Public Health One Flashcards
An academic core trainee in rheumatology wants to investigate whether there is any association between the use of antihypertensive drugs and gout. What would be the most appropriate study design, given that she has relatively little time in which to conduct the research?
Retrospective case-control study
A GP has moved to a new practice in an inner city area and wants to find out more about the health of the local population. He finds some research conducted the previous year by a public health consultant at the City Council, which provides information on the prevalence of a range of diseases, broken down according to age, gender and postcode. What type of study is the most likely source of this data?
- Cross-sectional study
A paediatric consultant is conducting research to investigate whether the diet of children in their first year of life is associated with their subsequent risk of food allergy. Parents of children aged 5-10 years with and without food allergies are asked to complete a questionnaire about their child’s diet between the ages of 6 months and 1 year (i.e. a case-control study). What is a major disadvantage of this approach?
- Recall bias
A medical student is assisting with a research project investigating whether local air pollution from traffic is associated with bronchiolitis in infants. The student is concerned that the study may be limited by confounding factors. Which of the following describes how confounding factors could influence this study?
Children who live in areas with high pollution may be more likely to have parents who smoke
A recently published paper found that increased exposure to background noise in populations living near Heathrow airport were associated with increased risk of cardiovascular disease. To support these results, the authors highlight previous research suggesting that acute exposure to noise may increase blood pressure and stress hormones. This is an example of which of the Bradford-Hill criteria supporting causality?
- Plausibility
A GP practice sets up a diabetes clinic to try to improve the glucose control of its patients with diabetes. Patients are provided with education and support, along with lifestyle advice and regular screening of their eyes, kidneys and feet. What type of prevention is this?
Tertiary
Which of the following is an example of primary prevention?
Advising pregnant mothers to take folic acid
An elderly man asks his GP why all men do not get screened for prostate cancer using PSA tests. The GP replies that few patients with high PSA turn out to have prostate cancer. What does this suggest about PSA as a screening test for prostate cancer?
The positive predictive value is low
The UK National Screening Committee is evaluating the breast cancer screening programme. One member of the committee highlights some research that found women with cancers detected through screening had a lower mortality than those detected after they became symptomatic. However, other members of the committee suggest that bias could have contributed to this apparent difference. Which type of bias from the following list are they referring to?
Length lead bias
Lead time bias can make screening programmes appear more effective than they actually are, in terms of reducing mortality. Which of the following best describes lead time bias?
By detecting the presence of disease earlier, screening can appear to increase the length of survival even if it has no impact on the course of the disease
A public health registrar has been given the task of conducting a health needs assessment of a housing estate in the large city where they work. What would be an advantage of using an epidemiological approach?
- It may be used to investigate the incidence and prevalence of disease
A public health consultant is asked by a local politician what the major health issues are in a small town within their constituency. She cannot find an existing health needs assessment so she conducts one herself. She does this by arranging focus groups with local healthcare professionals, teachers, social workers, business leaders and charities. She also invites local residents to attend public meetings and sends emails to them to identify issues that they feel are important. What approach to health needs assessment has been used in this case?
Corporation
A GP is concerned that one of her patients has a very high alcohol intake and is concerned about the future implications for the patient’s health. According to the theory of planned behaviour, which three factors determine an individual’s health behaviour?
Their attitude to the behaviour, subjective norms and perceived behavioral control
A student has decided to increase the amount of exercise they do in an effort to improve their overall health. After discussing their intended exercise plan with a fitness adviser, they joined the local gym and purchased some new running trainers. They have decided to have their gym induction next week. Which stage of the stages model of health behaviour is the student at currently?
Preparation
