Question

All health care providers report diagnoses of diabetes. What best describes this type of surveillance? (choose one)

		b) Active surveillance
		a) Notifiable disease surveillance
		c) Syndromic surveillance
		d) Sentinel surveillance
		e) Passive surveillance

If you compared the odds of a disease for a cohort of people exposed to some type of environmental agent, relative to a cohort of similar people who were not exposed, what would an odds ratio of 0.2 with a statistically significant p-value (p-value<0.05) represent? (Select the best ONE)

	a.	Exposure appears to be positively associated with the disease
	b.	Exposure appears to be negatively associated with the disease
	c.	Exposure is not associated with the disease
	d.	Exposure is definitely causative of the disease
	e.	None of the above

The odds ratio for people with ischemic heart disease not taking calcium supplements compared to people taking calcium supplements is 0.67. What is the odds ratio for ischemic heart disease in people taking calcium supplements compared to people not taking calcium supplements? (choose one)

		a) 1.33
		d) -.33
		e) 1.67
		c) 1.49
		b) -0.67

An observational study is being designed to assess the association of alcohol intake with cardiovascular disease. Which of the following factors is likely to be a confounder? (choose one)

		a) exposure to fluoride in the public water system
		b) smoking
		d) season of birth
		c) Zika virus

Answer 1

THE CENTERS FOR DISEASE CONTROL AND PREVENTION DIVISION OF DIABETES TRANSLATION SUPPORTS A NATIONAL AND STATE SURVEILLANCE SYSTEM THAT ANALYSES,INTERPRETS,AND REPORTS ON DIABETES RSK BEHAVIOURS,RISK FACTORS,CARE PRACTICES,MORBIDITY AND MORTALITY

PUBLIC HEALTH SUURVEILLANCE ALSO CALLED EPIDEMIOLOGICAL SURVEILLANCE CLINICAL SURVEILLANCE, SYNDROMIC SURVEILLANCE IS ACCORDING TO WHO 'THE CONTINUOUS ,SYSTEMATIC COLLECTION ,ANALYSIS AND INTERPRETATION OF HEALTH RELATED DATA NEEDED FOR THE PLANNING,IMPLEMENTATION AND EVALUATION OF PUBLIC HEALTH PRACTICE

SYNDROMIC SURVEILLANCE MAY BE USED TO TRACK EMERGING HEALTH RELATED ISSUES AT AN EARLY STAGE AND FIND ACTIVE SOLUTIONS IN A TIMELY MANNER. SURVEILLANCE SYSTEMS ARE GENERALLY CALLED UPON TO PROVIDE INFORMATION REGARDING WHEN AND WHERE HEALTH PROBLEMS ARE OCCURING AND WHO IS AFFECTED

PUBLIC HEALTH SURVEILLANCE SYSTEM CAN BE ACTIVE OR PASSIVE.A PASSIVE SURVEILLANCE SYSTEM CONSISTS OF THE REGULAR ,ONGOING REPORTING OF DISEASES AND CONDITIONS BY ALL HEALTH FACILITIES IN A GIVEN TERRITORY.

AN ACTIVE SURVEILLANCE SYSTEM IS ONE WHERE HEALTH FACILITIES ARE VISITED AND HEALTHCARE PROVIDERS AND MEDICAL RECORDS ARE VIEWED IN ORDER TO IDENTIFY A SPECIFIC DISEASE OR CONDITION.

PASSIVE SURVEIILANCE SYSTEMS ARE LESS CONSUMING AND LESS EXPENSIVE TO RUN BUTRISK UNDER REPORTING OF SOME DISEASES

ACTIVE SURVEILLANCE SYSTEMS ARE MOST APPROPRIATE FOR EPIDEMCS OR WHERE A DISEASE HAS BEEN TARGETED FOR ELIMINATION.

AN ACTIVE SURVEILLANCE SYSTEM PROVIDES STIMULUS TO HEALTH CARE WORKERS IN THE FORM OF INDIVIDUAL FEED BACK OR OTHER INCENTIVES.OFETN REPORTING FREQUENCY BY INDIVIDUAL HEALTH WORKERS IS MONITORED;HEALTH WORKERS WHO CONSISTENTLY FAIL TO REPORT OR COMPLETE THE FORMS INCOORECTLY ARE PROVIDED SPECIFIC FEEDBACK TO IMPROVE THEIR PERFORMANCE .THERE MAY ALSO BE INCENTIVES PROVIDED FOR COMPLETE REPORTING.

ACTIVE SURVEILLANCE REQUIRES SUBSTANTIALLY MORE TIME AND RESOURCES AND IS THEREFORE LESS COMMONLY USED IN EMERGENCIES.BUT IT IS OFTEN MORE COMPLETE THAN PASSIVE SURVEILLANCE.BUT IT IS OFTEN USED IF AN OUTBREAK HAS BEGUN OR IS SUSPECTED TO KEEP CLOSE TRACK OF THE NUMBER OF CASES.COMMUNITY HEALTH WORKERS MAY BE ASKED TO DO ACTIVE CASE FINDING IN THE COMMUNITY IN ORDER TO DETECT THOSE PATIENTS WHO MAY NOT COME TO HEALTH FACILITIES FOR TREATMENT.

2.THE ODDS OF AN EVENT IS THE NUMBER OF THOSE WHO EXPERIENCE EVENT DIVIDED BY THE NUMBER OF THOSE WHO DO NOT.IT IS EXPRESSED AS A NUMBER FROM ZERO (THE EVENT NEVER HAPPEN) .

AN ODDS OF 0.2 HOWEVER SEEMS LESS INTUITIVE ; 0.2 PEOPLE WILL EXPERIENCE THE EVENT FOR EVERY ONE THAT DOES NOT .

AN ODDS RATIO IS A MEASURE OF ASSOCIATION BETWEEN AN EXPOSURE AND AN OUTCOME .THE OR REPRESENTS THE ODDS THAT AN OUTCOME WILL OCCUR GIVEN A PARTICULAR EXPOSUE,COMPARED TO THE ODDS OF THE OUTCOME OCCURING IN THE ABSENCE OF THAT EXPOSURE.

0.2 THIS COULD BE STATED THAT THERE IS A DOUBLING OF THE ODDS OF THE OUTCOME,THIS IS NOT THE SAME AS SAYING A DOUBLING OF THE RISK. AN OR OF 0.2 MEANS THERE IS AN 80% DECREASE IN THE ODDS OF AN OUTCOME WITH A GIVEN EXPOSURE.SO WE CAN SELECT OPTION B THE EXPOSURE TO BE NEGATIVELY ASSOCIATED WITH THE DISEASE.

3.THE ODDS RATIO OF NOT TAKING CALCIUM SUPPLEMENTS AND PEOPLE TAKING CALCIUM SUPPLEMENTS THE RATIO IS 0.67

THE PEOPLE WHO NOT TAKING CALCIUM SUPPLEMENTS IS 0.4 THE PEOPLE WHO TAKING CALCIUM SUPPLEMENTS IS 0.6

0.4 / 0.6= 0.67

SO THE PEOPLE WHO TAKING CALCIUM SUPPLEMENTS IS 0.6 THE PEOPLE WHO NOT TAKING CALCIUM SUPPLEMENTS IS 0.4

0.6/ 0.4 =1.5

SO OPTION C=1.49 IS ACCURATE ODDS RATIO.

4.IN BOTH EXPERIMENTAL AND OBSERVATIONAL STUDIES OF ALCOHOL CONSUMPTION AND CARDIOVASCULAR DISEASE ,CIGARETTE SMOKING IS TREATED AS A CONFOUNDER OR NUISANCE PARAMETER.

BECAUSE SMOKING DAMAGE THE BLOOD VESSELS ,REDUCE THE AMOUNT OF OXYGEN IN THE BLOOD AND MAKES THE HEART BEAT FASTER .ALL THESE CAN MAKE THE HEART CONDITION WORSE AND ALSO SMOKING INCREASE THE FORMATION OF PLAQUE IN BLOOD VESSELS THE CHEMICALS IN CIGARETTE SMOKE CAUSE THE BLOOD TO THICKEN AND FORM CLOTS INSIDE VEINS AND ARTERIES.