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# An investigator evaluated 1000 persons in a community suspected to be suffering from STD and later confirmed by a serological test.

The results were: Present 120 Q1. Q2. Q3. Q4. 280 STD Absent 180 420

+ S. Test

The positive predictive value for the test is: In the above results, the specificity of the test is: In the above results, the sensitivity of the test is: In the above results the accuracy of the test is:

Q. Sensitivity of a screening test is: a. the ability to correctly identify individuals who have a specific disease b. the ability to correctly identify individuals who do not have a specific disease c. the ability to be as reliable as possible. d. The ability to be as precise as possible. Q. The negative predictive value of a screening test is the proportion of: a. true positives among all positives b. true negatives among all negatives c. false positives among all positives d. false negatives among all negatives ABSOLUTE RISK Done by comparing occurrences to calculate the risk that a health effect will r esult from an exposure. Comparisons can be done by: 1. absolute and 2. relative comparisons; These measures describe the strength of an association between exposure and outc ome.

In a prospective study to elicit the relationship between oral contraceptive use and the subsequent risk of developing endometrial cancer, a cohort of 1000 wom en were followed for 5 years. The results were as follows: ENDOMETRIAL CANCER Present Absent + 245 75 O.C.P. USE 50 630 What is the a) Absolute risk b) Relative risk and c) Attributable risk percent o f endometrial cancer in the study? Summary of measure effects: DISEASE Present Absent + RISK _

1. Absolute Risk: with risk factor= A/(A+B) without risk factor= C/C+D 2. Attributable Risk= A/(A+B) - C/(C+D) 3. Attributable Risk Percent = (Attributable Risk / Absolute Risk) 4. Relative Risk = A/(A+B) C/(C+D) i. e. Absolute risk with risk factor Absolute risk without risk factor X 100

Absolute Risk: Absolute Risk: in OCP users = 0.76 in OCP non-users = 0.07 Absolute Risk allows us to separately calculate the incidences of a particular dis ease in both populations with a risk factor and without it, for making risk com parisons. Attributable Risk Attributable Risk = A/(A+B) - C/(C+D) = 0.77 0.07 = 0.70 Attributable Risk allows us to attribute differences in the incidences of a diseas e to a particular risk factor. Attributable Risk Percent Attributable Risk Percent = Attributable RiskX 100 Absolute Risk =(0.70/ 0.77) X 100 = 91% Attributable Risk is often expressed as Attributable Risk Percent where Attributa ble Risk is a percentage of the Absolute Risk (Incidence Rate among those expose d to the risk factor) and this percentage is most frequently used to justify the inception of risk prevention programs when attributable risk factor percentages are high. Odds Ratio The association of an exposure and a disease (relative risk) in a case-control s tudy is measured by calculating the odds ratio (OR), which is the ratio of the o dds of exposure among the cases to the odds of exposure among the controls. The odds ratio is given by: A/B C/D or AD / BC ASSOCIATION BETWEEN MEAT CONSUMPTION AND FOOD POISONING: Odds Ratio This indicates that the cases were 11.6 times more likely than the controls to h ave recently eaten meat. The odds ratio is very similar to the risk ratio, particularly if a disease is ra re. For the odds ratio to be a good approximation, the cases and controls must be re presentative of the general population with respect to exposure. However, because the incidence of disease is unknown, the absolute risk can not be calculated. Q. In a prospective study to find the relationship between HIV status and subseq uent risk of developing non-Hodgkins B-cell lymphoma, a cohort of 600 men were fo

llowed from 1981 to 1991. The results of follow-up study are presented in the t able. Find: a) Abs. Risk Non Hodgkins B cell Lymphoma b) Attr. Risk Present Absent c) RR + 75 25 HIV 50 450

Q: The prevalence of STD in a community was 10%. The sensitivity of a serolo gical test employed was 80% with a specificity of 90%. 1. What would be the Positive Predictive Rate of the serological test? A. Very high B. low C. About 50% D. Negligible 2. What would be the Accuracy of the serological test? A. Very high B. low C. About 50% D. Negligible Q. A new radiologic scanning test for the early detection of osteogenic sar coma was used to evaluate 500 patients. The results of the study were as follows : OSTEOGENIC SAR COMA Present Absent + 100 150 TEST 75 175 1Q. What is the negative predictive value of the test? 2Q. What is the specificity of the test? 3Q. What is the positive predictive value of the test? 4Q. What is the sensitivity of the test? 5Q. What is the accuracy of the test? A. 100/250 B. 75/250 C. 175/250 D. 100/175 E. 175/325 Q. The results of a follow up study to see the association of lung cancer to smoking are as follows: Lung cancer Present Absent + 225 75 Smoking 100 565. 1Q. The absolute risk for smokers in the study is? 2Q. The relative risk for smokers in the above study is? 3Q. The attributable risk for smoking in the above study is

An investigator evaluated 100 patients suffering from major depression as co nfirmed by the attending psychiatrist. The results were: Clinical depression Present Absent + 12 18 Test _ 28 42 1Q.The positive predictive value for the test is? 2Q. In the above results, the specificity of the test is? 3Q. In the above results, the sensitivity of the test is? A. 12/40 B. 18/60 C. 42/60 D. 12/30 E. 42/60.