Deck 18: Epidemiology and Screening: Understanding Disease Patterns and Identifying Risks

Question 1

Because which of the following conduct their studies in a controlled laboratory environment, they can regulate all important aspects of the experimental conditions?

A) Basic scientists
B) Clinical scientists
C) Environmental scientists
D) Public health scientists

Answer 1

Basic scientists

Question 2

Which of the following are usually the first to identify new diseases, the adverse effects of new exposures, and new links between an exposure and a disease?

A) Basic scientists
B) Clinical scientists
C) Environmental scientists
D) Public health scientists

Answer 2

Clinical scientists

Question 3

Which of the following refers to the analysis of disease patterns according to the characteristics of person, place, and time, or in other words, who is getting the disease, where is it occurring, and how it is changing over time?

A) Disease control
B) Disease frequency
C) Disease distribution
D) Disease determinants

Answer 3

Disease distribution

Question 4

Now considered one of the founders of modern epidemiology, which of the following was the compiler of Statistical Abstracts for the General Registry Office in Great Britain from 1839 through 1880?

A) John Snow
B) John Graunt
C) James Lind
D) William Farr

Question 5

The Streptomycin Tuberculosis Trial was one of the first instances that which of the following was used in medical research?

A) Randomization
B) Stratification
C) Generalization
D) Standardization

Question 6

The people who were in Hiroshima, Japan when the atomic bomb exploded at the end of World War II are members of which type of population?

A) Fixed population
B) Dynamic population
C) Candidate population
D) Catchment population

Question 7

A person is a member of which type of population only as long as he or she has the defining state or condition?

A) Fixed population
B) Dynamic population
C) Candidate population
D) Catchment population

Question 8

Cumulative incidence is mainly used in which type of populations where there are no or small losses to follow-up?

A) Fixed populations
B) Dynamic populations
C) Candidate populations
D) Catchment populations

Question 9

Incidence is defined as the occurrence of new cases of disease that develop in which type of population over a specified time period?

A) Fixed population
B) Dynamic population
C) Candidate population
D) Catchment population

Question 10

The numerator and denominator of which commonly used measure of disease frequency often includes both livebirths and stillbirths?

A) Livebirth rate
B) Birth defect rate
C) Case fatality rate
D) Infant mortality rate

Question 11

Which of the following helps public health officials determine which exposures are most important to a given population and to prioritize prevention activities?

A) Risk difference
B) Prevalence difference
C) Incidence rate difference
D) Population risk difference

Question 12

Which of the following describes the public health impact of the exposure among the exposed?

A) Risk difference
B) Prevalence difference
C) Incidence rate difference
D) Population risk difference

Question 13

Which of the following measures is very useful for determining priorities for public health action?

A) Risk ratio
B) Risk difference
C) Attributable proportion among the exposed (APe)
D) Attributable proportion among the total population (APt)

Question 14

It is difficult to interpret absolute and relative measures of comparison based on which type of rates when the compared groups differ on a characteristic that affects the rate of disease?

A) Crude rates
B) Summary rates
C) Adjusted rates
D) Attributable rates

Question 15

The purpose of which survey is to "provide reliable national data on marriage, divorce, contraception, infertility, and the health of women and infants in the United States"?

A) National Survey of Family Growth
B) National Health Interview Survey
C) National Health and Nutrition Examination Survey
D) Behavioral Risk Factor Surveillance System

Question 16

Which of the following uses a stratified, multistage sampling scheme to select a sample of households that form a representative sample of the target population?

A) National Survey of Family Growth
B) National Health Interview Survey
C) National Health and Nutrition Examination Survey
D) Behavioral Risk Factor Surveillance System

Question 17

The purpose of which state-based survey is to monitor a wide-variety of health risk behaviors that are related to chronic disease, injuries, and death, including use of screening and preventive services, smoking, alcohol use, physical activities, fruit and vegetable consumption, seat belt use, and weight control?

A) National Survey of Family Growth
B) National Health Interview Survey
C) National Health and Nutrition Examination Survey
D) Behavioral Risk Factor Surveillance System

Question 18

Which of the following was a national probability survey that was conducted annually from 1965 to 2010?

A) National Hospital Discharge Survey (NHDS)
B) National Hospital Ambulatory Medical Care Survey (NHAMCS)
C) National Hospital Care Survey (NHCS)
D) National Ambulatory Medical Care Survey (NAMCS)

Question 19

Which type of study compares the rates of disease among natives of a homeland to rates among immigrants and among natives of the adopted country?

A) Cohort studies
B) Migrant studies
C) Case-control studies
D) Longitudinal studies

Question 20

Which type of variations in disease frequency are the most common type of periodic fluctuations?

A) Diurnal
B) Weekly
C) Seasonal
D) Annual

Question 21

Epidemiologists have varying opinions about the usefulness of investigating the causes of which of the following because follow-up investigations often fail to produce fruitful results and the consume time and resources?

A) Disease outbreaks
B) Disease clusters
C) Disease transmission
D) Disease progression

Question 22

The epidemic curve of which of the following rises rapidly to a peak and then falls gradually?

A) Point source outbreak
B) Continuous common source outbreak
C) Propagated outbreak
D) Disease cluster

Question 23

Which type of study is preferable when little is known about the health consequences of an exposure?

A) Cohort study
B) Ecological study
C) Case-control study
D) Cross-sectional study

Question 24

Investigators are usually confident that which type of controls are comparable to the cases with respect to demographic and other important variables?

A) Population controls
B) Hospital and clinic controls
C) Dead controls
D) Friend/spouse/relative controls

Question 25

In which type of study, cases serve as their own controls and the exposure during the hazard period is compared with that from a control period?

A) Cohort study
B) Ecological study
C) Cross-sectional study
D) Case-crossover study

Question 26

Which type of studies are fairly common in occupational settings using data from preemployment physical examinations and company health insurance plans?

A) Cohort studies
B) Ecological studies
C) Case-control studies
D) Cross-sectional studies

Question 27

Which type of trials usually take many years to conduct and require tens of thousands of participants because they often focus on reducing the incidence of diseases that typically occur at a yearly cumulative incidence of 1% or less?

A) Prevention trials
B) Therapeutic trials
C) Crossover trials
D) Parallel trials

Question 28

Which phase of a clinical trial provides metabolic and pharmacologic profiles of the drug, including determination of the maximally tolerated dose?

A) Phase 1
B) Phase 2
C) Phase 3
D) Phase 4

Question 29

Which of the following is used "to ensure balance in the mix of the treatment groups with regard to time of enrollment" and helps to control for "shifts in the nature of persons enrolled over the course of a trial"?

A) Blocking
B) Masking
C) Stratification
D) Standardization

Question 30

Which of the following accompanies randomization to ensure that key confounding variables are equally distributed between the treatment and comparison groups?

A) Blocking
B) Masking
C) Stratification
D) Standardization

Question 31

Cohort studies that are conducted in which type of population usually take into account population changes, such as in-and-out migration, and therefore the incidence rate is the most suitable measure of disease frequency for monitoring health outcomes in this setting?

A) Open population
B) Fixed population
C) Candidate population
D) Catchment population

Question 32

A general cohort would be assembled to study which of the following?

A) Medical procedures
B) Use of oral contraceptives
C) Unusual diets and lifestyles
D) Health effects of rare exposures

Question 33

The interval between the action of a cause and disease onset is referred to as which of the following?

A) Latent period
B) Hazard period
C) Induction period
D) Dormant period

Question 34

Proportional mortality ratio (PMR) studies suffer from which of the following, which means that a higher proportion of deaths from one cause must be counterbalanced by a lower proportion of deaths from another cause?

A) Placebo effect
B) Seesaw effect
C) Hawthorne effect
D) Healthy worker effect

Question 35

Public health has had a greater effect on the health of populations than medicine has had.

Question 36

Public health scientists focus their research questions mainly on disease diagnosis, treatment, and prognosis in individual patients.

Question 37

Location of residence, such as country, state, city, or neighborhood, is one of the most common ways to define a population.

Question 38

Regardless of the way in which it is defined, a population can be divided into subgroups on the basis of any characteristic.

Question 39

Most epidemiologists prefer to use the relative method of comparison for etiologic research because of the way it is anchored by a baseline value.

Question 40

Crude rates are summary measures of disease frequency that are based on the raw data.

Question 41

Although U.S. birth and death data pertain to the whole U.S. population, the target population for most national surveys is institutionalized civilians.

Question 42

The primary purpose of the census is to assign members of the House of Representatives to the states.

Question 43

Mortality data are adequate for examining nonfatal diseases, and they give a complete picture of the health status of a population.

Question 44

Race and ethnicity have a profound influence on disease patterns and can be particularly difficult to measure.

Question 45

Observational studies suffer the same ethical and feasibility issues as experimental studies.

Question 46

Ecological studies can be done quickly and inexpensively because they often rely on preexisting data.

Question 47

Trials that prevent or delay the onset of disease among healthy individuals are called secondary prevention trials.

Question 48

When trials involve procedures rather than pills, "sham" procedures are administered to match as closely as possible the experience of the treatment and comparison groups.

Question 49

Retrospective cohort studies are considered less vulnerable to bias because the outcomes have not occurred when the cohort is assembled and the exposures are assessed.

Question 50

Masking guarantees comparable follow-up efforts and outcome ascertainment, which in turn helps ensure valid results.

Question 51

Which type of studies are preferable when little is known about the disease because they allow the investigators to evaluate more than one hypothesis?

A) Cohort studies
B) Ecological studies
C) Case-control studies
D) Cross-sectional studies

Question 52

Which of the following depends on the rate at which new cases develop as well as the duration that the cases have the disease?

A) Incidence
B) Prevalence
C) Morbidity
D) Mortality

Question 53

The most difficult aspect of using which type of controls is determining which diseases or events are suitable for the control group?

A) Dead controls
B) Population controls
C) Hospital or clinic controls
D) Friend, spouse, and relative controls

Question 54

In which sampling approach does the investigator select a control from the population at risk when the case is diagnosed?

A) Cluster sampling
B) Survivor sampling
C) Case-base sampling
D) Risk set sampling

Question 55

Which type of bias can occur in cohort and experimental studies from differential losses to follow-up?

A) Recall bias
B) Interviewer bias
C) Information bias
D) Selection bias

Question 56

The best way to ensure that which type of bias does not occur is to obtain high participation rates among both cases and controls?

A) Recall bias
B) Information bias
C) Self-selection bias
D) Control-selection bias

Question 57

The healthy worker effect is a form of selection bias that occurs in two special types of which type of studies-proportional mortality ratio (PMR) and standardized mortality ratio (SMR) studies?

A) Cohort studies
B) Ecological studies
C) Case-control studies
D) Cross-sectional studies

Question 58

Although which type of bias can occur in both case-control and retrospective cohort studies, it is typically described in the context of a traditional case-control study with nondiseased controls?

A) Recall bias
B) Interviewer bias
C) Information bias
D) Selection bias

Question 59

A variable that is a step in the causal chain is referred to as which of the following?

A) Outlier
B) Mediator
C) Confounder
D) Biomarker

Question 60

Which of the following reflects the fact that treatments are given to individuals with a particular disease, and therefore, there is a mixing of effects between the treatment, the disease for which the treatment is given, and the outcome under study?

A) Positive confounding
B) Negative confounding
C) Confounding by indication
D) Confounding by severity

Question 61

A unique advantage of which of the following is that it will control for variables that study investigators are unable to measure?

A) Matching
B) Restriction
C) Randomization
D) Literature review

Question 62

Which of the following is advantageous when the case series in a case-control study is very small, and therefore other options for controlling confounding do not work well?

A) Matching
B) Restriction
C) Randomization
D) Literature review

Question 63

During the third phase of biostatistical history, between World Wars I and II, researchers took methods for testing hypothesis using in which type of research and applied them to medicine and public health?

A) Industrial research
B) Sociological research
C) Agricultural research
D) Ecological research

Question 64

Although many epidemiologists and biostatisticians emphasize the role of which of the following as an explanation for study findings, others believe that it is overemphasized to the point of misinterpreting study results?

A) Bias
B) Confounding
C) Random error
D) Generalization

Question 65

Which mathematical theory provides the basis for making statistical inferences?

A) Distribution
B) Elimination
C) Probability
D) Singularity

Question 66

Which of the following represents a low to moderate level of effect measure modification?

A) Statistical interaction
B) Homogeneity of effect
C) Departure from additivity
D) Departure from multiplicity

Question 67

Which of the following is said to occur when the excess relative risk among individuals with both factors is greater than the sum of the excess relative risks of each factor considered alone?

A) Synergy
B) Validity
C) Precision
D) Antagonism

Question 68

Epidemiologists conduct stratified analyses to evaluate simultaneously the presence of which of the following?

A) Bias and confounding
B) Bias and random error
C) Effect measure modification and random error
D) Effect measure modification and confounding

Question 69

Which section of a journal article provides the scientific interpretation of the findings, places the findings in the context of other research, and acknowledges the study limitations?

A) Results section
B) Discussion section
C) Conclusion section
D) Materials and methods section

Question 70

The main limitation of which type of study is that they do not allow investigators to infer the temporal sequence between exposure and disease if the exposure is a changeable characteristic?

A) Cohort studies
B) Ecological studies
C) Experimental studies
D) Cross-sectional studies

Question 71

Which method of data analysis is commonly used to control for demographic characteristics such as age?

A) Randomization
B) Standardization
C) Stratification
D) Multivariate analysis

Question 72

Most practicing epidemiologists consider which of Hill's guidelines to be useless because it has so many well-known exceptions?

A) Consistency
B) Specificity
C) Temporality
D) Plausibility

Question 73

Empiricism emphasizes which of the following-the formulation of explanatory hypotheses from making observations?

A) Causal inference
B) Inductive inference
C) Deductive inference
D) Statistical inference

Question 74

According to what man's hypothetico-deductive approach, hypotheses are formed using creativity and imagination, and no data are needed?

A) Harold Kushner
B) Karl Popper
C) John Stuart Mill
D) Sir Austin Bradford Hill

Question 75

Mandatory screening for which disease was instituted among immigrants and premarital couples to stop the spread of the disease before effective treatments were available?

A) HIV
B) Syphilis
C) Chlamydia
D) Human papilloma virus

Question 76

Which type of efforts do not prevent disease occurrence but instead identify asymptomatic individuals during the window between the pathological onset and the occurrence of clinical symptoms?

A) Health promotion
B) Primary prevention
C) Secondary prevention
D) Tertiary prevention

Question 77

Careful control of insulin levels and patient education to prevent retinopathy and other complications among patients with diabetes is an example of which type of efforts?

A) Health promotion
B) Primary prevention
C) Secondary prevention
D) Tertiary prevention

Question 78

Three major principles that apply to research with human subjects are identified in which of the following; respect for persons, beneficence, and justice, and these remain the fundamental principles in current U.S. regulations for human subjects research?

A) Belmont Report
B) Nuremburg Code
C) Declaration of Helsinki
D) Kefauver-Harris Bill

Question 79

Adherence to which ethical principle helps determine whether the burdens and benefits of research are distributed fairly?

A) Justice
B) Autonomy
C) Beneficence
D) Nonmaleficence

Question 80

When a new prevention measure for a disease is developed, both the incidence and prevalence of the disease will decrease over the long term.