Chapter 4

24 questions on CIC
a) 9
b) 7
c) 5
d) 4

2
a) 9
b) 7
c) 5
d) 4

3
 Median of a data set is the number that 50 percent of values
fall below and 50 % fall above.
◦ Put the numbers in order lowest to highest
◦ For even data sets one must average the two middle
numbers.

4
The IP concludes that the SSI rate in OR A is not equal to the SSI
rate in OR B, but in reality the two rates are equal. What type of
statistical error has she committed?
a) No error
b) She committed a Type 1 error
c) She committed a Type 2 error
d) She committed an error equal to β

5
The IP concludes that the SSI rate in OR A is not equal to the SSI
rate in OR B, but in reality the two rates are equal. What type of
statistical error has she committed?
a) No error
b) She committed a Type 1 error
c) She committed a Type 2 error
d) She committed an error equal to β

6
 Type 1 error (α) means rejecting the null hypothesis (Ho)
when it is true and attributing significance when there his
none. Type 1 error is always referred to as the significance
level.
 Type II error (β) means accepting the null hypothesis when it
is false. NOT attributing significance when it exists

7
 Keep significance level small (α) 0.05 or 0.01
◦ Note p value is usually 0.05

8
 Increase the sample size.
◦ As sample size increases data get closer to a normal
distribution.

9
 1. Cesarean section
2. Craniotomy
3. Coronary artery bypass graft
4. Laminectomy

a) 1,2
b) 2,3
c) 3,4
d) 1,4

10
 1. Cesarean section
2. Craniotomy
3. Coronary artery bypass graft
4. Laminectomy

a) 1,2
b) 2,3
c) 3,4
d) 1,4

11
 Surveillance should be conducted for 90 days on craniotomy
and CAB procedures.
 Superficial infections 30 days

12
a. Class 1 SSI rate
b. Appropriate antibiotic dosage
c. Central line associated blood stream infections (CLABSI)
d. Infections caused by multidrug resistant organisms

13
a. Class 1 SSI rate
b. Appropriate antibiotic dosage
c. Central line associated blood stream infections (CLABSI)
d. Infections caused by multidrug resistant organisms

14
 Hand hygiene
 MRSA colonization
 Falls
 Communicable disease reporting
 Instrument processing
 Needle sticks

15
 Hand hygiene process
 MRSA colonization outcome
 Falls outcome
 Communicable disease reporting process
 Instrument processing process
 Needle sticks outcome

16
a. Research
b. Surveillance
c. Benchmarking
d. Accreditation

17
a. Research
b. Surveillance
c. Benchmarking
d. Accreditation

18
a) When the data are plotted on a curve, it is skewed
b) The mean is less than the median
c) The skewness value is equal to 1
d) The mean median and mode of the data are equal

19
a) When the data are plotted on a curve, it is skewed
b) The mean is less than the median
c) The skewness value is equal to 1
d) The mean median and mode of the data are equal

20
21
a) Pain at the incision site 10 days after a breast reduction
procedure; drainage is culture-positive for methicillin
susceptible Staphylococcus aureus (MSSA)
b) Stitch abscess that is cultured 14 days after surgery and
is positive for enterococcus faecalis
c) Purulent drainage from an episiotomy that occurs
within 5 days of delivery
d) Burn wound that cultures positive for Acinetobacter
baumannii 10 days after debridement procedure.

22
a) Pain at the incision site 10 days after a breast reduction
procedure; drainage is culture-positive for methicillin
susceptible Staphylococcus aureus (MSSA)
b) Stitch abscess that is cultured 14 days after surgery and
is positive for enterococcus faecalis
c) Purulent drainage from an episiotomy that occurs
within 5 days of delivery
d) Burn wound that cultures positive for Acinetobacter
baumannii 10 days after debridement procedure.

23
 30 days
 Only skin or subcutaneous tissue PLUS 1 of the following
◦ Purulent drainage with or without laboratory confirmation
◦ Organisms isolated from aseptically obtained culture of
fluid or tissue from the incision
◦ Incision deliberately opened by a surgeon/MD
 AND one of the following symptoms pain, tenderness,
swelling, redness, heat. CULTURE NEGATIVE FINDING
DOES NOT MEET THIS CRITERION.
◦ Physician diagnosis.

24
1. The total number of patients in the unit for the time
period
2. The total number of central line catheters for the time
period
3. The number of patients who had blood stream infections
identified
4. The number of device days for the time period
a) 2,3
b) 1,3
c) 1,2
d) 3,4

25
1. The total number of patients in the unit for the time
period
2. The total number of central line catheters for the time
period
3. The number of patients who had blood stream infections
identified
4. The number of device days for the time period
a) 2,3
b) 1,3
c) 1,2
d) 3,4

26
 Y = Denominator= device days (same time every day, count
the number of patients with one or more central lines for the
time period).
 X =Numerator event or blood stream infections
 K= standardizes the result so it can be compared with other
quantities. Whole number is used 100, 1000, 10,000
 Smallest rate calculated has one digit to the left of the
decimal point

27
 2 infections
 Device days 15
 X=2 Y=15 X x
 2/15 X 100
 13.34 infections per 100 central line days

28
a) Procedure-specific
b) Provider Specific
c) Unit Specific
d) Device Specific

29
a) Procedure-specific
b) Provider Specific
c) Unit Specific
d) Device Specific

30
1. Standardized definitions are used consistently
2. Overall rates are used to accurately track trends over time
3. Adequate training of personnel to collect, store, manage,
and analyze data
4. Data are calculated using the same methodology as a
nationally validated system
a) 1,2,3
b) 2,3,4
c) 1,3,4
d) 1,2,4

31
1. Standardized definitions are used consistently
2. Overall rates are used to accurately track trends over time
3. Adequate training of personnel to collect, store, manage,
and analyze data
4. Data are calculated using the same methodology as a
nationally validated system
a) 1,2,3
b) 2,3,4
c) 1,3,4
d) 1,2,4

32
1. To evaluate the effect of a variable on outcomes
2. To analyze continuous data
3. To calculate an odds ratio or relative risk
4. If each cell of the table is greater than 5
a) 1,2,3
b) 1,2,4
c) 2,3,4
d) 1,3,4

33
1. To evaluate the effect of a variable on outcomes
2. To analyze continuous data
3. To calculate an odds ratio or relative risk
4. If each cell of the table is greater than 5
a) 1,2,3
b) 1,2,4
c) 2,3,4
d) 1,3,4

34
1. To evaluate the effect of a variable on outcomes
2. To analyze continuous data
3. To calculate an odds ratio or relative risk
4. If each cell of the table is greater than 5
a) 1,2,3
b) 1,2,4
c) 2,3,4
d) 1,3,4

35
1. To evaluate the effect of a variable on outcomes
2. To analyze continuous data
3. To calculate an odds ratio or relative risk
4. If each cell of the table is greater than 5
a) 1,2,3
b) 1,2,4
c) 2,3,4
d) 1,3,4

36
 Tests the association between two classifications of a set of
counts or frequencies (discrete data)
 Displayed as a 2x2 table rows = one variable columns are a
second variable
 Row column totals used to predict what count would be
observed and expected if the null hypothesis were true
 Used for medium to large samples
 Fishers exact test is used in place of the Chi-square x2 when
the sample size is < 20 or any one cell in the table is less
than 5
a) Mean
b) Median
c) Mode
d) Range
a) Mean
b) Median
c) Mode
d) Range
 Mean = average. Because the mean includes the value of
each of the numbers in a data set it can be pulled toward
extreme outliers, especially in a small data set.
 Median- middle of the data set, less affected by outliers
 Mode is the most frequently occurring number.
 Range-difference between highest number and lowest
number
 Causation
 The probability of committing a type one error
 The probability of committing a type two error
 The probability of the data being accurate and valid
 Causation
 The probability of committing a type one error
 The probability of committing a type two error
 The probability of the data being accurate and valid
 One rejects the null hypothesis (H0)when it is true. False
positive
 The p-value is the calculated probability of rejecting the null
hypothesis when it is true (usually 0.05)
a) 68.2
b) 95.5
c) 92.4
d) 99.7
a) 68.2
b) 95.5
c) 92.4
d) 99.7
3

1
a) Fisher’s exact
b) t test
c) Chi-square test
d) z test
a) Fisher’s exact
b) t test
c) Chi-square test
d) z test
a) Monitor the process of care
b) Facilitate the determination of variation
c) Eliminate natural variation
d) Monitor outcomes
a) Monitor the process of care
b) Facilitate the determination of variation
c) Eliminate natural variation
d) Monitor outcomes
 Method of quality control
 Used to monitor both process and outcomes in a systematic
and statistically valid manner.
 Control Charts can assist in determining special-cause of
common-cause variations which may be help for early
identification of abnormal events
a) 29 infections per 1,000 patient days
b) 26 infections per 1,000 patient days
c) 19 infections per 100 patient days
d) 39 infections per 1,000 patient days
a) 29 infections per 1,000 patient days
b) 26 infections per 1,000 patient days
c) 19 infections per 100 patient days
d) 39 infections per 1,000 patient days
 NEW cases = incidence
 9 cases MRSA surgical service
 230 patient days population at risk
 9/230 X 1000= 39 infections per 1000 patient days
 Medical patients
◦ 6 cases MRSA medical service
◦ 325 patient days
◦ 6/325 X 1000=

◦ 18 infections per 100 patient

a) Natives are immune to plague
b) An expected number of cases occurs each year in a given
geographical area
c) Plague has become resistant to all forms of treatment for
this population
d) The disease is seen in a seasonal pattern each year for this
area.
a) Natives are immune to plague
b) An expected number of cases occurs each year in a given
geographical area
c) Plague has become resistant to all forms of treatment for
this population
d) The disease is seen in a seasonal pattern each year for this
area.
a) Only one disease is involved
b) It is usually vector borne
c) There is a higher mortality rate
d) Several countries or continents are involved
a) Only one disease is involved
b) It is usually vector borne
c) There is a higher mortality rate
d) Several countries or continents are involved
a) The number of true negatives divided by the number of
positives found, times 100
b) The number of true negatives divided by the total number of
persons with disease, times 100
c) The number of true positives divided by the total number of
persons with disease, times 100
d) The number of true negatives divided by the total number of
persons without disease, times 100
a) The number of true negatives divided by the number of
positives found, times 100
b) The number of true negatives divided by the total number of
persons with disease, times 100
c) The number of true positives divided by the total number of
persons with disease, times 100
d) The number of true negatives divided by the total number of
persons without disease, times 100
 Sensitivity =TRUE POSITIVE RATE
◦ Proportion of true positives correctly identified as such
◦ The percentage of sick people who are correctly identified
as having the condition
 Specificity = TRUE NEGATIVE RATE
◦ The proportion of negatives correctly identified as such.
◦ The percentage of healthy people who are correctly
identified as not having the condition
a) Variance
b) Standard Deviation
c) Range
d) Bell Curve
a) Variance
b) Standard Deviation
c) Range
d) Bell Curve
a) 0.50
b) 0.68
c) 0.95
d) 0.98
a) 0.50
b) 0.68
c) 0.95
d) 0.98
 1=68.26 % of the data is within one SD of the mean
 2= 95.46 % of the data is within two SD of the mean
 3=99.73 % of the data is within three SD of the mean
a) Make no assumption about variance in the populations
b) Can only be used with ordinal levels of measurement
c) Require a normal distribution
d) Require equal population variances
a) Make no assumption about variance in the populations
b) Can only be used with ordinal levels of measurement
c) Require a normal distribution
d) Require equal population variances
• Make no assumptions about the distribution of population
values.
• Can be used with discrete, nominal ordinal and interval data
• Assumptions of normality are not required. Data is not
assumed to be normally distributed
Ordinal
Nominal
Discrete
Interval
a) Non-ill family members of the ill employees
b) Non-ill hospital employees matched for age and sex
c) Hospitalized patients with p. aeruginosa folliculitis matched
for age and sex
d) Non-ill members of the health club matched for age and
sex
a) Non-ill family members of the ill employees
b) Non-ill hospital employees matched for age and sex
c) Hospitalized patients with p. aeruginosa folliculitis matched
for age and sex
d) Non-ill members of the health club matched for age and
sex
 Cases- Begin with persons who have outcome of interest
(folliculitis)
 Controls- persons without the outcome of interest
◦ Be similar to the cases in their potential for exposure during the risk
period being evaluated
◦ Usually matched on one or more attributes (gender, age smoking status)
a) State the null and alterative hypothesis
b) Set the significance level
c) Eliminate outliers
d) Compare the probability value to the significance level
a) State the null and alterative hypothesis
b) Set the significance level
c) Eliminate outliers
d) Compare the probability value to the significance level
 State the research question
 Specify the null and alternative hypothesis
 Calculate test statistic
 Compute probability of test statistic or rejection region
 State conclusions
 Observations that deviate from all others SIGNIFICANTLY- far
from the mean
 May occur bay accident or errors in measurement
 Careful analysis, removal or weighting down can change
conclusions significantly.
 Investigate to determine the optimal method of analysis
a) -1 to 0
b) 0 to 1
c) -1 to 1
d) None of the above
a) -1 to 0
b) 0 to 1
c) -1 to 1
d) None of the above
 Calculates direction and magnitude of a relationship between
2 variables
 Calculates a value r measures the degree of the relationship
 The closer the r is to +/- 1 the stronger the relationship
 The closer the r is to 0 the weaker the relationship
 One variable increases and causes the other to increase as
well
 The longer a urinary catheter is in place the greater the risk
of developing a UTI
 IN this case the r would be closer to 1
 One variable increases causing the other to decrease
 Increased handwashing results in fewer infections
 R<1
a) Relatively flat
b) Negatively skewed
c) More peaked
d) A typical bell-shaped curve or normal distribution
a) Relatively flat
b) Negatively skewed
c) More peaked
d) A typical bell-shaped curve or normal distribution
 Measured by statistical packages
 Describes the shape of a frequency distribution “Do the
values fall into a normal distribution or are they skewed
(values fall out of the normal pattern, more values above and
or below mean).
 Kurtosis is how peaked or flat a curve is
 Mesokurtic- bell shaped VALUE of 0
 Leptokurtic- Peaked or pointy VALUE >0 positive numbers
 Platycurtic- flatter curve VALUE < 0 or negative numbers
a) Risk
b) Attack Rate
c) Host factor
d) Incidence
a) Risk
b) Attack Rate
c) Host factor
d) Incidence
a) Using only one coordinate
b) Arranged in rows and columns
c) Using a system of coordinates
d) Showing multiple complex factors at one time
a) Using only one coordinate
b) Arranged in rows and columns
c) Using a system of coordinates
d) Showing multiple complex factors at one time
a) 24
b) 10.8
c) 11
d) 9.5
a) 24
b) 10.8
c) 11
d) 9.5
a) Measure of central tendency
b) Most frequently occurring value
c) Determines the height and shape of a curve
d) Data sets can have more than one model referred to as
bimodal or multimodal
e) Data sets may have no repeated values and are referred to
has non-modal
f) Most useful for qualitative data or nominal data
a) Power is independent of sample size
b) Power is increased
c) Power is decreased
d) Power approaches zero
a) Power is independent of sample size
b) Power is increased
c) Power is decreased
d) Power approaches zero
 Ability of test to detect a specified difference such as the
probability of rejecting the null hypothesis when it is false.
◦ Affected by 3 factors:
Sample size > sample size = > power
Significance level – the higher the significance level the
higher the power
The “true” value of the parameter being tested. The greater
the effect size the greater the power of the test.
“true” effect in contrast with the hypothesis
a) Predictor variable
b) Moderating variable
c) Experimental variable
d) Confounding variable
a) Predictor variable
b) Moderating variable
c) Experimental variable
d) Confounding variable
 A confounding variable is a variable that has an important
confounding effect on the result but is not among the
variables being studied. It can suggest a false relationship
between variables, or it can hide a relationship that exists.
1. There is a continuous symmetrical distribution in which
both tails extend to infinity
2. The mean, median, and mode are identical
3. 68.3 percent of the data lies between the mean and 32
standard deviations
4. The shape of the curve is determined by the mean and
standard deviation
a) 1,2,3
b) 2,3,4
c) 1,3,4
d) 1,2,4
1. There is a continuous symmetrical distribution in which
both tails extend to infinity
2. The mean, median, and mode are identical
3. 68.3 percent of the data lies between the mean and 32
standard deviations
4. The shape of the curve is determined by the mean and
standard deviation
a) 1,2,3
b) 2,3,4
c) 1,3,4
d) 1,2,4
 Forms a symmetric bell-shaped curve
 50 percent of the scores like above and 50 percent below the
midpoint of the distribution
 The population clusters around a central point and then trails
off symmetrically in both directions with fewer and fewer
large and small individuals at the upper and lower ends
respectively
 Mean, median and mode are located at the midpoint of the x
axis
a) The incidence of disease is higher in those who are exposed
to the factor
b) Evidence that the independent and dependent variables are
related
c) The association has been observed in numerous studies
d) The onset of disease must precede exposure to the causal
factor
a) The incidence of disease is higher in those who are exposed
to the factor
b) Evidence that the independent and dependent variables are
related
c) The association has been observed in numerous studies
d) The onset of disease must precede exposure to the causal
factor
a) Strength of association
b) Consistency
c) Specificity
d) Temporality
e) Biological gradient
f) Plausibility
g) Coherence
h) Analogy
1. Is useful for showing 2 sets of data on a single graph
2. Uses bars on the x axis
3. Uses connecting lines and data points
4. Depicts the percentage of the total that each data point
represents
a) 1,3
b) 1,4
c) 3,4
d) 2,4
1. Is useful for showing 2 sets of data on a single graph
2. Uses bars on the x axis
3. Uses connecting lines and data points
4. Depicts the percentage of the total that each data point
represents
a) 1,3
b) 1,4
c) 3,4
d) 2,4
 Graphic or pictorial statistics present the numerical data that
have been collected in graphs or charts creating a picture of
the data
 Graph of a frequency distribution with values of the variable
on the x axis and the number of observation on the y axis
 Data points are plotted at the midpoints of the intervals and
are connected with a line
a) Tracking high-risk, high-volume procedures and potentially
preventable health-care associated infections (HAIs)
b) Providing whole-house infection rates
c) Tracking infections that are publically reported
d) Using the electronic surveillance systems to identify
infections
a) Tracking high-risk, high-volume procedures and potentially
preventable health-care associated infections (HAIs)
b) Providing whole-house infection rates
c) Tracking infections that are publically reported
d) Using the electronic surveillance systems to identify
infections
a) The number of hand hygiene episodes performed by
personnel divided by the volume of soap used in the facility
b) The number of hand hygiene episodes performed by
personnel divided by the number of patient days X 1000
c) The number of hand hygiene episodes performed by
personnel divided by the volume of alcohol-based hand
rub.
d) The number of hand hygiene episodes performed by
personnel divided by the number of hand hygiene
opportunities by ward or service
a) The number of hand hygiene episodes performed by
personnel divided by the volume of soap used in the facility
b) The number of hand hygiene episodes performed by
personnel divided by the number of patient days X 1000
c) The number of hand hygiene episodes performed by
personnel divided by the volume of alcohol-based hand
rub.
d) The number of hand hygiene episodes performed by
personnel divided by the number of hand hygiene
opportunities by ward or service
 Periodically conduct an observational study to determine the
rate of adherence ( # of episodes performed/# of
opportunities) by ward or service
◦ In addition to rate of adherence facilities may monitor quality such as
time spent or whether soap was used.

 Monitor the volume of specific hand hygiene products (e.g.,

soap, hand rub, hand lotion) used per 100 patient days
 Monitor adherence to artificial fingernail policies
a) Herpes zoster virus
b) Human herpes virus 8
c) Epstein-Barr virus
d) Human papillomavirus (HPV)
a) Herpes zoster virus
b) Human herpes virus 8
c) Epstein-Barr virus
d) Human papillomavirus (HPV)
a) Caused by human herpesvirus 8 HHV8
b) Cutaneous lesions with or without internal involvement.
c) Lesions-nodulous or blotches that may be red, purple,
brown, or black and are usually papular
a) Typically found on the skin but spread to mouth, GI tract and respiratory
tract is common. Growth can range from very slow to explosively fast.
Associated with significant morbidity and mortality
a) Coccidioides spp. are usually found at high elevations
b) Coccidioides spp. Are usually found in wet climates
c) Up to 50 percent of people in endemic areas have been
exposed to Coccidioides spores
d) Coccidioides spp. Are found on the surface of the soil
a) Coccidioides spp. are usually found at high elevations
b) Coccidioides spp. Are usually found in wet climates
c) Up to 50 percent of people in endemic areas have been
exposed to Coccidioides spores
d) Coccidioides spp. Are found on the surface of the soil
 Caused by inhalation of airborne spores of the soil fungus
Coccidioides immitis or c. posadasii
 Native to arid and desert areas in North America Central
America and South America Found in lower elevations that
receive < 20 inches of rain per year and have warm sandy soil
 Found 4-12 inches below the surface.
 10-50% of persons living in endemic areas have been
exposed to coccidiodides spp
a) Attributable fraction
b) Attributable risk
c) Population attributable risk percent
d) Negative predictive value
a) Attributable fraction
b) Attributable risk
c) Population attributable risk percent
d) Negative predictive value
 Calculation that can be derived from the attributable risk
 Attributable risk= the difference in rate of a condition
between an exposed population and an unexposed
population.
 ARP gives the proportion of cases attributable (and avoidable)
to this exposure in relation to all cases
 (relative risk-1) +relative risk
a) Generalizability
b) Size of the study
c) Validity of the study
d) Presence of bias
a) Generalizability
b) Size of the study
c) Validity of the study
d) Presence of bias
 Related to the power of a study
 Power is affected primarily by size of effect
and the size of the sample used to detect it
a) Migratory birds
b) Pigeons and doves
c) Water fowl
d) Domestic poultry
a) Migratory birds
b) Pigeons and doves
c) Water fowl
d) Domestic poultry
 Virus
 Occurs mainly in birds ESPECIALLY domestic poultry
 Highly contagious among birds- can be deadly
 Rare infections in humans caused serious illness and death
a) Applied epidemiology
b) Iceberg phenomenon
c) Causal web
d) Dendrogram
a) Applied epidemiology
b) Iceberg phenomenon
c) Causal web
d) Dendrogram
 Web of causation refers to the interrelationship of multiple
factors that contribute to the occurrence of a disease
a) The sensitivity of a diagnostic test is greatly increased
b) The specificity of a diagnostic test is much greater
c) The negative predictive value of a diagnostic test is very low
d) The positive predictive value of a diagnostic test is lowered
a) The sensitivity of a diagnostic test is greatly increased
b) The specificity of a diagnostic test is much greater
c) The negative predictive value of a diagnostic test is very low
d) The positive predictive value of a diagnostic test is lowered
The probability of having the disease given a positive screening
test result in the screened population.
 Proportion of patients without disease who test negative
Sensitivity = TP/(TP +FN)
Specificity = TN/ (TN+FP)
Positive predictive value (PPV) TP/(TP+FP)
Negative predictive value TN/(TN+FN)
Disease No Disease Totals
Positive test True +(TP) False + (FP)
Negative False – (FN) True – (TN)
test
Totals
 SARS No SARS
Positive SARS 2 18
test
Negative SARS 1 182
test

Sensitivity= 2/ (2+1) X 100 = 66.7 %

Specificity= 182/ (182+18) X 100 =91%
PPV = 2/(2+18) X 100 =10%
NPV =182/(182+1) X 100 = 99.5%
a) Sensitivity and specificity describe how well the screening
test performs against a “gold standard” test. Independent
of disease prevalence.
b) Positive predictive value (PPV) and negative predictive
(NPV)value are disease prevalence dependent.
c) Higher disease prevalence will increase the PPV and
decrease the NPV (Note in SARS example disease is not
prevalent PPV is low and NPV is higher.
a) Most norovirus outbreaks are caused by genotype Gll.2
b) Severe cases of norovirus are most common in adults aged
25-45
c) Noroviruses are the most common cause of epidemic
gastroenteritis worldwide
d) Norovirus outbreaks occur most commonly in the summer
months.
a) Most norovirus outbreaks are caused by genotype Gll.2
b) Severe cases of norovirus are most common in adults aged
25-45
c) Noroviruses are the most common cause of epidemic
gastroenteritis worldwide
d) Norovirus outbreaks occur most commonly in the summer
months.
 Most common cause of epidemic gastroenteritis worldwide
 Leading cause of foodborne outbreaks in the United States
 NoV outbreaks occur year round BUT in the US activity
increases during the winter months with 80% of reported
outbreaks occurring during November- April
 Most are attributed to Gll.4 which evolves rapidly over time

 Severe disease occurs most frequently among;

 Older adults
 Young children
 Immunocompromised patients
 Unexposed Exposed
Disease 9 17
No Disease 7 5

a. 0.21
b. 0.56
c. 0.30
d. 0.77
 Unexposed Exposed
Disease 9 17
No Disease 7 5

a. 0.21
b. 0.56
c. 0.30
d. 0.77
a) IE-IU=AR
a) IE incidence in exposed
b) IU incidence in unexposed

Calculate IE
number of exposed people with the disease/Total exposed
17/22 =0.77

Unexposed Exposed Total

Disease 9 17 26
No 7 5 12
disease
Total 16 22 38
 Number of unexposed people/ total unexposed
 9/16= -.56

 AR =IE-IU
 0.77-0.56=0.21
a) IBD is associated with increased morbidity and mortality
associated with CDI
b) Most patients acquire CDI in inpatient settings
c) CDI generally develops more slowly after hospital
admission among patients with IBD compared with patients
without IBD
d) IBD does not affect the risk of CDI from antibiotic exposure
a) IBD is associated with increased morbidity and mortality
associated with CDI
b) Most patients acquire CDI in inpatient settings
c) CDI generally develops more slowly after hospital
admission among patients with IBD compared with patients
without IBD
d) IBD does not affect the risk of CDI from antibiotic exposure
a) Most TB infections among homeless individuals are
reactivations of established disease
b) Sputum testing detects more than 90 percent of patients
with TB
c) Screening for TB with chest X-ray may be the most cos-
effective approach
d) Directly observed therapy in the acute hospital setting is
associated with the highest completion rates
a) Most TB infections among homeless individuals are
reactivations of established disease
b) Sputum testing detects more than 90 percent of patients
with TB
c) Screening for TB with chest X-ray may be the most cos-
effective approach
d) Directly observed therapy in the acute hospital setting is
associated with the highest completion rates
 Higher in homeless populations
 Most TB occurring in the homeless are primary infections
 Produce outbreaks with large clusters in which more than 50
percent of persons are infected.
 Homeless shelters are major sites of transmission.
 Screening by CXR periodically in all residents or specifically in
symptomatic persons (coughers) appears to be the most cost-effective
approach for detection and diagnosis in homeless populations.
Body Mass Index Cases Controls
BMI > 30 55 30
BMI<25 45 70

a. 0.35
b. 2.85
c. 1.83
d. 0.55
Body Mass Index Cases Controls
BMI > 30 55 30
BMI<25 45 70

a. 0.35
b. 2.85
c. 1.83
d. 0.55
BMI Controls Cases
BMI >30 A 55 B 30
BMI <25 C 45 D 70