Biostatistics Exam Review
Course Introduction
Biostatistics is the application of statistical methods to the analysis and interpretation of data in biological, medical, and health-related research. This course introduces fundamental concepts such as probability, descriptive statistics, hypothesis testing, confidence intervals, regression analysis, and the design of experiments. Students will learn to critically assess data, perform statistical analyses using software, and interpret results in the context of scientific and clinical studies, equipping them with essential skills for evidence-based decision-making in health sciences.
Recommended Textbook
Gordis Epidemiology 6th Edition by Celentano ScD
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19 Chapters
150 Verified Questions
150 Flashcards
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Page 2
MHS
Chapter 1: Introduction
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4 Verified Questions
4 Flashcards
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Sample Questions
Q1) Thanks to the contributions of Edward Jenner,the following disease was eradicated later by efforts organized by D.A.Henderson:
A) Cholera
B) Smallpox
C) Chickenpox
D) Polio
E) Zika
Answer: B
Q2) This historic character observed that childbed fever mortality was more common among women treated by physicians and medical students compared with women treated by midwives.Based on his observations,he implemented a hand wash policy that resulted in a decrease in mortality.Name the character that we are talking about.
A) John Snow
B) Edward Jenner
C) D.A. Henderson
D) Leon Gordis
E) Ignaz Semmelweis
Answer: E
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Chapter 2: The Dynamics of Disease Transmission
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Sample Questions
Q1) Malaria is a parasitic disease transmitted by the Anopheles mosquito bite.This mode of transmission is called
A) direct.
B) single exposure.
C) multiple exposure.
D) mosquitosis.
E) vector.
Answer: E
Q2) The population of Oriol City in June 2018 was 612,437.According to the Oriol City's health department,there were 329 new cases of Raven's disease during 2018.Counting those new cases,by December 31 it was estimated that there were 6580 persons with Raven's disease in Oriol City.What was the incidence rate of Raven's disease in 2018?
A) 26 per 100,000 population
B) 33 per 100,000 population
C) 54 per 100,000 population
D) 1074 per 100,000 population
E) 5000 per 100,000 population
Answer: C
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4
Chapter 3: The Occurrence of Disease: Idisease
Surveillance and Measures of Morbidity
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7 Verified Questions
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Sample Questions
Q1) In the student's health clinic of a certain university,140 cases of foot-hand-mouth disease were identified among the undergraduate students.This viral infection is usually mild,and none of the students got any complication.Because it is rare to observe this condition in people older than 10 years,the university reported their findings to the city's health department.Three officers were sent to the university to interview and examine all the infected students and their contacts.By sending the three officers,what type of surveillance was implemented by the city health department in response to the university's report?
A) Sentinel
B) Periodic
C) Systematic
D) Passive
E) Active Answer: E
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Chapter 4: The Occurrence of Disease: II Mortality and Other Measures of Disease Impact
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Sample Questions
Q1) A researcher finds that the standardized mortality rate (SMR) for epidemiologists compared with the general population is 100.What does that mean?
A) The observed number of deaths for epidemiologists is the same as the expected.
B) Epidemiologists have a mortality rate 100 times greater than the general population.
C) Epidemiologists have a mortality rate 100 times lower than the general population.
D) The general population experience a mortality rate increased as compared with epidemiologists.
E) Nothing can be said with this information.
Q2) For a disease such as seasonal influenza,which is less fatal and of short duration?
A) Incidence rates and mortality rates will be similar.
B) Mortality rates will be much higher than incidence rates.
C) Incidence rates will be much higher than mortality rates.
D) Incidence rates will be unrelated to mortality rates.
E) None of the above.
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Chapter 5: Assessing the Validity and Reliability of Diagnostic and Screening Tests
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14 Flashcards
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Sample Questions
Q1) Which of the following statements about specificity is the most accurate?
A) The probability that a diseased person (case) in the population tested will be identified as diseased by the test.
B) The probability that a person without the disease (noncase) in the population tested will be identified as nondiseased by the test.
C) The probability that a person identified as diseased by the test will be a diseased person (case) in the population.
D) The probability that a person identified as nondiseased by the test will be a person without the disease (noncase) in the population.
E) The probability that a diseased person (case) in the population tested will be identified as nondiseased by the test.
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Chapter 6: The Natural History of Disease: Ways of Expressing Prognosis
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Sample Questions
Q1) The following table describes the survival of patients treated from disease X from 2015 to 2017 followed for 3 years (assuming no loss to follow-up).If a person is treated and using all the information from the table,what is the probability of surviving 3 years after treatment? \(\begin{array}{r}
\text { Number alive at the end of year }\quad \\
\begin{array}{|l|l|l|l|l|}
\hline \text { Year of treatment } & \text { Number of patients treated } & \quad 1 \text { year } & \quad 2 \text { year } &\quad 3 \text { year } \\
\hline 2015 & 100 & 67 & 42 & 30 \\
\hline 2016 & 50 & 31 & 18 & \\
\hline 2017 & 75 & 52 & & \\
\hline \text { Totals } & 225 & 150 & 60 & 30 \\
\hline
\end{array}\end{array}\)
A) 0.29
B) 0.33
C) 0.61
D) 0.67
E) 0.71
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Chapter 7: Observational Studies
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Sample Questions
Q1) Researchers wanted to provide additional support for a causal association between human papillomavirus (HPV) and oropharyngeal cancers.They performed an epidemiologic study of 100 patients with newly diagnosed oropharyngeal cancer and 200 control patients without cancer to evaluate associations between HPV infection and oropharyngeal cancer.[D'souza G,Kreimer AR,Viscidi R,et al.A study of human papillomavirus and oropharyngeal cancer.N Engl J Med.2007;356(19):1944-1956.] What kind of study design is this?
A) Retrospective cohort study
B) Prospective cohort study
C) Case-control study
D) Randomized trial
E) Case report
Q2) A researcher study of Baltimore's neighborhoods showed that those neighborhoods with lower median household income experienced a higher teen pregnancy rate.What type of study design was used?
A) Cohort
B) Case-control
C) Ecologic
D) Experimental
E) Randomized trial
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Chapter 8: Cohort Studies
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Sample Questions
Q1) Which of the following statements is the most accurate characteristic of the nested case-control study?
A) A control who is selected early in the study could later develop the disease but cannot be a case in the same study.
B) In nested case-control studies, controls are a sample of individuals who are at risk for the disease at the time each case of disease develops.
C) Controls are randomly chosen from the defined cohort with which the study began.
D) The problems of possible recall bias from conventional case-control studies still remains.
E) Nested case-control studies are often less economical to conduct.
Q2) The main difference between a cohort study and a randomized trial is that
A) cohort studies are longitudinal and randomized trials are cross-sectional.
B) only clinical trials can evaluate the effect of a drug.
C) randomized trials are experimental and cohort studies are observational.
D) clinical trials are observational and cohort studies are experimental.
E) at the beginning of a clinical trial, participants are free of disease, and cohort studies start with patients with a disease.
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Page 10
Chapter 10: Assessing Preventive and Therapeutic
Measures: Randomized Trials
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Sample Questions
Q1) In a clinical trial,sometimes patients agree to receive an intervention but later decide to stop taking the medication.Moreover,some patients who were assigned to placebo decide to stop taking the placebo pill and buy the drug on their own (even when they do not know that they are taking a placebo pill).When this happens,researchers typically do the analysis according to the original assignment of the treatment regardless of the actual treatment received.What is the name of this procedure to analyze the data?
A) Randomization
B) Intention-to-treat analysis
C) Concealment of random allocation
D) Analysis as treated
E) Mediation analysis
Q2) Participants in a clinical trial might report different symptoms when they know they are part of the intervention group instead of the control group.To avoid that,researchers use the following:
A) Confounding
B) Randomization
C) Concealment of random allocation
D) Masking
E) Effect modifiers
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Chapter 11: Randomized Trials: Some Further Issues
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Sample Questions
Q1) Epidemiologists decided to investigate the effect of sunscreens on sunburns.They ran an epidemiologic study to see the association of sunscreens and sunburns.Overall,460 people have enrolled in the study.Investigators randomly allocated 230 people to the treatment group (sunscreens) and 230 to the control group (placebo).They exposed those 460 people to the high mountain trail on a sunny day.At the end of the study,30 people developed sunburns in the sunscreen group and 130 people developed sunburns in the placebo group.What type of study design is this?
A) Cross-sectional study
B) Prospective cohort study
C) Case-control study
D) Randomized trial
E) Case-control study.
Q2) What is the primary purpose of randomization?
A) To prevent bias in the assignment of treatment
B) To provide a probability basis for statistical testing
C) To ensure the same number of people are randomized to each group
D) To ensure that the subjects not to know which group they are assigned to
E) To guarantee the comparability of the different treatment groups
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Chapter 12: Estimating Risk: Is There an Association
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Sample Questions
Q1) Consider the following 2 × 2 table from a hypothetical cohort study.Calculate the incidence of cardiovascular disease (CVD) among the not exposed participants. \[\begin{array} { | l | c | c | c | }
\hline \text { Serum fasting glucose } & \text { Developed CVD } & \text { Did not develop CVD } & \text { Total } \\
\hline \geq 126 \mathrm { mg } / \mathrm { dL } \text { (exposed) } & 125 & 325 & 450 \\
\hline < 126 \mathrm { mg } / \mathrm { dL } \text { (not exposed) } & 50 & 500 & 550 \\
\hline \text { Total } & 175 & 825 & 1000 \\
\hline
\end{array}\]
A) 9 per 100 population
B) 28 per 100 population
C) 44 per 100 population
D) 50 per 175 population
E) 72 per 100 population
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Page 13
Chapter 13: More on Risk: Estimating the Potential for Prevention
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Sample Questions
Q1) A politician asks an epidemiologist how many cases of coronary heart disease can be prevented if they manage to eliminate the exposure to smoking in city A.The epidemiologists explain that,if they eliminate smoking,they could prevent 22% cases of coronary heart disease.What measure of association was used to answer this question?
A) Population attributable risk
B) Odds ratio
C) Relative risk
D) Incidence rate
E) Risk ratio
Q2) The following is a measure of the strength of association,typically used in case-control studies to measure the association between exposure and disease:
A) Incidence rate
B) Population attributable fraction
C) Attributable fraction
D) Prevalence
E) Odds ratio
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14
Chapter 14: From Association to Causation: Deriving
Inferences From Epidemiologic Studies
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6 Verified Questions
6 Flashcards
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Sample Questions
Q1) In a hypothetical cross-sectional study,marriage was found to be strongly associated with increased levels of happiness.Authors concluded that marriage was a cause of happiness.However,a reviewer of this study argued that because it is a cross-sectional study,it could not be determined whether marriage caused happiness or happiness caused marriage.What criterion of causal relationships was not met in the study according to the reviewer?
A) Strength of association
B) Biologic plausibility
C) Dose response
D) Temporal relationship
E) Replication of findings
Q2) Temporal relationship is a necessary criterion to establish causality.Which of the following epidemiologic study design allows to evaluate temporal relationship?
A) Cross-sectional
B) Case-control
C) Transversal
D) Cohort
E) Literature review
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Sample Questions
Q1) In a case-control study,a researcher found no association between exposure to A and disease B.Later she found out that there was a misclassification when measuring exposure to A,in both cases and controls.What is a potential explanation for the results (no association) of this case-control study?
A) Nondifferential misclassification
B) Differential misclassification
C) Selection bias
D) Confounding
E) Effect-modification
Q2) Investigators think that income might be a confounder in the relationship between Hispanic ethnicity and cardiovascular disease.They conduct a case-control study and they match cases and controls based on income.They find that Hispanics are more likely to have cardiovascular disease as compared with non-Hispanics.What would you conclude about income as a potential confounder in this association?
A) Income is a confounder.
B) Income is not a confounder.
C) Income is an effect modifier.
D) Income is not associated with cardiovascular disease.
E) Income is not associated with ethnicity.
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Chapter 16: Identifying the Roles of Genetic and Environmental Factors
in Disease
Causation
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Sample Questions
Q1) The following suggests environmental factors causing a disease:
A) Monozygotic twins getting the same disease
B) Family history of disease
C) Early development
D) A rapid change in the trends of disease over time
E) Biologic brothers adopted by different families getting the same disease
Q2) A total of 1,500 pairs of adult twins,600 monozygotic and 900 dizygotic,were studied to estimate the concordance for a childhood cancer.In the 600 monozygotic twins,40 of the pairs were concordant for the disease,60 of the pairs were discordant for the disease,and neither twin had the disease in the remaining 500 pairs.In the 900 dizygotic twins,30 of the pairs were concordant for the disease,120 of the pairs were discordant for the disease,and neither twin had the disease in the remaining 750 pairs.What is the concordant rate,in monozygotic twins,of the disease in twin pairs with at least one affected member?
A) 0.1
B) 0.4
C) 0.6
D) 0.7
E) 1.5
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Chapter 17: Using Epidemiology to Evaluate Health Services
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Sample Questions
Q1) The government of Country A decided to introduce a new treatment strategy for disease X.It was decided that,starting in January 1,2019,all patients diagnosed with disease X in public hospitals would receive the new treatment.Researchers were asked to evaluate the new treatment.Which of the following designs is the best approach to evaluate the new treatment?
A) Randomized clinical trial
B) Case-control study
C) Cross-sectional survey
D) Before-after study
E) Case-series
Q2) In general terms,a health indicator is a
A) rare disease that reflects how the system deals with complex conditions.
B) sentinel condition that is assumed to reflect the general level of health care.
C) disease that reflects infant health.
D) disease that reflects maternal and child health.
E) statistical test used to compare the health situation of two countries.
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Chapter 18: Epidemiologic Approach to Evaluating Screening Programs
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Q1) The following is a reason for an apparent lack of benefit from a screening program:
A) The available treatments are not effective even when administered early in the disease progression.
B) The clinical phase of disease is long and usually ends with the death of the patient.
C) The usual diagnosis of disease happens very late in the disease progression.
D) The preclinical phase of disease is very long.
E) The current therapies are very effective when administered in the preclinical phase of disease.
Q2) Which of the following statements is the most accurate example of tertiary prevention?
A) Receiving a yellow fever vaccination at a tertiary hospital
B) Using a mosquito net while visiting a malaria-endemic country
C) Taking preventative malaria drug before getting an infection
D) Receiving regular blood smear test to detect the malaria early
E) Joining malaria rehabilitation programs to reduce or eliminate long-term impairments and disabilities from previous infections
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Chapter 19: Epidemiology and Public Policy
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Q1) What is the name of the chart that is typically used to depict the results of a meta-analysis?
A) Forest plot
B) Pie chart
C) Box plot
D) Manhattan plot
E) Bar chart
Q2) When decision makers are in the process of assessing whether a new policy should be implemented to avoid a certain health risk,besides considering the scientific evidence available,they should also take into account the following societal consideration:
A) If that decision would make them look good with constituents
B) The proportion of the population would be protected by such policy
C) If that new policy was proposed by prestigious academics
D) The media's opinion about the policy
E) The incidence rate of the disease
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Chapter 20: Ethical and Professional Issues in Epidemiology
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Q1) To abide with the ethical principle of autonomy,epidemiologic research requires A) epidemiologists to provide financial incentives.
B) to obtain participant's consent before collecting any information.
C) to investigate only participants who are in excellent health.
D) share participant's information with any institution.
E) that only one researcher is able to access the data collected.
Q2) A challenge in epidemiologic research that explores the effect of race on cardiovascular disease is that
A) measuring race is hard because is a poorly understood concept and its validity is questionable.
B) measuring race requires DNA testing.
C) there are too many human races.
D) race is usually not associated with health outcomes.
E) cardiovascular disease is not well defined.
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