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PUBH 3131 Lecture Notes - Lecture 7: Odds Ratio, Attributable Risk, Protective Factor

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turquoiseseal559
20 Mar 2018
School
GWU
Department
Public Health
Course
PUBH 3131
Professor
Ulfers

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Document Summary

# of positive events/# of negative events. Protective associations: risk in exposed is less than that in unexposed. Rr less than 1: exposure is beneficial. Rr more than 1: exposure is bad. Lower the disease risk, close the or to rr. Or has more extreme value than rr. Odds ratio (or): measure of the association between frequency of exposure and frequency of outcome. Or less than 1: exposure might be a protective factor. Relative risk: ratio of incidence rate of a disease or health outcome in an exposed group to the incidence rate of the disease or condition in a nonexposed group. Gives risk in total population of disease due to exposure. Apply national or local age specific mortality rates. Smr >1: study population more deaths than expected for a similar age distribution. Cannot be compared to other smrs since they are based on different age distributions.

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Related Questions

1. The risk of acquiring disease is measured by the

a. Incidence rate

b. Incidence rate times the average duration of the disease

c. Incidence rate divided by the prevalence rate

d. Prevalence rate

e. Prevalence rate times the average duration of the disease

2. The strength of an association between a factor and a disease is best measure by .

a. Incubation rate

b. Incidence of the disease in the total population

c. Prevalence of the factor

d. Attributable risk

e. Relative risk

3. Case fatality rate for a given disease refers to

a. The crude mortality rate per 100,000 population

b. Cause-specific mortality rate due to the disease

c. A fatal outcome of any disease

d. The percentage of deaths among cases of the disease

e. The proportion of deaths due to the disease among all deaths from all causes

4. An investigator is interested in etiology of neonatal jaundice. To study this condition, he selected 100 children who were diagnosed with this condition and 100 children born in the same period and in the same hospital who did not have a diagnosis of neonatal jaundice. He then reviewed the obstetrical and delivery records of their mothers to determine various prenatal and perinatal exposures. This is an example of a(n):

a. Cross-sectional study

b. Case-control study

c. Cohort study

d. Clinical trial

e. Experiment

5. Which of the following statements describes the major advantages of a randomized clinical trial?

a. It avoids observer bias

b. It lends itself to ethical justification

c. It yields results replicable in other patients

d. It rules out self-selection of participants to the different treatment groups

d. It enrolls representative patients

6. A survey conducted in England revealed that of 224 families in which there had been a known case of poliomyelitis, 56 maintained parakeets as a family pet. In another British survey, 30 out of 99 poliomyelitis patients questioned kept parakeets. The inference that there is some relationship between the presence of a parakeet in a household and the occurrence of poliomyelitis among household members is

a. Correct b.

Incorrect because of failure to distinguish between incidence and prevalence

c. Incorrect because a proportionate ratio is used when a rate is required to support the inference

d. Incorrect because a failure to recognize a possible cohort phenomenon

e. Incorrect because there is no control or comparison group.

7. An investigator determines the correlation coefficient between triglyceride levels and degree of atherosclerosis in sampled blood vessels to be +1.67. On the basis of this you would conclude that:

a. Triglyceride level is a good predictor of atherosclerosis

b. Triglyceride level is not a good predictor of atherosclerosis

c. High triglyceride levels cause atherosclerosis

d. Atherosclerosis cause high triglyceride levels

e. The investigator has incorrectly determined the correlation coefficient

8. A screening test of known sensitivity and specificity is applied to two populations. The prevalence of the disease being screened for is 10% in population A and is 1% in population B. Which of the following is true?

a. The percent of all negative tests that have false-negative results is lower in population A than in population B.

b. Specificity is lower in population A than in population B.

c. Reliability is higher in population A than in population B.

d. The percent of all positive tests that have false-positive results is lower in population A than in population B.

e. Specificity is higher in population A than in population B.

9. Serum cholesterol levels are obtained for four healthy men. The probability that all will fall below the 10th percentile of the distribution of cholesterol for healthy males is:

a. 0.4

b. 1 – (0.1)4

c. (0.1)4

d. (0.9)4

e. Cannot be determined from these data

10. In a diabetes screening program, the screening level for a positive blood sugar level in test 1 is set at 160 mg/dl, and in test 2 at 130 mg/dl. The sensitivity is:

a. Greater in test 1

b. Greater in test 2

c. Equal in test 1 and 2

d. Dependent on the size of the population being evaluated

1. The risk of acquiring disease is measured by the a. Incidence rate b. Incidence rate times the average duration of the disease c. Incidence rate divided by the prevalence rate d. Prevalence rate e. Prevalence rate times the average duration of the disease

2. The strength of an association between a factor and a disease is best measure by a. Incubation rate b. Incidence of the disease in the total population c. Prevalence of the factor d. Attributable risk e. Relative risk

3. Case fatality rate for a given disease refers to a. The crude mortality rate per 100,000 population b. Cause-specific mortality rate due to the disease c. A fatal outcome of any disease d. The percentage of deaths among cases of the disease e. The proportion of deaths due to the disease among all deaths from all causes

4. An investigator is interested in etiology of neonatal jaundice. To study this condition, he selected 100 children who were diagnosed with this condition and 100 children born in the same period and in the same hospital who did not have a diagnosis of neonatal jaundice. He then reviewed the obstetrical and delivery records of their mothers to determine various prenatal and perinatal exposures. This is an example of a(n): a. Cross-sectional study b. Case-control study c. Cohort study d. Clinical trial e. Experiment

5. Which of the following statements describes the major advantages of a randomized clinical trial? a. It avoids observer bias b. It lends itself to ethical justification c. It yields results replicable in other patients d. It rules out self-selection of participants to the different treatment groups d. It enrolls representative patients

6. A survey conducted in England revealed that of 224 families in which there had been a known case of poliomyelitis, 56 maintained parakeets as a family pet. In another British survey, 30 out of 99 poliomyelitis patients questioned kept parakeets. The inference that there is some relationship between the presence of a parakeet in a household and the occurrence of poliomyelitis among household members is a. Correct b. Incorrect because of failure to distinguish between incidence and prevalence c. Incorrect because a proportionate ratio is used when a rate is required to support the inference d. Incorrect because a failure to recognize a possible cohort phenomenon e. Incorrect because there is no control or comparison group.

7. An investigator determines the correlation coefficient between triglyceride levels and degree of atherosclerosis in sampled blood vessels to be +1.67. On the basis of this you would conclude that: a. Triglyceride level is a good predictor of atherosclerosis b. Triglyceride level is not a good predictor of atherosclerosis c. High triglyceride levels cause atherosclerosis d. Atherosclerosis cause high triglyceride levels e. The investigator has incorrectly determined the correlation coefficient

8. A screening test of known sensitivity and specificity is applied to two populations. The prevalence of the disease being screened for is 10% in population A and is 1% in population B. Which of the following is true? a. The percent of all negative tests that have false-negative results is lower in population A than in population B. b. Specificity is lower in population A than in population B. c. Reliability is higher in population A than in population B. d. The percent of all positive tests that have false-positive results is lower in population A than in population B. e. Specificity is higher in population A than in population B.

9. Serum cholesterol levels are obtained for four healthy men. The probability that all will fall below the 10th percentile of the distribution of cholesterol for healthy males is: a. 0.4 b. 1 – (0.1)4 c. (0.1)4 d. (0.9)4 e. Cannot be determined from these data

10. In a diabetes screening program, the screening level for a positive blood sugar level in test 1 is set at 160 mg/dl, and in test 2 at 130 mg/dl. The sensitivity is: a. Greater in test 1 b. Greater in test 2 c. Equal in test 1 and 2 d. Dependent on the size of the population being evaluated

Part II 1.The California Occupational Mortality study data set was employed to assess mortality data for the years 1979-1981. A 2% sample of employed persons from the 1980 census of California was used. It contains the occupation of each person who had died. This study, like any occupation-based study, is restricted to the work life span as far as age of subjects is concerned. This study used ages 16-64 years. Certain persons, because of their source of work, were excluded as subjects: homemakers, retired persons, students, disabled, military personnel, etc. Only main-stream-type employment was used in this study to establish occupations at risk for heavy alcohol drinking. Using the Table below, answer the following:

1.What occupations are most vulnerable to acquiring cirrhosis of the liver from heavy drinking?

2.List several of the occupations identified by the research studies that are more vulnerable to alcohol-induced, cirrhosis related deaths and that have the highest mortality rates.

3. What are possible confounding variables for the research in occupations and heavy drinking that lead to fatal diseases?

4. Based on available research data, develop and construct a web of causation along with the appropriate decision trees for occupational group-related alcohol deaths. Table. Alcohol Related Deaths in California, 1979-1981 Cirrhosis 5.5% Digestive organ cancers 5.7% Injuries 13.7% Suicide and homicide 5.% All other causes 64.9%

Zika and microcephaly Since May 2015, Brazil has experienced a significant outbreak of Zika virus. In recent years, Brazilian officials reported an increase in the number of babies born with microcephaly.

1. Briefly describe what we know and what we do not know about Zika virus.

2. What has been done and what should be done to prevent Zika virus epidemic in US and world-wide?

QUESTION 1

  1. The first person to describe a carcinogen was:

    a.

    Rudolf Virchow
    b.

    Cladius Regaud
    c.

    Percivall Pott
    d.

    George Papanicolau
    e.

    Sidney Farber

QUESTION 2

  1. Who introduced the test for early detection of cervical cancerin 1942?

    a.

    Rudolf Virchow
    b.

    Cladius Regaud
    c.

    Percivall Pott
    d.

    George Papanicolau
    e.

    Sidney Farber

QUESTION 3

  1. All of the following are TRUE about risk factors for cancerEXCEPT:

    a.

    They cause DNA mutation
    b.

    Some can be avoided
    c.

    Some can be inherited
    d.

    They guide patient management
    e.

    They increase the probability of getting cancer

QUESTION 4

  1. All of the following are proven carcinogens EXCEPT:

    a.

    Tobacco
    b.

    Formaldehyde
    c.

    Soot
    d.

    Saccharin
    e.

    Human papilloma virus

QUESTION 5

  1. Which of the following is true about somatic mutations:

    a.

    They are present in an egg or sperm
    b.

    They can be inherited
    c.

    They can be present in all cells in the individual
    d.

    They can cause cancer family syndrome
    e.

    They cannot be inherited

QUESTION 6

  1. All of the following can be used as a guideline for causalinference of a carcinogen EXCEPT:

    a.

    Strength of association of the exposure with occurrence ofcancer
    b.

    Single correlation study showing exposure with the incidence ofcancer
    c.

    Dose response relation of the exposure and risk of cancer
    d.

    Disease or risk reduction with removal of exposure
    e.

    Biological plausibility of the exposure with the disease

QUESTION 7

  1. All of the following cancers have an infectious causeEXCEPT:

    a.

    Cervical Cancer
    b.

    Stomach Cancer
    c.

    Breast Cancer
    d.

    Liver Cancer
    e.

    Hodgkin lymphoma

QUESTION 8

  1. Medical treatments that cause cancer include all of thefollowing EXCEPT:

    a.

    MOPP chemotherapy for Hodgkin lymphoma
    b.

    Radiation therapy for sarcoma
    c.

    Tamoxifen for chemotherapy
    d.

    Smallpox vaccination
    e.

    Cyclosporine for immunosuppression

QUESTION 9

  1. All of the following are risk factors for breast cancerEXCEPT:

    a.

    Having breast implants
    b.

    Having prior ovarian cancer
    c.

    Having a mother with breast cancer
    d.

    Age
    e.

    Obesity

QUESTION 10

  1. The likelihood of getting cancer from exposure to a carcinogenis related to all of the following EXCEPT:

    a.

    The duration of exposure
    b.

    The geographic location of the exposure
    c.

    The degree of exposure
    d.

    The genetic susceptibility of the exposed person
    e.

    The mode of exposure (e.g., touching it, breathing it,swallowing it, etc).