Which of the following estimates of an odds ratio most strongly suggests a computational error?
1) 7.8
2) 1.2
3) -0.9
4) 20.9 correct answer: 3)
... [Show More] -0.9
An odds ratio of -0.9 most strongly indicates a computational error because an odds ratio is calculated using probabilities, which cannot be negative. An odds ratio is the probability that an event will occur divided by the probability that it will not occur. Since probabilities cannot be negative, a negative odds ratio would indicate computational error.
A supervisor of a small community health clinic serving a largely multi-national immigrant community assigns their project manager the responsibility of developing a new process to ensure complaints and conflicts are addressed promptly and respectfully for each patient. This is prompted by a recent complaint that a staff member was rudely addressing a limited English-speaking patient and her family when trying to communicate a diagnosis. In order to create a new process that takes into account the cultural and communication needs of the patients, the program manager must:
1) Create a new conflict process based solely on examples from other clinics.
2) Select a group of patients to provide input on how complaints should be resolved.
3) Wait until a new complaint occurs to observe the existing process.
4) Ask their coworkers how they personally deal with complaints and conflicts in the office. correct answer: 2) Select a group of patients to provide input on how complaints should be resolved.
The other answers are partly correct, as observation and assessment are part of developing a new process or policy, however, they do not take into account the culture of the organization and its patients or its existing policies. The correct answer is consistent with the National Culturally and Linguistically Appropriate Services (CLAS) Standards which are designed to advance health equity and eliminate health disparities through governance, communication, and engagement.
The sensitivity of a particular screening test for a disease is 95%, and the specificity is 90%. Which of the following statements is correct?
1) Of 100 people sampled from a population with the disease, the test will correctly detect 95 individuals as positive for the disease
2) Of 100 people sampled from a population with the disease, the test will correctly detect 90 individuals as positive for the disease
3) If a person tests positive, the probability of having the disease is 0.95
4) If a person tests positive, the probability of having the disease is 0.90 correct answer: 1) Of 100 people sampled from a population with the disease, the test will correctly detect 95 individuals as positive for the disease
A test with 95% sensitivity and 90% specificity will, from a population with the disease, detect the disease in 95 people. Sensitivity is the proportion of truly diseased people in the screened population who are identified as having the disease by the screening test. It measures the probability of correctly diagnosing a case or the probability that any given case will be identified by the test (e.g., true positives). Specificity is the proportion of truly non-diseased people who are so identified by the screening test. It is a measure of the probability of correctly identifying a non-diseased person with the screening test (e.g., true negatives).
Which measure of mortality would you calculate to determine the proportion of all deaths that is caused by heart disease? correct answer: 4) Proportionate mortality ratio
In this case, we would calculate the total number of deaths due to heart disease divided by the total number of deaths within the population of interest.
epidemiologic triad correct answer: refers to the interactions between the host, agent, and the environment to produce disease, particularly communicable disease.
Using this model, the host is typically a human, the agent is typically a bacteria, virus or other pathogenic organism, and the environment is the setting in which the interactions take place. In some cases, a fourth variable, known as a vector, may be involved in the interaction.
Health Impact Assessment (HIA) correct answer: a method for describing and estimating the effects that a proposed project or policy may have on the health of a population
- used to evaluate the public health consequences of proposed decisions in non-health sectors.
- systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and whether the health effects are distributed evenly within the population.
-provide practical recommendations for how to minimize negative health effects and maximize beneficial health effect
- doesn't examine the costs associated with its recommended strategies to promote health and mitigate adverse health impacts
Proportionate mortality ratio correct answer: calculated as the number of deaths due to a specific disease within a population divided by the total number of deaths in the population.
- of all deaths, the proportion caused by a certain disease
- can determine leading causes of death; "one of every four deaths in the U.S. id due to cancer" (1/4; 25%)
- doesn't tell us the risk of dying from disease
An appropriately tailored intervention message most importantly should:
1) Take into account characteristics of the target population
2) Be designed through community organizational strategies
3) Meet the criteria established by the funding agency
4) Be designed and tested by colleagues and experts in the field correct answer: 1) Take into account characteristics of the target population
As defined by Kreuter and Wray, targeted communication is intended to reach a segment of the population that shares specific characteristics, while tailored communication is intended to reach a specific individual. Both strategies increase the effectiveness of interventions and are premised on acquiring in-depth familiarity with the audience before the message is created, tested, and disseminated. Otherwise, the message will be meaningless to the target population.
3. The best use of clinical practice guidelines is as an:
1) indication of the best diagnostic and treatment practices based on the best available evidence.
2) enforceable standard of care against which deviations should be detected and corrected.
3) ideal therapy plan that should be supported in public health regulation and patient education.
4) information pamphlet for distribution in public health patient education programs. correct answer: 1) indication of the best diagnostic and treatment practices based on the best available evidence.
While courts may use these as an indication of the standard of practice within a professional community, these are guidelines rather than standards and are voluntary rather than enforceable. The quality of evidence can range from randomized controlled clinical trials, to observational studies, to anecdotal reports or even simply consensus among experts. Different groups often publish their own guidelines on a topic, sometimes citing the same evidence a [Show Less]