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In the definition of epidemiology, "distribution" refers to EXCEPT:
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In the definition of epidemiology, "determinants" generally includes EXCEPT:
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Agents
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Causes
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Control measures
-
Risk factors
-
Sources
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Epidemiology, as defined in this lesson, would NOT include which of the following activities?
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Describing the demographic characteristics of persons with acute aflatoxin poisoning in District A
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Prescribing an antibiotic to treat a patient with community-acquired methicillin-resistantStaphylococcus aureus infection
-
Comparing the family history, amount of exercise, and eating habits of those with and without newly diagnosed diabetes
-
Recommending that a restaurant be closed after implicating it as the source of a hepatitis A outbreak
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John Snow's investigation of cholera is considered a model for epidemiologic field investigations because it includes the following EXCEPT:
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Biologically plausible hypothesis
-
Comparison of a health outcome among exposed and unexposed groups
-
Multivariate statistical model
-
Spot map
-
Recommendation for public health action
Frage 5
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Public health surveillance does NOT include which of the following activity:
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Diagnosing whether a case of encephalitis is actually due to West Nile virus infection
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Soliciting case reports of persons with symptoms compatible with SARs from local hospitals
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Creating graphs of the number of dog bites by week and neighborhood
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Writing a report on trends in seat belt use to share with the state legislature
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All of the above
-
None of the above
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The hallmark feature of an analytic epidemiologic study is:
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Use of an appropriate comparison group
-
Laboratory confirmation of the diagnosis
-
Publication in a peer-reviewed journal
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Statistical analysis using logistic regression
Frage 7
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A number of passengers on a cruise ship from Puerto Rico to the Panama Canal have recently developed a gastrointestinal illness compatible with norovirus (formerly called Norwalk-like virus). Testing for norovirus is not readily available in any nearby island, and the test takes several days even where available. Assuming you are the epidemiologist called on to board the ship and investigate this possible outbreak, your case definition should include, at a minimum:
Antworten
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Clinical criteria, plus specification of time, place, and person
-
Clinical features, plus the exposure(s) you most suspect
-
Suspect cases
-
The nationally agreed standard case definition for disease reporting
Frage 8
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Compare food histories between persons with Staphylococcus food poisoning and those without
Antworten
-
Distribution
-
Determinants
-
Application
Frage 9
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Compare frequency of brain cancer among anatomists with frequency in general population
Antworten
-
Distribution
-
Determinants
-
Application
Frage 10
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Mark on a map the residences of all children born with birth defects within 2 miles of a hazardous waste site
Antworten
-
Distribution
-
Determinants
-
Application
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Graph the number of cases of congenital syphilis by year for the country
Antworten
-
Distribution
-
Determinants
-
Application
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Recommend that close contacts of a child recently reported with meningococcal meningitis receive Rifampin
Antworten
-
Distribution
-
Determinants
-
Application
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Tabulate the frequency of clinical signs, symptoms, and laboratory findings among children with chickenpox in Cincinnati, Ohio
Antworten
-
Distribution
-
Determinants
-
Application
Frage 14
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Essay entitled “On Airs, Waters, and Places,” suggested that environmental and host factors such as behaviors
Antworten
-
Hippocrates
-
John Graunt
-
John Snow
Frage 15
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first to quantify patterns of birth, death, and disease occurrence, noting disparities between males and females, high infant mortality, urban/rural differences, and seasonal variations
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John Graunt
-
John Snow
-
William Farr
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Father of modern vital statistics and surveillance
Antworten
-
William Farr
-
John Snow
-
John Graunt
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Father of field epidemiology
Antworten
-
John Graunt
-
John Snow
-
William Farr
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Study linking lung cancer to smoking
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Doll and Hill
-
John Snow
-
Kannel
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Reviewing reports of test results for Chlamydia trachomatis from public health clinics
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Meeting with directors of family planning clinics and college health clinics to discuss Chlamydia testing and reporting
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Developing guidelines/criteria about which patients coming to the clinic should be screened (tested) for Chlamydia infection
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Interviewing persons infected with Chlamydia to identify their sex partners
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Conducting an analysis of patient flow at the public health clinic to determine waiting times for clinic patients
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Comparing persons with symptomatic versus asymptomatic Chlamydia infection to identify predictors
Frage 25
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Comparing numbers and rates of illness in a community, rates are preferred for
Antworten
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Conducting surveillance for communicable diseases
-
Deciding how many doses of immune globulin are needed
-
Estimating subgroups at highest risk
-
Telling physicians which strain of influenza is most prevalent
Frage 26
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For the cruise ship scenario described in Question 7, how would you display the time course of the outbreak?
Antworten
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Endemic curve
-
Epidemic curve
-
Seasonal trend
-
Secular trend
Frage 27
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For the cruise ship scenario described in Question 7, if you suspected that the norovirus may have been transmitted by ice made or served aboard ship, how might you NOT display "place"?
Antworten
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Spot map by assigned dinner seating location
-
Spot map by cabin
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Shaded map of United States by state of residence
-
Shaded map by whether passenger consumed ship's ice or no
Frage 28
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Which variables might you include in characterizing the outbreak described in Question 7 by person?
Frage 29
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When analyzing surveillance data by age, which of the following age groups is preferred?
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1-year age groups
-
5-year age groups
-
10-year age groups
-
Depends on the disease
Frage 30
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A study in which children are randomly assigned to receive either a newly formulated vaccine or the currently available vaccine, and are followed to monitor for side effects and effectiveness of each vaccine, is an example of which type of study?
Antworten
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Cohort
-
Case-control
-
Clinical trial
-
Cross Sectional
Frage 31
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The Iowa Women's Health Study, in which researchers enrolled 41,837 women in 1986 and collected exposure and lifestyle information to assess the relationship between these factors and subsequent occurrence of cancer, is an example of which type(s) of study?
Antworten
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Cohort
-
Case-control
-
Clinical trial
-
Cross Sectional
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British investigators conducted a study to compare measles-mumps-rubella (MMR) vaccine history among 1,294 children with pervasive development disorder (e.g., autism and Asperger's syndrome) and 4,469 children without such disorders. (They found no association.) This is an example of which type(s) of study?
Antworten
-
Cohort
-
Case-control
-
Clinical trial
-
Cross Sectional
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A cohort study differs from a case-control study in that:
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Subjects are enrolled or categorized on the basis of their exposure status in a cohort study but not in a case-control study
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Subjects are asked about their exposure status in a cohort study but not in a case-control study
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Cohort studies require many years to conduct, but case-control studies do not
-
Cohort studies are conducted to investigate chronic diseases, case-control studies are used for infectious diseases
Frage 34
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A key feature of a cross-sectional study EXCEPT:
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It usually provides information on prevalence rather than incidence
-
It is limited to health exposures and behaviors rather than health outcomes
-
It is more useful for descriptive epidemiology than it is for analytic epidemiology
-
It is synonymous with survey
Frage 35
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The epidemiologic triad of disease causation refers to
Antworten
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Agent, host, environment
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Time, place, person
-
Source, mode of transmission, susceptible host
-
John Snow, Robert Koch, Kenneth Rothman
Frage 36
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For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Antworten
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Onset of symptoms
-
Usual time of diagnosis
-
Exposure
-
Latency Period
Frage 37
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For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Antworten
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Exposure
-
Onset of symptoms
-
Pathologic Changes
-
Usual Time of Diagnosis
Frage 38
Frage
For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Antworten
-
Exposure
-
Onset of symptoms
-
Usual Time of Diagnosis
-
Pathologic Changes
Frage 39
Frage
For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Antworten
-
Exposure
-
Onset of symptoms
-
Usual Time of Diagnosis
-
Pathologic Changes
Frage 40
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A reservoir of an infectious agent can be:
Antworten
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An asymptomatic human
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A symptomatic human
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An animal
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The environment
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All of the above
Frage 41
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Indirect transmission includes which of the following EXCEPT?
Frage 42
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Disease control measures are generally directed at which of the followingEXXCEPT ?
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Eliminating the reservoir
-
Eliminating the vector
-
Eliminating the host
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Interrupting mode of transmission
-
Reducing host susceptibility
Frage 43
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Disease 1: usually 40–50 cases per week; last week, 48 cases
Antworten
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Endemic
-
Outbreak
-
Pandemic
-
Sporadic
Frage 44
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Disease 2: fewer than 10 cases per year; last week, 1 case
Antworten
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Endemic
-
Outbreak
-
Pandemic
-
Sporadic
Frage 45
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Disease 3: usually no more than 2–4 cases per week; last week, 13 cases
Antworten
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Endemic
-
Outbreak
-
Pandemic
-
Sporadic
Frage 46
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A propagated epidemic is usually the result of what type of exposure?
Frage 47
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Which of the following are frequency measures?
Antworten
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Birth rate
-
Incidence
-
Mortality rate
-
Prevalence
Frage 48
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In a state that did not require varicella (chickenpox) vaccination, a boarding school experienced a prolonged outbreak of varicella among its students that began in September and continued through December. To calculate the probability or risk of illness among the students, which denominator would you use?
Antworten
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Number of susceptible students at the ending of the period (i.e., June)
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Number of susceptible students at the midpoint of the period (late October/early November)
-
Number of susceptible students at the beginning of the period (i.e., September)
-
Average number of susceptible students during outbreak
Frage 49
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All proportions are ratios, but not all ratios are proportions.
Frage 50
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Many of the students at the boarding school, including 6 just coming down with varicella, went home during the Thanksgiving break. About 2 weeks later, 4 siblings of these 6 students (out of a total of 10 siblings) developed varicella. The secondary attack rate among siblings was, therefore,:
Antworten
-
4 ⁄ 6
-
4 ⁄ 10
-
4 ⁄ 16
-
6 ⁄ 10
Frage 51
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Investigators enrolled 100 diabetics without eye disease in a cohort (follow-up) study. The results of the first 3 years were as follows:
Year 1: 0 cases of eye disease detected out of 92; 8 lost to follow-up
Year 2: 2 new cases of eye disease detected out of 80; 2 had died; 10 lost to follow-up
Year 3: 3 new cases of eye disease detected out of 63; 2 more had died; 13 more lost to follow-up
The person-time incidence rate is calculated as:
Antworten
-
5 ⁄ 100
-
5 ⁄ 63
-
5 ⁄ 235
-
5 ⁄ 250
Frage 52
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The units for the quantity you calculated in Question 8 could be expressed as:
Frage 53
Frage 54
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Generally preferred for chronic diseases without clear date of onset
Frage 55
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Used in calculation of risk ratio
Frage 56
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Affected by duration of illness
Frage 57
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Use the following information for Questions 57–61.
Within 10 days after attending a June wedding, an outbreak of cyclosporiasis occurred among attendees. Of the 83 guests and wedding party members, 79 were interviewed; 54 of the 79 met the case definition. The following two-by-two table shows consumption of wedding cake (that had raspberry filling) and illness status.
Ate wedding cake? Ill Well Total
Yes 50 3 53
No 4 22 26
Total 54 25 79
The fraction 54 ⁄ 79 is a/an:
Frage 58
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The fraction 50 ⁄ 54 is a/an:
Frage 59
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The fraction 50 ⁄ 53 is a/an:
Frage 60
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The best measure of association to use for these data is a/an:
Frage 61
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The best estimate of the association between wedding cake and illness is:
Antworten
-
6.1
-
7.7
-
68.4
-
83.7
-
91.7
-
94.3
Frage 62
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The attributable proportion for wedding cake is:
Antworten
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6.1%
-
7.7%
-
68.4%
-
83.7%
-
91.7%
-
94.3%
Frage 63
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Use the following diagram for Questions 63 and 64. Assume that the horizontal lines in the diagram represent duration of illness in 8 different people, out of a community of 700.
What is the prevalence of disease during July?
Antworten
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3 ⁄ 700
-
4 ⁄ 700
-
5 ⁄ 700
-
8 ⁄ 700
Frage 64
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What is the incidence of disease during July?
Antworten
-
3 ⁄ 700
-
4 ⁄ 700
-
5 ⁄ 700
-
8 ⁄ 700
Frage 65
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Which of the following mortality rates use the estimated total mid-year population as its denominator?
Antworten
-
Age-specific mortality rate
-
Sex-specific mortality rate
-
Crude mortality rate
-
Cause-specific mortality rate
Frage 66
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Vaccine efficacy measures are:
Antworten
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The proportion of vaccinees who do not get the disease
-
1 − the attack rate among vaccinees
-
The proportionate reduction in disease among vaccinees
-
1 − disease attributable to the vaccine
Frage 67
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To study the causes of an outbreak of aflatoxin poisoning in Africa, investigators conducted a case-control study with 40 case-patients and 80 controls. Among the 40 poisoning victims, 32 reported storing their maize inside rather than outside. Among the 80 controls, 20 stored their maize inside. The resulting odds ratio for the association between inside storage of maize and illness is:
Frage 68
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The crude mortality rate in Community A was higher than the crude mortality rate in Community B, but the age-adjusted mortality rate was higher in Community B than in Community A. This indicates that:
Antworten
-
Investigators made a calculation error
-
No inferences can be made about the comparative age of the populations from these data
-
The population of Community A is, on average, older than that of Community B
-
The population of Community B is, on average, older than that of Community A
Frage 69
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public health surveillance includes which activities EXCEPT?
Antworten
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Data collection.
-
Data analysis.
-
Data interpretation.
-
Data dissemination.
-
Disease control.
Frage 70
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Current public health surveillance targets which of the following?
Frage 71
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Public health surveillance can be described primarily as which of the following?
Antworten
-
A method to monitor occurrences of public health problems.
-
A program to control disease outbreaks.
-
A system for collecting health-related information.
-
A system for monitoring persons who have been exposed to a communicable disease.
Frage 72
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Public health surveillance is only conducted by public health agencies.
Frage 73
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Common uses and applications of public health surveillance include which of the following?
Antworten
-
Detecting individual persons with malaria so that they can receive prompt and appropriate treatment.
-
Helping public health officials decide how to allocate their disease control resources.
-
Identifying changes over time in the proportion of children with elevated blood lead levels in a community.
-
Documenting changes in the incidence of varicella (chickenpox), if any, after a law requiring varicella vaccination took effect.
-
All of the above
Frage 74
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Data collected through which of the following methods is NOT commonly used for surveillance?
Frage 75
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Health-care providers might be important sources of surveillance data used by public health officials, and they should receive feedback to close the surveillance loop as a courtesy; however, the results almost never have any relevance to patient care provided by those health-care providers.
Frage 76
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Vital statistics are important sources of data on which of the following?
Frage 77
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Vital statistics provide an archive of certain health data. These data do not become surveillance data until they are analyzed, interpreted, and disseminated with the intent of influencing public health decision-making or action.
Frage 78
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Key sources of morbidity data include which of the following EXCEPT?
Frage 79
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Notifiable disease surveillance usually focuses on morbidity from the diseases on the list and does not cover mortality from those diseases.
Frage 80
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The list of diseases that a physician must report to the local health department is typically compiled by the…
Frage 81
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A physician working in an emergency room in Town A, USA, has just examined a tourist from Southeast Asia with watery diarrhea. The physician suspects the man might have cholera. The physician should notify the …
Antworten
-
Local (town or county) health agency.
-
State health department.
-
Centers for Disease Control and Prevention (CDC).
-
U.S. Department of State.
-
Washington, D.C., embassy of country of origin (ask for health attaché).
Frage 82
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[blank_start]Notifiable disease surveillance[blank_end] State-based, with subsequent reporting to CDC.
Frage 83
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[blank_start]Notifiable disease surveillance[blank_end]Focused on identifying individual cases.
Frage 84
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[blank_start]Both[blank_end]
Can monitor trends over time.
Frage 85
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Based on statistically valid sample.
Frage 86
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Complete, unbiased reporting
Frage 87
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Evaluating and improving surveillance should address which of the following EXCEPT?
Antworten
-
Purpose and objectives of surveillance.
-
Resources needed to conduct surveillance.
-
Effectiveness of measures for controlling the disease under surveillance.
-
Presence of characteristics of well-conducted surveillance.
Frage 88
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Criteria for prioritizing health problems for surveillance include which of the following EXCEPT?
Antworten
-
Incidence of the problem.
-
Public concern about the problem.
-
Number of previous studies of the problem.
-
Social and economic impact of the problem.
Frage 89
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Watches for individual cases of disease of public health importance.
Antworten
-
Surveillance based on a specific case definition for a disease (e.g., listeriosis).
-
Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
-
Both.
-
Neither
Frage 90
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Watches for diseases that might be caused by acts of biologic or chemical terrorism.
Antworten
-
Surveillance based on a specific case definition for a disease (e.g., listeriosis).
-
Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
-
Both.
-
Neither
Frage 91
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Can watch for disease before a patient seeks care from a health-care provider.
Antworten
-
Surveillance based on a specific case definition for a disease (e.g., listeriosis).
-
Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
-
Both.
-
Neither
Frage 92
Frage
Requires little effort on the part of the health department.
Antworten
-
Surveillance based on a specific case definition for a disease (e.g., listeriosis).
-
Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
-
Both
-
Neither
Frage 93
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Routine analysis of notifiable disease surveillance data at the state health department might NOT include looking at the number of cases of a disease reported this week …
Antworten
-
and during the previous 2–4 weeks.
-
and the number reported during the comparable weeks of the previous 2–5 years.
-
simultaneously by age, race, and sex of the patient.
-
by county.
-
by county, divided by each county's population (i.e., county rates).
Frage 94
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One week, a state health department received substantially more case reports of a disease in one county than had been reported during the previous 2 weeks. No increase was reported in neighboring counties. Possible explanations for this increase include which of the following?
Frage 95
Frage
The primary reason for preparing and distributing periodic surveillance summaries is which of the following?
Antworten
-
Document recent epidemiologic investigations.
-
Provide timely information on disease patterns and trends to those who need to know it.
-
Provide reprints ofMMWR articles, reports, and recommendations.
-
Acknowledge the contributions of those who submitted case reports.
Frage 96
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Surveillance detected 23 of 30 actual cases of a disease.
Frage 97
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Of 16 statistically significant aberrations (deviations from baseline) detected by syndromic surveillance, only one represented an actual outbreak of disease.
Frage 98
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Underreporting is not a problem for detecting outbreaks of notifiable diseases because the proportion of cases reported tends to remain relatively stable over time.
Frage 99
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Initiating surveillance for a public health problem or adding a disease to the notifiable disease list is justified for which of the following reason?
Antworten
-
If it is a communicable disease with a high case-fatality rate.
-
If the problem is new and systematically collected data are needed to characterize the disease and its impact on the public.
-
If a program at CDC has recommended its addition to better understand national trends and patterns.
-
all of the above
Frage 100
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The case definition used for surveillance of a health problem should be the same as the case definition used for clinical (treatment) purposes.
Frage 101
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A state health department decides to strengthen its notifiable disease reporting. The one best action to take is to …
Antworten
-
allow reporting through use of the Internet.
-
require more disease-specific forms from local health departments.
-
ensure that all persons with a responsibility to report understand the requirements and reasons for reporting and how reports will be used.
-
reduce the number of diseases on the list.
Frage 102
Frage
Which of the following best describes the similarities and differences in the three distributions shown in Figure 2.11?
Antworten
-
Same mean, median, mode; different standard deviation
-
Same mean, median, mode; same standard deviation
-
Different mean, median, mode; different standard deviation
-
Different mean, median, mode; same standard deviation
Frage 103
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Which of the following terms accurately describe the distribution shown in Figure 2.12?
Antworten
-
Negatively skewed
-
Positively skewed
-
Symmetrical
Frage 104
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What is the likely relationship between mean, median, and mode of the distribution shown in Figure 2.12?
Frage 105
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The mode is the value that:
Antworten
-
Is midway between the lowest and highest value
-
Occurs most often
-
Has half the observations below it and half above it
-
Is statistically closest to all of the values in the distribution
Frage 106
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The median is the value that:
Antworten
-
Is midway between the lowest and highest value
-
Occurs most often
-
Has half the observations below it and half above it
-
Is statistically closest to all of the values in the distribution
Frage 107
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Is statistically closest to all of the values in the distribution
Antworten
-
Is midway between the lowest and highest value
-
Occurs most often
-
Has half the observations below it and half above it
-
Is statistically closest to all of the values in the distribution
Frage 108
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The geometric mean is the value that:
Antworten
-
Is midway between the lowest and highest value on a log scale
-
Occurs most often on a log scale
-
Has half the observations below it and half above it on a log scale
-
Is statistically closest to all of the values in the distribution on a log scale
Frage 109
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In epidemiology, the measure of central location generally preferred for summarizing skewed data such as incubation periods is the:
Antworten
-
Mean
-
Median
-
Midrange
-
Mode
Frage 110
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The measure of central location generally preferred for additional statistical analysis is the:
Antworten
-
Mean
-
Median
-
Midrange
-
Mode
Frage 111
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Which of the following is NOT considered measures of spread?
Antworten
-
Interquartile range
-
Percentile
-
Range
-
Standard deviation
Frage 112
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The measure of spread most affected by one extreme value is the:
Antworten
-
Interquartile range
-
Range
-
Standard deviation
-
Mean
Frage 113
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The interquartile range covers what proportion of a distribution?
Frage 114
Frage
The measure of central location most commonly used with the interquartile range is the:
Antworten
-
Arithmetic mean
-
Geometric mean
-
Median
-
Midrange
-
Mode
Frage 115
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The measure of central location most commonly used with the standard deviation is the:
Antworten
-
Arithmetic mean
-
Median
-
Midrange
-
Mode
Frage 116
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The algebraic relationship between the variance and standard deviation is that:
Antworten
-
The standard deviation is the square root of the variance
-
The variance is the square root of the standard deviation
-
The standard deviation is the variance divided by the square root of n
-
The variance is the standard deviation divided by the square root of n
Frage 117
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Before calculating a standard deviation, one should ensure that:
Antworten
-
The data are somewhat normally distributed
-
The total number of observations is at least 50
-
The variable is an interval-scale or ratio-scale variable
-
All of the above
Frage 118
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Simply by scanning the values in each distribution below, identify the distribution with the largest standard deviation.
Antworten
-
1, 10, 15, 18, 20, 20, 22, 25, 30, 39
-
1, 3, 8, 10, 20, 20, 30, 32, 37, 39
-
1, 15, 17, 19, 20, 20, 21, 23, 25, 39
-
41, 42, 43, 44, 45, 45, 46, 47, 48, 49
Frage 119
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Given the area under a normal curve, which two of the following ranges are the same? (Circle the TWO that are the same.)
Antworten
-
From the 2.5th percentile to the 97.5th percentile
-
From the 5th percentile to the 95th percentile
-
From the 25th percentile to the 75th percentile
-
From 1 standard deviation below the mean to 1 standard deviation above the mean
-
None of the above
Frage 120
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The primary use of the standard error of the mean is in calculating the:
Antworten
-
confidence interval
-
error rate
-
standard deviation
-
variance
Frage 121
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Tables and graphs are NOT important tools for which tasks of an epidemiologist?
Frage 122
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A table in a report or manuscript should include EXCEPT:
Antworten
-
Title
-
Row and column labels
-
Footnotes that explain abbreviations, symbols, exclusions
-
Source of the data
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Explanation of the key findings
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The following table is unacceptable because the percentages add up to 99.9% rather than 100.0%
Age group No. Percent
< 1 year 10 19.6
1–4 9 17.6
5–9 9 17.6
10–14 17 33.3
≥15 6 11.8
Total 53
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In the following table, the total number of persons with the disease is:
Cases Controls Total
Exposed 22 12 34
Unexposed 3 13 16
Total 25 25 50
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A table shell is the:
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Box around the outside of a table
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Lines ("skeleton") of a table without the labels or title
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Table with data but without the title, labels or data
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Table with labels and title but without the data
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The best time to create table shells is:
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Just before planning a study
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As part of planning the study
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Just after collecting the data
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Just before analyzing the data
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As part of analyzing the data
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Recommended methods for creating categories for continuous variables include:
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Basing the categories on the mean and standard deviation
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Dividing the data into categories with similar numbers of observations in each
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Dividing the range into equal class intervals
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Using categories that have been used in national surveillance summary reports
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Using the same categories as your population data are grouped
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All of the above
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None of the above
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In frequency distributions, observations with missing values should be excluded.
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The following are reasonable categories for a disease that mostly affects people over age 65 years:
Age Group
< 65 years
65–70
70–75
75–80
80–85
85
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In general, before you create a graph to display data, you should put the data into a table.
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On an arithmetic-scale line graph, the x-axis and y-axis each should:
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Begin at zero on each axis
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Have labels for the tick marks and each axis
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Use the same tick mark spacing on the two axes
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All of the above
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[blank_start]Semilogarithmic-scale line graph[blank_end]A wide range of values can be plotted and seen clearly, regardless of magnitude
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[blank_start]Arithmetic-scale line graph[blank_end]A constant rate of change would be represented by a curved line
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[blank_start]Semilogarithmic-scale line graph[blank_end]The y-axis tick labels could be 0.1, 1, 10, and 100
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[blank_start]Both[blank_end]
Can plot numbers or rates
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[blank_start]Bar chart[blank_end]Used for categorical variables on the x-axis
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Bar chart
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Histogram
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Both
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Neither
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[blank_start]Both[blank_end]
Columns can be subdivided with color or shading to show subgroups
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Both
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Bar Chart
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Histogram
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Neither
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[blank_start]Histogram[blank_end]Displays continuous data
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-
Histogram
-
Bar chart
-
Both
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Neither
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[blank_start]Histogram[blank_end] Epidemic curve
Antworten
-
Histogram
-
Bar Chart
-
Both
-
Neither
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Which of the following shapes of a population pyramid is most consistent with a young population?
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Tall, narrow rectangle
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Short, wide rectangle
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Triangle base down
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Triangle base up
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A frequency polygon differs from a line graph because a frequency polygon:
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Displays a frequency distribution; a line graph plots data points
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Can show percentages on the y-axis; a line graph cannot
-
Cannot be used to plot data over time
-
All of the above
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Y-axis shows percentages from 0% to 100%
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Plotted curve usually begins in the upper left corner
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Plotted curve usually begins in the lower left corner
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Horizontal line drawn from 50% tick mark to plotted curve intersects at median
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A scatter diagram is the graph of choice for plotting:
Antworten
-
Anabolic steroid levels measured in both blood and urine among a group of athletes
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Mean cholesterol levels over time in a population
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Infant mortality rates by mean annual income among different countries
-
Systolic blood pressure by eye color (brown, blue, green, other) measured in each person
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Which of the following requires more than one variable?
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Frequency distribution
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One-variable table
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Pie chart
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Scatter diagram
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Simple bar chart
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Compared with a scatter diagram, a dot plot:
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Is another name for the same type of graph
-
Differ because a scatter diagram plots two continuous variables; a dot plot plots one continuous and one categorical variable
-
Differ because a scatter diagram plots one continuous and one categorical variable; a dot plot plots two continuous variables
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Plots location of cases on a map
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A spot map must reflect numbers; an area map must reflect rates.
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To display different rates on an area map using different colors, select different colors that have the same intensity, so as not to bias the audience.
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In an oral presentation, three-dimensional pie charts and three-dimensional columns in bar charts are desirable because they add visual interest to a slide.
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A 100% component bar chart shows the same data as a stacked bar chart. The key difference is in the units on the x-axis.
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When creating a bar chart, the decision to use vertical or horizontal bars is usually based on:
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The magnitude of the data being graphed and hence the scale of the axis
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Whether the data being graphed represent numbers or percentages
-
Whether the creator is an epidemiologist (who almost always use vertical bars)
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Which looks better, such as whether the label fits below the bar
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[blank_start]Grouped bar chart[blank_end] Number of cases of dog bites by age group (adult or child) and sex of the victim
Antworten
-
Grouped bar chart
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Histogram
-
Line graph
-
Pie chart
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[blank_start]Pie chart[blank_end]Number of cases of dog bites by breed of the dog
Antworten
-
Pie chart
-
Grouped bar chart
-
Histogram
-
Line graph
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[blank_start]Line graph[blank_end]Number of cases of dog bites per 100,000 population over time
Antworten
-
Line graph
-
Grouped bar chart
-
Histogram
-
Pie Chart
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Number of cases of dog bites over time
Antworten
-
Grouped bar chart
-
Histogram
-
Line graph
-
Pie chart
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Which are the most common ways that a local health department uncovers outbreaks?
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-
Performing descriptive analysis of surveillance data each week
-
Performing time series analysis to detect deviations from expected values based on the previous few weeks and comparable periods during the previous few years
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Receiving calls from affected residents
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Receiving calls from healthcare providers
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Reviewing all case reports received each week to detect common features
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Factors that influence a health department's decision whether or not to conduct a field investigation in response to one or more cases of disease include
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If a particular outbreak presents an unusual opportunity to learn more about the disease and its epidemiology by conducting a study, but early disease control measures would interfere with the study, one should conduct the study quickly, then implement control measures immediately afterwards.
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Outbreak with known causative agent, source, and mode of transmission
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Outbreak with known causative agent, but unknown source and mode of transmission
Antworten
-
Disease control and prevention efforts take priority over investigation efforts
Investigation efforts take priority over disease control and prevention efforts
-
If the agent is known but the source and mode of transmission are not known (example: Salmonella eventually traced to marijuana), then the health department does not know how to target its intervention. Investigation to learn the source and/or mode is necessary.
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Outbreak with unknown causative agent, source, and mode of transmission
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Use the following steps of an outbreak investigation for Question 5:
1. Analyze data by time, place, and person
2. Conduct a case-control study
3. Generate hypotheses
4. Conduct active surveillance for additional cases
5. Verify the diagnosis
6. Confirm that the number of cases exceeds the expected number
7. Talk with laboratorians about specimen collection
For an investigation of an outbreak, what is the logical conceptual order of the steps listed above?
Antworten
-
1-2-3-4-5-6-7
-
5-6-4-1-2-3-7
-
6-5-3-1-2-7-4
-
6-5-7-4-1-3-2
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To avoid skipping a critical step, investigators should conduct the steps of an outbreak investigation in the precise order you answered in Question 164.
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200 cases of Marburg virus infection in several districts in Angola over several months (usually none)
Antworten
-
Cluster
-
Epidemic
-
Outbreak
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40 cases ofSalmonella Enteritidis in 1 week traced to a single meal served at a cafeteria (usually none)
Antworten
-
Cluster
-
Epidemic
-
Outbreak
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10 cases of cancer diagnosed over 2 years among residents of a single neighborhood (previous data not available)
Antworten
-
Cluster
-
Epidemic
-
Outbreak
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Why should an investigator who has no clinical background nonetheless talk to a patient or two as an early step in the outbreak investigation?
Antworten
-
To advise the patient about common risk factors and the usual course of the illness, after reviewing such information in appropriate reference material
-
To develop hypotheses about the cause of the outbreak
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To learn more about the clinical manifestations of the disease
-
To verify the clinical findings as part of verifying the diagnosis
-
To verify the laboratory findings as part of verifying the diagnosis
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A case definition during an outbreak investigation should NOT specify:
Antworten
-
Clinical features
-
Time
-
Place
-
Person
-
Hypothesized exposure
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Ideally, a case definition is 100% accurate in identifying who does and does not have the disease in question, but in reality few case definitions achieve this ideal.
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Once a case definition for an outbreak investigation has been established, it should not be changed.
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Common methods of identifying additional cases (expanding surveillance) as part of an outbreak investigation include:
Antworten
-
Advising the public through newspapers, TV, radio, and the health department's website to contact the local health department
-
Asking case-patients who they were with at the time of exposure (if known)
-
Sending a fax to healthcare providers
-
Telephoning the infection control practitioners at local hospitals
-
All of the above
-
None of the above
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A case report form devised for an outbreak investigation usually includes which of the following types of information?
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Descriptive epidemiology is essential for "characterizing the outbreak" by time, place, and person, but has little bearing on the analytic epidemiology.
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A malfunctioning space heater was used each time the outside temperature dropped below freezing
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At the Eclipse Restaurant, sodium nitrite was mistaken for table salt in the preparation of breakfast one morning only
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Common cold passed from classmate to classmate
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A group of tourists on a weeklong bus tour of a European country experienced an outbreak of norovirus. The group had followed a consistent meal time pattern: each morning they had breakfast together in whichever hotel they had stayed from 6:00 a.m. to 7:00 a.m., stopped for lunch from 1:00 p.m. to 2:00 p.m., then had dinner together either at the next hotel or at a restaurant at about 7:00 p.m. The incubation period for norovirus is about 24-48 hours, with a median of about 33 hours. On which day and at which meal was exposure most likely?
Antworten
-
April 19 Dinner
-
April 20 Breakfast
-
April 20 Lunch
-
April 20 Dinner
-
April 21 Breakfast
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Possible explanations for a case that occurs substantially later than the other cases in an outbreak include:
Antworten
-
Similar but unrelated disease
-
Secondary case
-
Case with unusually long incubation period
-
Time of exposure later than others
-
Error in recording date
-
All of the above
-
None of the above
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A spot map is particularly useful for displaying:
Antworten
-
Geographic location of exposure of each case-patient
-
Residence of each case-patient
-
Incidence rate of disease by area
-
Prevalence rate of disease by area
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Which of the following may be useful in generating hypotheses in an outbreak setting?
Antworten
-
Review the literature
-
Look at the descriptive epidemiology
-
Look at the outliers
-
Talk with the local health authorities
-
Talk with a few of the case-patients
-
Talk with subject matter experts
-
All of the above
-
None of the above
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The key feature of an analytic (epidemiologic) study is
Antworten
-
Analysis by time, place, and person
-
Calculation of a risk ratio or odds ratio
-
Use of Epi Info to analyze the data
-
Presence of a comparison group
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Disease control measures can be directed at the:
Antworten
-
Agent
-
Source
-
Mode of transmission
-
Portal of entry
-
Host susceptibility
-
All of the above
-
None of the above
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Use the information in the following paragraph and data in the table for Questions 185–188.
An outbreak of gastrointestinal disease occurred 24-36 hours after people had attended a wedding. Of the 203 attendees (including the bride and groom), 200 completed questionnaires, and 50 reported illness compatible with the case definition. Tabulated food consumption histories are presented in the table below.
Ate Specified Food Did Not Eat Specified Food
Food Item Ill Well Total Ill Well Total
Punch 46 (25%) 138 184 4 (25%) 12 16
Wedding Cake 45 (45%) 55 100 5 (5%) 95 100
Sushi 10 (91%) 1 11 40 (21%) 149 189
What is the following study?
Antworten
-
Case Control
-
Cohort
-
Cross Sectional
-
Randomized Control Trial
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The most appropriate measure of association for these data is the:
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Which food is the most likely culprit?
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Results of this outbreak investigation should be communicated to EXEPT: