1 - 3 - EPIDEMIOLOGY AND PUBLIC HEALTH IN DERMATOLOGY

Question 1

study of disease in the population, and it includes the incidence, prevalence, distribution, cause, and natural history of disease.

Answer 1

Epidemiology

Question 2

interventional studies that include randomized controlled trials (RCTs

Answer 2

Clinical trials

Question 3

evaluates how an individual receives health care and interacts with the health care system

Answer 3

Health services research

Question 4

most commonly refers to studies of how patients interact with their health care and disease

Answer 4

Patient-oriented research

Question 5

course of the disease from its onset until its, or the patient’s, end or resolution, the latter of which may be study outcomes of interest

Answer 5

natural history of disease

Question 6

measure of how an individual is affected by an illness

Answer 6

burden of disease

Question 7

observation of primary interest

Answer 7

outcome

Question 8

the strongest association between a risk factor or intervention and an outcome

Answer 8

causal association

Question 9

application of a substance or an action to subjects in an experimental study

Answer 9

intervention

Question 10

attribute that increases the likelihood of developing a disease or other outcome of interest

Answer 10

risk factor

Question 11

occurs when an attribute or other factor is found to be related to an outcome of interest

Answer 11

association

Question 12

systematic error that causes the results of a study to deviate from the truth

Answer 12

Bias

Question 13

systematic error in a study caused by how subjects are selected or not selected for a study

Answer 13

Selection bias

Question 14

bias that occurs because of reporting

Answer 14

. Information bias i

Question 15

occurs when two risk factors or exposures are associated with each other and the outcome of interest

Answer 15

Confounding

Question 16

measure of an effect in an** ideal setting**

Answer 16

Efficacy

Question 17

Studies that minimize bias are thought to be _______

Answer 17

**internally valid, **which means that if the study was repeated using the same study design and the same study cohort, the same results would be found

Question 18

Studies that measure efficacy are called __________

Answer 18

explanatory studies

Question 19

how well an intervention works in the real world

Answer 19

Effectiveness

Question 20

Studies that represent results that are reproducible in many other study settings are thought to be _________

Answer 20

externally valid or generalizable

Question 21

refers to studies that compare two or more treatments that are generally accepted to be effective

Answer 21

Comparative effectiveness

Question 22

often defined based on disease status or having a risk factor of interest

Answer 22

cohort

Question 23

subjects receive an active intervention (ie, drug or other treatment)

Answer 23

Experimental studies

Question 24

first studies performed in humans and are often designed with the notion that they are human pharmacology studies

Answer 24

Phase I studies

Question 25

goal is to evaluate a drug’s dose range, safety, tolerability, pharmacokinetics, and pharmacodynamics

Answer 25

Phase I studies

Question 26

also called initial efficacy studies

Answer 26

Phase II studies

Question 27

conducted to initially determine the effect of an intervention on patients with the disease of interest

Answer 27

Phase II studies

Question 28

also called comparative efficacy studies,

Answer 28

Phase III studies

Question 29

designed to assess the efficacy of an intervention compared with that of a “control” treatment (either active treatment or placebo)

Answer 29

Phase III studies

Question 30

postmarketing studies

Answer 30

Phase IV studies

Question 31

usually conducted after a treatment obtains FDA approval for marketing

Answer 31

Phase IV studies

Question 32

They may also be called effectiveness studies because of their focus on how well the approved drug works in the general population and how safe the drug is in a larger population and over a longer period of time

Answer 32

Phase IV studies

Question 33

also known as large simple studies or Peto studies, are effectiveness studies that focus on understanding how an intervention works in the **routine clinical setting**

Answer 33

pragmatic trials

Question 34

are those in which subjects are observed and exposures and outcomes are measured in routine care without any effort to intervene or otherwise influence any measured factors

Answer 34

Observational studies

Question 35

sometimes called a prospective study,

Answer 35

cohort study

Question 36

follows a group of patients over time and monitors the effect of a risk factor or exposure on the development of an outcome

Answer 36

**cohort study**

Question 37

sometimes also called a retrospective study

Answer 37

case-control study

Question 38

quantitative study of studies

Answer 38

meta-analysis

Question 39

It is a systematic review that attempts to combine the results of multiple studies in order to create a pooled effect estimate of an outcome of interest

Answer 39

meta-analysis

Question 40

frequency of a disease or other outcome of interest over a given period of time

Answer 40

Prevalence

Question 41

It is measured as the number of individuals with a disease divided by the number of individuals sampled over a specified time period

Answer 41

Prevalence

Question 42

frequency of **new cases of a disease** or other outcome among those who are at risk of the disease or outcome of interest within a specified period of time

Answer 42

Incidence

Question 43

refers to those who have the potential to develop the disease or other outcome of interest

Answer 43

“at-risk population”

Question 44

typical effect estimate is the

Answer 44

risk ratio or relative risk, also called a hazard ratio

Question 45

the ratio of the odds that a case is exposed compared with the odds that a control is exposed

Answer 45

odds ratio

Question 46

proportion of truly diseased individuals (ie, true positives and false negatives) who are defined as having the disease by a test (ie, true positives).

Answer 46

sensitivity | It is also called the true positive rate

Question 47

the proportion of individuals who truly do not have the disease (ie, false positives and true negatives) who are defined by the test as not having the disease (ie, true negatives).

Answer 47

specificity | It is also called the true negative rate

Question 48

proportion of individuals who have a positive test that truly have the disease

Answer 48

positive predictive value

Question 49

proportion of individuals who have a negative test who truly do not have the disease

Answer 49

negative predictive value

Question 50

What bias is present in this scenario? In a cohort study evaluating whether a topical therapy used to treat psoriasis is more effective than a systemic therapy, this bias would occur if those selected for treatment with a topical steroid had less severe disease than those selected for the systemic therapy

Answer 50

Selection bias

Question 51

In a case-control study, this bias can occur if the source population from which the cases are drawn is different from the control source population.

Answer 51

Selection bias

Question 52

What bias is present in this scenario? In a hypothetical case-control study evaluating the association between nonsteroidal antiinflammatory drug (NSAID) use and colon cancer, comparing cases of colon cancer drawn from patients admitted to the hospital with control participants drawn from patients with arthritis admitted to the hospital may result in a falsely low effect estimate because the control participants likely have had a high exposure to NSAIDs

Answer 52

Selection bias

Question 53

What bias is present in this scenario? In a case-control study evaluating the association between cigarettes and lung cancer, because of previous reports and package warnings about cigarettes, it is likely that those with cancer are more likely to recall and report a history of cigarette use than those without lung cancer.

Answer 53

Information bias

Question 54

In a cohort study evaluating the risk of cancer among patients with psoriasis, this bias could be introduced if the method of information gathering (ie, psoriasis subjects answer survey questions while waiting patiently for phototherapy) elicits more detailed responses about cancer risk factors, such as cigarette use, in the psoriasis patient cohort than in the cohort of patients without psoriasis (ie, subjects without psoriasis answer survey questions while completing an office visit after a wart treatment).

Answer 54

Information bias

Question 55

Sometimes called pivotal studies

Answer 55

Phase III studies

Question 56

Identify the type of RCT Dutch study of home versus outpatient ultraviolet B phototherapy for psoriasis (PLUTO) 3 and a UK study of prophylactic antibiotics for prevention of cellulitis (PATCH II)

Answer 56

Pragmatic RCT

Question 57

Identify the study design in an effort to answer the question of whether or not treatment of acne with isotretinoin increases the risk of developing inflammatory bowel disease (IBD), this study design could be employed.

Answer 57

Cohort study

Question 58

Identify the study design appropiriate with the scenario: Individuals with acne and no prior history of IBD who are treated with isotretinoin (the exposed group) could be followed and compared with individuals who have not been treated with isotretinoin (the unexposed group) to determine if there is a difference between the two groups in risk of developing IBD

Answer 58

Cohort study

Question 59

These studies sample a group with a disease of interest and another that does not have the disease.

Answer 59

Case-control study

Question 60

The study subjects are then interrogated or preceding data are examined to determine the prevalence of a risk factor

Answer 60

Case-control study

Question 61

Palmer and coworkers used this study design to identify loss-of-function variants of filaggrin that are associated with atopic dermatitis.

Answer 61

Case-control study

Question 62

calculated based on the prevalence of exposure in the two groups

Answer 62

effect estimate, typically an odds ratio

Question 63

particularly useful for studying rare outcomes, take much less time (subjects are not followed for the outcome to occur), and are particularly subject to selection and recall biases

Answer 63

Case-control studies

Question 64

What is the study design in this scenario: measuring the prevalence of a particular disease or other outcome in a population

Answer 64

Cross-sectional studies

Question 65

Quality reporting tools and checklists for systematic reviews or meta-analyses.

Answer 65

* AMSTAR (A Measurement Tool to Assess Systematic Reviews) * PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) * QUOROM (Quality of Reporting of Meta-Analyses)

Question 66

Quality reporting tool and checklist for clinical trials

Answer 66

CONSORT (Consolidated Standards of Reporting Trials)

Question 67

Quality reporting tool and checklist for observational studies

Answer 67

STROBE (Strengthening the Reporting of Observational Studies in Epidemiology)

Question 68

the Cochrane group’s recommended scale for grading quality of evidence and strength of recommendations

Answer 68

GRADE scale

Question 69

This scale allows for grading of evidence for diagnostic tests, prognostic markers, and harm that many other scales do not

Answer 69

Oxford Centre for Evidence-Based Medicine (OCEBM) scale

Question 70

how is incidence measured

Answer 70

In a given time frame, incidence is measured by dividing the number of individuals who developed a disease by the number of individuals in the at-risk population

Question 71

It is the absolute risk in the exposed persons minus the absolute risk in the nonexposed persons.

Answer 71

Attributable risk or risk difference