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Clinical Epidemiology Assignment Questions
This assignment is based on the learning objectives and concepts as described in the Unit Learning Guide. There are 11 questions worth a total of 64 marks and this assignment will contribute 64% towards the total assessment for this subject.
Your assignment should be typed, with adequate space left between questions. Assignments should be submitted via vUWS. Be as concise as possible in your answers, and use the number of marks allocated to each question as a guide for how much to write.
Please answer questions 1–4 based on the following scenarios:
Question 1: You work in an inpatient psychiatric ward as a nurse. One of your patients with chronic schizophrenia, Desmond, a 28-year-old man, normally mumbles to himself, but will occasionally speak to other patients when they play games together. Base on your observation, you mention to a colleague that maybe social skills group training sessions would increase Desmond’s conversational skills. Your colleague shakes his head and says “I don’t think so because Desmond is in and out of this hospital, he’s a lost cause.” Task [2 marks]
Write a focused research question for this particular problem that will help you organise a
search of the literature for an answer (use the PICO elements as appropriate). b. Identify the PICO elements in your research question
Question 2: Lee Wane, a 79-year-old man with a history of type 2 diabetes mellitus from a nearby nursing home has recently been admitted with a stage III pressure ulcers on his heels. As a Diabetic Nurse consultant, with a Master in Epidemiology degree, the unit nurses have called you in for a diabetic wound consult. You have to choose between standard moist wound therapy and negative pressure wound therapy using vacuum-assisted closure to improve the patient wound healing process in your discussion. Task [2 marks]
Write a focused research question for this particular problem that will help you organise a
search of the literature for an answer (use the PICO elements as appropriate). b. Identify the PICO elements in your research question
Question 3: In the past 2 years, as an Infectious Disease Specialist in one of the tertiary hospitals in Australia, you have attended to 23 migrant patients who were referred by their General Practitioners with symptoms not typical of pulmonary tuberculosis. After taking a detailed history and performing appropriate physical examinations, as well as reviewing a range of relevant investigations, you clinically diagnosed and microbiologically confirmed that those patients have multi-drug resistance pulmonary tuberculosis (MDR-TB). The Public Health Department was notified of disease and the patients were managed accordingly. Now, you and some colleagues from Western Sydney University want to investigate the risk factors for MDR-TB. Task [2 marks]
Write a focused research question for this particular problem that will help you organise a
search of the literature for an answer (use the PICO elements as appropriate). b. Identify the PICO elements in your research question.Clinical Epidemiology Assignment Questions
Question 4: As a Psychologist, you work with patients with advanced cancer and have been informed in a recent conference to suggest pain diaries for your patients as a form of pain management therapy. You have been wondering for some time now whether or not these diaries actually improve pain control or make pain worse by making patients more aware of their pain. Task [2 marks]
Write a focused research question for this particular problem that will help you organise a
search of the literature for an answer (use the PICO elements as appropriate). b. Identify the PICO elements in your research question
Question 5: Please select the single best answer for each of questions I – IV I. Randomised controlled trials provide strong evidence that an observed effect is due to the
intervention. One main reason is because [1 mark]:
a) When the study participants are randomised, many characteristics and potential
confounders are likely to be evenly distributed in the groups b) It is easier to measure the outcome variable with great precision in randomised controlled
trials compared to other study designs. c) The exposure level and the outcome are measured at the same time d) The study participants are volunteers and therefore motivated to take part in the study e) None of the above
Blinding is an important feature of a randomised controlled trials because [1 marks]:
a) It helps prevent measurement bias – the biased assessment of outcomes b) It helps reduce contamination and compliance problems c) It helps reduce confounding and selection bias d) It is required to do an intention-to-treat analysis e) It helps improve chance event and reduce misclassification
III. A double-blind study was designed to test the efficacy of a drug. One group of the patients consisting of 1227 participants were given a placebo and the other group of patients consisting of 1220 were given the active drug. Both groups were to be followed up for one year. After 6-months of the trial, 35% of participants in the placebo groups dropped out of the study and 4% of the participants taking the active drug dropped out of the study. What is the SINGLE BEST explanation for this occurrence [1 mark]?
a) Failure of the active drug b) Insufficient information to interpret data c) Breakdown of the double-blind study d) Systematic error e) Chance event
When epidemiologists judge the evidence to establish a possible cause of a health outcome, they
consider [1 mark]:
a) The strength of the association between an exposure and the outcome b) Evidence that the exposure of interest has appeared before the outcome. c) Evidence showing that reductions in the exposure level will reverse the risk of the outcome. d) A, B and C e) A and B only
Q6: Now select ONLY ONE research question from any of Questions 1 to 4 above that will help you organize a search of the clinical literature for an answer. If you were to search Medline/PubMed/Web of science for original research on this question:
Describe what your search strategy would be, including keywords, MeSH terms, inclusion
and exclusion criteria, as well as evidence of the Boolean operators used [4 marks]. b. What type of study design would best be able to address your selected research question? State why [1
mark]. c. Cite the best article from among those you find, using any referencing style of your choice [1
mark].
Clinical Epidemiology Assignment Questions
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