Chapter·BiostatisticsCohort studies

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1

A case-control study with a focus on risk factors that may influence the development of depression was conducted among the elderly population in one tertiary hospital in Malaysia. The study involved 150 elderly patients diagnosed with depressive illness from the psychiatry ward, as well as another group of 150 elderly patients without any history of depressive illness (but hospitalized for other reasons) at the same ward. The data were collected through questionnaires, and 2 principal investigators (who were also the patients’ attending physicians) acted as interviewers after proper training for the purposes of this study. Multivariate analyses of logistic regression with independent variables were employed to determine the adjusted odds ratio for the risk of developing depression. The study results showed that a lower level of social support, lack of education, and the presence of chronic illnesses highly correlated with depression. In order to maximally avoid bias that may stem from this kind of study design, what should the researchers have done differently to increase the validity of their results?

AUsed open-ended questions

BBlinded the investigators

CIncluded more interviewers

DUsed closed testing procedures on the data

EUsed Bonferroni correction on data

2

A recent study attempted to analyze whether increased "patient satisfaction" driven healthcare resulted in increased hospitalization. Using this patient population, the sociodemographics, health status, and hospital use were assessed. Next year, patient satisfaction with health care providers was assessed using 5 items from the Consumer Assessment of Health Plans Survey. Which of the following best describes this study design?

ARetrospective case-control

BCross-sectional study

CProspective case-control

DRetrospective cohort

EProspective cohort

3

A 15-year-old female presents to her family physician for an annual school physical exam and check-up. She is accompanied by her mother to the visit and is present in the exam room. The patient has no complaints, and she does not have any past medical problems. She takes no medications. The patient reports that she remains active, exercising 5 times a week, and eats a healthy and varied diet. Which of the following would be the best way for the physician to obtain a more in-depth social history, including sexual history and use of alcohol, tobacco, or recreational drugs?

ADisallow the mother to be present in the examination room throughout the entirety of the visit

BGive the patient a social history questionnaire to fill out in the exam room

CAsk the mother to step outside into the hall for a portion of the visit

DAsk the patient the questions directly, with her mother still in the exam room

ESpeak softly to the patient so that the mother does not hear and the patient is not embarrassed

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