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Question 1 of 8
1. Question
A study compares the detection of colon polyps in 50 subjects by using both CT colonography and conventional colonoscopy (gold standard). As a part of the study, 2 independent radiologists assess the CT images to diagnose polyps. Each radiologist is blinded to the other radiologist’s reading. The kappa statistic for these raters is 0.73. Which of the following does the kappa statistic best describe?
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Question 2 of 8
2. Question
The drug ad applies to the next 2 items.
A 54-year-old man comes to the office for follow-up of type 2 diabetes mellitus. The patient also has a history of hypertension, obesity, and chronic kidney disease (CKD). Medications include an antihyperglycemic agent and insulin. Blood pressure is 148/92 mm Hg and pulse is 81/min and regular. BMI is 34 kg/m2. Physical examination is otherwise unremarkable. Laboratory results are as follows:
Fasting glucose
146 mg/dL
Hemoglobin A1c
8.0%
Based on his serum creatinine level, his CKD has progressed, and the calculated glomerular filtration rate (eGFR) is now 42 mL/min/1.73 m2, down from 55 mL/min/1.73 m2 as measured 6 months ago.
Item 1 of 2
Based on the ad, which of the following is the most accurate statement concerning the use of kanebaflozin in this patient?
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Question 3 of 8
3. Question
The drug ad applies to the next 2 items.
A 54-year-old man comes to the office for follow-up of type 2 diabetes mellitus. The patient also has a history of hypertension, obesity, and chronic kidney disease (CKD). Medications include an antihyperglycemic agent and insulin. Blood pressure is 148/92 mm Hg and pulse is 81/min and regular. BMI is 34 kg/m2. Physical examination is otherwise unremarkable. Laboratory results are as follows:
Fasting glucose
146 mg/dL
Hemoglobin A1c
8.0%
Based on his serum creatinine level, his CKD has progressed, and the calculated glomerular filtration rate (eGFR) is now 42 mL/min/1.73 m2, down from 55 mL/min/1.73 m2 as measured 6 months ago.
Item 2 of 2
As stated in the ad, the proportion of subjects reaching A1c <7.0% was one of the prespecified secondary endpoints evaluated at week 26. Compared to the placebo group, a greater proportion of subjects in the 2 kanebaflozin groups achieved A1c <7.0%; however, researchers did not perform or report tests for the statistical significance of the differences in secondary endpoints among the 3 groups. Which of the following is the most likely reason that these statistical tests were not conducted?
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Question 4 of 8
4. Question
As part of a study on treatment of uncomplicated cellulitis, outpatients age >12 seeking care at the emergency department with cellulitis and no wound, purulent drainage, or abscess were randomly assigned to either cephalexin plus trimethoprim-sulfamethoxazole for 7 days (n = 85) or cephalexin plus placebo for 7 days (n = 87). The primary outcome was clinical cure, defined as absence of fever and more than minimal erythema, swelling, or tenderness (days 14-21). A total of 24 patients in the cephalexin plus trimethoprim-sulfamethoxazole group and 18 patients in the cephalexin plus placebo group did not complete treatment as prescribed or failed to complete the test-of-clinical-cure visit; they were categorized as noncompliant patients. The principal investigator of the study wanted to conduct a per-protocol analysis of the data. Which of the following describes how the data pertaining to noncompliance should be treated to conduct such an analysis?
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Question 5 of 8
5. Question
Several tests have been developed to measure the serologic markers of breast cancer. These tests have different specificities and sensitivities for the early stage of breast cancer. Which of the following tests could be the best screening test for the early detection of breast carcinoma if applied to a population with a stable incidence of the disease?
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Question 6 of 8
6. Question
In a cohort of 100 patients with rheumatoid arthritis who are starting treatment with rituximab, a study is conducted to determine the association between basal expression of CD35 and CD46 in B lymphocytes in peripheral blood and time to repopulation of these cells. Data analysis includes correlation analysis evaluated at a 5% significance level. Results show that lower levels of basal CD46 expression are significantly associated with higher B-lymphocyte repopulation times (p < 0.05). A similar trend is observed with CD35 but without statistical significance (p > 0.05). Based on these results, which of the following pairs of correlation coefficient and 95% confidence interval for the relationship between basal CD46 expression and B-lymphocyte repopulation time would be consistent with the findings of the study?
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Question 7 of 8
7. Question
A randomized, placebo-controlled, single-blind clinical trial will be conducted to evaluate the effectiveness of a new antispasmodic drug in the treatment of childhood functional abdominal pain. Based on a power analysis, a total of 300 participants age 12-18 with functional abdominal pain will be needed to achieve 80% power to detect a statistically significant treatment effect. Potential participants will be randomly assigned (at a 1:1 ratio) to receive the new drug or placebo for 6 weeks, and all participants will be blinded to treatment assignments. The primary outcome will be a reduction of ≥2 points on a 6-point pain scale or report of no pain. The secondary outcome will be a physician-rated overall pain severity score. The study will have a total follow-up time of 12 weeks. Based on this information, which of the following is most likely to result in an increase in the internal validity of this study?
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Question 8 of 8
8. Question
Over the course of 5 years, a pediatric endocrinologist has seen a marked increase in the prevalence of depression among patients with obesity in her practice. She partners with a pediatric psychiatrist to devise a short screening test for depression for this specific population. The new screening test is found to be 90% sensitive and 84% specific. If this test is used on a sample of patients with obesity in which 35% are known to have depression, what is the chance that a patient with obesity who tests negative is actually free from depression?
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