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Epidemiology & Biostatistics Exam Questions and Answers CORRECT AND VERIFIED 100% PASS Health - CORRECT ANSWER-The Absence of Illness with six dimensions What are the Six dimensions of Helath? - CORRECT ANSWER-1. Social
- Environmental
- Physical
- Intellectual
- Emotional
- Spiritual Biostatistics - CORRECT ANSWER-The application of statistical principles to medical, public health, and biological applications Involves collecting, summarizing, interpreting information and making inferences that appropriately account for uncertainty Summarizing a sample of population then making inferences about entire population What are some issues/limitations of Biostatistics? - CORRECT ANSWER-you must clearly define the objective or research question must choose the appropriate study design
must choose a sufficiently large representative sample must carefully collect and analyze data must quantify uncertainty must appropriately account for relationships among characteristics must limit inferences to appropriate population Physical Health - CORRECT ANSWER-The ability of the human body to function properly; includes physical fitness and activities of daily living Social Health - CORRECT ANSWER-The ability to have satisfying relationships; interaction with social institutions Mental Health - CORRECT ANSWER-Ability to think clearly, reason objectively and act properly Emotional Health - CORRECT ANSWER-Ability to cope, adjust and adapt; self- efficacy and self esteem Spiritual Health - CORRECT ANSWER-Feeling as if part of a greater spectrum of existence; personal beliefs and choices Environmental Health - CORRECT ANSWER-Comprised of external factors (i.e. one's surrounding such as habitat or occupation)
What are the two primary disciplines that provide the foundations of public health? - CORRECT ANSWER-1. Epidemiology
- Biostatistics Epidemiology - CORRECT ANSWER-The study of the distribution and determinants of health related states or events in human populations, and the application of this study to prevent and control health problems Does Epidemiology involve scientific investigation? - CORRECT ANSWER-Yes Distribution - CORRECT ANSWER-Study of frequency and pattern of health events in the population Frequency - CORRECT ANSWER-Number, and number in relation to the population Pattern - CORRECT ANSWER-The health related state or event by person, place, and time characteristics Determinants - CORRECT ANSWER-Search for causes and other factors of health related states or events Disease - CORRECT ANSWER-Any impairment of normal physiological function affecting all or part of an organism, especially a specific pathological change. Characterized by an identifiable group of signs or symptoms What are the five causes of disease? - CORRECT ANSWER-1. Pathogens
- Chemicals
- Inherent Weakness
- Lifestyle
- Physical Stresses
What are some examples of Pathogens? - CORRECT ANSWER-viruses, bacteria, fungi, or parasites capable of producing disease What are some examples of Chemicals? - CORRECT ANSWER-drugs, acids, heavy metals What are some examples of Inherent Weaknesses? - CORRECT ANSWER-suppressed immune system, susceptibility gene What are some examples of Lifestyle? - CORRECT ANSWER-lack of physical activity, smoking, obesity What are some examples of Physical Stresses? - CORRECT ANSWER-radiation, extreme temperatures, workplace injuries What are the five classifications of disease? - CORRECT ANSWER-1. Congenital and Hereditary
- Allergies and Inflammatory
- Degenerative
- Metabolic
- Cancer What is an example of a metabolic disease? - CORRECT ANSWER-Diabetes What is Primary Prevention of disease? - CORRECT ANSWER-Education; preventing disease before its an issue legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)
Vertical Transmission - CORRECT ANSWER-Transmission of disease from mother to child Horizontal Transmission - CORRECT ANSWER-Transmission of disease from person to person within a population May involve direct transmission, a common vehicle, an airborne pathogen, or a vector borne pathogen What are the six disease transmission concepts? - CORRECT ANSWER-1. Fomite
- Vector
- Reservoir
- Zoonoses
- Vehicle
- Carrier What is the FOMITE disease transmission concept? - CORRECT ANSWER-objects or materials that carry infection, not water or food What is the VECTOR disease transmission concept? - CORRECT ANSWER-The indirect transmission of an infectious agent that occurs when a vector bites or touches a person What is the RESERVOIR disease transmission concept? - CORRECT ANSWER-Someone or something that holds a disease what is the ZOONOSES disease transmission concept? - CORRECT ANSWER-Disease that can be transmitted to humans from animals
What is the VEHICLE disease transmission concept? - CORRECT ANSWER-Indirect transmission of an infectious agent that occurs when a vehicle touches a persons body or is ingested A nonliving intermediary such as a fomite, food, or water delivers an infectious agent from its reservoir to a susceptible host. What is the CARRIER disease transmission concept? - CORRECT ANSWER-People who carry disease but don't themselves get sick Descriptive Epidemiology - CORRECT ANSWER-A means to characterizing the distribution of health related states by person (who), place (where), time (when), clinical criteria (what) What are the four ways to describe disease? - CORRECT ANSWER-1. Endemic
- Epidemic
- Outbreak
- Pandemic Endemic Disease - CORRECT ANSWER-Common to a population (i.e. heart disease in the US) Epidemic Disease - CORRECT ANSWER-Disease that increases beyond what is normal in a population Outbreak Disease - CORRECT ANSWER-Disease that is local & usually short lived Pandemic Disease - CORRECT ANSWER-Disease that crosses continents, countries, etc. It is found everywhere Common Source - CORRECT ANSWER--point
- intermittent (occurring in irregular intervals)
- Retrospective cohort study
- Case control study
- Cross sectional study
- Ecologic Study
- Case Report or case series Randomized control trial - CORRECT ANSWER-A study in which people are allocated at random (by chance alone) to receive one of several clinical interventions. Cross Over Trial - CORRECT ANSWER-Testing group of people with one thing and then wait and retest them with another later on. Needs less people Same group of people for control and placebo A WAY OF DOING A RANDOMIZED CONTROL TRIAL Prospective Cohort Study - CORRECT ANSWER-Observational study involving a group (cohort) of individuals who meet inclusion criteria and differ in respect to certain factors under study that are followed prospectively (over long period of time) to determine how certain factors affect rates of a certain outcome assess exposure Nested Case Control Study - CORRECT ANSWER-variation of a case-control study in which only a subset of controls from the cohort are compared to the incident cases You match special cases with similar controls
very similar to case control study but larger group of people over longer amount of time which are then broken up into smaller groups throughout the study STUDY INSIDE A STUDY/ PARTICIPANTS FROM COHORT STUDY Retrospective Cohort Study - CORRECT ANSWER-conceived after some people have already developed the outcomes of interest. The investigators jump back in time to identify a cohort of individuals at a point in time before they have developed the outcomes of interest, and they try to establish their exposure status at that point in time Case Control Study - CORRECT ANSWER-Matching people of gender, age, race, etc. and looking for what makes them different Observational study involving individuals with (cases) and without (controls) outcome of interest Cross sectional Study - CORRECT ANSWER-Observational study conducted at a point in time to determine the prevalence of a disease Ecologic Study - CORRECT ANSWER-observational study defined by the level at which data are analysed, namely at the population or group level, rather than individual level Case Report Study - CORRECT ANSWER-Detailed report of a specific feature (person) of a case No Control group Analytic studies can be either _________ or ___________ - CORRECT ANSWER-Experimental or observational What study designs are analytical? - CORRECT ANSWER-Randomized controlled trial cross over trial prospective cohort study
Possibly the most famous example of a _____________ of a disease was Mary Mallon or Typhoid Mary. - CORRECT ANSWER-Carrier Would Identifying the extent of a public health problem be ANALYTICAL or DESCRIPTIVE EPIDEMIOLOGY? - CORRECT ANSWER-Descriptive Epidemiology because "characterizing the distribution" Would Identifying the efficacy of a new drug be ANALYTICAL or DESCRIPTIVE EPIDEMIOLOGY? - CORRECT ANSWER-Analytical Epidemiology Would monitoring the change in obesity for a given community over time be ANALYTICAL or DESCRIPTIVE EPIDEMIOLOGY? - CORRECT ANSWER-Descriptive Epidemiology Would Testing a hypothesis about a risk factor for a disease be ANALYTICAL or DESCRIPTIVE EPIDEMIOLOGY? - CORRECT ANSWER-Analytical Epidemiology Which analytic study design is not observational? - CORRECT ANSWER-Randomized Control Trial An infectious disease may or may not be contagious. (T or F) - CORRECT ANSWER-True What are the observational study designs? (4) - CORRECT ANSWER-Case-series study or case report Cross-sectional (prevalence) survey Case-control study Cohort study What are the experimental study designs? - CORRECT ANSWER-Randomized Control (clinical) trial
How does one determine which study design is best? (6 reasons) - CORRECT ANSWER- Depends on the study question What is current knowledge on topic How common is disease (and risk factors) How long would study take what are costs Ethical issues CASE SERIES study design - CORRECT ANSWER-Systematic review of common features of a small number (more than one person) of cases Known for being simplest of study designs bc it is a description of interesting observations in a small number of individuals Do not involve control patients (patients free of disease) What are some ADVANTAGES to the case report or case series study design? - CORRECT ANSWER--it is cost efficient
- can identify new diseases What are some DISADVANTAGES of the case report or case series study design? - CORRECT ANSWER--No comparison group
- No specific research question
- case series are not planned and have no research hypotheses What is a famous example of a case series study? - CORRECT ANSWER-Gottleib (1981) studied 5 young homosexual men with rare form of pneumonia and other unusual infections Initial report was followed by more cases ( cases in NY and CA; "cluster" in southern CA;
5000+ men and women enrolled in 1948 Longitudinal cohort study Exams every 2 years for cardiovascular risk factors - surveillance Ancillary studies - hearing, exercise, nutrition, neurological studies 5000+ offspring & spouses enrolled in 1976 Third generation enrolled in 2002 What are some ADVANTAGES of a CASE CONTROL STUDY? (3) - CORRECT ANSWER-Cost and time efficient for rare outcomes Can get sufficient number of cases (useful for rare conditions) What are some DISADVANTAGES of a CASE CONTROL STUDY? - CORRECT ANSWER-Need careful selection of cases Need careful selection of controls Bias (selection, observation, & recall) Hard to establish temporal relationship Cannot estimate incidence or rate at which a disease develops How do you choose your STUDY SAMPLE for a CASE CONTROL STUDY? (and what are those groups) - CORRECT ANSWER-You need an exposure and comparison group Exposure group: Common risk factors - general population (e.g., Framingham Study) Rare risk factors - special exposure cohort (e.g., soldiers exposed to agent orange)
Comparison group: Similar on all other factors that might affect outcome Select subjects on the basis of outcome Cases _________ disease Controls are _______ of disease - CORRECT ANSWER-Have & Free Are CASE CONTROL STUDIES retrospective or prospective in time? - CORRECT ANSWER- Investigation is retrospective in time What type of study design is best for diseases with long latency period? - CORRECT ANSWER- Case Control Studies Selection Bias - CORRECT ANSWER-select cases or controls and some drop out - leaving groups not comparable Observation Bias - CORRECT ANSWER-knowledge of disease might influence reporting of exposure (over reporting among cases) In Case Control Studies should the collection of exposure data be blind? - CORRECT ANSWER- Yes, in case control studies, the collection of exposure data should be completely blind (Should not be aware of the participants outcome status when collecting the exposure data) Example: 1000 participants examining relationship between smoking and CVD
- 20 develop MI—is there a relationship between MI and BMI
- Match controls to cases on other risk factors
What are some DISADVANTAGES of a CROSS OVER TRIAL? (2) - CORRECT ANSWER-carry-over effects wash-out period must be long enough to minimize carry-over effects but short enough for so that participants remain involved with the study How many phases are there of a cross over trial? - CORRECT ANSWER- 4 What are the different phases of a cross over trial? - CORRECT ANSWER-1. Phase I (Safety)
- Phase II (Feasibility Study)
- Phase III (Clinical Trial)
- Phase IV (Post Marketing) What are some features of the Phase I trial for Cross Over Trials? (main objective?) (how many people does it involve?) (status of subjects?) (about how many phase ones are conducted?) - CORRECT ANSWER-First time in humans; main objective to assess toxicity and safety in humans - pharmacokinetics Usually involves 10-15 patients Subjects usually healthy Some are placebo-controlled Usually two to three separate Phase I studies are conducted
What are some features of the Phase II Trial for Cross Over Trials? - CORRECT ANSWER- Confounding factor - CORRECT ANSWER-a factor not controlled for in the study but still related to other factors and the outcome Bias - CORRECT ANSWER-A systematic error that introduces uncertainty in estimates of effect or association Clinical Trial - CORRECT ANSWER-a specific type of study involving human participants who are randomized to the comparison groups Cohort - CORRECT ANSWER-a group of participants that usually share some common characteristics who are monitored or followed over time Concurrent - CORRECT ANSWER-At the same. Optimally, comparison treatments are evaluated concurrently or in parallel Cross sectional - CORRECT ANSWER-at a point in time Incidence (of a disease) - CORRECT ANSWER-The number of new cases (of disease) over a period of time Intention-to-treat - CORRECT ANSWER-an analytical strategy whereby participants are analyzed in the treatment they are assigned regardless of whether they follow the study protocol completely (i.e. regardless of whether they take all of the assigned medication) Matching - CORRECT ANSWER-a process of organizing comparison groups on the basis of similar characteristics
