# Epidemly and biostat

Epidemly and biostat
give a full detailed answer to each question. please explain why each answer is true or false. please give a detailed rational for the multiple choice….. sources that may help

1. Gordis, L. (2009). Epidemiology: with Student Consult (4
th
Ed). Print and Online Access. Philadelphia, PA: Saunders.
http://www.amazon.com/Epidemiology-4th-Edition-Leon-Gordis/dp/1416040021
2. Polit D.F. (2010). Statistics and Data Analysis for Nursing Research (2nd Edition)
http://www.amazon.com/Statistics-Analysis-Nursing-Research-Edition/dp/0135085071
3. Grove, S. K. (2007). Statistics for Health Care Research: A Practical Workbook. Philadelphia, PA: Saunders. ISBN:
9781455709960

Assignment 1

Use the space assigned after each question for your answer. All the questions must be answered, justified USING YOUE OWN WORDS and show your calculations for credit. The Assignment includes 16 questions.

Q1. The crude mortality rate fluctuated moderately in New York City between 1940 and 1980, yet the age adjusted rate fell by 42% (see table below). What is the most probable explanation? [ONE POINT]
New York City United States
1940 11.3 10.2 10.8 10.8
1950 8.9 10.0 8.4 9.6
1960 8.1 11.1 7.6 9.5
1970 7.7 11.2 7.1 9.5
1980 6.6 10.8 5.9 8.9

Q2. There were 1,859,000 deaths in the United States in 1982. What additional information is required to compute the crude mortality rate? [ONE POINT]
For Questions 3, and 4, answer if the statements are true or false
Q3. Case fatality measures the rate at which people without a disease develop the disease during a specific period of time. [ONE POINT]
1. True 2. False

Q4. Incidence is a measure of disease frequency [ONE POINT]
1. True 2. False

Q5. A city contains 100,000 people (45,000 males and 55,000 females), and 1,000 people die per year (600 males and 400 females). There were 50 cases (40 males and 10 females) of lung cancer per year, of whom 45 died (39 males and 6 females). Calculate:
a. Crude mortality rate [ONE POINT]

b. Sex-specific mortality rate [ONE POINT]
c. Case fatality rate for lung cancer [ONE POINT]
d. proportionate mortality rate (PMR) for lung cancer [ONE POINT]

Q6. What is the annual incidence rate (per 1,000 persons) of lung cancer, if it is diagnosed in 70 patients per year within a community of 30,000 unaffected individuals? (Please show your calculations) [ONE POINT]

Annual incidence is ___________________________________________

Q7. Colon cancer is diagnosed in 20 patients per year within a community of 10,000 unaffected individuals. Half of the affected individuals die from colon cancer. What is the case fatality of colon cancer in this community? (Please show your calculations) [ONE POINT]
The case fatality for colon cancer is ______________________________________

Q8. Breast cancer is diagnosed in 20 patients per year within a community of 10,000 unaffected individuals. A screening test is applied to all residents of this community. What is the sensitivity (in %) of the screening test, if it detects 9 of the breast cancers. What is the specificity if the test correctly determines that 9,900 of the unaffected persons do not have breast cancer? (Please show your calculations)
a. The sensitivity of the test is [ONE POINT]_______________________________
b. The specificity of the test is [ONE POINT] _____________________________

c. Write comments about the validity of the screening test. [ONE POINT]

Q9. A physical examination and an audiometric test were given to 500 persons with suspected hearing problems, of whom 400 were actually found to have them. The results of the examinations were as follows:

1- Physical examination Hearing problems
Results Present Absent
Positive 340 20
Negative 60 80

a. Sensitivity of the physical examination [ONE POINT] =

b. Specificity of the physical examination [ONE POINT] =

c. Predicted value positive [ONE POINT] =

2- Audiometric test Hearing problems
Results Present Absent
Positive 380 10
Negative 20 90

a. Sensitivity of the audiometric test [ONE POINT]=

b. Specificity of the audiometric test [ONE POINT]=

Q9a. Compared with the physical examination, the audiometric test is: [ONE POINT]
a. Equally sensitive and specific
b. Less sensitive and less specific
c. Less sensitive and more specific
d. More sensitive and less specific
e. More sensitive and more specific

Q10. The age adjusted mortality rates are used to: [ONE POINT]
a. Compare deaths in persons of the same age groups
b. Correct death rates for errors in the statement of age
c. Eliminate the effects of differences in the age distributions of populations in comparing death rates
d. Determine the actual number of deaths that occurred in specific age groups in a population

Q11. The table below shows the population and # of deaths from disease Z.

Age Community X Community Y
# of people # of death from disease Z # of people # of death from disease Z
Young 5,000 55 2000 39
Old 9,000 110 1000 61

Please calculate the age-adjusted death rate for disease Z in communities X and Y by the direct method, using the total of both communities as the standard population. (Please show your calculations)

a. Age-adjusted death rate from disease Z in community X is: [TWO POINTS]
___________________________________________________________________
b. Age-adjusted death rate from disease Z in community Y is: [TWO POINTS]
___________________________________________________________________

Q12. Epidemic refers to: [ONE POINT]
a. Disease that is constantly present in a community
b. Disease rate in excess of 10 per 1,000 subjects
c. The occurrence of illnesses of similar nature clearly in excess of the normal expectation for that population at that time
d. Disease that occur seasonally
e. All of the above

Q13. Which of the following are correct interpretation of the data in the table below? [ONE POINT]
a. No interpretation may be drawn because hospital A has older population than hospital B
b. The crude mortality rates differ between the two hospitals
c. No interpretation may be drawn because diagnostic standards may differ between the two hospitals
d. The age-specific mortality rates are greater in hospital B
e. The age-adjusted mortality rates are equal in the two hospitals
Table: Patient mortality by age in two urban hospitals in 1988
Hospital A Hospital B
Age (years) Death Patient Death rate/1000 Deaths Patients Death rate/1000
<50 10 500 20 30 1000 30
>49 50 1000 50 30 500 60
Totals 60 1500 60 1500

Q14a. Explain the relationship between sensitivity and false negative results? Give example [ONE POINT]
Q14b. Explain the relationship between specificity and false positive results? Give example [ONE POINT]

Q15. Why might clinical health care professional find positive and negative predictive values more useful than sensitivity and specificity in evaluating a test? [ONE POINT]

Q16. A colleague informs the epidemiologist of a new screening test for the early detection of lung cancer. How might the test be assessed before it is used by the general medical community? [ONE POINT]

Identify the 5 Ks of Sikhism, and explain which one intrigues you the most.
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