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Question 1 of 5
1. Question
Question 1 of 5
A study is conducted to assess the relationship between ethnicity and end-stage renal disease. Two groups of pathologists independently study specimens from 1,000 kidney biopsies. The first group of pathologists is aware of the race of the patient from whom the biopsy came, while the second group is blinded as to the patient’s race. The first group reports ‘hypertensive nephropathy’ much more frequently for black patients than the second group. Which of the following types of bias is most likely present in this study?
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Question 2 of 5
2. Question
Question 2 of 5
A cohort study is conducted to assess the relationship between a high-fat diet and colorectal adenocarcinoma. The study shows that no association exists between the exposure and the outcome after controlling for known risk factors (age, fiber consumption, and family history of cancer): relative risk – 1.35 (p = 0.25). The investigators also report that 40% of the subjects in the high-fat group and 36% of those in the low-fat group were lost to follow-up. Based on this information, which of the following biases is most likely to be present?
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Question 3 of 5
3. Question
Question 3 of 5
A study is conducted to assess the relationship between the use of an over-the-counter pain reliever during pregnancy and the development of neural tube defects in offspring. Mothers whose children have neural tube defects and age-matched controls with unaffected children are interviewed using a standard questionnaire. The study shows that use of the pain reliever during pregnancy increases the risk of neural tube defects, even after adjusting for race, other medications, family history of congenital abnormalities and serum folate level: OR = 1.5, p = 0.03. Which of the following biases is of major concern when interpreting the study results?
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Question 4 of 5
4. Question
Question 4 of 5
A large-scale clinical trial is being planned to evaluate the effect of a non-selective beta-blocker, propranolol, on the clinical course of portal hypertension. The primary outcomes of the study are all-cause mortality and major gastrointestinal hemorrhage. Secondary outcomes are minor gastrointestinal hemorrhage and the number of hospitalizations. The investigators are concerned about the possibility that episodes of major gastrointestinal hemorrhage could be over-reported in the placebo group. Which of the following is the most useful technique to reduce this possibility?
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Question 5 of 5
5. Question
Question 5 of 5
In a population with a high incidence of cardiovascular disease, diabetics are at least twice as likely to die from myocardial infarction as are non-diabetics. A case-control study conducted in the community identifies 1,000 people with sustained myocardial infarction and 1,000 people without sustained myocardial infarction. The subjects are asked whether they have a history of diabetes mellitus. According to the study results, diabetes has a protective effect against myocardial infarction. Which of the following best explains the observed study results?
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