Epi Final Flashcards by Austin Wieman

________________ refers to the benefits of a treatment, procedure, or service among those who use it in contrast to those who do not.
A. Efficacy
B. Effectiveness
C. Validity
D. Healthy participant effect

Effectiveness

How well did you know this?

Not at all

Perfectly

Epidemiology involves studying only infectious diseases, not events like injury, obesity, mental health disorders, seat belt use, etc.
A. True
B. False

False

How well did you know this?

Not at all

Perfectly

Epidemiologic research involves which of the following?
A. Exploratory methods
B. Descriptive methods
C. Analytic methods
D. Exploratory, descriptive, and analytic methods

D. Exploratory, descriptive, and analytic methods

How well did you know this?

Not at all

Perfectly

Humans can serve as all the following, except:
A. Fomites
B. Reservoirs
C. Hosts
D. Humans can serve as none of these

Fomites

How well did you know this?

Not at all

Perfectly

In the definition of epidemiology, “distribution” refers to which of the following?
A. Time and place
B. Heaven and earth
C. Frequency and pattern
D. Cause and effect

Frequency and pattern

How well did you know this?

Not at all

Perfectly

Public health surveillance includes all of the following, except:
A. Public health action
B. Systematic collection of data
C. Analysis of data
D. Interpretation and dissemination of data
E. None of these is part of public health surveillance

Public health action

How well did you know this?

Not at all

Perfectly

The definition of epidemiology involves all the following, except:
A. Study of determinants
B. Study of disease frequency
C. Study of disease patterns
D. Health-related states or events
E. All of these are included in the definition of epidemiology

All of these are included in the definition of epidemiology

How well did you know this?

Not at all

Perfectly

Those diseases and infections that are transmitted between vertebrate animals and humans are referred to as:
A. Vectors
B. Zoonoses
C. Vehicles
D. Biological

Zoonoses

How well did you know this?

Not at all

Perfectly

Which of the following is an example of active primary prevention?
A. Eating vitamin-enriched foods
B. Drinking fluoridated water
C. Exercise
D. Automatic sprinklers in a home to put out a fire

Exercise

How well did you know this?

Not at all

Perfectly

Which of the following is the best example of a fomite?
A. Clothing
B. Fly
C. Habitat
D. Time

Clothing

How well did you know this?

Not at all

Perfectly

A primary case is the same as an index case.
A. True
B. False

False

How well did you know this?

Not at all

Perfectly

Application of the study of the distribution and determinants of health-related states or events in human populations to prevent and control health problems is not part of the definition of epidemiology.
A. True
B. False

False

How well did you know this?

Not at all

Perfectly

John Graunt identified two types of dying, which are:
A. Passive and aggressive
B. Acute and chronic
C. Vertical and horizontal
D. With pain and without pain

Acute and chronic

How well did you know this?

Not at all

Perfectly

Which of the following is not a contribution made by Florence Nightingale?
A. Helped create changes in hygiene in military hospitals
B. Published extensively on public health
C. Developed and applied statistical methods
D. Found that food and water were not suspect as the primary means of transmission of typhoid

Found that food and water were not suspect as the primary means of transmission of typhoid

How well did you know this?

Not at all

Perfectly

Who advanced useful treatment and remedies (which other physicians rejected at the time) such as exercise, fresh air, and a healthy diet?
A. Hippocrates
B. John Graunt
C. James Lind
D. Thomas Sydenham

Thomas Sydenham

How well did you know this?

Not at all

Perfectly

Who developed a vaccine against smallpox based on careful observation?
A. Benjamin Jesty
B. Edward Jenner
C. Louis Pasteur
D. Robert Koch

Edward Jenner

How well did you know this?

Not at all

Perfectly

Who developed and applied the case-control study design?
A. Florence Nightingale
B. Olli S. Miettinen
C. Janet Lane-Claypon
D. Jerome Cornfield

Janet Lane-Claypon

How well did you know this?

Not at all

Perfectly

Who introduced the words epidemic and endemic?
A. Hippocrates
B. John Graunt
C. James Lind
D. Thomas Sydenham

Hippocrates

How well did you know this?

Not at all

Perfectly

Who investigated the relationship between smoking and lung cancer using a cohort study design?
A. Wynder and Graham
B. Doll and Hill
C. Miettinen
D. Both Wynder and Graham, and Doll and Hill

Doll and Hill

How well did you know this?

Not at all

Perfectly

Who pioneered the randomized clinical trial and presented criteria for determining causal association?
A. Olli S. Miettinen
B. Joseph Berkson
C. Jerome Cornfield
D. Sir Austin Bradford Hill

D. Sir Austin Bradford Hill

How well did you know this?

Not at all

Perfectly

Who revealed the dangers of poisoning from lead used by potters in their glaze?
A. John Graunt
B. William Farr
C. Bernardino Ramazzini
D. Lemuel Shattuck

C. Bernardino Ramazzini

How well did you know this?

Not at all

Perfectly

Who used an experimental study design to determine that dietary factors were influential in treating and preventing scurvy?
A. Hippocrates
B. John Graunt
C. James Lind
D. Thomas Sydenham

James Lind

How well did you know this?

Not at all

Perfectly

Who was a pioneer in the field of toxicology?
A. Florence Nightingale
B. Janet Lane-Claypon
C. Alice Hamilton
D. Beverly Ririe

Alice Hamilton

How well did you know this?

Not at all

Perfectly

Who was the naval surgeon who eradicated beriberi from the Japanese navy by adding vegetables, meat, and fish to their diet, which until then had been mostly rice?
A. T.K. Takaki
B. Akira Hana
C. Ninata Sukura
D. Ren Aoi

T.K. Takaki

How well did you know this?

Not at all

Perfectly

Whose report set forth the importance of establishing state and local boards of health in the United States? A. John Graunt B. William Farr C. Bernardino Ramazzini D. Lemuel Shattuck

Lemuel Shattuck

A description of communicable disease prevention and control may include all the following, except: A. Remove, eliminate, or contain the cause or source of infection B. Disrupt and block the chain of disease transmission C. Protect the susceptible population against infection and disease D. All of these are part of communicable disease prevention and control

All of these are part of communicable disease prevention and control

Infectious disease is best defined as: A. Harmful development in a microscopic organism B. Alteration of the organism's normal functioning C. Disease caused by an invading pathogen D. A body not capable of carrying on its normal functions

Disease caused by an invading pathogen

The capacity and strength of the disease to produce severe and fatal cases of illness is known as: A. Variolation B. Virulence C. Pathogenicity D. Pathogenesis

Virulence

The capacity of a microorganism to enter and grow in or upon tissues of the host is called: A. Etiology B. Pathogenesis C. Invasiveness D. Virulence

Invasiveness

What is the herd immunity threshold for COVID-19 (Omicron)? A. 33% to 60% B. 69% to 83% C. 82% to 96% D. 92% to 94%

82% to 96%

What is the incubation period for COVID-19? A. 1–3 weeks B. 2–14 days C. 1–3 days D. 4–10 days

2–14 days

Which of the following best defines pathogen? A. Extent of pathogenicity B. A microscopic organism (plant or animal) C. An organism capable of causing disease D. All of these are correct

An organism capable of causing disease

Which of the following is not a type of immunity? A. Acquired B. Active C. Passive D. Transfer

Transfer

Which of the following stages is associated with the incubation period? A. Stage of susceptibility B. Stage of presymptomatic disease C. Stage of clinical disease D. Stage of recovery, disability, or death

Stage of presymptomatic disease

True or False? An organism is only pathogenic if it can enter a host. A. True B. False

True

True or False? Antibiotics are toxic. A. True B. False

True

Epidemiologic research has associated several conditions with obesity. Which of the following is not one of them? A. Cardiovascular disease B. Sleep apnea C. Osteoarthritis D. Influenza E. Diabetes Type 2 F. Cancer (Breast, Colon)

Influenza

Match the following cancers with their known carcinogens: (Format as a matching question in test settings; options provided here for reference.) Leukemia – Aromatic amines, solvents Lung – Radon Liver – Aromatic amines, solvents Gastrointestinal tract – Asbestos

Correct Matches: 1 → Aromatic amines, solvents 2 → Radon 3 → Aromatic amines, solvents 4 → Asbestos

Match the following chronic conditions to their risk factors: Osteoporosis – Estrogen Respiratory/asthma – Asbestos Dermatologic – Arsenic

Correct Matches: 1 → Estrogen 2 → Asbestos 3 → Arsenic

Cancer has been associated with all the following, except: A. Environmental hazards B. Infectious pathogens C. Tobacco smoking D. Alcohol abuse E. High blood pressure F. Cancer has been associated with all of these

High blood pressure

Disability is an umbrella term for which of the following? A. Participation restriction B. Activity limitation C. Impairment D. Activity limitation and impairment E. All of these are correct

All of these are correct

The Health Belief Model involves cues to action. Which of the following best defines this concept? A. One's opinion of chances of getting a condition B. Strategies to activate readiness C. One's opinion of the tangible and psychological costs of the advised action D. One's belief in the efficacy of the advised action to reduce risk or seriousness of impact

Strategies to activate readiness

The increased risk of Burkitt's lymphoma has been associated with which of the following? A. Hepatitis B and C viruses B. Human papillomavirus C. Epstein-Barr virus D. Human T-cell lymphotropic virus

Epstein-Barr virus

The time from exposure to clinical signs of a chronic disease is the: A. Incubation period B. Latency period C. Susceptibility period D. Mortal period

Latency period

Today, approximately ____ in 10 deaths among Americans can be attributed to chronic disease. A. 5 B. 6 C. 7 D. 8

Which of the following best characterizes chronic disease? A. Severe B. Short duration C. Caused by a single pathogen D. Long and continuous duration

Long and continuous duration

Which of the following risk factor types is associated with all the following: heart disease, cancer, stroke, accidents, diabetes, cirrhosis, suicide, and homicide? A. Behavior B. Environment C. Biological/genetic D. Social

Social

True or false? Polyunsaturated fats, compared with monounsaturated fatty acids, are associated with greater risk of breast cancer. A. True B. False

True

Based on a survey of 50 students, 30% said they get 7 or more hours of sleep per night on average. What is the 95% confidence interval for this estimate? A. 17.2 to 42.8 per 100 B. 17 to 43 per 100 C. 20.8 to 39.2 per 100 D. 17.3 to 42.7 per 100

17 to 43 per 100

Suppose that in a given region, 20% of its population is younger than 15 years and 10% is older than 65 years. What would the dependency ratio be? A. 46 B. 50 C. None of these is correct D. 43

In the age range reflected in this table, what percentage of the population of Black people is female? A. 51% B. 52% C. 54% D. 56%

56%

Would the 95% confidence interval be wider for White people or Black people? A. White people B. Black people

Black people

The fraction is a: A. Proportion B. Rate C. None of these is correct D. Ratio

Ratio

The fraction is a: A. Ratio B. Rate C. None of these is correct D. Proportion

Proportion

The fraction is a: A. Ratio B. Proportion C. None of these is correct D. Rate

Rate

What is the mean number of weekly COVID-19 cases in Europe (July 3–31, 2023)? A. 21,613 B. 18,041 C. 21,624 D. 18,829

18,829

What is the median number of weekly COVID-19 cases in Europe (July 3–31, 2023)? A. 21,613 B. 21,624 C. 18,829 D. 18,041

18,041

To ensure that the sample represents the population of interest, which of the following sampling designs is preferred? A. Convenience sampling B. Judgmental sampling C. Consecutive sampling D. Quota sampling E. Simple random sampling

Simple random sampling

What is the name of a study that involves the statistical aspects of a systematic review? A. Ancillary analysis B. Secondary analysis C. All of these are correct D. Meta-analysis

Meta-analysis

Which of the following epidemiologic questions fits with an analytical study? A. Who? B. What? C. When? D. Where? E. Why?

Why?

Which of the following is not associated with an exploratory study design? A. Literature review B. Depth interviews C. Focus group D. Case report E. Cohort study

Cohort study

Which probability sampling design is best for obtaining representation from various subgroups of the population? A. Simple random B. Systematic C. Stratified D. Cluster

Stratified

True or False? A secular trend represents periodic increases and decreases in the occurrence of health-related states or events. A. True B. False

False

True or False? A stationary population pyramid has a broad base and a tall, pointed shape. A. True B. False

False

True or False? Effect modification and confounding refer to the same thing. A. True B. False

False

True or False? Statistical inference is a conclusion about the target population based on a sample from the accessible population. A. True B. False

True

___________ is defined as the effect on patient outcomes that may occur due to the expectation by a patient that a particular intervention will have an effect. Interviewer effect Recall effect Selection effect Placebo effect

Placebo effect

An unplanned type of experimental study where the levels of exposure to a presumed cause differ among a population in a way that is relatively unaffected by extraneous factors, such that the situation resembles a planned experiment, is called a: nonrandomized experiment natural experiment placebo-controlled experiment All of these are correct

natural experiment

Assessment of the effectiveness of radiation versus surgery in prostate cancer patients would be considered a: therapeutic trial preventive trial

therapeutic trial

Investigation of the effectiveness of the poliomyelitis vaccine would be considered a: therapeutic trial preventive trial

preventive trial

What effect does randomization in a large intervention study have? Randomization is not needed in large interventions Minimizes confounding Minimizes moderation Minimizes mediation

Minimizes confounding

Which of the following designs is potentially most useful for making a judgment about causality? Cross-sectional Case-control Case series Experimental

Experimental

Which of the following is a primary disadvantage of using hospital controls in a case-control study? More costly and time consuming than getting controls from the general population These controls tend to overestimate the true association between exposure and outcome variables. They differ from healthy people such that they do not accurately represent the exposure distribution in the population where cases were obtained. More likely to be aware of antecedent events or exposures

They differ from healthy people such that they do not accurately represent the exposure distribution in the population where cases were obtained.

Which of the following is a useful way to evaluate association between variables in an ecologic study? Pearson correlation coefficient Coefficient of determination Slope coefficient from a regression model Risk ratio Odds ratio Pearson correlation coefficient, coefficient of determination, and slope coefficient from a regression model Coefficient of determination, slope coefficient from a regression model, and risk ratio

Pearson correlation coefficient, coefficient of determination, and slope coefficient from a regression model

Which of the following is not a descriptive study design? Ecologic study Case report, case series Cohort Cross-sectional All of these are examples of descriptive study designs.

Cohort

Which of the following is not associated with a phase II trial? Relatively small group of patients Randomization Tests side effects Tests tolerability

Randomization

Which of the following is the appropriate measure of association in a case-control study involving exposure status by outcome status? Risk ratio Rate ratio Odds ratio Relative risk

Odds ratio

Which of the following is the appropriate measure of association in a cohort study involving person-time data? Risk ratio Rate ratio Odds ratio Relative risk

Rate ratio

Which of the following study designs involves the population as the unit of analysis? Ecologic study Case report, case series Cohort Cross-sectional

Ecologic study

Which of the following study designs provides a useful way to obtain prevalence data? Ecologic study Case report, case series Cohort Cross-sectional

Cross-sectional

True or False? Experimental studies involving randomization are always preferred over nonrandomized studies.

False

True or False? Selection of a population at high risk of developing the outcomes of interest is a primary strategy to ensure the accumulation of an adequate number of cases that will develop the end point(s).

True

True or False? The experimental study is effective when the outcome of interest is rare. True False

False

True or False? The nested case-control study is efficient, flexible, and effective at minimizing bias. True False

True

True or False? The correlation coefficient is useful for measuring associations among continuous variables in ecologic studies.

True

Suppose a simple regression model is calculated assessing the association between exercise (hours per week) and pulse per minute. Pulse is the dependent variable. The estimated slope is –0.5, r = –0.5 and r² = 0.25. Which of the following is true? There is a perfect negative association. Twenty-five percent of the variation in pulse is explained by exercise. As exercise increases by 1 hour, pulse increases by 0.5, on average. There is a positive association between exercise and pulse.

Twenty-five percent of the variation in pulse is explained by exercise.

In a case-control study assessing the association between coffee drinking and myocardial infarction, the odds ratio was 2.25. It was 1 for smokers and 1 for nonsmokers. What do these results say about confounding and effect modification? Positive confounding and no effect modification No confounding or effect modification Positive confounding and effect modification Negative confounding and effect modification

Positive confounding and no effect modification

Match the following control with its description. 3 Increase sample size 2 Blind 1 Random assignment A way to control for confounding A way to control for bias A way to control for a chance finding

3: Increase sample size → A way to control for a chance finding 2: Blind → A way to control for bias 1: Random assignment → A way to control for confounding

A case-control study found a positive association between self-reported alcohol use during pregnancy and fetal alcohol syndrome. This statistical association is due to: chance bias

bias

A case-control study showed a strong positive association between coffee drinking and heart disease. This statistical association is due to: chance bias confounding

confounding

A cohort study found no statistical association between smoking and coronary heart disease (RR = 1, p-value = 0.75). This statistical association is due to: chance bias confounding

chance

A randomized clinical trial measured the association between a new drug and survival, and found that drug A versus placebo did not significantly improve 10-year survival (RR = 0.35, 95% Confidence Interval: 0.14–55.01). This statistical association is due to: chance bias confounding

chance

A woman with a child who has a neurologic problem may better recall events that occurred during pregnancy (e.g., medication use, environmental exposure, or illness) than a woman with a child who does not have a neurologic problem. If you conducted a case-control study examining the association between medication use during pregnancy and having a child with neurologic problems, would you expect the odds ratio to be: overestimated underestimated

overestimated

Bias may occur in all the following research stages, except: Reviewing the literature related to the research question. Selecting the sample. Measuring the exposure and outcome variables. Analyzing the data. Interpreting the results.

Bias may occur in any stage.

Selection bias may consist of which of the following? Detection bias Performance bias Volunteer bias Healthy worker effect Attrition bias

All of these are correct.

Which of the following best describes lead-time bias? Slow-progressing cases of disease with a better prognosis are more likely to be identified than faster-progressing cases of disease with a poorer prognosis. Screening advances the time of diagnosis, making it difficult to evaluate the benefit of early treatment. It occurs when screening identifies an illness that would not have shown clinical signs before a person's death from other causes.

Screening advances the time of diagnosis, making it difficult to evaluate the benefit of early treatment.

Which of the following is a way to adjust for confounding at the design phase of a study? Restriction Stratification Multiple regression Propensity score All of these are correct.

Restriction

Which of the following is an effective way to minimize the influence of a chance finding that results because of sampling? Increase the target population. Increase the sample size. Increase the number of research questions. All of these are ways to minimize chance findings.

Increase the sample size.

Which of the following is not a type of selection bias in cohort studies? Healthy worker effect Attrition bias Prevalence-incidence bias All of these are types of selection bias in cohort studies.

All of these are types of selection bias in cohort studies.

True or False? All study designs that utilize interviews, particularly those in which the interviewer knows the outcome status of the participant, are susceptible to interviewer bias. True False

True

True or False? Convenience sampling does a better job in obtaining a representative group than random sampling. True False

False

True or False? Interviewer bias in a cross-sectional study is best minimized by blinding. True False

False

Areas where children are less likely to be vaccinated for chicken pox have higher levels of this illness. Which of John Stuart Mills canons does this best describe? Method of difference Method of agreement Method of concomitant variation None of these is correct.

Method of concomitant variation

In the epidemiology triangle, the term “agent” is equivalent to which of the following? Host Pathogen Environment None of these is correct.

Pathogen

Precipitating factors are best defined as: factors essential to the development of diseases, conditions, injuries, disability, and death. factors or conditions allowing or assisting the disease, condition, injury, disability, or death to begin and to be able to run its course of events. factors or conditions already present that produce a susceptibility or disposition in a host to a disease or condition without causing it. None of these is correct.

factors essential to the development of diseases, conditions, injuries, disability, and death.

Predicting the proportion of currently diagnosed patients with a given cancer who will be alive in 5 years, based on 25 years of data, is an example of: inductive reasoning. deductive reasoning.

inductive reasoning.

Refer to the following diagrams. Which of the following is a necessary cause? A A, B, C A, A, D F B

Refer to the following diagrams. Which of the following is a sufficient cause? A A, B, C A, A, D F B

A, B, C

Refer to the following diagrams. Which of the following is not a component cause? A A, B, C A, A, D F B

Temporality is a causal guideline. Of the following study designs, which is best for establishing temporality? Cross-sectional Ecologic Case-control Experimental

Experimental

The epidemiology triangle was originally developed for: infectious disease. chronic disease.

infectious disease.

Why is a strong statistical association in a single study insufficient to show causal relations? Chance Bias Confounding All of these are correct.

All of these are correct.

True or False? A valid statistical association is a necessary part of establishing a cause-effect relationship. True False

True

True or False? A web of causation is a graphical, pictorial, or paradigmatic representation of complex sets of events or conditions caused by an array of activities connected to a common core or common experience or event. It is used primarily in the context of infectious disease. True False

False

True or False? Descriptive epidemiology involves identifying and quantifying associations, testing hypotheses, and identifying causes of health-related states or events. True False

False

True or False? Risk factor and cause mean the same thing. True False

False

True or False? We never accept a hypothesis as being true, but rather either reject the hypothesis or fail to reject the hypothesis, based on Popper's principle of refutation. True False

True

Based on the analysis reported in the chapter, which of the following variables has the weakest association with life expectancy? Poverty Education Health insurance Disability Birth rate

Birth Rate

Important concepts identified in social epidemiology that affect the distribution of health-related states or events include which of the following? Job stress Social capital Social relationships Social inequality All of these are correct. Social capital, relationships, and inequality

All of these are correct.

In 2021, the U.S. poverty rate was lowest in which of the following groups? Black people Disabled people Single people People living in cities People not fully employed

People living in cities

Social factors affect ________ of individual and population health. 5% to 10% 20% to 30% 50% to 60% 80% to 90%

80% to 90%

Social inequality influences which of the following? Economic stability Education access and quality Healthcare access and quality Neighborhood and built environment All of these are correct.

All of these are correct.

Which of the following is not a key social determinant of health? Medical factors Economic stability Education access and quality Healthcare access and quality Neighborhood and built environment Social and community context

Medical factors

True or False? Food insecurity and hunger mean the same thing. True False

False

True or False? Social epidemiology focuses on the effects of social-structural factors on health outcomes within and among populations. True False

True

True or False? The five social determinants of health listed tend to be mutually exclusive and affect health in complex ways. True False

False

A screening test for a newly discovered disease is being evaluated. To determine the effectiveness of the new test, it was administered to 900 workers. Of the individuals diagnosed with the disease, 150 tested positive. A negative test finding occurred in 60 people who had the disease. A total of 50 people who were not diseased tested positive for it. Assume the prior probability is not known. What was the sensitivity of the test? 0.75 0.71 0.88 0.93

0.71

0.93

0.75

0.91

A screening test for a newly discovered disease is being evaluated. To determine the effectiveness of the new test, it was administered to 900 workers. Of the individuals diagnosed with the disease, 150 tested positive. A negative test finding occurred in 60 people who had the disease. A total of 50 people who were not diseased tested positive for it. Assume the prior probability is not known. What is the overall accuracy of the test? 0.75 0.71 0.88 0.93 0.91

0.88

In Peru, there were 4,487,553 confirmed cases of COVID-19 and 219,539 deaths from the disease. What is the case-fatality rate? 4.1% 2.2% 2.9% 4.9%

4.9%