CLINICAL EPIDEMIOLOGY II

ONLINE QUIZ 2
Topics Included:
1.
2.
3.
4.

Prognosis
Economic Analysis
Practice Guidelines
Meta-analysis

These are systematically developed

statements about appropriate health
care for specific health circumstances.
A. Clinical Practice Guidelines
(CPG)
B. Clinical Reviews
C. Meta-analysis
D. Treatment
Which of the following threat to
validity (bias) is tested by the question
Was follow-up sufficiently long and
complete?;
A. Measurement
B. Migration
C. Sampling
D. Susceptibility
Which of the following is a sufficiently
long follow-up for a prognostic study?
A. Five-year survival in patients
with complicated DM
B. Twelve months survival in
patients with resected
pancreatic cancer
C. Thirty-day survival in MI
patients admitted at the ICU
D. All of the above
All probable direct and indirect cost
should be included in costeffectiveness. Example of direct cost
is?
A. Transportation fare of patient
going to hospital
B. Salary of accompanying nurse
C. Cost of the cleansing enema
prior to colonoscopy

D. Professional fee of the attending

physician
For PTB screening of first year college
students, chest x-ray is 70% effective
with an actual cost of Php150 and
sputum culture is 95% effective with
an actual cost of Php800 pesos are
being compared. What is the cost per
unit outcome of sputum culture?
A. 215 pesos
B. 800 pesos
C. 950 pesos
D. 843 pesos (800/0.95)
The most significant research study
is? (evidence ba to?)
A. Level I (rct,meta analysis)
B. Level II (quasi exptal, casecont,
cohort)
C. Level III (case series,case
study,expert)
D. Level IV (expert??)
Clinical Practice Guideline on the
treatment of appendicitis should
contain?
A. Only the best option that is
expected to result to the best
outcome
B. All options and all outcomes
C. Most reasonable options and
the corresponding outcomes
D. All published options and
corresponding outcomes
Characteristic of a useful Clinical
Practice Guideline (CPG);
A. Monitored to be working
B. Available to users
C. Up-to-date
D. All
A patient was diagnosed with
melanoma on his neck. A report you
just read concludes that melanomaspecific mortality is increased in
patients with invasive melanoma of
the scalp/neck compared to those in
the extremities. Assuming the study
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was valid and generalizable to patients

seen in your clinic, what will you tell
your patient?
A. He has a higher risk of dying
because of melanoma
B. He is more likely to die of other
causes than his melanoma
C. He needs a biopsy of a mole on
his arm
D. You need more time to study
the journal article
To assure that an adequate literature
search is done in a meta-analysis, one
should look for;
A. Multiple computerized literature
databases search must be
found in the methodology
section
B. Medline search
C. Use of the gray literature
D. Literature search in English
language only
To address the possibility of
publication bias in the search for titles
in a meta-analysis, the authors should
mention in the Methods section;
A. No language restrictions
B. Review of the reference lists to
find further trials
C. Showing the funnel plot of odds
ratio against the sample size
D. Key words that were used are
listed
This type of article provides an
overview of original research using a
precise protocol with a statement of
objectives and a literature review
conducted according to a specific and
reproducible methodology.
A. Systematic review
B. Practice guideline
C. Primary study
D. Meta-analysis
The PERSPECTIVE in an Economic
Analysis pertains to the point of view
of?

A. The one paying for the

intervention
B. The physician using the
intervention
C. The researcher doing the study
D. The policy maker who will
implement the program
One reason why CPGs were
developed.
A. Educate patients and physicians
about current best practice
B. Promote EBM
C. Improve professional
performance
D. Provide opinions in clinical
decision making
This type of article provides an
overview of original research using a
precise protocol with a statement of
objectives, literature review and that
includes combining and analyzing the
data of individual trials.
A. Systematic review
B. Meta-analysis
C. Economic analyses
D. Practice guidelines
Cost-effectiveness integrates
effectiveness study and costing. The
best study design for the effectiveness
portion is?
A. Case series
B. Case-control
C. RCT
D. Cross-sectional
A study that summarize or draw
conclusions from an original research
is known as;
A. Analytic
B. Primary
C. Integrative
D. Cohort
All probable direct and indirect cost
should be included in costeffectiveness. Example of indirect cost
is?
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A. Merienda of patient and

companion while waiting
B. Alcohol and cotton balls used
during injection
C. The patient record fee
D. Delivery cost of drug
One area where CPG is needed.
A. There is lack of evidence
backing up protocols
B. Presence of variations on the
current management
C. Clinical practice changes are not
applicable in your area of
practice
D. Very few cases met in your
practice
Which design establishes the
temporal relationship between factors
and outcome?
A. Cross-sectional
B. Cohort
C. Case report
D. Case series
Multivariate analysis in a prognostic
study is performed to:
A. Minimize bias
B. Make the results more complex
C. Examine the effect of prognostic
factors one at a time
D. All of the above
Economic analysis compares
alternative strategies in terms of the
cost and the outcome. When the
outcomes of strategies are equal and
only the costs are compared, this is?
A. Cost-effectiveness
B. Cost-benefit
C. Cost-minimization
D. Cost-utility
For PTB screening of first year college
students, chest x-ray is 70% effective
with an actual cost of Php150 and
sputum culture is 95% effective with
an actual cost of Php800 pesos are

being compared. What is the cost per

unit outcome of chest X-ray?
A. 150 pesos
B. 800 pesos
C. 215 pesos
D. 950 pesos
To reduce bias, which approach is
engaged in a prognostic study?
A. Random sampling
B. Restriction
C. Matching
D. All of the above
A valid Clinical Practice Guideline?
A. Must satisfy all validity criteria
B. Must satisfy at least one validity
question
C. Do not include literature search
in the validity guides
D. Must satisfy two thirds of the
criteria
Essential for the dissemination and
implementation of CPG is?
A. Level of knowledge, attitudes
and practices of physicians
about practice guidelines
B. Comprehension ability of
practitioners
C. Level of compliance of
physicians
D. Adaptability of physicians to
changes
In appraising an article on prognosis,
which of the following is a validity
guide?
A. Are the study patients similar to
my own?
B. How large is the likelihood of
outcome to occur in those with
the prognostic factor in a
specified period of time?
C. Is the objective of the article
similar to your clinical dilemma?
D. Was there adjustment for other
prognostic factors?

A study on survival of breast cancer

patients after combined surgery and
anti-estrogen treatment is planned,
the study design should be;
A. RCT
B. Cross-sectional
C. Case-control
D. Cohort
Which one is a threat to the validity of
a meta-analysis?
A. Combining studies that are
dissimilar
B. Selection bias
C. Including quantitative studies in
the analysis
D. High confidence interval
Health care strategies that are
compared in a economic analysis
should always include the newly
introduced strategy and?
A. Any other strategy
B. The current standard strategy
C. Another new strategy
D. A discarded strategy

Which of the following is an integrative

study?
A. Systematic review
B. Review
C. Meta-analysis
D. All are correct
Although recently some have
attempted, with varying degrees of
success, to apply this technique to
epidemiologic research, ideally, metaanalyses are applied to.
A. Randomized clinical trials (RCTs)
B. Case series
C. Cohort
D. Cross sectional designs
The following are true of valid
prognostic study designs:
A. True cohort designs are usually
valid

B. A point in time in the course of

illness to start the observation
C. Long enough time to observe
the outcomes
D. All of the above
To be able to assess the benefits and
costs of a recommendation in the CPG,
the said recommendation must be?
A. Simple
B. Specific
C. Comprehensive
D. All
The PERSPECTIVE in an Economic
Analysis influences?
A. Relevance of study to the case
scenario
B. Significance of the study
C. Validity of the study
D. Results of the study
To assure that an adequate literature
search is done in a meta-analysis, one
should look for searches made in;
A. MEDLINE
B. EMBASE
C. Current Contents
D. All of the above should be
included in the search
For PTB screening of first year college
students, chest x-ray is 70% effective
with an actual cost of Php150 and
sputum culture is 95% effective with
an actual cost of Php800 pesos are
being compared. This economic
analysis is?
A. Cost-effectiveness
B. Cost-benefit
C. Cost-minimization
D. Cost-utility
A major advantage of a meta-analysis
over other integrative studies;
A. It can combine several smaller
studies, thus increasing the
number of subjects in the final
analysis and subsequently
improving the power to detect a
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treatment effect if one is

present
B. It might answer questions about
whether an overall study result
differs among various
subgroups
C. It is an excellent critical review
of the literature that points out
the strengths and weaknesses
of previous research on a given
topic
D. It is an easy way to get
published
Is the guideline likely to account for
important recent developments? This
can be answered by checking;
A. Date of publication of the
guideline
B. Date of expiration of guideline
C. Date of guideline
implementation
D. Guideline bibliography for dates
of most recent articles included