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Question 1
Incorrect
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A study done on a group of epileptics records the numbers of seizures in the weeks before and after a dietary intervention. The decrease in seizures is on average 20. (95% CI=15 to 25| P=0.0024)Which of the following options is true?
Your Answer: The difference is statistically significant and so the treatment works
Correct Answer: This is a before and after study with no control group and so the results should be viewed with great caution
Explanation:While the results of this before and after study can provide some preliminary insight into the effects of the dietary intervention, the results should be viewed with great caution as they may be considered merely anecdotal. The lack of a control group contributes to confounding the data. Therefore, while the difference may be statistically significant and the confidence interval is compatible with a fall in the number of seizures after therapy, the results cannot be introduced as the standard without a control group to compare with.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 2
Incorrect
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Out of 30 children who are exposed to a chemical, 15 develop a disorder, compared to only 1 child out of 10 developing the same disorder who were not exposed.The following can be deduced from this information:
Your Answer:
Correct Answer: The relative risk of exposure to the chemical is 5
Explanation:Relative risk is the probability of an outcome occurring in an exposed group as compared to the probability of that outcome in an unexposed group. In the scenario given, 50% of the children exposed developed the disease while only 10% of the children who were unexposed developed the disease. The relative risk was therefore 50/10=5. There is no further information about whether the study was controlled, the confidence interval, or the type of study. It therefore cannot be confirmed whether the chemical is causative and if it should be avoided.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 3
Incorrect
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According to a cross-sectional survey of >500 subjects, an estimated 10% of a group of children that have a sibling with severe eczema, have asthma. On the other hand, only 0.5% without a sibling with severe eczema have asthma. You want to test the difference of 9.5% for significance. Which of the following tests would you use?
Your Answer:
Correct Answer: Fisher’s exact test
Explanation:To quantify differences between percentages you can use Fisher’s exact test.Odds ratios, relative risks and number needed to treat are ways of quantifying differences between percentages in two groups, however are not in themselves significance tests.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 4
Incorrect
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A study of 500 men shows a significant correlation between their blood pressures and weights (r = 0.45, P = 0.0014).Which one of the following is true?
Your Answer:
Correct Answer: There is a linear tendency for heavier men to have higher blood pressures
Explanation:The main result of a correlation is called the correlation coefficient (or r). It ranges from -1.0 to +1.0. The closer r is to +1 or -1, the more closely the two variables are related.If r is close to 0, it means there is no relationship between the variables. If r is positive, it means that as one variable gets larger the other gets larger. If r is negative it means that as one gets larger, the other gets smaller (often called an inverse correlation).
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 5
Incorrect
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A cohort study is being designed to look at the relationship between smoking and prostate cancer. What is the usual outcome measure in a cohort study?
Your Answer:
Correct Answer: Relative risk
Explanation:A cohort study is a particular form of longitudinal study that samples a cohort (a group of people who share a defining characteristic, typically those who experienced a common event in a selected period, such as birth or graduation), performing a cross-section at intervals through time.
The relative risk (RR) or risk ratio is the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group. Relative risk is used in the statistical analysis of the data of experimental, cohort and cross-sectional studies, to estimate the strength of the association between treatments or risk factors, and outcomes. -
This question is part of the following fields:
- Epidemiology And Statistics
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Question 6
Incorrect
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One of the main disadvantages of case control studies is:
Your Answer:
Correct Answer: The potential for recall bias
Explanation:Case control studies are observational studies which retrospectively determine whether a patient might have been exposed to a risk factor for a certain disease, as compared to a control group from the general population. They can be used for a range of outcomes as well as rare diseases. One of the biggest problems with this type of study is recall bias. Research subjects may selectively remember factors that are more predictive of the disease outcome when compared to the control group. All studies should have prior power calculations before the study commences.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 7
Incorrect
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A randomised controlled trial of a new treatment for hypertension yields a P-value of 0.00036.Which one of the following gives the best interpretation of this information?
Your Answer:
Correct Answer: To understand the clinical importance of the treatment we should also consider the confidence interval for the difference
Explanation:The level of statistical significance is often expressed as a p-value between 0 and 1. The smaller the p-value, the stronger the evidence that you should reject the null hypothesis.A p-value less than 0.05 (typically ≤ 0.05) is statistically significant. It indicates strong evidence against the null hypothesis, as there is less than a 5% probability the null is correct (and the results are random). Therefore, we reject the null hypothesis, and accept the alternative hypothesis.However, this does not mean that there is a 95% probability that the research hypothesis is true. The p-value is conditional upon the null hypothesis being true is unrelated to the truth or falsity of the research hypothesis.A lower p-value is sometimes interpreted as meaning there is a stronger relationship between two variables. However, statistical significance means that it is unlikely that the null hypothesis is true (less than 5%).To understand the strength of the difference between two groups (control vs. experimental) a researcher needs to calculate the effect size.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 8
Incorrect
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In a study, 50 out of 100 smokers developed lung cancers and 50 out of 200 non-smokers developed lung cancers. Which of the following is accurate?
Your Answer:
Correct Answer: Relative risk=2
Explanation:Relative risk = (Incidence in exposed group)/incidence in unexposed group). So in this case RR = (50/100)/(50/200) = 2.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 9
Incorrect
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We want to compare body mass index (BMI) values between children from several ethnic groups, taking into account differences in the age distributions of the groups.The appropriate analysis is:
Your Answer:
Correct Answer: Linear regression analysis with age and ethnicity as predictors
Explanation:Linear regression is a basic and commonly used type of predictive analysis. The overall idea of regression is to examine two things: (1) do a set of predictor variables do a good job in predicting an outcome (dependent) variable? (2) Which variables, in particular, are significant predictors of the outcome variable, and in what way do they–indicated by the magnitude and sign of the beta estimates–impact the outcome variable.These regression estimates are used to explain the relationship between one dependent variable and one or more independent variables. Three major uses for regression analysis are (1) determining the strength of predictors, (2) forecasting an effect, and (3) trend forecasting
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 10
Incorrect
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In a double blind trial of a new diabetes medication, 25% more in the treated group responded positively than those in the control group (95% CI 10% to 50%| P=0.004)
Your Answer:
Correct Answer: The therapy benefits an additional 1 in 4 (95% CI 2 to 10), patients who receive it
Explanation:In the final result of this double blind study, 25% or one in four of patients who received the treatment responded positively. Though the difference is significant at P<0.05, it is better to present this as a significant difference at 0.4%. The number needed to treat (NNT) is defined as the inverse of the absolute risk reduction. Taking this as 0.25 (25%), the NNT is 1/0.25 = 4. However given the 95% confidence interval is between 10-50% for absolute risk reduction, the NNT with 95% CI is between 2 and 10. Therefore we cannot say with certainty that the NNT is at least 4.
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This question is part of the following fields:
- Epidemiology And Statistics
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