NR 503 Final Exam With Answers Latest Update 2021

Definitions of study designs: Chapter 10: Differentiate between the case-control and cohort studies. Ask yourself, which is used when, and why. • Case-control = with the disease. Controls = without the disease. Case-Control has diseased and non-diseased people. • Cohort study = exposed and non-exposed people. A cohort study differs from a case-control study in that: o Subjects are enrolled or categorized on the basis of their exposure status in a cohort study but not in a case-control study o Subjects are asked about their exposure status in a cohort study but not in a case- control study o Cohort studies require many years to conduct, but case-control studies do not o Cohort studies are conducted to investigate chronic diseases, case-control studies are used for infectious diseases • Primary prevention: Primary = Prevent (initial development) • Secondary prevention: (screening), cost-effective, early detection, existing disease • Tertiary prevention: reducing impact of disease Case-Control: * Examine the possible relationship of an exposure to a certain disease * Identify group of individuals with the disease (cases) * For comparison, gather a group of people without that disease (controls) * Determine what proportion of the cases were exposed and were not * Also determine what proportion of the controls were exposed and not * Text: Thus, in a case-control study, if there is an association of an exposure with a disease, the prevalence of history of exposure should be higher in persons who have the disease (cases) than in those who do not have the disease (controls). * Ask yourself: Why is this important to the NP in primary care? How does this inform a provider’s decision-making? • Cohort Studies: Chapter 13: Comparing Cohort and Case-Control Studies: See Figure 13-1 and 13-2 (busy pictures but hang in there) • Chapter 13 comparison of studies - important to review • Matching: Chapter 10: Text: A major concern in conducting a case-control study is that cases and controls may differ in characteristics or exposures other than the one that has been targeted for study. • Randomization: The point of randomization is to prevent any potential biases on the part of the investigators/researchers. Text: Thus, the use of randomization is crucial to protect the study from any biases that might be introduced consciously or subconsciously by the investigator into the assignment process. • Bias: (selection bias) (source of cases) Issues related to generalizability; cases from a single source less than desirable than if from multiple sources with a varying pool of cases. Ask yourself, why? • Causality: Table 14-3: Using the Evidence in Developing Recommendations TABLE 14-3 The Process for Using the Evidence in Developing Recommendations on the Effectiveness of Prenatal Interventions Stage I: Categorizing the Evidence by the Quality of Its Source. (In each category, studies are listed in descending order of quality.) • 1.Trials (planned interventions with contemporaneous assignment of treatment and nontreatment) o a.Randomized, double-blind, placebo-controlled with sufficient power appropriately analyzed. o b.Randomized, but blindness not achieved. o c.Nonrandomized trials with good control of confounding, that are well conducted in other respects. o d.Randomized, but with deficiencies in execution or analysis (insufficient power, major losses to follow-up, suspect randomization, analysis with exclusions). o e.Nonrandomized trials with deficiencies in execution or analysis. • 2.Cohort or case-control studies o a.Hypothesis specified before analysis, good data, confounders accounted for. o b.As above, but hypothesis not specified before analysis. o c.Post hoc, with problem(s) in the data or the analysis. • 3.Time-series studies o a.Analyses that take confounding into account. o b.Analyses that do not consider confounding. • 4.Case-series studies: Series of case reports without any specific comparison group Among other issues that must be considered in reviewing the evidence are the precision of definition of the outcome being measured, the degree to which the study methodology has been described, adequacy of th