What is the leading cause of death in sub-saharan Africa?
Infectious diseases
True or false:
The presence of bias in an observational study of the effect of an exposure on disease risk implies there is a systematic difference between the observed association and disease and the true association
True
True or false:
The presence of bias in an observational study of the effect of an exposure on disease risk implies there are missing values in the response (disease outcome) measurements
True
Can prospective cohort studies measure incidence?
Yes
What does it mean when confidence intervals do not include 1?
Chance can be excluded as a likely explanation of findings
What is at the top of the evidence hierarchy?
Systematic reviews and meta analysis
True or false:
The random effects model should be used when it is reasonable to assume that the underlying treatment effect is the same in all studies that are part of the meta-analysis
False
What risk factor had the highest number of attributable deaths in 2001?
Smoking
What is the measure of disease occurrence which can be obtained from cross-sectional studies?
Prevalence
What are 4 advantages of cohort studies?
can look at multiple outcomes, follow the natural course of the disease, calculate incidence, it is good for looking at rare exposures
What is an advantage of a case-control study?
You can examine the effect of multiple exposures
What is used to describe factors associated with exposure of interest and outcome of interest but NOT the causal pathway?
Confounders
What is the excess fraction?
Indicates what proportion of the risk in a person exposed to a risk factor is attributable to that factor
What is the standard mortality ratio?
Rate ratio adjusted for age
What score is used to evaluate the quality of clinical trials?
Jadad- looks at randomisation, blinding and withdrawals
What does a symmetrical funnel plot suggest?
that there is no publication bias
What is the size of each box in a forest plot proportional to?
The weight of the study
What does the centre of the diamond in a forest plot indicate?
The pooled point estimate
Which type of bias does blinding reduce?
Measurement bias
How often does the UK census occur?
Every decade
What is the most commonly diagnosed cancer in the UK?
Large bowel cancer
What does validity mean in terms of screening?
the ability to distinguish between subjects with and without a condition- depends on both specificity and sensitivity
What is specificity?
• Specificity= d/ b+ d, ability to identify those without the disease
What is sensitivity?
• Sensitivity= a/ a+ c, ability of a test to correctly identify diseased individuals
What is the PPV?
• The PPV is the probability that a patient who tests positive actually has the disease: a/a+b
What is the NPV?
• NPV patients who tests negative and doesn’t have the disease: d/ c+d
What type of screening is screening older people for hypertension?
• Screening high BP in older people: It is “mass” because it applies to the whole population, and “opportunistic” because the opportunity to undergo screening occurs when the patient presents to the doctor or health care professional for another reason
name 3 ways of controlling confounding at the analysis stage
• Stratification, standardisation and regression are the three ways of controlling confounding at the analysis stage.
What is mass screening?
screening test involving the whole population usually define by age or gender
What are the hosts of schistosmiasis?
• 2 hosts of schistosmiasis tramsitted by cerceriae are humans and snails
What is the most prevalent neglected tropical disease in Africa?
Hookworm
What is used against schistosmiasis?
Praziquantel
who donated 120 million doses of azithromyosin for trachoma?
Pfizer
What is the cost of a rapid impact package for neglected tropical diseases in Africa?
Less than 50 cent per person
Which company made a large commitment to the MDT in eliminating leprosy?
Novartis
Which company has vowed to ‘donate albendazole to WHO for every country that needs it until LF is eliminated as a public health problem’.
GSK
What have epidemiological studies on CVD in the USA shown?
Age adjusted death rates have decreased since 1950. age adjusted death rates are the weighted average of death rates taking account of disease frequency and the age structure of the population
What is the main way of achieving health promotion?
• The main way of achieving health promotion is by enabling the increase in control of the health determinants
In what type of study is the case status known before the exposure status?
Case-control
Name an incorrect reason for an increase in the crude mortality rate from intrahepatic bile duct tumours
The population has increased while the number of deaths remains the same
When someone migrates do they tend to become similar to those of the country of adoption (cancer)
Yes
What type of infection does rubella cause?
A mild self limiting infection
With rubella, did vaccination of adolescent girls cause high levels of population immunity?
No
How do you calculate the odds ratio and when is it used?
Odds that a case was exposed/ odds that a control was exposed. It is used with case control studies
What medication was donated to treat onchocerciasis and lymphatic filariasis?
Mectizan
What are the top 10 causes of mortality (2012 death rates)?
Ischaemic heart disease, stroke, COPD, lower resp infections, trachea/ bronchus/ lung cancers, HIV/AIDS, diarrhoea diseases, diabetes mellitus, road injury, hypertensive heart disease
How is data from hospitals recorded?
ICD coding, OPCS