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In an Asian country with a population of 6 million people, 60,000 deaths occurred during the year ending December 31, 1995. These included 30,000 deaths from cholera in 100,000 people who were sick with cholera.
7. What was the cause-specific mortality rate from cholera in 1995?
8. What was the case-fatality rate from cholera in 1995?
9. Age-adjusted death rates are used to:
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- a. Correct death rates for errors in the statement of age
- b. Determine the actual number of deaths that occurred in specific age groups in a population
- c. Correct death rates for missing age information
- d. Compare deaths in persons of the same age group
- e. Eliminate the effects of differences in the age distributions of populations in comparing death rates
10. The mortality rate from disease X in city A is 75/100,000 in persons 65 to 69 years old. The mortality rate from the same disease in city B is 150/100,000 in persons 65 to 69 years old. The inference that disease X is two times more prevalent in persons 65 to 69 years old in city B than it is in persons 65 to 69 years old in city A is:
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- a. Correct
- b. Incorrect, because of failure to distinguish between period and point prevalence
- c. Incorrect, because of failure to adjust for differences in age distributions
- d. Incorrect, because of failure to distinguish between prevalence and mortality
- e. Incorrect, because a proportion is used when a rate is required to support the inference
11. The incidence rate of a disease is five times greater in women than in men, but the prevalence rates show no sex difference. The best explanation is that:
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- a. The crude all-cause mortality rate is greater in women
- b. The case-fatality rate for this disease is lower in women
- c. The case-fatality rate for this disease is greater in women
- d. The duration of this disease is shorter in men
- e. Risk factors for the disease are more common in women
12. Of 2,872 persons who had received radiation treatment in childhood because of an enlarged thymus, cancer of the thyroid developed in 24 and a benign thyroid tumor developed in 52. A comparison group consisted of 5,055 children who had received no such treatment (brothers and sisters of the children who had received radiation treatment). During the follow-up period, none of the comparison group developed thyroid cancer, but benign thyroid tumors developed in 6. Calculate the relative risk for benign thyroid tumors:
13. In a study of a disease in which all cases that developed were ascertained, if the relative risk for the association between a factor and the disease is equal to or less than 1.0, then:
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- a. There is no association between the factor and the disease
- b. The factor protects against development of the disease
- c. Either matching or randomization has been unsuccessful
- d. The comparison group used was unsuitable, and a valid comparison is not possible
- e. There is either no association or a negative association between the factor and the disease
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Questions 14 and 15 are based on the information given in the table below.
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Table I01-5. Rates of Atherosclerotic Heart Disease (ASHD) per 10,000 Population, By Age and Sex, Framingham, Massachusetts
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MEN
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WOMEN
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Age at Beginning of Study (yr)
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ASHD Rates at Initial Exam
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Yearly Follow-up Exams (Mean Annual Incidence)
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ASHD Rates at Initial Exam
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Yearly Follow-up Exams (Mean Annual Incidence)
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29-34
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76.7
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19.4
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0.0
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0.0
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35-44
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90.7
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40.0
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17.2
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2.1
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45-54
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167.6
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106.5
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111.1
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29.4
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55-62
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505.4
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209.1
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211.1
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117.8
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14. The relative risk for developing ASHD subsequent to entering this study in men as compared to women is:
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- a. Approximately equal in all age groups
- b. Lowest in the oldest age group
- c. Lowest in the youngest and oldest age groups, and highest at ages 35-44 and 45-54 years
- d. Highest in the youngest and oldest age groups, and lowest at ages 35-44 and 45-54 years
- e. Highest in the oldest age group
15. The most likely explanation for the differences in rates of ASHD between the initial examination and the yearly follow-up examinations in men is:
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- a. The prevalence and incidence of ASHD increase with age in men
- b. Case-fatality rates of ASHD are higher at younger ages in men
- c. The rates of ASHD in men is declining.
- d. The case-fatality rate in ASHD is highest in the first 24 hours following a heart attack
- e. The initial examination measures the prevalence of ASHD, whereas the subsequent examinations primarily measure the incidence of ASHD
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16. Several studies have found that approximately 85% of cases of lung cancer are due to cigarette smoking. This measure is an example of:
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- a. An incidence rate
- b. An attributable risk
- c. A relative risk
- d. A prevalence risk
- e. A proportionate mortality ratio
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Questions 17 and 18 refer to the following information:
The results of a 10-year cohort study of smoking and coronary heart disease (CHD) are shown below:
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OUTCOME AFTER 10 YRS
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At Beginning of Study
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CHD Developed
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CHD Did Not Develop
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2,000 Healthy smokers
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65
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1,935
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4,000 Healthy nonsmokers
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20
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3,980
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17. The incidence of CHD in smokers that can be attributed to smoking is:
18. The proportion of the total incidence of CHD in smokers that is attributable to smoking is:
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Questions 19 and 20 are based on the following information:
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In a cohort study of smoking and lung cancer, the incidence of lung cancer among smokers was found to be 9/1,000 and the incidence among nonsmokers was 1/1,000. From another source we know that 45% of the total population were smokers.
19. The incidence of lung cancer attributable to smoking in the total population is:
20. The proportion of the risk in the total population that is attributable to smoking is:
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