• The strength of an association between a factor and a disease is best measured by (1 mark)

1. incubation period
2. incidence of the disease in the total population
3. prevalence of the factor
4. attributable risk
5. relative risk

• The risk of acquiring a disease is measured by the (1 mark)

1. Incidence rate
2. Incidence rate times the average duration of the disease
3. Incidence rate divided by prevalence rate
4. Prevalence rate
5. Prevalence rate times the average prevalence of the disease

 

 

• Researchers conducted a study to investigate whether drinking white wine causes migraines. The researchers recruited 600 people who drank white wine and 600 who did not drink white wine. None of the participants reported ever experiencing migraine. Over the next five years participants were contacted annually and asked about their experience of migraine. They found that half of those who drank white wine reported migraine compared with only one-quarter of those who did not drink white wine. The results from the study are presented in the following table:

		Migraine
		Yes	No	Total
Drink white wine	Yes	300	300	600
	No	150	450	600
	Total	450	750	1,200

 

3a. Which of the following measures of association is appropriate to describe the association between drinking white wine and migraine is:

1. Prevalence rate ratio
2. Odds ratio
3. Relative risk (risk ratio)
4. Rate ratio
5. Incidence rate

3b. The correct value for this measure of association for this study, as calculated from the table above, is (1 mark):

1. 0.5
2. 1.0
3. 3.0
4. 2.0
5. 0.25

3c. Your interpretation of this result is (1 mark):

1. Those who drink white wine have half the risk of migraine of those who don’t drink white wine.
2. Those who drink white wine have twice the risk of migraine of those who don’t drink white wine.
3. Those who drink white wine have three times the risk of migraine of those who don’t drink white wine.
4. There is no association between drinking white wine and migraine.
5. None of the above.

4. Six thousand Australians aged 55 years were given a health check and 300 were found to have diabetes. Ten years later (at age 65) all 6,000 attended a second health check and another 600 had developed diabetes. The 300 people initially identified with diabetes have received ongoing treatment for their diabetes (5 marks).

4a. What was the prevalence of diabetes in the sample at age 55? Give the answer as a percentage (1 mark)

4b. What was the prevalence of diabetes in the sample at age 65? Give the answer as a percentage. (1 mark)

4c. How many people were at risk of developing diabetes at the start of the 10 year period? (1 mark)

4d. What was the incidence of diabetes in these people? (1 mark)

4e. Is this a measure of cumulative incidence or incidence rate? Why? (1 mark)

5. Figure 1 below represents a study of nine women in their 60’s with a strong history of familial breast cancer. All were initially healthy when they joined the study during the period 2010 to 2014 and were followed up for the remainder of the period to observe the onset of breast cancer. (4 marks)

Calculate the following quantities:           (1 mark each)

5a. The incidence rate

5b. The cumulative incidence (as an average per year)

5c. The point prevalence in mid 2012 (to three decimal places)

5d. The point prevalence in mid 2014 (to three decimal places)
Figure 1. Nine initially healthy people followed up between 2010 and 2014 to observe the onset of breast cancer

Note: the three downward arrows mark the mid points of three years

2010			2011			2012			2013			2014				Years at risk
																1
																2
																4
																5
																4
																2
																3
																5
																3

 

Legend:

Time spent without breast cancer

Time spent with breast cancer

Onset of breast cancer

Indicates subject left the study (lost to follow-up or died)

 

6. Suicide deaths among men by marital status – numbers and age specific rates, Australia, 1985-89

	Suicide deaths		Rates
Age	Married	Not married	Married	Not married
15-34	685	2904	14.7	35.2
35-49	855	611	19.3	50.7
50-64	1195	714	19.8	49.2

Source:  Health WIZ newsline, Spring 1993

 

6a. In males of working age is suicide more or less likely for unmarried men compared with married men?  Support with figures. (2 marks)

 

6b. Estimate how many of the 2,904 suicides could be prevented in a hypothetical world where each unmarried male aged 15-34 could have married his high school sweetheart or found his ideal life partner? (4 marks)

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