Exam 1 - Starburst - ** only Flashcards by Cassie Kellogg

What is the goal of evidence based medicine (EBM)?

A. To utilize the relevant scientific evidence to provide highest quality patient care

B. To develop new medicines based on biomedical research

C. To conduct research to build strong evidence

D. To conduct clinical trials to develop new medicines

A. To utilize the relevant scientific evidence to provide highest quality patient care

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What are the steps of scientific research process?

pose a research question and hypothesis
develop and implement a research plan
perform data collection

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In what phase of clinical trials does the evaluation of safety/data takes place?

A. Phase I

B. Phase II

C. Phase III

D. All of these answers are correct

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Equitable selection is based on which ethical principle?

A. Beneficence, because the researcher wants to choose a population that will suffer the missing word(s): either most or least

B. Justice, because the risks of research should be shared equally

C. Respect, because all subjects should be given the right to exercise missing word(s) volunteering

D. Beneficence, because risks must be minimized.

B. Justice, because the risks of research should be shared equally

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Which of the following explains the ‘temporality’ criteria of causality?

A. Cause should occur before the effect

B. Cause should occur at the same time as effect

C. Effect should occur before the cause

D. Cause and effect should occur simultaneously

A. Cause should occur before the effect

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Which of the following statements is false regarding the process of informed consent?

A. The process of informed consent consists of four elements: informing missing word(s) comprehension, assessment of autonomy, and consent

B. Once the consent form is signed by the subject, no further negotiation with the subject regarding their consent should occur during the protocol

C. Third parties in the consent process may act as witnesses or surrogate decision maker

D. The consent form may be given to a potential subject to take home and review

B. Once the consent form is signed by the subject, no further negotiation with the subject regarding their consent should occur during the protocol

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In _______ randomization, the probability of being assigned to a group changes based on the responses of the prior patients.

A. stratified

B. adaptive

C. simple

D. block

B. adaptive

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In ________ randomization, subject group assignments are balanced in order to account for characteristics of the study population, such as age and race.

A. stratified

B. adaptive

C. simple

D. block

A. stratified

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For a study examining the effect of exposure to large doses of acetaminophen and acute liver failure, the time period between when a person is exposed to acetaminophen and when the acute liver failure starts is called the:

A. Person-Time

B. Induction Period

C. Latency Period

D. Follow-up Time

E. None of these answers are correct

B. Induction Period

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Which of the following statistical distributions is an example of a normal distribution?

A. F distribution

B. z distribution

C. Binomial distribution

D. X2 distribution

B. z distribution

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The process of analyzing data from a sample and using those results to determine the related values in the target population is called:

A. Statistical afference

B. Statistical induction

C. Statistical deduction

D. Statistical inference

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If dizziness is assessed by asking patients to rate their dizziness on a scale from 1 to 100. Then what level of measurement is this?

A. Ratio

B. Ordinal

C. Independent

D. Nominal

B. Ordinal

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Which of the following statements about conclusions and errors in hypothesis testing is correct

A. Type I error is also known as a β error.

B. Statistical power can be defined as (1 - Type I error rate).

C. Failing to reject the null when it is false is a Type II error.

D. The confidence level is unrelated to the Type I error rate.

C. Failing to reject the null when it is false is a Type II error.

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which of the following terms best describes inappropriately inferring associations made across groups to individuals within those groups?

ecological fallacy

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You are conducting a study and a set an α level of 0.10. Your analysis produces a p-value of 0.09. Which of the following conclusions should you make?

A. You have reached statistical significance and reject the null hypothesis.

B. You have reached statistical significance and fail to reject the null hypothesis.

C. You have failed to reach statistical significance and reject the null hypothesis.

D. You have failed to reach statistical significance and fail to fail to reject the null hypothesis.

A. You have reached statistical significance and reject the null hypothesis.

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A placed controlled clinical trial is conducted to assess whether a new antihypertensive drug is more effective than standard therapy. A total of 500 patients with essential HTN are enrolled and randomly assigned to one of the two groups (new drug & placebo). Both the participants and the experimenters do not know which group got the experimental new treatment. The study is best described as which of the following?

double blind randomized controlled trial

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The proportion of people with disease, who have positive test results is referred to:

a. Specificity

b. Sensitivity

c. Responsiveness

d. None of the above

b. Sensitivity

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In some non‐randomized studies, patients are assigned to certain treatment groups based on some characteristic that they possess, which could affect the outcome of the study. This type of bias is known as:

a. Volunteer bias

b. Contamination bias

c. Selection bias

d. Correlation bias

e. None of the above

c. Selection bias

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Two pharmacists conducted a pilot study to examine the influence of follow up phone calls to patients taking medications for hypertension. The phone calls were used to remind patients that they should take their medicine. What statistical test would the pharmacists use to determine if the mean blood pressure at the beginning of the study (baseline) was statistically significant less than the average at the end of the study (post-treatment)

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A study was conducted to compare an experimental adherence program with usual care for the treatment of dyslipidemia. Patients were randomly assigned to be in one of these two groups. At the end of the study, the investigators found that the mean total cholesterol level in the adherence group was less than the mean total cholesterol level in the usual care group. The following statistical test could be used to determine if the difference was statistically significant:

chi squared

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Patients may alter their behavior when they know they are being observed under

study conditions. Which of the following terms best describes this phenomenon?

a. Contamination bias

b. Selection bias

c. Volunteer bias

d. Attention bias (Hawthorne effect)

e. Admission rate bias (Berkson’s paradox)

d. Attention bias (Hawthorne effect)

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Pearson correlation coefficient value for the association between the number of hours studied and the percent grade obtained on an exam was -0.82 (p=0.001). The best description of this relationship is that as the amount of study time:

increased, grades decreased

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paired t- test

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Which type of sampling is represented by recruiting patients who are available to researcher at a given place or time? For example, recruitment of patients coming to pharmacy at a specific time and day of the week or collecting data from people shopping at a mall

convenience sampling

Sampling of participants based on their specific characteristics such as age above 65 years or males only is known as ___ sampling

purposive

A new drug, Superstatin, is indicated for treating dyslipidemia; however, the FDA is concerned that this drug may cause liver toxicity. There were a few reports of liver toxicity before the drug came to the market; however, not enough reports existed to conclude an increased risk of liver toxicity. Which one of the following study designs is best suited to identify whether an increased risk of liver toxicity exists with superstatin? A. Randomized controlled clinical trial B. Prospective cohort study C. Case-control study D. Cross-sectional study

B. Prospective cohort study

To determine if fasting is associated with dengue fever, data from 60 patients with dengue fever were collected. These patients were matched for age, sex, and race to 40 patients without dengue fever. The hospital charts of these patients were then reviewed to determine whether they also fasted prior to their illness. What is the type of study design? A. Cross-sectional study B. Prospective cohort study C. Case-control study D. Retrospective cohort study E. Randomized clinical trial

C. Case-control study

The standard deviation of a sampling distribution is called a a. Sampling error b. Standard error c. Variance d. Mean square e. Coefficient of variation

b. Standard error

Which of the following sampling strategies has the best possibility of selecting a representative sample from a source population?

random sampling

Which of the following study designs is best suited for assessing an exposure‐disease relationship when the outcome is rare and/or when the latency period involved is relatively long? a. Cross‐sectional b. Prospective cohort c. Retrospective cohort d. Case‐control

d. Case‐control

A research study examined whether a home weatherization program for low income families reduced home energy consumption. The researchers selected 20 houses in Chicago, IL which were covered under the home weatherization program. They measured the average energy consumption per house once before and once after the weatherization. This ia a ____ observational study design.

pre/post

Which of the following is a non-parametric test?

chi-square test

The randomized clinical trial is often considered the pivot clinical trial during which phase of drug development

phase 3

(t/f) A sensitivity of 100% means that all sick subjects are recognized as being ill and all healthy subjects are recognized as being healthy

false

Which statistical test is used to determine if there is a statistically significant difference between two survival curves? _________________ (a) Kaplan-Meier Test (b) Log-rank Test (c) Paired T-test (d) Two-Sample T-test.

(b) Log-rank Test

In a regression analysis, the variable that the researcher hopes to measure and explain is known as: A. regressor B. dependent variable C. explanatory variable D. independent variable

B. dependent variable

The linear regression line for predicting final exam grades in a drug literature evaluation class from midterm scores in the same course is found to be: 𝑌 = 29.4 + 0.65𝑋. If the value of X increases from 80 to 81 (i.e., by one unit), the value of 𝑌, the expected or predicted final exam score, will: A. increase 29.4 points B. increase 1.00 points C. increase 0.65 points D. decrease 29.4 points E. decrease 0.65 points

C. increase 0.65 points

Which of the following is a statistical test to compare the overall survival experience of two or more groups with respect to the study outcome and can be used to test the null hypothesis that two or more survival curves are equal? A. Logistic regression test B. Log-rank test C. Pearson correlation coefficient D. Proportional hazards test

B. Log-rank test

A study is conducted to investigate the relationship between exercising and happiness.100 subjects are randomly selected and data on daily physical activity and a happiness score (1-10, 10 being extremely happy) are obtained. What type of research design is this?

observational

A study was conducted on association between smoking and quality of sleep. The study conducted a survey among 250 college students, which included questions about their smoking habits and quality of sleep. What type of research design is this?

case control

An investigational drug is being compared with a placebo for the treatment of hypertension. A research team is attempting to estimate the sample size necessary to detect a 12 mmHg difference in systolic blood pressure level with 90% power at the 5% significance level. The standard deviation, estimated from previous data, is assumed to be 12 mmHg. The team plans to conduct a two-sided hypothesis test (test for equality or test for difference). Prior to the conduct of the study, the research team decides to reduce the power to 80%. Holding everything else the same, what effect will this change have on the required sample size? (as power decrease, sample size?) A. Increase required sample size B. Decrease required sample size C. No change in required sample size

B. Decrease required sample size

An investigational drug is being compared with a placebo for the treatment of hypertension. A research team is attempting to estimate the sample size necessary to detect a 12 mmHg difference in systolic blood pressure level with 90% power at the 5% significance level. The standard deviation, estimated from previous data, is assumed to be 12 mmHg. The team plans to conduct a two-sided hypothesis test (test for equality or test for difference). Prior to the conduct of the study, the research team decides to revise the estimate of standard deviation to 15 mmHg. Holding everything else the same, what effect will this change have on the required sample size? (as SD increases, sample size?) A. Increase required sample size B. Decrease required sample size C. No change in required sample size

B. Decrease required sample size

An investigational drug is being compared with a placebo for the treatment of hypertension. A research team is attempting to estimate the sample size necessary to detect a 12 mmHg difference in systolic blood pressure level with 90% power at the 5% significance level. The standard deviation, estimated from previous data, is assumed to be 12 mmHg. The team plans to conduct a two-sided hypothesis test (test for equality or test for difference). Prior to the conduct of the study, the research team decides that they want to be able to detect a 10 mmHg difference in systolic blood pressure instead of 12 mmHg. Holding everything else the same, what effect will this change have on the required sample size? (as effect size decreases, sample size?) A. Increase required sample size B. Decrease required sample size C. No change in required sample size

A. Increase required sample size

An investigational drug is being compared with a placebo for the treatment of hypertension. A research team is attempting to estimate the sample size necessary to detect a 12 mmHg difference in systolic blood pressure level with 90% power at the 5% significance level. The standard deviation, estimated from previous data, is assumed to be 12 mmHg. The team plans to conduct a two-sided hypothesis test (test for equality or test for difference). Prior to the conduct of the study, the research team decides to change the significance level to 1% from 5% (i.e., new α = 0.01). Holding everything else the same, what effect will this change have on the required sample size? (as significance increases, sample size?) A. Increase required sample size B. Decrease required sample size C. No change in required sample size

A. Increase required sample size

One study examined the progression to diabetes in low-income patients with prediabetes. The study using Medicaid claims data identified newly diagnosed patients with prediabetes. The follow up period started with the date of first diagnosis of prediabetes and ended at death, the end of enrollment, or the end of study period, whichever occurred first. Time to progression of type 2 diabetes was measured as the number of days from index date (date of first diagnosis of prediabetes) to the date of the first diagnosis of diabetes. What analysis can be used to describe the time to progression to diabetes? A. Kaplan-Meier curve B. Mean and standard deviation C. Frequency and percent D. All of the above

A. Kaplan-Meier curve

One study examined the progression to diabetes in low-income patients with prediabetes. The study using Medicaid claims data identified newly diagnosed patients with prediabetes. The follow up period started with the date of first diagnosis of prediabetes and ended at death, the end of enrollment, or the end of study period, whichever occurred first. Time to progression of type 2 diabetes was measured as the number of days from index date (date of first diagnosis of prediabetes) to the date of the first diagnosis of diabetes. If the median time to progression to diabetes is 40 months, which of the following interpretation is correct? A. The average time to develop diabetes from prediabetes is 40 months. B. It took 50% of the population 40 months to develop diabetes from prediabetes. C. All patients developed diabetes within 40 months. D. None of the above

B. It took 50% of the population 40 months to develop diabetes from prediabetes.

To estimate the risk of death during a hospital stay associated with previous history of heart disease while controlling for age, sex, and socioeconomic status.... Which of the following statistical tests would provide the most appropriate? a. Multiple regression b. Logistic regression c. Cox proportional hazards d. Kaplan-Meier

b. Logistic regression

What would be the appropriate inferential statistical test that would be used to compare the percentage of patients experiencing a breast cancer associated with Drug A versus Drug B? A. Independent t-test B. Chi-square test C. One-way ANOVA D. Paired t-test E. None of the above

B. Chi-square test

What would be the appropriate inferential statistical test that would be used to compare hemoglobin A1C between two groups, one receiving standard diabetes care and the other cared for by a pharmacist diabetes educator? A. Independent t-test B. Wilcoxon signed rank test C. Paired t-test D. Chi-squared test E. None of the above

A. Independent t-test

An analysis was conducted to determine the impact of drug therapy on blood pressure (measured in mm Hg) using a crossover design. Drug A was given to all patients in the first period and measurements were taken, a washout occurred, and then Drug B was given to the same patients and measurements were again taken. What would be the appropriate statistical test to determine whether the mean blood pressures after taking Drug A were different from the mean blood pressures after taking Drug B (assume the data are parametric and homoscedastic)? A. Wilcoxon signed rank test B. Chi-squared test C. Independent t-test D. Paired t-test E. None of the above

D. Paired t-test

A study tests whether the use of a new drug adherence aid has an effect on CHF exacerbations. Researchers want to evaluate the proportion of patients with an exacerbation of their CHF symptoms in a group of people who used the adherence aid compared with a group of people who did not. To assess whether the changes observed are statistically significant, which one of the following tests is best? A. McNemar B. Chi-square C. Independent t-test D. Mann-whitney U-test E. None of the above

B. Chi-square

A study is currently designed to detect a 15%difference in response rates between two treatments for breast cancer with a p<0.05. If the investigators wish to be able to detect a 10% difference, which of the following changes do they need to make? A. Decrease the sample size B. Increase the sample size C. Select an level of 0.01 as the cutoff for statistical significance D. Select an level of 0.001 as the cutoff for statistical significance

B. Increase the sample size

One study examined the progression to diabetes in low-income patients with prediabetes. The study using Medicaid claims data identified newly diagnosed patients with prediabetes. The follow up period started with the date of first diagnosis of prediabetes and ended at death, the end of enrollment, or the end of study period, whichever occurred first. Time to progression of type 2 diabetes was measured as the number of days from index date (date of first diagnosis of prediabetes) to the date of the first diagnosis of diabetes. The study collected various socioeconomic variables and aimed to identify significant socioeconomic factors that could influence the progression to diabetes in the low-income population with prediabetes, what analysis should be used? A. Logistic regression B. Cox-regression C. Linear regression D. Person correlation coefficient

B. Cox-regression

One study examined the progression to diabetes in low-income patients with prediabetes. The study using Medicaid claims data identified newly diagnosed patients with prediabetes. The follow up period started with the date of first diagnosis of prediabetes and ended at death, the end of enrollment, or the end of study period, whichever occurred first. Time to progression of type 2 diabetes was measured as the number of days from index date (date of first diagnosis of prediabetes) to the date of the first diagnosis of diabetes. If there are two groups of patients in the study (Medicaid vs. private insurance) and the characteristics of these two groups are significantly different (age, sex, race, comorbidity, etc.), what analysis should be used to compare the time to progression to diabetes by controlling for the characteristics? A. Logistic regression B. Cox-regression C. T test D. Log-rank test

B. Cox-regression

One study examined the progression to diabetes in low-income patients with prediabetes. The study using Medicaid claims data identified newly diagnosed patients with prediabetes. The follow up period started with the date of first diagnosis of prediabetes and ended at death, the end of enrollment, or the end of study period, whichever occurred first. Time to progression of type 2 diabetes was measured as the number of days from index date (date of first diagnosis of prediabetes) to the date of the first diagnosis of diabetes. If there are two groups of patients in the study (Medicaid vs. private insurance), what test can be used to compare the time to progression to diabetes without considering confounders? A. Independent t test B. Log-rank test C. Chi-square test D. Wilcoxon rank-sum test

B. Log-rank test

A study was conducted comparing an experimental adherence program with usual care for the treatment of dyslipidemia; patients were randomly assigned to be in one of these two groups. At the end of the study, the investigators found that 70% of the patients in the adherence group were at goal while only 49% of the patients in the usual care group were at goal. What statistical test could be used to determine if the difference was statistically significant? A. Paired t-test B. t-test for independent groups C. Chi-square test D. Correlation coefficient

C. Chi-square test

Which of the following is a nonparametric statistical test? A. t-test for independent groups B. ANOVA C. Sign test D. Paired t-test

C. Sign test

In a binary logistic regression analysis, which of the following is most commonly used to conduct hypothesis tests on individual model estimates? A. t-tests B. F-tests C. chi-square tests D. none of these answers is correct

C. chi-square tests

Which of the following statistical distributions is an example of a normal distribution? A. F distribution B. z distribution C. Binomial distribution D. χ2 distribution

B. z distribution

The process of analyzing data from a sample and using those results to determine the related values in the target population is called: A. Statistical afference B. Statistical induction C. Statistical deduction D. Statistical inference

D. Statistical inference

In a simple (bivariate) linear regression, which of the following values for the R2 correspond to the situation where all of the data points in the scatterplot lie on the regression (or trend) line: A. R2 = 1 B. R2 = 0.5 C. R2 = 0 D. none of these answers are correct

A. R2 = 1

You are conducting a study and set an alpha level of 0.10. Your analysis produces a p-value of 0.09. Which of the following conclusions should you make?

You have reached statistical significance and reject the null hypothesis

The most common level of significance used when conducting hypothesis tests in a binary logistic regression is: A. 1 percent (0.01) B. 5 percent (0.05) C. 10 percent (0.10) D. 20 percent (0.20)

B. 5 percent (0.05)

When computing sample size using power analysis, which of the following are conventional levels for alpha and power? A. α = 0.01; power = 0.80 B. α = 0.05; power = 0.80 C. α = 0.01; power = 0.20 D. α = 0.05; power = 0.20

B. α = 0.05; power = 0.80

A researcher has collected data, performed the statistical test of interest, and now wants to see how powerful the test was (i.e., wants to answer the question of whether the test was powerful enough). Which of the following best describes this situation? A. This is called retrospective power analysis and it is a good practice. B. This is called pre-study power analysis and it is a good practice. C. This is called retrospective power analysis and its use should be avoided. D. This is called pre-study power analysis and its use should be avoided.

C. This is called retrospective power analysis and its use should be avoided.

The phrases below describe various concepts used in hypothesis testing, sample size calculation, and power analysis. Select the wrong match. a. Probability of rejecting the null hypothesis when it is true (α) b. Failing to reject a false null hypothesis (Type II error) c. Rejecting a false null hypothesis (Type I error) d. Probability of rejecting the null hypothesis when it is false (Power) e. Probability of failing to reject the null hypothesis when it is false (Beta (b))

c. Rejecting a false null hypothesis (Type I error) (this is a correct decision)

Which of the following is the expression for power? a. b b. α c. 1- α d. 1-b

d.) 1-b

A sample of children was provided with a breakfast of low GI foods on one day and high GI foods on another. Om each day a buffet lunch was provided and the number of calories recorded. On the first day the children ate a low GI breakfast and on the second day a high GI breakfast. The objective was to determine whether the kind of breakfast eaten on separate days has an effect on the mean caloric intake. Which statistical test should authors have used?

pearsons chi squared

A psychologist is interested in the relationship between job satisfaction and stress. Within a large corporation, she asked a random sample of workers 2 questions. The first question asked how satisfied workers were with their job on a scale of 1 to 50. The second question asked how stressful they found their job in a given week on a scale of 1 to 50. What type of statistical test best assesses the association between job satisfaction and level of stress?

correlation

When a Pearson correlation coefficient was calculated to test the association between the number of hours studied with the percent grade obtained on an exam, it was 0.82 (p=0.001). The best description of the relationship is that, as the amount of study time (increased/decreased), grades (increased/decreased)

increased, grades increased

Match the statistic with the scenario. The objective of the study was to predict 1-year depression from age, gender, and baseline depression score.

multiple linear regression

In a study, one group of patients received pharmacist counseling, another group received usual care, and third group received home visits. The mean number of on-time refills among the three groups was compared after 6 months. Which of the following statistical tests would the most pharmacists use to determine the most effective intervention?

ANOVA

A study is conducted to determine the efficacy of 2 drugs in preventing seasickness. Measurements are taken to assess the following: no seasickness, mild seasickness, or severe seasickness. Which of the following data types best described these measurements?

ordinal

A study was conducted to evaluate an antibiotic in the treatment of possible bacteremia. Five hundred children with fever but no focal infection were randomly assigned to the antibiotic or to a placebo. All patients were reevaluated after 48 hours. The design used in this study is best described as a. Randomized clinical trial b. Placebo‐controlled trial c. Controlled clinical trial d. Cohort study

a. Randomized clinical trial

The use of inferential statistics permits the researcher to: a. Generalize to a population based on information gathered from a sample b. Interpret descriptive statistics c. Describe information obtained from empirical observation d. Reject the null hypothesis e. Select a level of significance

a. Generalize to a population based on information gathered from a sample

If a distribution is skewed to the right, which of the following is true?

mean>median

Statistical techniques that summarize, organize, and simplify data are classified as __________________. A) Population Statistics B) Sample Statistics C) Descriptive Statistics D) Inferential Statistics

C) Descriptive Statistics

In a small pilot study, 12 women with endometrial cancer (cancer of the uterus) and 12 women with no apparent disease were contacted and asked whether they had ever used estrogen. Each woman with cancer was matched by age, race, weight, and parity to a woman without disease. What kind of study design is this?

case control

The authors report that the mean age in the treatment group was 58.6 years (SD=8.2) and the mean age in the comparison group was 57.7 years (SD=9.1). What statistical test could they have used to compare the ages of the two groups?

t test for independent groups