Assessment 3 (consists of two sections):
• Section 1 – tests understanding of screening and diagnostic.
• Section 2 – tests skills for critically appraising a research article.
Section 1 (35 marks)
1. You are considering introducing a new screening test for hepatitis B. You know that the test has a sensitivity of 86% and specificity of 90%. The prevalence of hepatitis B in the population to be screened is estimated to be 5%. The population to be screened counts 1000 people. Please address the following tasks:
a. Based on the provided data, please a) summaries the results of the screening test in a table, including labels for the rows and columns; b) and in no more than 250 words provide calculations and explanation on how you got to the results of the screening test in the table. The word count includes both calculations and explanation (10 marks – 5 marks for correctly outlining and filling out the table; 5 marks for calculations and explanation)
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b. How well has the test performed in this population (hint: positive predictive value (PPV) and negative predictive value (NPV))? Please show calculations and explain the calculated values i.e. state what the calculated values measure and what they represent. (10 marks = 5 marks for correctly calculated and interpreted PPV and 5 marks for correctly calculated and interpreted NPV).
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c. How well would the test performe in clinical setting (hint: positive likelihood ratio (LR+ve) and negative likelihood ratio (LR-ve))? Please show calculations and explain the calculated values i.e. state what the calculated values measure and what they represent. (10 marks = 5 marks for correctly calculated and interpreted LR+ and 5 marks for correctly calculated and interpreted LR-).
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2. A researcher wants to study whether women who are physically active during pregnancy and meet the physical activity and sedentary behavior guidelines have lower rates of breast cancer in later life. Funders asked that an analysis and report are completed within two years. Which study design should the researcher choose and describe how might they study this relationship? What is the measure of association that can be calculated based on this study design? (5 marks)
Response:
Section 2 (65 marks) – limit 1800 words (+/- 10%)
Critically appraise the article:
Frei P, Poulsen AH, Johansen C, Olsen JH, Steding-Jessen M, Schuz J. Use of mobile phones and risk of brain tumours: update of Danish cohort study. BMJ 2011;343:d6387. doi: 10.1136/bmj.d6387 The paper can be accessed via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197791/
Please read the paper and address the following tasks:
1. Specify the aim and the hypothesis (both null and alternative) of the study (2 marks)
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2. Specify the type of the study (study design) (2 mark)
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3. What are the outcomes and how are they measured? (3 mark)
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4. What are the exposures and how are they measured? (3 mark)
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5. Discuss on whether the findings of the paper be explained by chance. (15 marks)
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6. Discuss on whether the findings of the paper be explained by selection bias or information (measurement) bias. (20 mark)
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7. Discuss on whether the findings of the paper be explained by confounding. (15 marks)
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8. Discuss external validity of the study. (5 marks)
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