NEUROLOGY
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference
Ch. 1 — Introduction — The Global Burden of Neurological
Diseases
Stem
A national health agency reports that neurological disorders
account for a rising proportion of years lived with disability
(YLDs) over the past decade, despite stable crude mortality. You
Page | 1
,are asked to interpret this trend for policy-makers and
recommend a priority action. What is the single best
interpretation and immediate priority?
Options
A. The increase in YLDs reflects improved survival from
neurological diseases; prioritize expansion of acute stroke units.
B. The increase indicates better diagnostic coding; prioritize a
coding audit before policy changes.
C. The increase suggests a demographic shift toward older
populations; prioritize long-term neurorehabilitation and
chronic care capacity.
D. The increase is likely due to environmental causes; prioritize
an environmental exposure study.
Correct answer
C
Rationales
Correct: Rising YLDs with stable mortality typically reflect aging
populations with more chronic neurological disability—Queen
Square reasoning emphasizes system-level responses like
Page | 2
,strengthening long-term neurorehabilitation and chronic
neurological care.
A: Acute stroke unit expansion addresses mortality and early
disability, but the pattern is more consistent with chronic
disability burden, not solely acute care.
B: Coding improvements can affect numbers but are less likely
to produce sustained decade-long rises across multiple
disorders. Policy should act on probable demographic drivers
rather than delay.
D: Environmental causes may contribute but are speculative;
immediate priority is capacity for chronic care.
Teaching point
Rising YLDs with stable mortality generally imply chronic-care
needs from aging populations.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
2
Page | 3
, Reference
Ch. 1 — The Global Burden of Neurological Diseases
Stem
You are designing a burden-of-disease study for epilepsy in a
middle-income country. The goal is to estimate disability-
adjusted life years (DALYs). Which methodological choice best
reduces bias when combining incidence, prevalence, and
mortality data from heterogeneous regional sources?
Options
A. Use national hospitalization discharge data exclusively
because hospitals capture severe cases.
B. Apply age-standardization and incorporate local prevalence
surveys with capture–recapture correction.
C. Use global meta-analytic estimates and scale them by
population size.
D. Use only mortality registries to avoid misclassification of non-
fatal cases.
Correct answer
B
Page | 4
A QUEEN SQUARE TEXTBOOK
3RD EDITION
• AUTHOR(S)ROBIN HOWARD
TEST BANK
1
Reference
Ch. 1 — Introduction — The Global Burden of Neurological
Diseases
Stem
A national health agency reports that neurological disorders
account for a rising proportion of years lived with disability
(YLDs) over the past decade, despite stable crude mortality. You
Page | 1
,are asked to interpret this trend for policy-makers and
recommend a priority action. What is the single best
interpretation and immediate priority?
Options
A. The increase in YLDs reflects improved survival from
neurological diseases; prioritize expansion of acute stroke units.
B. The increase indicates better diagnostic coding; prioritize a
coding audit before policy changes.
C. The increase suggests a demographic shift toward older
populations; prioritize long-term neurorehabilitation and
chronic care capacity.
D. The increase is likely due to environmental causes; prioritize
an environmental exposure study.
Correct answer
C
Rationales
Correct: Rising YLDs with stable mortality typically reflect aging
populations with more chronic neurological disability—Queen
Square reasoning emphasizes system-level responses like
Page | 2
,strengthening long-term neurorehabilitation and chronic
neurological care.
A: Acute stroke unit expansion addresses mortality and early
disability, but the pattern is more consistent with chronic
disability burden, not solely acute care.
B: Coding improvements can affect numbers but are less likely
to produce sustained decade-long rises across multiple
disorders. Policy should act on probable demographic drivers
rather than delay.
D: Environmental causes may contribute but are speculative;
immediate priority is capacity for chronic care.
Teaching point
Rising YLDs with stable mortality generally imply chronic-care
needs from aging populations.
Citation
Howard, R. (2021). Neurology: A Queen Square Textbook (3rd
ed.). Ch. 1.
2
Page | 3
, Reference
Ch. 1 — The Global Burden of Neurological Diseases
Stem
You are designing a burden-of-disease study for epilepsy in a
middle-income country. The goal is to estimate disability-
adjusted life years (DALYs). Which methodological choice best
reduces bias when combining incidence, prevalence, and
mortality data from heterogeneous regional sources?
Options
A. Use national hospitalization discharge data exclusively
because hospitals capture severe cases.
B. Apply age-standardization and incorporate local prevalence
surveys with capture–recapture correction.
C. Use global meta-analytic estimates and scale them by
population size.
D. Use only mortality registries to avoid misclassification of non-
fatal cases.
Correct answer
B
Page | 4
