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Question 1
Incorrect
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A double-blinded randomised controlled trial is proposed to assess the effectiveness of a new blood pressure medication.
Which type of bias can be avoided by ensuring the patient and doctor are blinded?Your Answer: Recall bias
Correct Answer: Expectation bias
Explanation:Observers may subconsciously measure or report data in a way that favours the expected study outcome. Therefore, by blinding the study we can eliminate expectation bias.
Recall bias is a systematic error that occurs when the study participants omit details or do not remember previous events or experiences accurately.
Verification can occur during investigations when there is a difference in testing strategy between groups of individuals, which might lead to biasness due to differing ways of verifying the disease of interest.
Nonresponse bias is the bias that occurs when the people who respond to a survey differ significantly from the people who do not respond to the survey.
A distortion that modifies an association between an exposure and an outcome because a factor is independently associated with the exposure and the outcome. Randomization is the best way to reduce the risk of confounding.
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This question is part of the following fields:
- Statistical Methods
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Question 2
Incorrect
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In reference to confounding variables, which among the given is not true?
Your Answer: Stratification is a technique used to control for confounding
Correct Answer: In the analytic stage of a study confounding can be controlled for by randomisation
Explanation:Randomisation can be used to provide control over the confounding variables during the design stage of a study however during analytical stage a technique called stratification is used for controlling confounding variables. Since the question asks for the information that is factually incorrect.
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This question is part of the following fields:
- Statistical Methods
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Question 3
Correct
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The average diastolic blood pressure of a control group was found out to be 80 with a standard deviation of 5 in a study aimed at exploring the efficiency of a novel anti-hypertensive drug. The trial was randomised.
Making an assumption that the data is normally distributed, find out the number of patients that had diastolic blood pressure over 90.Your Answer: 3%
Explanation:Since the data is normally distributed, 95% of the values lie with in the interval 70 to 90. This can be calculated as follows:
Interval= Mean ± ( 2 times standard deviation)
= 80 ± 2(5)
= 80 ± 10
= 70 & 90The rest of the 5% are distributed symmetrically beyond 90 and below 70 which means 2.5% of the values lie above 90.
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This question is part of the following fields:
- Statistical Methods
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Question 4
Incorrect
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Among the following which one is not a criterion for the assessment of causality?
Your Answer: Specificity
Correct Answer: Sensitivity
Explanation:For establishing a cause effect relationship, following criteria must be met:
1. Coherence & Consistency
2. Temporal Precedence
3. Specificity
As can be seen, sensitivity (The probability of a positive test) is not among these deciding factors..
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This question is part of the following fields:
- Statistical Methods
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Question 5
Incorrect
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What is the primary purpose of funnel plots?
Your Answer: Demonstrate the heterogeneity of a meta-analysis
Correct Answer: Demonstrate the existence of publication bias in meta-analyses
Explanation:Funnel plot is essentially a scatterplot of the effect of treatment against a particular measure of study precision. Its primal purpose is to serve as a visual aid and help in detection of bias or systematic heterogenity.
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This question is part of the following fields:
- Statistical Methods
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Question 6
Correct
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A 26-year-old doctor has recently been diagnosed with lung cancer. He would like to find out his survival time for the condition.
Which statistical method is used to predict survival rate?Your Answer: Kaplan-Meier estimator
Explanation:The Weibull distribution are used to describe various types of observed failures of the components. it is used in reliability and survival analysis.
Regression Analysis is used to measure the relationship between among two or more variable. It determines the effect of independent variables on the dependent variables.
Student t-test is one of the most commonly used method to test the hypothesis. It determines the significant difference between the means of two different groups.
A time series is a collection of observations of well-defined data obtained at regular interval of time.
Kaplan-Meier estimator is used to estimate the survival function from lifetime data. It can be derived from maximum likelihood estimation of hazard function. It is most likely used to measure the fraction of patient’s life for a certain amount of time after treatment.
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This question is part of the following fields:
- Statistical Methods
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Question 7
Incorrect
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The following results were obtained In a new drug trial:
Improved Not improved
Placebo group 36 26
Treatment group 44 16
Regarding the statistical analysis or interpretation of the trial, One of these is trueYour Answer: A Student's t-test could be used
Correct Answer: The data could be evaluated using the chi square test
Explanation:This data is in a 2 × 2 contingency table so a chi square test can be used. There is a special chi squared formula that gives a value that can be looked up in a table giving the p value.
Since we are comparing proportions not means, the Student’s t test CANNOT be used.
There is no linear regression to plot so Pearson’s co-efficient cannot be calculated.
Nothing is so obvious that no statistical analysis is needed.
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This question is part of the following fields:
- Statistical Methods
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Question 8
Incorrect
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A graph was plotted after administration of fentanyl infusion to a patient. The following are the x- and y-axis of the graph:
X-axis: Dose of fentanyl
Y-axis: Mu receptor occupancy, measured using positron emission tomography
Given the data above, what would be the best representation of the graph if the data on the x-axis are converted to logarithms?Your Answer: Wash-in exponential curve to a straight line
Correct Answer: Rectangular hyperbola to sigmoid curve
Explanation:The dose-response curve plots the graph of the dose (drug concentration) versus the response. As doses increase, the response increment diminishes; finally, doses may be reached at which no further increase in response can be achieved. This relation between drug concentration and effect is traditionally described by a hyperbolic curve. When the x-axis is plotted in log scale, the graph yields a sigmoid curve.
Efficacy (Emax) and potency (EC50) can be derived from this curve. Emax is the maximal effect achievable, with increasing concentration of a drug. EC50 is the concentration of the drug, wherein half of the maximal effect is achieved.
When the graph is plotted using a log [response/1-response] against log dose, the sigmoid curve becomes a straight line (Hill plot). A graph that transforms from a straight line to exponential curve is mathematically incorrect. A graph that transforms from either a wash-in or wash-out exponential curve to a straight line comes from an initial set of data plotted against time, to a logarithmic transformation of the initial data set against time.
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This question is part of the following fields:
- Statistical Methods
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Question 9
Correct
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In the United Kingdom, a new breast cancer screening test is being conducted compared to the conventional use of mammography. This test predicts that if the breast cancer is diagnosed at an earlier stage, it could improve the survival rate but the overall results remains constant.
This is an example of what kind of bias?Your Answer: Lead time bias
Explanation:Recall bias introduced when participants in a study are systematically more or less likely to recall and relate information on exposure depending on their outcome status.
In procedure bias, the researcher decides assignment of a treatment versus control and assigns particular patients to one group or the other non-randomly. This is unlikely to have occurred in this case, although it is not mentioned specifically.
Self Selection or volunteer bias occur when those subjects are selected to participate in the study who are not the representative of the entire target population. those subjects may be from high socio-economic status and practice those activities or lifestyle that improves their health.
Lead-time bias occurs when a disease is detected by a screening test at an earlier time point rather than it would have been diagnosed by its clinical appearance. In this bias, earlier detection improves the survival time in the intervention group.
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This question is part of the following fields:
- Statistical Methods
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Question 10
Incorrect
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Which of the following is the best associated option with Kaplan-Meier survival plot?
Your Answer: An accurate prediction of increasing survival with time after treatment.
Correct Answer: An estimate of decreasing survival with time after an event.
Explanation:Also known as the “product limit estimate’’, the Kaplan-Meier survival plot is used to estimate the true survival function from the collected data.
Using this plot, probabilities of occurrence of an event at a certain point in time can be computed. The successive probabilities are multiplied by any earlier computed probabilities to get the final estimate. For a given population, the survival probability at any particular time on the plot = (number of subjects living at the start – number of subjects who died)/number of subjects living at the start.
The description of a scatter plot is a graphical representation using Cartesian coordinates to display values for more than two variables for data set. It is used for to assess the relationship between 2 different variables.
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This question is part of the following fields:
- Statistical Methods
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