22 Oct Learning Epidemiology through Pandemics and Triumphs

Learning Epidemiology through Pandemics and Triumphs

 

Discussion Prompt

 

Epidemiology is the foundation of public health and has often had a pivotal role in shaping not only public health but human history in response to diseases or through research that has been completed. It is important to understand completely the impact that epidemiology has had. In order to do this, please select either a major epidemic/pandemic, milestone, or triumph as listed in your text and discuss this. Your discussion should include:

 

A brief description of the major epidemic/pandemic, milestone, or triumph

 

The population or segment of population that it effected

 

The distribution of the disease or impact of the triumph/milestone

 

Determinants associated with your topic

 

Specific statistics, such as mortality rates or survival rates

 

Interventions associated with your topic

 

Any ethical considerations

 

You should also consider the statics involved. This includes any research questions or hypotheses that may have been involved and the type of data that was collected.

 

DQ2 Getting Started with Stats

 

Discussion Prompt

 

Epidemiology involves scientific studies of the population to produce better health outcomes. Biostatistics is an integral part of epidemiology.

 

Please provide the reason behind this and the relationship between the two. Also, provide the steps that are taken in the research process including example hypotheses, questions, types of variables, and the two types of research that are used. Finally, explain what validity and reliability mean in your own words.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 2 Discussion

 

DQ1 Population Dynamics

 

Discussion Prompt

 

Epidemiology can be used to examine the population as it is, make predictions, and also understand changes that occur. It can also be used to complete community health assessments. This week you are going to consider your community, either your state or your local community

 

Describe the population of your community by gender, race, and age. Is this population fixed or dynamic and what causes this? Look at the last 100 years to determine trends that have been occurring. What would the pyramid look like for your population?

 

Also look at the four factors associated with community health assessments. How do these factors impact your community? Can you recommend interventions that could improve the health or have improved the health of your community? The following websites can provide information that will help you. In addition to these, looking at your local and state health departments can help also.

 

CDC Behavioral Risk Factor Surveillance System (BRFSS) (Links to an external site.)

 

United Health Foundation: America’s Health Rankings (Links to an external site.)

 

US County Health Rankings & Roadmaps

 

DQ2 Statistical Article Review

 

Discussion Prompt

 

There are concepts that you will use often in biostatistics. This week we will work on finding this information and understanding it in scientific articles. For the discussion, please select a peer reviewed scientific article from the library or other source and review it for your classmates. The review should contain the following:

 

Summary

 

Population

 

Sample

 

Parameters

 

Confidence interval

 

Type of test

 

Statistical power/effect size

 

Results

 

Interpretation of the statistical testing

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 3 Discussion

 

Applying Descriptive Epidemiology

 

Discussion Prompt

 

We found this week that there are two types of epidemiological studies, descriptive and analytic. Descriptive epidemiology describes the problem using person, place, and time. There are variations to every disease when we consider these factors, both infectious and chronic. Descriptive epidemiology can find the problems for analytic epidemiology to study more.

 

 Explore different conditions or diseases that are of interest to you or impact your community. Select one to learn more about and describe it to your class keeping in mind all the aspects of descriptive epidemiology. Using national databases, think about the problem, agent, condition, host characteristics, environmental concerns, and temporal variation. Does the disease change with the season? Do you find the disease higher in certain races or countries? Find studies that support your descriptions.

 

CIA: The World Factbook (Links to an external site.)

 

US County Health Rankings & Roadmaps (Links to an external site.)

 

United Health Foundation: America’s Health Rankings (Links to an external site.)

 

CDC Behavioral Risk Factor Surveillance System (BRFSS) (Links to an external site.)

 

WHO: Health Statistics and Information Systems

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 4 Discussion

 

DQ1 Prevalence and Incidence

 

Discussion Prompt

 

This week we learned about different measures of morbidity and mortality. Incidence and prevalence are two of the most important topics for an epidemiologist. This is how disease is normally reported in and these measures can help to direct more targeted measures as far as addressing outcomes.

 

Consider the health topic you explored last week. Find the current and historical prevalence and incidence rates for the disease or condition. Report this to the class with your analysis of it and which, if either mean more.

 

What do these number say about the disease or condition?

 

Are there interventions that address these issues and have an impact on the prevalence or incidence?

 

DQ2 Mortality Rates and Life Span

 

Discussion Prompt

 

Mortality and morbidity rates are good indicators of the health of the population.

 

Consider two different populations, Sweden and the United States. Look up their morbidity rates and their top causes of death using the CIA World Factbook (Links to an external site.).

 

How has this changed in the last 100 years?

 

Are there any other measurements of mobility or mortality associated with either of these populations that you can provide?

 

Consider your topic that you have been discussing. Share the morbidity and mortality rates associated with it.

 

 

 

 

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 5 Discussion

 

Using Data in Epidemiology

 

Discussion Prompt

 

Data can be found anywhere and everywhere, especially with hospitals using electronic health records and the fact that most records are now kept electronically. Epidemiologists use this data to look for trends, monitor health, make predictions, examine relationships, and draw inferences. Outcomes of these studies are used to support needed changes in public health to improve health outcomes.

 

Before selecting data to use, epidemiologists need to make sure they have access to the data and that the data is relevant to the study they are completing. They also need to consider the limitations that may be associated with the data as well as any flaws in data accuracy, as all this will impact the results of the study.

 

For this discussion, put yourself in the role of an epidemiologist. Explore the different types of data that are available to you. Using your project topic from last week, find three sources of data that could be used for proposed study. For the discussion, provide the following analysis of the data sources:

 

Summary of the data source

 

Nature of the data source

 

Availability of the data source

 

Completeness of the data source

 

Strengths of the data source

 

Limitations of the data source

 

How you could apply this data source in your proposed study

 

APA reference of website

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 6 Discussion

 

Comparing Epidemiological Studies

 

Discussion Prompt

 

Research studies can be divided into three types of studies- experimental, quasi-experimental, and observational. In epidemiology, most of the studies are observational. Observational studies can be either analytic or descriptive. Analytic studies can help provide information about disease etiology and also support preventative measures in public health.

 

This week we examine ecologic, cross-sectional, and case-control studies. Compare and contrast these types of studies in terms of epidemiology. Give the strengths and limitations of these types of studies as well as what they are used for in research. Provide examples of each type of study that you find in the literature.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 7 Discussion

 

Analyzing Cohort Studies

 

Discussion Prompt

 

Cohort studies can tell us several things that other studies can’t. They can tell about causality between variables, enable a wide range of exposure-disease association to be studied, and allow researchers to better understand rare disease or conditions. For this discussion, you will need to find a cohort study other than the ones listed on Table 7-6 of your book and review it. Your review should include the following:

 

A summary of the study

 

The year it began and ended (if applicable)

 

Population based or exposure based

 

Retrospective or prospective

 

The focus

 

The study population

 

The sample

 

Baseline exposure instruments

 

Follow-up exposure instruments

 

Frequency of exposure follow-up

 

Statistical test used to analysis the data

 

Advantages of using the cohort design

 

Limitations of the study

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 8 Discussion

 

Community Interventions

 

Discussion Prompt

 

True experiments are difficult to complete when we think about human subjects. In epidemiology and public health, we often do community interventions or trials instead that are quasi-experiments. The discussion this week involves analyzing a community intervention or trial. Using the topic that you have chosen for your project, select a community intervention related to this. Review the intervention. In this discussion you should include the following:

 

Summary of intervention and study

 

Populations involved

 

How they selected the samples

 

Evaluations that were completed

 

Type of design method

 

Type of inquiry

 

Limitations of the study

 

Statistical analysis

 

Pertinent findings

 

Social change

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 3 Assignment

 

Descriptive Statistics Paper- Getting Started with SPSS

 

Purpose

 

The purpose of this assignment is to obtain and apply a basic knowledge of SPSS and data interpretation.

 

Course Outcomes

 

This assignment provides documentation of student ability to meet the following course outcomes:

 

CO4: Interpret the output from statistical computing packages to draw appropriate inferences and report results effectively.

 

CO9: Determine appropriate method, study design, and statistical analysis for potential research studies

 

Preparing the Assignment

 

This week we will be using an excerpt from the National Health Interview Survey available through the CDC here: https://www.cdc.gov/nchs/nhis/2019nhis.htm (Links to an external site.).

 

Download the required data set  (Links to an external site.)(in Excel format), that includes the coded variables and their values, run descriptive statistics using SPSS, copying and pasting your printout as well as interpreting your results in a narrative. The variables that you will need to discuss are:

 

2013 NCHS Urban-Rural Classification Scheme for Counties

 

health status

 

gender

 

age

 

educations

 

 

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 4 Assignment  

 

Epidemiological Study

 

Purpose

 

The purpose of this assignment is to apply knowledge of epidemiology, statistics, and the research method to formulate a research study of interest. This includes defining the population, identifying and providing support for a gap in literature, identifying a research question, and providing general statistics in relation to this to support the need for study.

 

Course Outcomes

 

This assignment provides documentation of student ability to meet the following course outcomes:

 

CO1: Apply probabilistic, biostatistical, and epidemiological terminology and core concepts to public health issues.

 

CO3: Critique proposed, ongoing and/or completed epidemiological studies or research.

 

CO5: Apply basic epidemiological methods (e.g. study designs and measures) and statistical methods (qualitative and quantitative) to real world outbreaks or case studies.

 

CO6: Explain the importance of epidemiology for informing scientific, ethical, economic, and policy development related to public health issues.

 

CO7: Examine epidemiologic, biologic, social, and behavioral aspects of infectious and chronic diseases.

 

C09: Determine appropriate method, study design, and statistical analysis for potential research studies

 

Preparing the Assignment

 

This week you will start on your project that you will work on over two courses, MPH 515 and MPH 516. The project is a research proposal. You will receive feedback after every submission that you will use to make edits to your project and include it in the next submission.

 

This week you will identify your study of interest, as well as define the population that you are interested in studying. You will also need to complete a simple literature review to find support for the need for your proposal and define the gap that your study will address. To accomplish this, you will need to provide at least 5 peer-reviewed journal articles to be included in the gap and need for the study.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 5 Assignment  

 

Applying Graphs to Data

 

Purpose

 

The purpose of this assignment is to apply knowledge of data analysis and interpretation by developing graphs in SPSS using provided datasets. 

 

Course Outcomes

 

This assignment provides documentation of student ability to meet the following course outcomes:

 

CO4: Interpret the output from statistical computing packages to draw appropriate inferences and report results effectively.

 

CO8: Apply knowledge of data sets free from bias in developing studies to improve public health outcomes by identifying potential trends in relation to epidemiology.

 

Preparing the Assignment

 

This week we will examine the best ways to demonstrate data using graphs and tables.  Using the data set from last week (Links to an external site.), develop a histogram and a box plot for the continuous variable of age providing a narrative for methods used and your results. Also, describe which would be best to show the age. For the scatter plot, plot the respondent and spouse age. Describe the variables that are graphed and why they were chosen as well as any outliers or trends. Finally, report results and your interpretation of the data.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 6 Assignment  

 

Categorical Data

 

Purpose

 

The purpose of this assignment is to apply knowledge of data analysis and interpretation by developing and running a chi-square analysis for categorical data in SPSS. This includes proper result reporting in the form of a paper with output from SPSS and appropriate tables included.  

 

Course Outcomes

 

This assignment provides documentation of student ability to meet the following course outcomes:

 

CO4: Interpret the output from statistical computing packages to draw appropriate inferences and report results effectively.

 

CO8: Apply knowledge of data sets free from bias in developing studies to improve public health outcomes by identifying potential trends in relation to epidemiology.

 

Preparing the Assignment

 

One way to look at categorical data is through Chi-Square, where the expected results are compared to the observed results. You will complete a Chi-Square analysis for this assignment using the same data set extraction from week 3 (Links to an external site.). The variables you will consider are education and health status. You will include a narrative that includes possible hypotheses and null hypotheses, an explanation of the relationship between the variables, and the report the important results in APA format.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 7 Assignment  

 

Correlation

 

Purpose

 

The purpose of this assignment is to apply knowledge of data analysis and interpretation by developing and running an analysis of assumptions and a test of correlation in SPSS. This includes proper result reporting in the form of a paper with output from SPSS and appropriate tables included.    

 

Course Outcomes

 

This assignment provides documentation of student ability to meet the following course outcomes:

 

CO4: Interpret the output from statistical computing packages to draw appropriate inferences and report results effectively.

 

CO8: Apply knowledge of data sets free from bias in developing studies to improve public health outcomes by identifying potential trends in relation to epidemiology.

 

Preparing the Assignment

 

Correlation is a way to look at the relationships of variables, not just their association. Correlation tests can also provide effect size of one variable on another. For this paper, you will use the data set provided from your statistics book. (Links to an external site.)

 

You will complete a correlation test in SPSS that considers the number of cups of tea consumed and the cognitive level of participants. You are expected to provide an analysis of data to ensure that assumptions of normality are met and include this in your narrative and results. You are also expected to provide hypotheses, any statistically significant results, and their interpretation.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 8 Assignment  

 

Epidemiological Study

 

Purpose

 

The purpose of this assignment is to apply knowledge of epidemiology, statistics, and the research method to formulate a research study of interest. This includes adding on to the assignment from week four and the feedback received. The focus this week is selecting the appropriate study design and providing research questions and hypotheses as well as a purpose statement.

 

Course Outcomes

 

This assignment provides documentation of student ability to meet the following course outcomes:

 

CO1: Apply probabilistic, biostatistical, and epidemiological terminology and core concepts to public health issues.

 

CO3: Critique proposed, ongoing and/or completed epidemiological studies or research.

 

CO5: Apply basic epidemiological methods (e.g. study designs and measures) and statistical methods (qualitative and quantitative) to real world outbreaks or case studies.

 

CO6: Explain the importance of epidemiology for informing scientific, ethical, economic, and policy development related to public health issues.

 

CO7: Examine epidemiologic, biologic, social, and behavioral aspects of infectious and chronic diseases.

 

CO9: Determine appropriate method, study design, and statistical analysis for potential research studies

 

Preparing the Assignment

 

The final assignment for this session explores the research questions and the methodology of the intended research project. This will build upon your assignment from week 4 and any feedback that you have received. Make corrections to your assignment and include it after the introduction for further review and feedback. This paper should also include the research method that you feel best aligns with your study (quantitative, qualitative, mixed methods), appropriate research questions and hypotheses, and the purpose statement of your project.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 1 Quiz  

 

Question 1The epidemiologic and clinical descriptions of a disease are different.

 

  True

 

  False

 

Question 2Koch published Die Aetiologie der Tuberkulose in 1882, a breakthrough that led to improved classification of disease by specific causal organisms.

 

  True

 

  False

 

Question 3E. coli O157:H7 is not considered a threat to the food supply of the United States.

 

  True

 

  False

 

Question 4The Framingham Heart Study, begun in 1948, pioneered research into coronary heart disease risk factors.

 

  True

 

  False

 

Question 5Education in epidemiology can be obtained via special summer session programs and online programs.

 

  True

 

  False

 

Question 6The study of diseases linked to harmful physical energy, such as ionizing radiation, would be outside the scope of epidemiology.

 

  True

 

  False

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 2 Quiz  

 

Question 1The epidemiologist John Cassel argued that the agent, host, and environment triad provided an adequate explanation for chronic diseases of noninfectious origin.

 

  True

 

  False

 

Question 2An important risk factor for the population is always important for the individual.

 

  True

 

  False

 

Question 3A dynamic population is one that adds new members through immigration and births and loses members through emigration and deaths.

 

  True

 

  False

 

Question 4Doll and Peto demonstrated that the mortality ratios for lung cancer were similar among those who smoked 1–14 cigarettes per day and those who smoked 15–24 cigarettes per day.

 

  True

 

  False

 

Question 5The term “health disparities” refers to differences in health outcomes (e.g., mortality and burden of disease) that are closely linked with social, economic, and environmental disadvantage.

 

  True

 

  False

 

Question 6What level of prevention is represented by halfway houses for persons recovering from addiction?

 

  Tertiary prevention

 

  Primary prevention, active

 

  Secondary prevention

 

  Primary prevention, passive

 

 

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 3 Quiz  

 

Question 1Race and ethnicity tend to overlap with nativity and religion.

 

  True

 

  False

 

Question 2In the United States, breast cancer is the leading cause of cancer deaths among females.

 

  True

 

  False

 

Question 3The human biological clock phenomenon is linked to place variation in diseases.

 

  True

 

  False

 

Question 4Lung cancer is the leading cause of cancer deaths among both males and females in the United States.

 

  True

 

  False

 

Question 5One of three main purposes of descriptive epidemiology is to aid in the creation of hypotheses.

 

  True

 

  False

 

Question 6Age-specific and age-adjusted mortality rates by sex in the United States generally show the following sex difference(s):

 

  Rates for males are equal to rates for females during the first 5 years of life.

 

  Rates for males are equal to rates for females during the first 5 years of life, and rates for males are higher than rates for females from age 6 to age 85 and older.

 

  Rates for males are higher than rates for females from birth to age 85 and older.

 

  Rates for males are higher than rates for females from age 6 to age 85 and older.

 

  Rates for females are higher than rates for males from birth to age 85 and older.

 

 

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 4 Quiz  

 

Question 1A prerequisite for using the direct method of age adjustment is that the age-specific death rates in the study population must be stable.

 

  True

 

  False

 

Question 2At the initial examination in the Framingham study, coronary heart disease was found in 5 per 1000 men ages 30–44, and in 5 per 1000 women ages 30–44. The inference that in this age group men and women have an equal risk of getting coronary heart disease is incorrect because the data are prevalence data and not incidence data.

 

  True

 

  False

 

Question 3Certain diseases can occur more than once in the same individual during a stated period of time. Repeated cases of the disease have no effect upon incidence rates.

 

  True

 

  False

 

Question 4The proportional mortality ratio (%) is defined as the mortality due to a specific cause during a time period divided by the mortality due to all causes during the same time period times 100.

 

  True

 

  False

 

Question 5Calculation of the standardized mortality ratio is an example of the direct method of age adjustment.

 

  True

 

  False

 

Question 6When the duration of a disease becomes short and the incidence is high, the prevalence becomes similar to incidence.

 

  True

 

  False

 

 

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 5 Quiz  

 

Question 1The National Health Survey consists of several distinct programs conducted by the National Center for Health Statistics.

 

True

 

 False

 

 Question 2Health insurance statistics provide a generally representative picture of the health status of the U.S. population.

 

   True

 

 False

 

Question 3The Freedom of Information Act exempts (does not allow) the release of personal medical data.

 

True

 

 False

 

 Question 4The Vital Statistics Registration System in the United States collects data on all vital events including:

 

births, deaths, and fetal deaths.

 

births.

 

deaths.

 

births and deaths.

 

fetal deaths.

 

Question 5Which of the following is not one of the four criteria for the quality of epidemiologic data?

 

   The reason the data are collected

 

The nature of the data

 

   The completeness of the data

 

The availability of the data

 

Question 6An abrupt drop in mortality due to a specific disease from one year to the next is most likely due to:

 

fewer older persons dying from chronic diseases each year.

 

 listing of cause of death by the physician on the death certificate.

 

   a coding mistake when using the International Classification of Disease (ICD) system.

 

a change in the International Classification of Disease (ICD) system.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 6 Quiz  

 

Question 1Which of the following is an example of exposure data in ecologic studies?

 

  All are correct.

 

  Smoking prevalence

 

  Per capita income

 

  Per capita calorie intake

 

  Mean ambient temperatures

 

Question 2Case-control studies are among the best observational designs to study diseases of:

 

  low prevalence.

 

  high validity.

 

  high prevalence.

 

  low case fatality.

 

Question 3Examples of descriptive epidemiologic studies do not usually include:

 

  cohort studies.

 

  counts.

 

  case series.

 

  cross-sectional studies.

 

Question 4A large medical center’s oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital’s epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption. The resulting data are as follows:

 

DATA

 

 

Cancer Patients

 

Other Patients

 

Men

 

Women

 

Men

 

Women

 

Lifestyle Variable

 

 

Alcohol

 

185

 

120

 

270

 

260

 

Tea drinking

 

140

 

110

 

230

 

225

 

Coffee drinking

 

190

 

140

 

270

 

240

 

 

 

Note:

 

Total number of male cancer patients = 200

 

Total number of female cancer patients = 150

 

Total number of male patients (other diseases) = 300

 

Total number of female patients (other diseases) = 300

 

What type of study is this?

 

  Experimental

 

  Cohort

 

  Case-control

 

  Clinical trial

 

  Intervention

 

Question 5A large medical center’s oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital’s epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption. The resulting data are as follows:

 

 

 

DATA

 

 

Cancer Patients

 

Other Patients

 

Men

 

Women

 

Men

 

Women

 

Lifestyle Variable

 

 

Alcohol

 

185

 

120

 

270

 

260

 

Tea drinking

 

140

 

110

 

230

 

225

 

Coffee drinking

 

190

 

140

 

270

 

240

 

 

 

Total number of male cancer patients = 200

 

Total number of female cancer patients = 150

 

Total number of male patients (other diseases) = 300

 

Total number of female patients (other diseases) = 300

 

Does this study have an exposure status variable?

 

  Yes, sex of patient

 

  No

 

  Yes, lifestyle

 

  Yes, disease type

 

  Insufficient information to answer this question

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 7 Quiz  

 

Question 1Failing to account for age cohort effects in smoking prevalence may:

 

  obscure the fact that there had been a shift in the age of onset for lung cancer toward earlier ages as well as the differences in smoking prevalence for males and females, and by level of education.

 

  obscure the fact that older cohorts had higher prevalence of smoking in comparison to younger cohorts.

 

  obscure the fact that there had been a shift in the age of onset for lung cancer toward earlier ages.

 

  obscure the differences in smoking prevalence for males and females, and by level of education.

 

Question 2A five-year prospective cohort study has just been completed. The study was designed to assess the association between supplemental vitamin A exposure and mortality and morbidity for measles. The RR for incidence of measles was 0.75, and the RR for measles mortality was 0.5.

 

Which statement is correct?

 

  One of the problems that this study may have faced is individuals lost to follow-up during the five-year period.

 

  Supplemental vitamin A increases the incidence of measles.

 

  A cohort study is not an appropriate study design in this case because the association between one exposure and two different outcomes is being considered.

 

  A cohort study is not a good design to study this association because measles is a very common disease.

 

  None are correct.

 

Question 3An example of passive follow-up in cohort studies is: 

 

  telephone calls to study participants.

 

  collection and maintenance of data by federal and state governments.

 

  use of written invitations to return to the study site.

 

  use of follow-up mailings.

 

Question 4Subjects for an exposure-based cohort study of lead exposure would be selected most appropriately from:

 

  certain occupational groups such as workers who manufacture batteries.

 

  male Harvard alumni from 1916 to 1950.

 

  All are correct.

 

  the residents of a large U.S. county.

 

Question 5Cohort study is to risk ratio as: 

 

  ecologic fallacy is to cross-sectional study and case-control study is to odds ratio.

 

  genetics is to environment.

 

  case-control study is to odds ratio.

 

  ecologic fallacy is to cross-sectional study.

 

Question 6A major advantage of cohort studies over case-control studies with respect to the role of a suspected factor in the etiology of a disease is that: 

 

  they permit direct determination of risk of disease in those exposed to the suspected factor.

 

  it is easier to obtain controls not exposed to the suspected factor.

 

  they take less time and are less costly.

 

  they can utilize a more representative population.

 

  they can be done on a double-blind basis.

 

 

 

MPH515 Epidemiology and Biostatistics for Public Health Application I

 

Module 8 Quiz  

 

Question 1 Controlled clinical trials enable researchers to: 

 

  test new drugs, new therapies, and new medical devices.

 

  exercise control over who will receive an exposure.

 

  identify definitive relationships between causes and effects.

 

  All are correct.

 

Question 2A major advantage of community trials is that they are able to:

 

  control delivery of the intervention to many study units.

 

  estimate directly the realistic impact of behavior change.

 

  randomize subjects precisely to the study conditions.

 

  All are correct.

 

Question 3To assess clinical end points, investigators:

 

  compare rates of disease.

 

  compare rates of death.

 

  compare rates of recovery.

 

  All are correct.

 

Question 4 The purpose of randomization is to reduce error that results from:

 

  the way in which the outcome is assessed.

 

  subjects’ participation in the trial.

 

  assignment to study conditions.

 

  the way in which the outcome is assessed and assignment to study conditions.

 

  All are correct.

 

Question 5Surrogate endpoints for a clinical trial of a drug to control hypertension may include: 

 

  subclinical disease.

 

  physical measures such as reduction in blood pressure.

 

  occurrence of strokes and heart attacks.

 

  subclinical disease and physical measures such as reduction in blood pressure.

 

Question 6The purpose of a double-blind design in clinical trials is to reduce error that results from:

 

  the way in which the outcome is assessed.

 

  subjects’ knowledge of their assignment to study conditions.

 

  nonrandom assignment to study conditions.

 

  the way in which the outcome is assessed and subjects’ knowledge of their assignment to study conditions.

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