Biostatistics Lecture Series

Dr. Terrell – Fall 2012

Practice Questions only - no answers & explanations!

The proportion of any normal distribution that lies within ±2 standard deviations of the mean is?
a) 50% b) 68% c) 95% d) 99%

The power of a study designed to test whether a new medication (e.g., Sweetless) reduces a
measurement (e.g., blood sugar) by a clinically significant amount (e.g., 20 mg/dL) is the
probability of concluding that
a) a difference exists, when there truly is a difference.
b) a difference exists, when there truly is no difference.
c) no difference exists, when there truly is a difference.
d) no difference exists, when there truly is no difference.

The Null Hypothesis, when we are comparing the results of two different
samples, usually refers to the situation where:
a) the underlying population is the same and any differences between the
two samples are probably due to chance.
b) the underlying population is the same and any differences between the
two samples are probably not due to chance.
c) the underlying populations are different and any differences between
the two samples are probably due to chance.
d) the underlying populations are different and any differences between
the two samples are probably not due to chance.

How can the statistical power of a study be improved?

a) Use a non-parametric test of significance
b) decrease the sample size
c) increase the sample size
d) Incorporate more variation in the range of salaries in the two groups
Use the following case to answer all questions on this page. A study was conducted to
determine the risk of eating pizza weekly on developing male teenage obesity. A group of
obese teenage males were collected and their diets were classified to whether they ate pizza
at least once per week or not. A similar group of teenage males who were not obese had their
diets classified as to whether they ate pizza weekly or not. Below is the following data.
Obesity No Obesity
Weekly Pizza 25 80
No Weekly Pizza 100 560

What type of study is this?

a) diagnostic test b) Cohort study c) Case-control study d) RCT

What is the risk factor?

a) obesity b) gender c) diet d) age

What is the odds ratio for obesity and weekly pizza?

a) 1.57 b) 1.6 c) 1.75 d) .25 e) .31

What test of significance is used to determine whether the risk of developing obesity is different
for those who eat pizza weekly and those who do not?
a) t-test b) Correlation analysis c) ANOVA d) Chi square

The results from a test of significance in this study yields a P = 0.03122.

What is the correct interpretation of the outcome from this test of
significance?
a) The null hypothesis is supported, there is no difference between the
risk of eating pizza weekly and developing obesity.
b) The null hypothesis is supported, there is a difference between the risk
of eating pizza weekly and developing obesity.
c) The null hypothesis is rejected, there is no difference between the risk
of eating pizza weekly and developing obesity.
d) The null hypothesis is rejected, there is a difference between the risk of
eating pizza weekly and developing obesity.
Use this case study for all questions on this page. A study was
conducted at a pizza parlor. Servers were compared with cooks over a five
year span to determine the risk of injury due to pizza grease on the kitchen
floor. Below are data.
What type of study is this?
a) Diagnostic tests b) Cohort study c) Case-control study d)
Randomized Controlled Trial

What is the risk factor?

a) Cooks b) servers c) pizza grease d) fall
(broken coccyx)

What coefficient do you compute in calculating this risk?

a) PPV b) Relative Risk c) Odds ratio d) Correlation

What is the risk of falling due to pizza grease?

Fall No Fall
Pizza (cooks) 5 20
No Pizza (servers) 2 38

a) 0.21 b) 0.4 c) 0.5 d) 1 e) 2.5 f) 4 g) 4.75

What type of variables are used in this study?

a) categorical b) continuous

What test of significance is used to determine whether the difference in risk

of falling between cooks and servers is real?
a) Chi square b) T-test c) ANOVA d) Correlation
e) Regression

The results from a test of significance in this study yields a P = 0.019. What
is the correct interpretation of the outcome from this test of significance?
a) The null hypothesis is supported, there is no difference between the
risk of cooks &servers
b) The null hypothesis is supported, there is a difference between the risk
of cooks & servers
c) The null hypothesis is rejected, there is no difference between the risk
of cooks & servers
d) The null hypothesis is rejected, there is a difference between the risk of
cooks & servers
In the above study, the fact that the staff were or were not drunk would be
considered
a) a confounding risk factor that was accounted for.
b) a confounding risk factor that was not accounted for.
c) an additional group that has to be accounted for.
d) extraneous data.

Increasing the number of independent diagnostic tests,

a) increases the probability that at least one of the tests will be abnormal
b) decreases the probability that at least one of the tests will be abnormal
c) has no affect on the probability that at least one of the tests will be
abnormal

How many subjects do you need for a study consisting of a std dev of 4 and
effect size difference of 2?
a) 16
b) 36
c) 64
d) 128

The concept that describes the fact that all samples vary inherently to some
extent from the population is known as:
a) standard error
b) Type 1 error
c) Type 2 error
d) Bias
e) Random sampling variation

What is the typical critical values for P-values and Power, respectively?
a) .05 and .8
b) .8 and .05
c) .1 and .9
d) .9 and .1
 Use the following case for the next three questions. A 33-year old male patient of yours
tests positive for HIV. He asks you two questions “Does this mean I have HIV?” and “how
sensitive is the test?”

What analysis do you use to answer his question of “Does this mean I have HIV?”
a) test sensitivity b) test specificity c) PPV d) NPV e) Prevalence

Use the diagnostic test statistical values below to answer his first question (use the space below
for your calculations:
Prevalence of HIV = 10%
Test sensitivity = 90%
FP rate = 9%
a) 10% chance he has HIV d) 20% chance he has HIV
b) 50% chance he has HIV e) 9% chance he has HIV
c) 90% chance he has HIV

He asks you “How sensitive is this test?

a) 9 out 10 infected people will test positive
b) 10 out of 100 infected people will test positive
c) 81 out of 900 non-infected people will test positive
d) 100 out 900 people will test positive.
In a study comparing men (n=40) and women (n=43) and their preferences for either chocolate
or potato chips, the appropriate statistical test to analyze the data is a(n)
a) t-test b) Correlation analysis c) ANOVA d) Chi square

The Null Hypothesis, when we are comparing the results of two different
samples, usually refers to the situation where:
a) the underlying population is the same and any differences between the
two samples are probably due to chance.
b) the underlying population is the same and any differences between the
two samples are probably not due to chance.
c) the underlying populations are different and any differences between
the two samples are probably due to chance.
d) the underlying populations are different and any differences between
the two samples are probably not due to chance.

What type of clinical study yields results that are generally considered most
valid?
a) Case-Control b) Cohort c) Randomized Controlled Trial
Use this case for the next three questions. A study reports that the
average salaries of men (n=28) and women (n=26) doctors appears to be
different. The appropriate test of significance to determine if the difference
is real is:
a) Relative risk analysis b) Odds ratio c) ANOVA d) Chi square
e) T-test

In this study, the test of significance yields a P = 0.0612. What is the correct
interpretation?
a) The null hypothesis is supported, there is no difference between the
average salaries.
b) The null hypothesis is supported, there is a difference between the
average salaries.
c) The null hypothesis is rejected, there is no difference between the
average salaries.
d) The null hypothesis is rejected, there is a difference between the
average salaries.

How can the statistical power of this study be improved?

e) Use a non-parametric test of significance
f) decrease the sample size
g) increase the sample size
h) Incorporate more variation in the range of salaries in the two groups
Use this graph for the next four questions:

What is the independent variable?

Does a relationship exist?

What percentage of 35 year olds answered “yes”?

What percentage of 10 year olds said “yes”?

Use this case for the next four questions. You want to improve the care
for patients with diabetes in your clinic. You collect data on how many
patients there are with diabetes (N = 80). These patients get randomly
assigned to two groups and their hemoglobin A1c values* are measured.
One group receives diabetes education and a comprehensive disease
management program for six months; the other group does not receive this.
At the end of six months, the hemoglobin A1c values is measured in both
groups.
*Note: The hemoglobin A1c is a measure of diabetic control, the lower the value
the better. In a well controlled patient with diabetes, it should be under 7.

Write out the research question in the space below:

What type of clinical study is designed here?

a) diagnostic tests b) cohort study c) case-control study d) RCT

How can the validity of this study be maximized?

a) give a placebo to the control group.
b) make the evaluator unaware of which group received the treatment
and the placebo.
c) Decrease the sample size of the study
d) Both A & B

What statistical test would be best to evaluate whether or not there was a
statistically significant change in the hemoglobin A1c values with your
disease management program?
a) Chi-square b) Correlation analysis c) ANOVA d) t-test e) odds
ratio analysis
You want to compare your care for patients with high blood pressure with the
other three physicians in your practice. You collect from each physician, the
average blood pressures for their patients with hypertension (N = 231; mean
BP = 122, 127 and 134, respectively for each of three physicians) . What
test of significance would be best to evaluate whether or not there was a
statistically significant difference in the hypertensive care by each physician,
as measured by the average blood pressure values of their patients?
a) Chi-square b) Correlation analysis c) ANOVA d) t-test e) odds
ratio analysis

One of the physicians in your practice objects to the above analysis. He

claims that it is not the average blood pressure value that makes a
difference, but whether or not the blood pressure is at or below a specified
target value. You reclassify all the patients as above or below the target
value for the three physicians. What test of significance is used?
a) Chi-square b) Correlation analysis c) ANOVA d) t-test e) odds
ratio analysis

In comparing one-sample to a known population or long-running number,

what test do you use?
a) T-test
b) ANOVA
c) Z-test
d) Fisher-exact test
e) Krushkall-wallis test

Which one below is a mismatch between parametric and the equivalent non-
parametric test?
a) Unpaired t-test and Mann-whitney U-test
b) Paired T-test and Wilcoxon-signed rank test
c) ANOVA and Fisher-exact test
d) Simple Linear Regression and logistic regression
e) Correlation and spearman-rank correlation

What is the best reason why we prefer to use parametric tests over non-
parametric tests?
a) Parametrics have more power
b) Parametrics do not require the normality assumption
c) Parametrics are more commonly cited in the literature
d) Non-parametrics are easier to compute
e) Non-parametrics require larger sample sizes
Use the following output table from a Regression Analysis:

What are the independent and dependent variables? Write them below.

What variable(s) is not associated with the dependent variable?

Interpret the results