the disease over that 5 year period? A. 0.05 B. 0.075 C. 0.09 D. 0.1 E. 0.2

B. Odds ratio of 6

26. The Health Department is investigating an outbreak of diarrhea in a school cafeteria. They conduct a case-control study questioning 200 children who became ill with diarrhea and 200 children who did not become ill. Investigators asked each child if they ate lettuce served on tacos. 120 children who became ill reported eating the lettuce, and 40 children who did not become ill also reported eating the lettuce. Which of the following represents the association between eating lettuce and developing diarrhea? A. Odds ratio of 4 B. Odds ratio of 6 C. Relative risk of 15% D. Relative risk reduction of 0.03

D. 4

27. Researchers conducted a cohort study to look at individuals exposed to smoking and the risk of becoming obese. The study enlisted 1000 participants. 400 of the participants smoked and had a BMI over 30. Out of 500 participants who did not have a BMI greater than 30, 100 of the participants smoked. Which of the following is the relative risk of the relationship between smoking and obesity? A. 0.25 B. 0.40 C. 2.5 D. 4

D. Statistically significant small increase in risk

28. In a cohort study of elderly women, the relative risk for hip fractures among those who exercise regularly is 1.2 (95% confidence interval 1.1 to 1.8 p < 0.05). Which of the following is the most appropriate conclusion about the effect of regular exercise on the risk of hip fracture? A. Statistically nonsignificant small increase in risk B. Statistically nonsignificant small decrease in risk C. Statistically significant small decrease D. Statistically significant small increase in risk

C. going down

29. An investigator is studying the effect of the number of hours watching television (Factor A) on the percent of hemoglobin A1C in people with type 2 diabetes mellitus. Two different variables, Factor A and hemoglobin A1C are compared. The results of the study indicate a correlation coefficient of -0.6. Which of the following graphs shown best corresponds to these results? A. going up B. going kinda up C. going down D. staying levelish

B. The findings are clinically insignificant but statistically significant

30. A new drug for Stage 4 Lung cancer treatment has come out. The new drug is three times more expensive than the conventional treatment. The mean time prognosis is 8.2 months for the experimental group compared with conventional treatment of 8 months (p=0.04). Which is the following most appropriate interpretation of these study results? A. The findings are clinically and statistically significant. B. The findings are clinically insignificant but statistically significant C. The findings are clinically significant but statistically significant D. The findings are neither clinically nor statistically significant.

C. 0.8

31. What was the relative risk? Treat group (n = 975) Placebo group (n = 984) all-cause mortality: treat - 116 (12%) placebo - 151 (15%) A. 0.25 B. 0.6 C. 0.8 D. 1.25 E. 2

D. 34

32. What is the number needed to treat? Treat group (n = 975) Placebo group (n = 984) all-cause mortality: treat - 116 (12%) placebo - 151 (15%) A. 16 B. 24 C. 30 D. 34 E. 50

B. Positive predictive value

35. A researcher is attempting to determine the efficacy of a new test to identify scleroderma in asymptomatic patients. He conducted several experimental trials and found the test does effectively predict the occurrence of scleroderma in patients. He wants to calculate the likelihood that a positive test result for a patient is, in fact a true positive result. What statistical value should he calculate? A. Negative predictive value B. Positive predictive value C. Sensitivity D. Specificity

B. No

36. You are a surgeon and a new Wound Protector has come out. Based on this data in the figure should you consider using this wound protector in patients with ≥25 kg/m2? (Forest plot goes over middle line thing for BMI of over 25 kg/m2 A. Yes B. No

B. Beneficence, justice and respect for persons.

37. The three ethical principles listed in the Belmont Report are: A. Autonomy, self-determination and informed consent. B. Beneficence, justice and respect for persons. C. Information, comprehension, and volunteerism D. Assessment, rationalization and guidance.

C. Acting in the best interests of patient

38. Which of the following is considered a pillar of ethical research as interpreted from the Declaration of Helsinki? A. Refusal to enroll patients based on a physician's personal beliefs B. Enrolling patients with the money to pay for the study drug C. Acting in the best interests of patient D. The benefit to society outweighs any harm to the possible patient

C. Educational level

39. What might interfere with a research subject giving consent? A. Insurance B. Cash or credit C. Educational level D. Gender

D. Ordinal

8. The Ann Arbor staging for lymphoma is considered what type of data? A. Interval B. Dichotomous C. Nominal D. Ordinal E. Ratio

B. Nominal

9. Only looking at data on the number of patients with cancer who are either in remission or in active treatment. What is this data? A. Interval B. Nominal C. Ordinal D. Ratio

C. 80%

A new clinical diagnostic test is developed for the detection of chronic HCV infection. Of the 200 individuals tested, a hundred patients had a confirmed diagnosis with chronic HCV (confirmed by the gold standard of reactive antibody test and positive molecular test for HCV RNA). Of those 100 confirmed with the disease, 80 tested positive with the new test. Of a hundred patients confirmed without HCV, 95 tested negative using the new test. 33. What is the sensitivity of the test? A. 5% B. 20% C. 80% D. 95%

D. 83%

A new clinical diagnostic test is developed for the detection of chronic HCV infection. Of the 200 individuals tested, a hundred patients had a confirmed diagnosis with chronic HCV (confirmed by the gold standard of reactive antibody test and positive molecular test for HCV RNA). Of those 100 confirmed with the disease, 80 tested positive with the new test. Of a hundred patients confirmed without HCV, 95 tested negative using the new test. 34. What is the Negative Predictive Value of the test? A. 8% B. 20% D. 83% E. 95%

D. vaccination of a child against HPV

A study is being conducted on the affect an educational pamphlet has on parents willingness to vaccinate their child against Human Papillomavirus (HPV). The study is being done in a large outpatient pediatric office. A previous study has shown that the literacy level is at the third-grade level for most of the parents who bring their children to the office. 3. What is the dependent variable? A. educational pamphlet B. study is taking place in one pediatric outpatient office C. literacy Level D. vaccination of a child against HPV

C. literacy Level

A study is being conducted on the affect an educational pamphlet has on parents willingness to vaccinate their child against Human Papillomavirus (HPV). The study is being done in a large outpatient pediatric office. A previous study has shown that the literacy level is at the third-grade level for most of the parents who bring their children to the office. 5. What is a possible confounder? A. educational pamphlet B. study is taking place in one pediatric outpatient office C. literacy Level D. vaccination of a child against HPV

B. study is taking place in one pediatric outpatient office

A study is being conducted on the affect an educational pamphlet has on parents willingness to vaccinate their child against Human Papillomavirus (HPV). The study is being done in a large outpatient pediatric office. A previous study has shown that the literacy level is at the third-grade level for most of the parents who bring their children to the office. 6. What is a possible selection bias? A. educational pamphlet B. study is taking place in one pediatric outpatient office C. literacy level D. vaccination of a child against HPV

B. study is taking place in one pediatric outpatient office

A study is being conducted on the affect an educational pamphlet has on parents willingness to vaccinate their child against Human Papillomavirus (HPV). The study is being done in a large outpatient pediatric office. A previous study has shown that the literacy level is at the third-grade level for most of the parents who bring their children to the office. 7. What is the main problem with the described study above when it comes to the external validity? A. educational pamphlet B. study is taking place in one pediatric outpatient office C. literacy Level D. vaccination of a child against HPV

A. educational pamphlet

A study is being conducted on the affect an educational pamphlet has on parents willingness to vaccinate their child against Human Papillomavirus (HPV). The study is being done in a large outpatient pediatric office. A previous study has shown that the literacy level is at the third-grade level for most of the parents who bring their children to the office.4. What is the independent variable? A. educational pamphlet B. study is taking place in one pediatric outpatient office C. literacy Level D. vaccination of a child against HPV

B. 14 per 100,000

The population of Atlantis on March 30, 2003 = 183,000. The number of newly diagnosed cases of syphilis occurring between 1/1/2003 and 6/30/2003 = 26. The number of active cases of syphilis according to the city register on 6/30/2003 = 604. 21. Incidence proportion of newly diagnosed cases of syphilis for the 6-month periods was A. 7 per 100,000 B. 14 per 100,000 C. 26 per 100,000 D. 28 per 100,000 E. 130 per 100,000

E. 330 per 100,000

The population of Atlantis on March 30, 2003 = 183,000. The number of newly diagnosed cases of syphilis occurring between 1/1/2003 and 6/30/2003 = 26. The number of active cases of syphilis according to the city register on 6/30/2003 = 604. 22. The prevalence rate of active syphilis cases as of 6/30/2003 was: A. 14 per 100,000 B. 130 per 100,000 C. 144 per 100,000 D. 264 per 100,000 E. 330 per 100,000