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    Epidemiology - Nbde2

    Hochgeladen von

    mohammed
    dental exam

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    © All Rights Reserved
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    = se e NATIONAL BOARDS PART II REVIEW Epidemiology 2001 Kerry Maguire, DDS, MSPH 7 Epidemiology: the study of distribution and determinants of disease frequency in human populations Types of Epidemiologic Studies Descriptive Studies: describe the general characteristics of the distribution of disease, particularly in relation to person, place and time, Examples include: ~ Correlational studies & Case reports and case series (LG crosssectonl surveys > Analytic Studies: use appropriate comparison groups as a means of testing epidemiologic hypotheses Case Controt Studies Advantages Disadvantages Quick and inexpensive Inefficient for rar exposures. Efficient design for diseases with long latency periods Prone to selection and recall bias Efficient design for rare diseases ___ Difficult to establish temporal relationship, May examine multiple etiologies of a single disease between exposure and disease Cohort Studies Advantases Disadvantages Efficient for study ofrare exposures Inefficient for study of rare diseases May examine multiple effects ofa single exposure Expensive and time consuming Ayo demi empoRTIEaTansap betieen Retuspre design ques esily exposure and disease 7 y of adequate records Prospective design minimizes bias “7/0, Loss to follow-up may affect validity Intervention Smdies: a study design in which conditions are under the direct contro ofthe investigator. In nology study in which a population is eleced Tara planned tal of a regimen whose effet ere ‘measured by comparing the outcome ofthe regimen inthe experimental group with another regimen in a control rou. Biostatistics Mean: the calculated “average” ofa set of values ‘Median: the midpoint in a group of measurements ‘Mode: the most frequently occurring value in a set of observations ~~‘Standard Normal Distribution: a continuous frequency distribution of infinite range with the following properties: + itis continuous, symmetrical distribution; both tails infinity * the arithmetic mean, mode and median are identical * the shape is completely determined by the mean and standard deviation mpl —maatene Statistical Sionificance value: the probability that an effect atleast as extreme as that observed in a particular study could have occurred by chance alone assuming there is no relationship between exposure and disease. For example, £0.05 means there is no more than a 5% or 1 in 20 probability of observing a result as extreme as this, ee 74 ‘Measures of Disease Frequency Prevalence existing cases of adisease at a given point in time total population Incidence Hnew cases of a disease during a given period of time total population at risk 2x2 Table Disease + : Total Screening test atd results etd Total ate bed atbterd Sensitivity a Specific Predictive Value Positive a a+b Predictive Value Newative ici ord a Board Review Questions: 1999 Examination 1. A diagnostic test foiled to identify five cases ofa true disease. This type of failure is known as a $a. false negative. false positive. . positive predictive value. 4. negative predictive value. 2. In determining the caries rate for older adults, an epidemiologist usually uses the DMFT index, BECAUSE it ‘can be difficult to ascertain why teeth are missing, a. Both the statement and the reason are correct and related. . Both the statement and the reason are correct but NOT related. ¢. The statement is correct, but the reason is NOT. 4. The statement is NOT correct, but the reason is accurate. ¢. NEITHER the statement NOR the reason is correct. History of Smoking Tong Cancer Present Tang Cancer Absent Exposed a b Not Exposed e d 3. Using the table above, a researcher can safely conclude that the rate of lung cancer in the NON-SMOKERS is which of the following? a. alatb %, cletd ©. alate 4. biota c. dtd 4, A researcher establishes the following null hypothesis: “There is no difference in student achievement between the programmed self-instructional strategy and a conventional lecture-discussion format.” In this study, the DEPENDENT variable will be the a. type of instruction used. b. number of students who participated, . relevance of the course material. % d. examination scores obtained 5. On the basis of diagnostic test results, a dentist correctly classifies a group of patients as being free from disease, These results possess high a. sensitivity. *b. specificity. c._ generalizability. repeatability. 6. What is the mode of the following data set? 11,1, 1,2,2,2,3,3,7,9 (n= 10; sum = 30) dal ee ae 7 7, To evaluate the effectiveness of a dental health program, researchers will use a pretest ~ posttest design. Which of the following will represent the preferred method for placing subjects into the experimental and control ‘groups? a. Random assignment b. Interviewing ¢. Matching. 8, The rate at which new disease occurs is classified as which of the following? a. Incidence b. Prevalence fe. Extent ._ Attributable risk 9, Information about subjects in a study included their ethnicity. What level of measurement is ethnicity? a, nominal. b. ordinal. cc. interval. 4. ratio. 10, The following data were collected for men and women in a study: ‘Mean DFS ia Mew i 32, me ‘Women 29 ‘What is the appropriate statistical test to determine if they are truly different? a. chi-squared, +b. test, ©. correlation. 4. linear regression. 11, A dentist reviews the charts of ll the patients in his practice and observes that 200 of them have periodontal disease. One year later he repeats the review and cbserves that 300 have periodontal disease. What is the incidence of periodontal disease in this practice? +a. 100 cases per year. 4 200 cases per year. ¢. 300 cases per year 4. $00-cases per year. 12. A diagnostic test produces the following results among a group of 100 patients: ‘True positive 32 False positive 8 True negative 40 False negative 20 Whats the sensitivity of the test? 2. 20percent ‘b. 40 percent. % Ac, 60 percent. 4. 80 percent. Derbal Public Health Dr Maguire (977 National Board Part IL Note: I was not allowed to take notes, so these questions are my recollections. They are not worded exactly as on the examination, they are not in the same order as on the examination, and not all of the distractor choices for each question are included. In some cases, I was only able to recall the theme of the question. An asterisk* indicates a question about which I made a written complaint. DPHOS Section (22/400 questions on the examination) fot Duapetirnl Satcky—(vealinton abet, unk) 1. Information about subjects in a study included their ethnicity. What level of surement is ethnicity? CR) nominal. — 7% 7 B. = ordinal. Ae interval. D. ratio. 2. Of the following, what is the most efficient route for absorption of mercury from a patient's amalgam restorations? ae ‘A. ingestion of amalgam fragments. B.___ direct absorption through gingival tissue. ed) inhalation of vapor. 3. A patient may not display symptoms of HIV infection for months or years after exposure to the virus. This is an example of A. virulence. eS latency. 4. Which of the following is the correct approach to disposal of clinic materials that are bagged separately as contaminated waste? cs disposal after being properly decontaminated. disposal with regular trash. C. disposal by a certified hazardous waste contractor. 5. Use of a thoracic collar on a patient lead apron is recommended while taking x-rays. Which of the following strategies may be used to limit exposure in place of this collar? _A. use of E-speed film. (2B) collimation of x-ray beam. *6. Increasing which of the following will result in a decr staff in a dental office? eI Kv. (>B) distance. Se milliamps. 2 of radiation exposure for 7. A dentist who fails to complete a planned course of treatment without adequate notice to the patient is guilty of: CF a Ss f } _/ breach of contract. 8. A19 year- -old woman being seen as a. new.patient for an examination has 28 teeth, with 4 class I amalgam restorations on teeth numbers 3, 14, 19, and 30. She reports having had her 3° molars removed. Oral hygiene is adequate and there are no pocket depths greater than 3mm. According to FDA guidelines for radiographic exposure, what should she receive? A, full mouth series. _bite wings only. panoramic and bite wing x-rays. D. panoramic x-ray only. +9. Which impression materials most dificult to effectively decontaminate? A.__ alginate. - ~~~ _— §B)) reversible hydrocolloid ees Hors C= _ polyvinylchioride. ant feof? eon voreadl *10. What metal used in dentistry are patients most commonly allergic to? A.__ mercury. Sw Nickel Are nary aig. fo ee sof silver. a D. cadmium. 11. The following data were collected for men and women in a study: Mean DFS Men 3.2, Women. 2.9 What is the appropriate statistical test to determine if they are truly different? chi squared. t-test. correlation. D. linear regression. *12. Which of the following are principles used in ethical decision making? A. duty, breach, and damage. - Be) beneficence, autonomy, and justice. \ inte 13. Which ethical principal requires that informed consent be obtained? non-maleficence, autonomy. beneficence. D. justice, 14. What purpose do anti-siphon valves in water lines serve? ob prevent water from being drawn into handpiece from patient. B2) prevent water from dental unit from being drawr water supply. C. ‘prevent water from handpience tr a ear eS cena ing drawn in uni 15. A diagnostic test produces the following results among a group of 100 patients: True positive 32h True negative 40 2ye False positive 8— v False negative 20¢ ve What is the sensitivity of the test? oe A. 20 percent. v >B. 40 percent. _ ae pee C. : 60 percent. D. 80 percent. ok 3 16. When prescribing fluoride tablets for a 2 ¥2 year-old child whose drinking water has been tested at 0.4 ppm fluoride, what dosage should be used? >A. 25mg. | Ba Ge j = s B50 mg. os i Cc .75ma. Siig i Dame olags 5 4 17. A dentist reviews the charts of all the patients in his practice and observes that 200 of them have periodontal disease. One year later, he repeats the review and observes that 300 have periodontal disease. What is the incidence of periodontal disease in his practice? (2A) 100 cases per year. B. 200 cases per year. e 300 cases per year. D. 500 cases per year. 18. What part of the hepatitis B virus is its vaccine based on? “SAD s antigen. ‘B.S antibody. C.— eantigen. D. — e antibody. S Ast zen 19. What is the most common cause of tooth loss in the US? Bea. periodontal disease, BD) caries. Cc trauma. *20. Which of the following has the greatest potential to cause caries? oF ictose. maltose. fructose. *21. Which of the following regimens for providing topical fluoride provides the greatest benefit with the least risk of harmful side-effects? high dose, high frequency. .) low dose, high frequency. high dose, low frequency. D. _, low dose, low frequency. 22. What is the most common cause of oral cancer? alcohol. tobacco. radiation. exposure to toxic materials. Behavioral Sciences Section (18/400 questions on the examination) ene a tee but wo the theme Mt most covrek answers . Dental, Uranuuaicabion ~ — Chninours is the but rei bork. I. Types of Epidemiologic studies Epidemiology - The study of the distribution and determinants of disease frequency in human popuTations~ A.Descriptive Studies - describe the general characteristics of the distribution of a disease, particularly in relation to person, place,and time. 1.Correlational Study 2.Case Reports and Case Series 3.Cross Sectional surveys B.Analytical Studies - use appropriate comparison groups as a means of testing epidemiologic hypotheses 1.0bservational a.Case-Control sthdies Advantages quick and inexpensive efficient design for disease with long latency periods efficient design for rare diseases ability to examine multiple etiologies of a single disease Disadvantages inefficient for the study of rare exposures * difficult to establish temporal relationship between exposure and disease a * prone to selection and recall bias cannot directly compute incidence rates, unless population based Cohort Studies Advantages * efficient for the study of rare exposures * ability to examine multiple effects of a single ability to determine temporal relationship between exposure and disease * prospective design minimizes bias in eliciting exposure information oY * ability to measure directly the incidence of disease sadvantages + inefficient for the study of rare diseases + may be very expensive and time consuming + retrospective design requires availability of adequate records * loss to follow-up may affect validity 2.Intervention Studies II.Measures of Disease Frequency A.Prevalence = #ekisting cases of disease at a given point in time Za total popula B.Incidence_ T+ # new cases of a disease during a given period of time ‘ total population at risk II. Biostatistics Mean Median Mode Standard Normal Distribution Statistical Significance pvalue--the probability that an effect at least as extreme as that observed in a particular study could have occurred by chance. Given that there truly is no relationship between exposure -and_disease p< 0.05 there is no more than a 5% or 1 in 20 probability of observing a result as extreme as this observed by chance alone. oly 169 (On the basis of diagnostic test results, dentist correctly

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