An investigator evaluated 1000 persons in a community suspected to be suffering f rom 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 specifi city of the test is: In the above results, the sensitivity of the test is: In th e above results the accuracy of the test is: Q. Sensitivity of a screening test is: a. the ability to correctly identify indi viduals who have a specific disease b. the ability to correctly identify individ uals who do not have a specific disease c. the ability to be as reliable as poss ible. d. The ability to be as precise as possible. Q. The negative predictive va lue of a screening test is the proportion of: a. true positives among all positi ves b. true negatives among all negatives c. false positives among all positives d. false negatives among all negatives ABSOLUTE RISK Done by comparing occurren ces to calculate the risk that a health effect will r esult from an exposure. Co mparisons can be done by: 1. absolute and 2. relative comparisons; These measure s 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 Pr esent 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? Summ ary of measure effects: DISEASE Present Absent + RISK _ 1. Absolute Risk: with risk factor= A/(A+B) without risk factor= C/C+D 2. Attrib utable 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 ri sk factor Absolute risk without risk factor X 100 Absolute Risk: Absolute Risk: in OCP users = 0.76 in OCP non-users = 0.07 Absolut e 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 paris ons. Attributable Risk Attributable Risk = A/(A+B) - C/(C+D) = 0.77 0.07 = 0.70 A ttributable Risk allows us to attribute differences in the incidences of a diseas e to a particular risk factor. Attributable Risk Percent Attributable Risk Perc ent = Attributable RiskX 100 Absolute Risk =(0.70/ 0.77) X 100 = 91% Attributabl e 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 r isk 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 cas e-control s tudy is measured by calculating the odds ratio (OR), which is the ra tio of the o dds of exposure among the cases to the odds of exposure among the c ontrols. 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 rat io is very similar to the risk ratio, particularly if a disease is ra re. For th e odds ratio to be a good approximation, the cases and controls must be re prese ntative 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 Absen t c) RR + 75 25 HIV 50 450 Q: The prevalence of STD in a community was 10%. The sensitivity of a serolo gic al test employed was 80% with a specificity of 90%. 1. What would be the Positiv e Predictive Rate of the serological test? A. Very high B. low C. About 50% D. N egligible 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 s pecificity of the test? 3Q. What is the positive predictive value of the test? 4 Q. 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 canc er 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 nfi rmed by the attending psychiatrist. The results were: Clinical depression Presen t 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 resul ts, the sensitivity of the test is? A. 12/40 B. 18/60 C. 42/60 D. 12/30 E. 42/60 .