greenberg _ epidemiology self - assessment study questions

Greenberg: Epidemiology Self-Assessment

Question 1 of 145 Next question >

You incorrectly answered .

An outbreak of illness from West Nile virus (WNV) infection took place in the northeastern

United States between July and October, 2001 (CDC: Serosurveys for West Nile virus

infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). West Nile virus

had occurred for the first time in the United States the preceding year. This unusual pattern of

occurrence is best described as

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor

H. Prognostic factor

I. Natural history

J. Case fatality

K. Median survival

L. Randomized controlled clinical trial

M. Cohort study

N. Case–control study

The answer is A.

Question 2 of 145 < Previous question Next question >




infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). A person who has

the symptoms consistent with severe WNV neurologic disease, but does not have definitive

serologic evidence of infection

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is E.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). Among Staten

Island residents, 2.5 per 100,000 persons developed severe WNV neurologic disease during

this time period. This measure is best described as

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is C.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). Clinical outcome of

severe WNV neurologic disease was substantially worse for elderly patients. Advanced age is

best described as

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is H.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). Persons with

fever/headache were ten times more likely than others to have serum evidence of WNV

infection. Fever/headache is best described as

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is G.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). A study of antiviral

agents is conducted for the treatment of severe WNV neurologic disease in which treatment

assignments to individual patients are made by chance

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is L.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). The first person

with severe WNV neurologic disease became ill the week of July 15. This individual is best

described as

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is B.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). Two of 21 patients

with severe WNV neurologic disease died. This is best described by

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is J.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). A study is

conducted comparing prior use of mosquito repellent by persons with and without severe WNV

neurologic disease. This is best described as

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is N.



In a case–control study of the relationship of dietary intake of fruits and vegetables and the

risk of developing hypertension, the control subjects are sampled from participants at a health

fair. Select the type of bias or error that would most likely result.

A. Selection bias

B. Nondifferential misclassification

C. Confounding

D. Ecologic fallacy

E. Random error

The answer is A.



In a case–control study of inflammation and the development of coronary heart disease, 20-

year-old stored frozen blood specimens are used to measure C-reactive protein in cases and

controls. There is concern that during storage the specimens have deteriorated, yielding lower

levels than when they were first obtained. Select the type of bias or error that would most

likely result.

A. Selection bias


C. Confounding

D. Ecologic fallacy

E. Random error

The answer is B.



In a case–control study of alcohol consumption and the risk of hepatocellular carcinoma, both

cases and controls underreport exposure to alcohol. Select the type of bias or error that would

most likely result.

A. Selection bias


C. Confounding

D. Ecologic fallacy

E. Random error

The answer is B.



In a cohort study of the effect of obesity on the development of left ventricular hypertrophy,

the investigator reviewing the echocardiogram is blinded to whether the subject is obese or

not. Select the most likely effect on the study findings from the lettered options.

A. Overestimation

B. Underestimation

C. No effect

D. Cannot be determined

The answer is C.



The recurrence risk among first-degree relatives of cases is compared with risk among first-

degree relatives of people without the disease. Select the appropriate study design from the

following lettered options.

A. Sib-pair (linkage) study

B. Familial aggregation study

C. Cohort study

D. Migrant study

E. Twin study

F. Inbreeding study

G. Segregation study

The answer is B.



In a cohort study of obesity and the risk of development of type 2 diabetes, the loss to follow-

up is 35% among the obese subjects and 15% among the nonobese subjects. Select the most

likely effect on the study findings from the lettered options.

A. Overestimation

B. Underestimation

C. No effect


The answer is D.



Which is the best measure to estimate how fast new cases of acute myelogenous leukemia

develop among workers exposed to benzene?

A. Five-year survival

B. Prevalence

C. Incidence rate

D. Risk

E. Case fatality

F. Median survival

The answer is C.



Prevalent patients with histories of myocardial infarctions are enrolled in a case–control study

of inflammation as measured by C-reactive protein as a risk factor for developing myocardial

infarction. Among patients who have had a myocardial infarction, higher C-reactive protein is

associated with a higher case fatality rate. Select the most likely effect on the study findings

from the lettered options.

A. Overestimation

B. Underestimation

C. No effect


The answer is B.



Concordance of the disease in monozygotic twins is compared with that among dizygotic

twins. Select the appropriate study design from the following lettered options.



C. Cohort study

D. Migrant study

E. Twin study

F. Inbreeding study


The answer is E.



The number of alleles that each person with disease shares with their sibling without the

disease is studied. Select the appropriate study design from the following lettered options.



C. Cohort study

D. Migrant study

E. Twin study

F. Inbreeding study


The answer is A.





infection—New York and Connecticut counties, 2000. MMWR 2001; 50:37). A study is

conducted in which the rates of subsequent WNV infection are compared in communities with

and without mosquito abatement programs. This is best described as

A. Epidemic

B. Sentinel case

C. Incidence rate

D. Risk

E. False-positive

F. False-negative

G. Risk factor


I. Natural history

J. Case fatality

K. Median survival


M. Cohort study


The answer is M.



The likelihood that cases inherited two copies of the same allele from a single ancestor is

compared with the corresponding likelihood among controls. Select the appropriate study

design from the following lettered options.



C. Cohort study

D. Migrant study

E. Twin study

F. Inbreeding study


The answer is F.



A case–control study was designed to determine whether selected alleles at one locus are risk

factors for coronary artery disease. A laboratory technician incorrectly records a series of

results for controls.

A. Inbreeding

B. Confounding

C. Misclassification

D. Linkage disequilibrium

E. Selection bias

F. None of these applies

The answer is C.



The diagram below represents the decision to use medical therapy or bypass surgery in a 50-

year-old patient with severe angina. The utilities are hypothetical outcomes scored from 0 to

100. Respective probabilities are also shown on the diagram. The preferred outcome is to

survive as long as possible without angina.

Decision tree for coronary bypass surgery.

What is the mortality threshold, that is, the probability of death associated with surgery that

would necessitate a decision to change to medical therapy for the 50-year-old patient

described above?

A. .03

B. .04

C. .05

D. .06

E. .07

The answer is C.



In a cohort study of hormone replacement therapy and the risk of developing atherosclerotic

coronary artery disease, high socioeconomic status is associated with both use of hormone

replacement therapy and risk of developing coronary artery disease. Select the type of bias or

error that would most likely result.

A. Selection bias


C. Confounding

D. Ecologic fallacy

E. Random error

The answer is C.



Select the most appropriate answer based on the decision diagram in the figure below, which

represents the portion of a decision tree that depicts the use of a test to make a medical

decision. The probability that the test is positive is represented by p(Pos), and the probability

that the test is negative is indicated by p(Neg). If the test is positive, the patient may have

disease (ie, a true-positive) or the patient may not have disease (ie, a false-positive) with

probabilities represented by p(Dis) and p(No Dis), respectively.

The same disease outcomes are possible with a negative test. If the test is negative, the

probability of disease is represented by p(Dis–N) and the probability of no disease is

represented by p(No Dis–N). N indicates that the test is scored as negative.

Portion of a decision tree that illustrates the use of a test to formulate a medical decision

The probability that the test is positive can be easily determined based on the concept of

predictive values discussed in Chapter 6: Diagnostic Testing. In the figure, consider true-

positives, true-negatives, false-positives, and false-negatives (TP, TN, FP, and FN) as

proportions, and Prev. as the pretest prevalence, which is occasionally termed the pretest

probability. Which of the following calculations can be used to determine the probability p(Pos)

at the chance node 1?

A. TP x Prev. + FN x Prev.

B. TP x Prev. + TN x (1 – Prev.)

C. TP x Prev. + FP x (1 – Prev.)

D. TP x (1 – Prev.) + FP x Prev.

E. TP x (1 – Prev.) + FN x (1 – Prev.)

The answer is C.








In the diagram above, the expected utility for medical therapy is

A. 57 + 62 = 119.0

B. (57 + 62) x (.67) = 79.73

C. (57 x .67) + (62 x .33) = 58.65

D. (57 x .33) + (62 x .67) = 60.35

E. (57 x .33) + (5 years) = (62 x .67) + (10 years) = 75.35

The answer is D..



In a case–control study of rheumatoid arthritis and alcohol intake, the cases tend to

overreport drinking alcohol, whereas the controls who were hospitalized with gastrointestinal

illnesses tend to underreport drinking alcohol. Select the most likely form of bias or error from

the lettered options.

A. Selection bias

B. Random error

C. Information bias

D. Ecologic fallacy

E. Confounding

F. Birth cohort effect

The answer is C.








If you were to base your decision on the Estimated Utility (EU) in the diagram above, what

would your preferred choice be?

A. Bypass surgery

B. Medical therapy

C. Observe the patient and consider bypass surgery in 6 months

D. Observe the patient and consider bypass surgery in 9 months

E. No rational therapeutic choice can be made based on the available data

The answer is A.








Because the survival at 5 and 10 years is the same for surgery and medical therapy, what

outcome event would lead to the preferred choice of bypass surgery?

A. A greater proportion of surgery patients has no angina at 10 years

B. A greater proportion of surgery patients has no angina at 5 and 10 years

C. A greater proportion of medical patients has no angina at 10 years

D. A greater proportion of medical patients has no angina at 5 and 10 years

E. An equal proportion of surgery and medical patients has no angina at 10 years

The answer is A.




factors for coronary artery disease. The cases are identified from those admitted to a

cardiology ward and the controls are sampled from those hospitalized with a neurologic

disease.

A. Inbreeding

B. Confounding



E. Selection bias


The answer is E.




factors for coronary artery disease. Identical twins are more likely to enroll in a twin study

than are nonidentical twins.

A. Inbreeding

B. Confounding



E. Selection bias


The answer is F.



In a cohort study of the relationship of intake of fruits and vegetables and protection against

coronary artery disease, blood pressure is associated positively with coronary artery disease

and is inversely associated with dietary intake of fruits and vegetables. The investigators

report that fruit and vegetable intake protects against the development of coronary artery

disease, but does not control for the effects of blood pressure. Select the most likely form of

bias or error from the lettered options.

A. Selection bias

B. Random error

C. Information bias

D. Ecologic fallacy

E. Confounding


The answer is E.



In a case–control study of the relationship of stressful life events and the occurrence of

coronary artery disease, patients with coronary artery disease are more likely to report past

stressful events than are the healthy controls. Select the most likely effect on the study

findings from the lettered options.

A. Overestimation

B. Underestimation

C. No effect


The answer is A.



During 5 years of follow-up, the risk of developing Alzheimer's disease among those with a

particular allele versus among those without this allele is compared. Select the appropriate

study design from the following lettered options.



C. Cohort study

D. Migrant study

E. Twin study

F. Inbreeding study


The answer is C.



In a case–control study of dietary intake and the development of colon cancer, the food

frequency questionnaires yield imprecise estimates of actual food consumption for all

respondents. Select the most likely form of bias or error from the lettered options.

A. Selection bias

B. Random error

C. Information bias

D. Ecologic fallacy

E. Confounding


The answer is B.



Select the most appropriate answer based on the decision diagram in the figure below, which

represents the portion of a decision tree that depicts the use of a test to make a medical

decision. The probability that the test is positive is represented by p(Pos), and the probability

that the test is negative is indicated by p(Neg). If the test is positive, the patient may have

disease (ie, a true-positive) or the patient may not have disease (ie, a false-positive) with

probabilities represented by p(Dis) and p(No Dis), respectively.

The same disease outcomes are possible with a negative test. If the test is negative, the

probability of disease is represented by p(Dis–N) and the probability of no disease is

represented by p(No Dis–N). N indicates that the test is scored as negative.

Portion of a decision tree that illustrates the use of a test to formulate a medical decision

In the figure above, consider PVP as the predictive value positive and PVN as the predictive

value negative. At the chance node labeled 2, the probability of disease is given by which of

the following?

A. The PVP

B. The 1 – PVP

C. The PVN

D. The 1 – PVN

E. The TP x FP

The answer is A.



The results of several case–control studies of the association between exposure to rug

shampoo and the development of Kawasaki disease are examined to produce a summary

conclusion. Select the most appropriate study design from the lettered options.

A. Case–control study

B. Cohort study

C. Clinical trial

D. Cross-sectional study

E. Meta-analysis

F. Ecologic study

The answer is E.



The ability to assign by chance the type of antihypertensive agent used reduces the likelihood

of confounding of diet and physical activity in a study of treatment of blood pressure

elevation. Select the most appropriate study design from the lettered options.


B. Cohort study

C. Clinical trial

D. Ecologic study

E. Cross-sectional study

The answer is C.



A study evaluates the per-capita intake of calcium and the prevalence of hypertension in 8

different countries. Select the most appropriate study design from the lettered options.


B. Cohort study

C. Clinical trial


E. Meta-analysis

F. Ecologic study

The answer is F.



In a study of risk factors for the development of coronary artery disease and coronary heart

disease mortality as depicted in the figure below, the following relationship is found. Choose

the most appropriate criterion for establishing a causal relationship from the lettered options.

Association between the number of risk factors and coronary heart disease mortality.

A. Strength of the association

B. Dose–response relationship

C. Correct temporal sequence

D. Consistency of results

E. Biologic plausibility

The answer is B.




factors for coronary artery disease. The blood used to assess genotype was stored in a

freezer, later determined to have a defective thermostat.

A. Inbreeding

B. Confounding



E. Selection bias


The answer is C.



A case–control study shows an association between exposure to aluminum and Alzheimer's

disease. At autopsy the pathologic lesions in the brains of patients who have died with

Alzheimer's disease are found to contain elevated amounts of aluminum. Choose the most

appropriate criterion for establishing a causal relationship from the lettered options.






The answer is E.




factors for coronary artery disease. One of the alleles is found more frequently among those in

a particular ethnic group; this group also has high rates of cardiac disease under study.

A. Inbreeding

B. Confounding



E. Selection bias


The answer is B.



Two hundred patients with rheumatoid arthritis are randomly assigned to 6 months of a new

anti-inflammatory drug or standard care. Select the most appropriate study design from the

lettered options.


B. Cohort study

C. Clinical trial


E. Meta-analysis

F. Ecologic study

The answer is C.



Which is the best measure to estimate the typical length of life of patients with breast cancer

after diagnosis?


B. Prevalence

C. Incidence rate

D. Risk

E. Case fatality

F. Median survival

The answer is F.



Which is the best measure to estimate the proportion of patients with breast cancer who will

be alive 5 years after diagnosis?


B. Prevalence

C. Incidence rate

D. Risk

E. Case fatality

F. Median survival

The answer is A.



Which is the best measure to estimate the proportion of the U.S. population that is

overweight?


B. Prevalence

C. Incidence rate

D. Risk

E. Case fatality

F. Median survival

The answer is B.

Question 48 of 145


Which is the best measure to estimate the proportion of professional football players who will

suffer a knee injury during a season?


B. Prevalence

C. Incidence rate

D. Risk

E. Case fatality

F. Median survival

The answer is D.



In a cohort study of cigarette smoking and prostate cancer, 42% of the subjects are lost to

follow-up after 5 years. Select the most likely form of bias or error from the lettered options.

A. Selection bias

B. Random error

C. Information bias

D. Ecologic fallacy

E. Confounding


The answer is A.



Which is the best measure to estimate how quickly people develop hypertension, after age 21?


B. Prevalence

C. Incidence rate

D. Risk

E. Case fatality

F. Median survival

The answer is C.



A study is conducted in a country to evaluate the prevalence of type 2 diabetes. Select the

most appropriate study design from the lettered options.


B. Cohort study

C. Clinical trial


E. Meta-analysis

F. Ecologic study

The answer is D.



A survival curve for patients with multiple myeloma is shown in the figure below.

Survival curve for patients with multiple myeloma. (Adapted from Reis LAG et al: SEER Cancer

Statistics Review, 1973–1995. National Cancer Institute, 1998.)

From this curve, the proportion of patients surviving 1-year is estimated to be closest to

A. 40%

B. 50%

C. 60%

D. 70%

E. 80%

The answer is D.



Five published case–control studies of the association between exposure to lead and

diminished cognitive function in children yield the following odds ratios: 1.4 (95% CI 0.9–2.5),

1.7 (95% CI 1.3–2.5), 2.4 (95% CI 1.1–4.5), 1.9 (95% CI 1.4–2.4), and 1.2 (95% CI 1.05–

1.6). Choose the most appropriate criterion for establishing a causal relationship from the

lettered options.






The answer is D.



Estimate the approximate 1-year risk of developing melanoma in a retirement community of

10,000 among whom 10 are found to have melanoma during an initial screening and 1 new

case is found at a subsequent screening exam 1 year later, assuming no entries or losses of

subjects and no deaths from other causes.

A. 0.0001

B. 0.0001 cases/person-year

C. 0.001

D. 0.001 cases/person-year

E. .010

F. .010 cases/person-year

G. .10

H. .10 cases/person-year

I. 1.0

J. 1.0 cases/person-year

The answer is A.



In 2001 within the United States, the incidence of primary and secondary syphilis reversed a

10-year pattern of decline. National surveillance data were analyzed to characterize the

epidemiology of syphilis (Data from CDC: Primary and secondary syphilis—United States,

2002. MMWR 2003;52:1117.) The incidence rates are shown by race and gender in the table

below.

Incidence Rates (per 100,000 Person-Years) of Primary and Secondary

Syphilis By Race and Gender, United States, 2002.a

Race

Gender White Black All

Male 2.2 13.5 3.8

Female 0.2 6.5 1.1

All 1.2 9.8 2.4

aData from CDC: Primary and secondary syphilis—United States, 2002. MMWR 2003;52:1117.

The group with the greatest rapidity of new occurrences.

A. White males

B. Black males

C. White females

D. Black females

E. All males

F. All females

G. All blacks

H. All whites

The answer is B.



Estimate the prevalence of melanoma in a retirement community of 10,000 among whom 10

are found to have melanoma during an initial screening and 1 new case is found at a

subsequent screening exam 1 year later.

A. 0.0001


C. 0.001


E. .010


G. .10


I. 1.0


The answer is C.



Individuals with hypertension are randomized to a diuretic, a calcium channel blocker, a -

blocker, and an angiotensin-converting enzyme inhibitor in order to evaluate relative safety

and efficacy. Select the most appropriate study design from the lettered options.


B. Cohort study

C. Clinical trial

D. Ecologic study

E. Cross-sectional study

The answer is C.






2002. MMWR 2003;52: 1117.) The incidence rates are shown by race and gender in the table

below.



Race


Male 2.2 13.5 3.8

Female 0.2 6.5 1.1

All 1.2 9.8 2.4


The black-to-white ratio of incidence rates among women is:

A. 6.5/0.2

B. 6.5/1.1

C. 6.5 – 0.2

D. (6.5 x 2.2)/(13.5 x 0.2)

E. (6.5 – 0.2)/6.5

The answer is A.







below.



Race


Male 2.2 13.5 3.8

Female 0.2 6.5 1.1

All 1.2 9.8 2.4


The group with the lowest rapidity of new occurrences.

A. White males

B. Black males

C. White females

D. Black females

E. All males

F. All females

G. All blacks

H. All whites

The answer is C.






2002. MMWR 2003;52: 1117.) Based on the information in the table below, which city has the

highest overall incidence rate?


Syphilis By City and Gender, United States, 2002.a

Gender

City Male Female

Phoenix, Arizona 6.2 3.8

Houston, Texas 5.7 0.9

New York, New York 11.0 0.4

Louisville, Kentucky 11.5 10.8

San Francisco, California 78.8 1.0


A. Phoenix, Arizona

B. Houston, Texas

C. New York, New York

D. Louisville, Kentucky

E. San Francisco, California

The answer is E.







least gender disparity in incidence rates?



Gender

City Male Female







A. Phoenix, Arizona

B. Houston, Texas




The answer is D.



Patients with newly developed breast cancer are asked about previous dietary intake of fat.

Their responses are compared to patients admitted to the hospital for plastic surgery

procedures. Select the most appropriate study design from the lettered options.


B. Cohort study

C. Clinical trial


E. Meta-analysis

F. Ecologic study

The answer is A



Which is the best measure to assess the risk of death among persons with West Nile Virus

infection?


B. Prevalence

C. Incidence rate

D. Risk

E. Case fatality

F. Median survival

The answer is E.



A study is performed that examines the prevalence of hypertension and the per capita intake

of sodium in the diet. It is found that the countries with higher sodium consumption have a

higher prevalence of hypertension.

A second study is performed in an individual country that examines the intake of sodium in

the diet and the level of blood pressure. In this study subjects with higher sodium intake in

the diet do not have higher blood pressure. Select the most likely form of bias or error from

the lettered options.

A. Selection bias

B. Random error

C. Information bias

D. Ecologic fallacy

E. Confounding


The answer is D.






2002. MMWR 2003;52: 1117.) Based on the information in the table below, for males

migrating from New York to Phoenix, the incidence rate should

Incidence rates (per 100,000 person-years) of primary and secondary

syphilis by city and gender, United States, 2002.a

Gender

City Male Female







A. Decrease

B. Increase

C. Stay the same

D. Change, but direction cannot be determined

E. Increase, then fall below original levels

The answer is A.







greatest gender disparity in incidence rates?



Gender

City Male Female







A. Phoenix, Arizona

B. Houston, Texas




The answer is E.



A study about risk of myocardial infarction among cigarette smokers was conducted for five

years, between 1998 and 2003. The results of observations on six patients are depicted

schematically in the figure below.

Observations on six elderly cigarette smokers (A–F). Solid lines indicate times observed while

subjects were at risk of developing myocardial infarctions; dashed lines indicate times observed

after myocardial infarctions.

Among these patients, the risk of developing a myocardial infarction by the end of the first

year of follow-up is

A. 1/6 = 0.17

B. 1/5 = 0.20

C. 2/6 = 0.33

D. 2/5 = 0.40

E. 3/5 = 0.60

The answer is A.






2002. MMWR 2003;52: 1117.) Based on the information in the table below, for females

migrating from New York to Phoenix, the incidence rate should

Incidence rates (per 100,000 person-years) of primary and secondary

syphilis by city and gender, United States, 2002.a

Gender

City Male Female







A. Decrease

B. Increase

C. Stay the same

D. Change, but direction cannot be determined

E. Increase, then fall below original

The answer is B.



Recent data on the incidence and survival of selected cancers in the United States are

presented in the table below.

Incidence Rates (per 100,000 Person-Years) by Race and Sex and

Overall Survival Rates at One and Five Years for Selected Cancers,

United States.a

Incidenceb

Survivalc

Type of Cancer

White Males

White Females

Black Males

Black Females

1 year

5 years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34

aData from Ries LAG et al: SEER Cancer Statistics, 1975–2000. National Cancer Institute,

2003.

bFor 2000, age-adjusted to the 2000 population of the United States.

cFor persons diagnosed in 1995.

The lowest overall rapidity of new occurrences.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is B.







United States.a

Incidenceb

Survivalc

Type of

Cancer

White

Males

White

Females

Black

Males

Black

Females

1

year

5

years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



The smallest male-to-female ratio of incidence rates among whites.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is C.







United States.a

Incidenceb

Survivalc

Type of

Cancer

White

Males

White

Females

Black

Males

Black

Females

1

year

5

years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



The highest overall incidence rate.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is D.









The prevalence of myocardial infarction in mid-2002 was

A. 1/6 = 0.17

B. 2/6 = 0.33

C. 1/4 = 0.25

D. 2/4 = 0.50

E. 2/3 = 0.67

The answer is D.







United States.a

Incidenceb

Survivalc

Type of Cancer

White Males

White Females

Black Males

Black Females

1 year

5 years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



The greatest male-to-female ratio of incidence rates among blacks.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is A.







lowest overall incidence rate?



Gender

City Male Female







A. Phoenix, Arizona

B. Houston, Texas




The answer is B.







United States.a

Incidenceb

Survivalc

Type of

Cancer

White

Males

White

Females

Black

Males

Black

Females

1

year

5

years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



The least level of racial disparity in incidence rates.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is A.







United States.a

Incidenceb

Survivalc

Type of

Cancer

White

Males

White

Females

Black

Males

Black

Females

1

year

5

years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



Mortality rate is furthest from incidence rate.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is D.









The incidence rate of myocardial infarction over the observation period was:

A. 3/6 = 0.50 cases/person year

B. 3/10 = 0.30 cases/person year

C. 2/15 = 0.13 cases/person year

D. 3/15 = 0.20 cases/person year

E. 3/5 = 0.60 cases/person year

The answer is D.







United States.a

Incidenceb

Survivalc

Type of Cancer

White Males

White Females

Black Males

Black Females

1 year

5 years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



Greatest percentage of overall fatalities occur between 1 and 5 years.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is A.



A survival curve for patients with multiple myeloma is shown in the figure below.

Survival curve for patients with multiple myeloma. (Adapted from Reis LAG et al: SEER Cancer

Statistics Review, 1973–1995. National Cancer Institute, 1998.)

From this curve, the median survival is estimated to be between

A. 0 and 1 year

B. 1 and 2 years

C. 2 and 3 years

D. 3 and 4 years

E. 4 and 5 years

The answer is C.







United States.a

Incidenceb

Survivalc

Type of

Cancer

White

Males

White

Females

Black

Males

Black

Females

1

year

5

years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



Lowest case fatality.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is D.



In a retirement community of 10,000 among whom 10 are found to have melanoma during an

initial screening and 1 new case is found at a subsequent screening exam 1 year later,

estimate the approximate incidence rate of developing melanoma, assuming no entries or

losses of subjects and no deaths from other causes.

A. 0.0001


C. 0.001


E. .010


G. .10


I. 1.0


The answer is B.



An outbreak of Ebola hemorrhagic fever occurred in Uganda between August 2000 and

January 2001. Contact tracing from three laboratory-confirmed patients identified the chains

of transmission for 27 cases (Francesconi P et al: Ebola hemorrhagic fever transmission and

risk factors of contacts, Uganda. Emerg Infect Dis 2003;9:1430). A total of 22 patients died.

The case-fatality (in %) was:

A. 2

B. 22

C. 66

D. 81

E. Cannot be determined

The answer is D.






risk factors of contacts, Uganda. Emerg Infect Dis 2003;9:1430). The distribution of dates of

onset was from September 18 through October 28, with the following numbers of cases in

successive weeks of the outbreak: 3, 3, 4, 4, 9, 3, 1. The sentinel cases for this outbreak

most likely occurred in which week?

A. 1

B. 3

C. 5

D. 7


The answer is A.







United States.a

Incidenceb

Survivalc

Type of

Cancer

White

Males

White

Females

Black

Males

Black

Females

1

year

5

years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



The lowest black-to-white ratio of incidence rates among females.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is E.







below.



Race


Male 2.2 13.5 3.8

Female 0.2 6.5 1.1

All 1.2 9.8 2.4


The male-to-female ratio of incidence rates among whites is:

A. 2.2/1.2

B. 2.2 – 0.2

C. (2.2 x 6.5)/(13.5 x 0.2)

D. (2.2 – 0.2)/2.2

E. 2.2/0.2

The answer is E.







below.



Race


Male 2.2 13.5 3.8

Female 0.2 6.5 1.1

All 1.2 9.8 2.4


The black-to-white excess rate of occurrence (in cases per 100,000 person-years) among

males is

A. 3.7

B. 7.0

C. 9.7

D. 11.3

E. 13.3

The answer is D.



A study was conducted among a total of 83 contacts of patients, 20 of whom became ill and

63 remained well. Information was collected on the types of interactions between patients and

their contacts, as shown in the table below.

Interaction Histories for Contacts of Patients with Ebola Hemorrhagic

Fever.a

Contact No Contact

Interaction with patient Ill Well Total Ill Well Total

Sharing meals 6 9 15 14 54 68

Washing clothes 11 24 35 9 39 48

Exposure to body fluids 15 15 30 5 48 53

Sleeping in same hut 11 17 28 9 46 55

Touching body 19 51 70 1 12 13

aData from Francesconi P et al: Ebola hemorrhagic fever transmission and risk factors of

contacts, Uganda. Emerg Infect Dis 2003;9:1430.

Which type of contact had the lowest risk ratio?

A. Sharing meals

B. Washing clothes

C. Exposure to body fluids

D. Sleeping in same hut

E. Touching body

The answer is B.






risk factors of contacts, Uganda. Emerg Infect Dis 2003;9:1430). The incidence rate probably

was highest in which week?

A. 1

B. 3

C. 5

D. 7


The answer is C.







Fever.a

Contact No Contact









Given these study results, which of the following infection control practices would be most

effective?

A. Handwashing and use of gloves

B. Sterilize plates and utensils

C. Wear surgical masks

D. Daily washing of clothing

E. Boiling all drinking water

The answer is A.







Fever.a

Contact No Contact









Which type of contact had the highest attack rate?

A. Sharing meals

B. Washing clothes



E. Touching body

The answer is C.







Fever.a

Contact No Contact









Which type of contact appears to confer the highest risk of transmission?

A. Sharing meals

B. Washing clothes



E. Touching body

The answer is C.







United States.a

Incidenceb

Survivalc

Type of Cancer

White Males

White Females

Black Males

Black Females

1 year

5 years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



Highest case fatality.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is C.



A population-based evaluation was conducted in Japan of annual screening for lung cancer

with low-dose computed tomography. The subjects underwent baseline evaluations in 1996,

with repeat annual examinations the next two years. Confirmation of a lung cancer diagnosis

was based on cellular pathology. A summary of the results of all three screenings combined is

provided in the table below.

Summary of Low-Dose Computed Tomography (CT) Screening for Lung

Cancer in Japan.a

Cancer

CT Result Present Absent Total

Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786

aData from Sone S et al: Results of three-year mass screening programme for lung cancer

using mobile low-dose spiral computed tomography scanner. Br J Cancer 2001;84:25.

Specificity (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is L.







below.



Race


Male 2.2 13.5 3.8

Female 0.2 6.5 1.1

All 1.2 9.8 2.4


The overall male-to-female excess rate of occurrence (in cases per 100,000 person-years)

A. 2.0

B. 7.0

C. 2.7

D. 1.4

E. 8.6

The answer is C.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



The prevalence of disease (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is E.







Fever.a

Contact No Contact









Which type of contact had the highest risk ratio?

A. Sharing meals

B. Washing clothes



E. Touching body

The answer is C.







Fever.a

Contact No Contact









Which type of contact had the lowest attack rate?

A. Sharing meals

B. Washing clothes



E. Touching body

The answer is E.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Negative predictive value (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is M.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



False-negatives out of all cancer patients (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is H.







United States.a

Incidenceb

Survivalc

Type of Cancer

White Males

White Females

Black Males

Black Females

1 year

5 years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



Mortality rate is closest to incidence rate.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is C.







United States.a

Incidenceb

Survivalc

Type of

Cancer

White

Males

White

Females

Black

Males

Black

Females

1

year

5

years

Oral cavity 15 6 21 5 83 59

Esophagus 8 2 11 4 42 12

Pancreas 12 9 18 13 19 4

Bladder 41 10 20 8 91 83

Brain 9 6 5 3 53 34


2003.



Median survival occurs between 1 and 5 years.

A. Oral cavity

B. Esophagus

C. Pancreas

D. Bladder

E. Brain

The answer is E.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Likelihood ratio for a positive test result

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is J.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Positive predictive value (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is I.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Pretest odds of disease

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is A.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Posttest odds of disease

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is D.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Posttest probability

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is C.



A randomized, double-blind, placebo-controlled clinical trial is conducted to determine whether

memantine, an N-methyl-D-aspartate (NMDA) antagonist, can reduce clinical deterioration in

patients with Alzheimer's disease (reference: Reisberg B et al: Memantine in moderate-to-

severe Alzheimer's disease. N Engl J Med 2003;348:1333). Among 252 patients randomized

in equal numbers to memantine (20 mg per day) or a placebo, the groups were similar at

baseline with respect to demographic characteristics and level of dementia. The study period

was 28 weeks, with 29 experimental patients and 42 controls not completing the study. Based

upon cognitive, functional, and behavioral assessments, 29% of patients treated with

memantine and 10% of controls demonstrated a predefined favorable clinical response.

Serious adverse events occurred among 13% of patients on memantine and 18% of controls.

The similarity of treatment groups with respect to baseline characteristics most likely occurred

because of

A. Use of intention-to-treat analysis

B. The placebo effect

C. Use of randomization

D. Use of blinding

E. Use of informed consent

The answer is C.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Sensitivity (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is K.













One control in ten had a clinical response. This is best explained by




D. Use of blinding


The answer is B.













The risk of not responding clinically among controls was

A. 0.10

B. 0.29

C. 0.71

D. 0.79

E. 0.90

The answer is E.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Positive results out of all tests (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is G.













The risk of not responding clinically among memantine patients was

A. 0.10

B. 0.29

C. 0.71

D. 0.79

E. 0.90

The answer is C.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



False-positives out of all persons without cancer (%)

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is F.













Although more controls than patients treated with memantine failed to complete the study, all

patients were analyzed according to the original assignment. This is best described as

A. Use of intention-to-treat



D. Use of blinding


The answer is A.



A cohort study is conducted to evaluate the relationship between exposure to solid foods at an

early age and the development of asthma. In the study, 1000 infants who had solid food

introduced before 4 months of age are compared to 1000 infants who had solid food

introduced after 6 months of age. The results are shown in the table below.

Relationship Between Exposure to Solid Foods at an Early Age and

Development of Asthma.

Health Status

Introduction of Solid Food Asthma No Asthma Total

Early 200 800 1000

Late 100 900 1000

Total 300 1700 2000

What is the risk of asthma in the group that had early introduction of solid foods?

A. 0.10

B. 0.15

C. 0.20

D. 0.25

E. 0.35

The answer is C.













The risk ratio of a serious adverse effect among patients treated with memantine compared to

the corresponding reference risk among controls was

A. 0.13

B. 0.18

C. 0.72

D. 0.82

E. 0.87

The answer is C.













The results suggest that compared with controls, patients treated with memantine have

A. Better clinical response and fewer serious adverse effects

B. Better clinical response, but more serious adverse effects

C. Worse clinical response, but fewer serious adverse effects

D. Worse clinical response and more serious adverse effects

E. The same clinical response, but fewer serious adverse effects

The answer is A.













Some patients may have enrolled with cognitive deficits great enough to impair their

understanding of the purpose and risks of the study. In these instances, caregivers

represented the patients in accepting the risks and benefits of the study. This process is best

described as

A. Use of intention-to-treat



D. Use of blinding


The answer is E.













Neither patients nor clinicians who evaluated them knew individual treatment assignments.

This may be described as




D. Use of blinding


The answer is D.









Cancer in Japan.a

Cancer


Positive 56 532 588

Negative 4 13,194 13,198

Total 60 13,726 13,786



Likelihood ratio for a negative test result

A. .004

B. .07

C. .09

D. .10

E. .44

F. 3.9

G. 4.3

H. 6.7

I. 9.5

J. 23.9

K. 93.3

L. 96.1

M. 100

The answer is B.













The risk ratio of not responding clinically among patients treated with memantine compared to

the corresponding reference risk among controls was

A. 0.10

B. 0.29

C. 0.71

D. 0.79

E. 0.90

The answer is D.









Health Status


Early 200 800 1000

Late 100 900 1000

Total 300 1700 2000

The point estimate for the risk ratio (early introduction of solids versus late introduction) for

the occurrence of asthma indicates that the risk of asthma associated with early introduction

of solids is

A. Decreased

B. Increased

C. Not affected


The answer is B.









Health Status


Early 200 800 1000

Late 100 900 1000

Total 300 1700 2000

What is the risk of asthma in the group that had late introduction of solid foods?

A. 0.10

B. 0.15

C. 0.20

D. 0.25

E. 0.35

The answer is A.



A cohort study is performed to evaluate the relationship between inflammation as measured

by a high C-reactive protein and the occurrence of myocardial infarction among women. In the

study, 500 subjects with high C-reactive protein and 500 subjects with normal C-reactive

protein are studied over a 20-year period.

During the study, 50 of the women with high C-reactive protein and 15 of the women with

normal C-reactive protein develop a newly diagnosed myocardial infarction.

The incidence rate (per 10,000 person years) for a myocardial infarction for a person with

normal C-reactive protein is

A. 15

B. 25

C. 30

D. 50

E. 60

F. Incidence cannot be determined

The answer is A.









Health Status


Early 200 800 1000

Late 100 900 1000

Total 300 1700 2000

What is the risk ratio (early introduction of solids versus late introduction) for the occurrence

of asthma?

A. 0.05

B. 0.50

C. 1.0

D. 2.0

E. 3.0

The answer is D.









The attributable risk percent is

A. 25%

B. 35.5%

C. 50%

D. 70%

E. 90%

The answer is D..









The incidence rate (per 10,000 person years) for myocardial infarction among women with a

high C-reactive protein is

A. 15

B. 25

C. 30

D. 50

E. 60

F. Incidence cannot be determined

The answer is D.









Health Status


Early 200 800 1000

Late 100 900 1000

Total 300 1700 2000

The 95% confidence interval for the point estimate is 1.4 to 4.5. The correct interpretation of

these results is

A. A statistically significant association exists between early introduction of solids and

increased risk for the development of asthma at the level of p < 0.05.

B. A statistically significant relationship exists between early introduction of solid foods

and decreased risk for the development of asthma at the level of p < 0.05.

C. It can be concluded with 95% confidence that early introduction of solids is protective

for development of asthma.

D. Breast feeding is an important intervention to prevent the development of asthma.

E. The risk of asthma is not statistically significantly different between early and late

introduction of solid foods at the level of p < 0.05.

The answer is A.



For the situation below, select the best descriptor from the following options.

In a pair-matched case–control study to assess post-menopausal hormone replacement as a

risk factor for atherosclerotic coronary heart disease, patients were matched with controls on

age, race, years since menopause, area of residence, and age at menarche.

A. Concordant pair

B. Discordant pair

C. Not applicable

D. Cannot be determined from the information provided

E. More efficient than other case–control designs

The answer is E.







Fever.a

Contact No Contact









The most frequent type of contact was

A. Sharing meals

B. Washing clothes



E. Touching body

The answer is E.









The risk difference is

A. 0.005

B. 0.007

C. 0.07

D. 0.05

E. 1.0

The answer is C.









The incidence rate ratio for myocardial infarction is

A. 0.9

B. 1.0

C. 2.3

D. 3.3

E. 5.0

The answer is D.




In a case–control study of nosocomial urinary tract infection and catheter care among patients

with a Foley catheter, information about catheter care is obtained by interviewing patients

about 6 months after discharge from the hospital.

A. Publication bias

B. Confounding

C. Interviewer bias

D. Misclassification

E. Cohort effect

F. Selection bias

The answer is D.



Select the most appropriate advantage that best applies to the case–control design from the

following lettered options. Assessing risk factors for adrenal insufficiency (Addison's disease).

A. The study can be conducted at nominal expense

B. Efficient for the study of rare diseases

C. Efficient for the study of rare exposures

D. The incidence rate in the population can be estimated directly

E. The temporal relationship between exposure and disease is clearly defined

F. The ability to conduct an assessment quickly

The answer is B.





with a Foley catheter, cases are sampled from patients who had been on a surgical ward and

controls who had been on a medical ward.

A. Publication bias

B. Confounding

C. Interviewer bias


E. Cohort effect

F. Selection bias

The answer is F.





with a Foley catheter, patients who had a bladder infection are more likely to remember the

number of times the catheter had been changed.

A. Publication bias

B. Confounding

C. Interviewer bias


E. Cohort effect

F. Selection bias

The answer is D.





with a Foley catheter, the interviewer probes more deeply when questioning patients who had

had a bladder infection because she did not want to "miss anything."

A. Publication bias

B. Confounding

C. Interviewer bias


E. Cohort effect

F. Selection bias

The answer is C.




following lettered options. Assessing risk factors for an epidemic of a newly recognized

condition with rapid onset of liver disease in several communities.







The answer is F.



For the measure below, slect the most appropriate calculation from the following options.

The odds of exposure among cases in an unmatched case–control study of risk factors for

adenocarcinoma of the esophagus, in which chronic heartburn was found in 70 of 150 cases

and 20 of 150 controls.

A. 70/150

B. 20/230

C. 20/150

D. (80 x 280)/(20 x 70)

E. 70/80

F. (70 x 130)/(80 x 20)

G. Cannot be calculated with available information

The answer is E.




The prevalence of exposure among cases in an unmatched case–control study of risk factors

for adenocarcinoma of the esophagus, in which chronic heartburn was found in 70 of 150

cases and 20 of 150 controls.

A. 70/150

B. 20/230

C. 20/150

D. (80 x 280)/(20 x 70)

E. 70/80

F. (70 x 130)/(80 x 20)


The answer is A.




The odds ratio for exposure in an unmatched case–control study of risk factors for



A. 70/150

B. 20/230

C. 20/150

D. (80 x 280)/(20 x 70)

E. 70/80

F. (70 x 130)/(80 x 20)


The answer is F.




The risk of disease among the exposed for an unmatched case–control study of risk factors for



A. 70/150

B. 20/230

C. 20/150

D. (80 x 280)/(20 x 70)

E. 70/80

F. (70 x 130)/(80 x 20)


The answer is G.

Question 143 of 145


following lettered options. Assessing risk factors for a long-standing high rate of infant

mortality in a developing country.







The answer is A.

Question 144 of 145


In a pair-matched case–control study of cell phone usage while driving as a risk factor for

automobile accidents, a male driver was using his cell phone when the accident occurred and

his matched control was not using a cell phone at the corresponding time.

A. Concordant pair

B. Discordant pair

C. Not applicable



The answer is B.

Question 145 of 145 < Previous question



In an unmatched case–control study of risk factors for deep vein thrombosis, a patient with

deep vein thrombosis had traveled in an airplane, and a control of similar age had not.

A. Concordant pair

B. Discordant pair

C. Not applicable



The answer is C.

greenberg _ epidemiology self - assessment study questions

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