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  • Question 1 - What is the nature of the hypothesis that a researcher wants to test...

    Incorrect

    • What is the nature of the hypothesis that a researcher wants to test regarding the effect of a drug on a person's heart rate?

      Your Answer: Two-tailed alternative hypothesis

      Correct Answer: One-tailed alternative hypothesis

      Explanation:

      A one-tailed hypothesis indicates a specific direction of association between groups. The researcher not only declares that there will be a distinction between the groups but also defines the direction in which the difference will occur.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      10.1
      Seconds
  • Question 2 - Which statement about confounding is incorrect? ...

    Correct

    • Which statement about confounding is incorrect?

      Your Answer: In the analytic stage of a study confounding can be controlled for by randomisation

      Explanation:

      In the analytic stage of a study, confounding cannot be controlled for by the technique of stratification. (This is false, as stratification is a technique commonly used to control for confounding in observational studies.)

      Stats Confounding

      A confounding factor is a factor that can obscure the relationship between an exposure and an outcome in a study. This factor is associated with both the exposure and the disease. For example, in a study that finds a link between coffee consumption and heart disease, smoking could be a confounding factor because it is associated with both drinking coffee and heart disease. Confounding occurs when there is a non-random distribution of risk factors in the population, such as age, sex, and social class.

      To control for confounding in the design stage of an experiment, researchers can use randomization, restriction, of matching. Randomization aims to produce an even distribution of potential risk factors in two populations. Restriction involves limiting the study population to a specific group to ensure similar age distributions. Matching involves finding and enrolling participants who are similar in terms of potential confounding factors.

      In the analysis stage of an experiment, researchers can control for confounding by using stratification of multivariate models such as logistic regression, linear regression, of analysis of covariance (ANCOVA). Stratification involves creating categories of strata in which the confounding variable does not vary of varies minimally.

      Overall, controlling for confounding is important in ensuring that the relationship between an exposure and an outcome is accurately assessed in a study.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      10.6
      Seconds
  • Question 3 - You record the age of all of your students in your class. You...

    Correct

    • You record the age of all of your students in your class. You notice that your data set is skewed. What method would you use to describe the typical age of your students?

      Your Answer: Median

      Explanation:

      When dealing with a data set that is quantitative and measured on a ratio scale, the mean is typically the preferred measure of central tendency. However, if the data is skewed, the median may be a better choice as it is less affected by the skewness of the data.

      Measures of Central Tendency

      Measures of central tendency are used in descriptive statistics to summarize the middle of typical value of a data set. There are three common measures of central tendency: the mean, median, and mode.

      The median is the middle value in a data set that has been arranged in numerical order. It is not affected by outliers and is used for ordinal data. The mode is the most frequent value in a data set and is used for categorical data. The mean is calculated by adding all the values in a data set and dividing by the number of values. It is sensitive to outliers and is used for interval and ratio data.

      The appropriate measure of central tendency depends on the measurement scale of the data. For nominal and categorical data, the mode is used. For ordinal data, the median of mode is used. For interval data with a normal distribution, the mean is preferable, but the median of mode can also be used. For interval data with skewed distribution, the median is used. For ratio data, the mean is preferable, but the median of mode can also be used for skewed data.

      In addition to measures of central tendency, the range is also used to describe the spread of a data set. It is calculated by subtracting the smallest value from the largest value.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
      10
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  • Question 4 - What is the term used to describe the study design where a margin...

    Incorrect

    • What is the term used to describe the study design where a margin is set for the mean reduction of PANSS score, and if the confidence interval of the difference between the new drug and olanzapine falls within this margin, the trial is considered successful?

      Your Answer:

      Correct Answer: Equivalence trial

      Explanation:

      Study Designs for New Drugs: Options and Considerations

      When launching a new drug, there are various study design options available. One common approach is a placebo-controlled trial, which can provide strong evidence but may be deemed unethical if established treatments are available. Additionally, it does not allow for a comparison with standard treatments. Therefore, statisticians must decide whether the trial aims to demonstrate superiority, equivalence, of non-inferiority to an existing treatment.

      Superiority trials may seem like the obvious choice, but they require a large sample size to show a significant benefit over an existing treatment. Equivalence trials define an equivalence margin on a specified outcome, and if the confidence interval of the difference between the two drugs falls within this margin, the drugs are assumed to have a similar effect. Non-inferiority trials are similar to equivalence trials, but only the lower confidence interval needs to fall within the equivalence margin. These trials require smaller sample sizes, and once a drug has been shown to be non-inferior, larger studies may be conducted to demonstrate superiority.

      It is important to note that drug companies may not necessarily aim to show superiority over an existing product. If they can demonstrate that their product is equivalent of even non-inferior, they may compete on price of convenience. Overall, the choice of study design depends on various factors, including ethical considerations, sample size, and the desired outcome.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 5 - How can histrionic personality disorder be identified? ...

    Incorrect

    • How can histrionic personality disorder be identified?

      Your Answer:

      Correct Answer: Impressionistic and vague speech

      Explanation:

      Impressionistic and vague speech is a diagnostic criterion for histrionic personality disorder according to the DSM-5, while the other listed elements are characteristic of the borderline pattern as defined by the ICD-11.

      Personality Disorder: Histrionic

      A histrionic personality disorder, also known as a dramatic personality disorder, is a psychiatric condition characterized by a consistent pattern of attention-seeking behaviors and exaggerated emotional responses. To diagnose this disorder, the DSM-5 requires the presence of at least five of the following symptoms: discomfort when not the center of attention, seductive of provocative behavior, shallow and shifting emotions, using appearance to draw attention, vague and impressionistic speech, dramatic of exaggerated emotions, suggestibility, and considering relationships to be more intimate than they actually are. However, the ICD-11 has removed the diagnosis of histrionic personality disorder from its list of recognized disorders.

    • This question is part of the following fields:

      • General Adult Psychiatry
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  • Question 6 - Which statement is incorrect about the evidence supporting the management of schizophrenia? ...

    Incorrect

    • Which statement is incorrect about the evidence supporting the management of schizophrenia?

      Your Answer:

      Correct Answer: Evidence supports better outcomes with high-dose antipsychotic therapy

      Explanation:

      The available evidence regarding high-dose antipsychotic therapy is mixed and generally unfavorable.

      Schizophrenia Treatment

      When it comes to treating schizophrenia, there are several consistent findings that have been discovered. One of these is that clozapine is more effective than other antipsychotics for neuroleptic-refractory positive symptoms. Additionally, transcranial magnetic stimulation (TMS) has been found to be effective, while cognitive behavioural therapy can reduce psychotic symptoms. Family and patient psychoeducation can also reduce relapses, and social skills training has been shown to improve outcomes. Finally, early intervention during the first episode of psychosis has been found to improve outcomes as well.

    • This question is part of the following fields:

      • General Adult Psychiatry
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  • Question 7 - What statistical test would be appropriate to compare the mean blood pressure measurements...

    Incorrect

    • What statistical test would be appropriate to compare the mean blood pressure measurements of a group of individuals before and after exercise?

      Your Answer:

      Correct Answer: Paired t-test

      Explanation:

      Choosing the right statistical test can be challenging, but understanding the basic principles can help. Different tests have different assumptions, and using the wrong one can lead to inaccurate results. To identify the appropriate test, a flow chart can be used based on three main factors: the type of dependent variable, the type of data, and whether the groups/samples are independent of dependent. It is important to know which tests are parametric and non-parametric, as well as their alternatives. For example, the chi-squared test is used to assess differences in categorical variables and is non-parametric, while Pearson’s correlation coefficient measures linear correlation between two variables and is parametric. T-tests are used to compare means between two groups, and ANOVA is used to compare means between more than two groups. Non-parametric equivalents to ANOVA include the Kruskal-Wallis analysis of ranks, the Median test, Friedman’s two-way analysis of variance, and Cochran Q test. Understanding these tests and their assumptions can help researchers choose the appropriate statistical test for their data.

    • This question is part of the following fields:

      • Research Methods, Statistics, Critical Review And Evidence-Based Practice
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  • Question 8 - What is the most accurate approximation of the lifetime occurrence rate of major...

    Incorrect

    • What is the most accurate approximation of the lifetime occurrence rate of major depression?

      Your Answer:

      Correct Answer: 15%

      Explanation:

      Epidemiological surveys and prevalence estimates have been conducted to determine the prevalence of various mental health conditions. The Epidemiological Catchment Area (ECA) study was conducted in the mid-1980s using the Diagnostic Interview Schedule (DIS) based on DSM-III criteria. The National Comorbidity Survey (NCS) used the Composite International Diagnostic Interview (CIDI) and was conducted in the 1990s and repeated in 2001. The Adult Psychiatric Morbidity Survey (APMS) used the Clinical Interview Schedule (CIS-R) and was conducted in England every 7 years since 1993. The WHO World Mental Health (WMH) Survey Initiative used the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) and was conducted in close to 30 countries from 2001 onwards.

      The main findings of these studies show that major depression has a prevalence of 4-10% worldwide, with 6.7% in the past 12 months and 16.6% lifetime prevalence. Generalised anxiety disorder (GAD) has a 3.1% 12-month prevalence and 5.7% lifetime prevalence. Panic disorder has a 2.7% 12-month prevalence and 4.7% lifetime prevalence. Specific phobia has an 8.7% 12-month prevalence and 12.5% lifetime prevalence. Social anxiety disorder has a 6.8% 12-month prevalence and 12.1% lifetime prevalence. Agoraphobia without panic disorder has a 0.8% 12-month prevalence and 1.4% lifetime prevalence. Obsessive-compulsive disorder (OCD) has a 1.0% 12-month prevalence and 1.6% lifetime prevalence. Post-traumatic stress disorder (PTSD) has a 1.3-3.6% 12-month prevalence and 6.8% lifetime prevalence. Schizophrenia has a 0.33% 12-month prevalence and 0.48% lifetime prevalence. Bipolar I disorder has a 1.5% 12-month prevalence and 2.1% lifetime prevalence. Bulimia nervosa has a 0.63% lifetime prevalence, anorexia nervosa has a 0.16% lifetime prevalence, and binge eating disorder has a 1.53% lifetime prevalence.

      These prevalence estimates provide important information for policymakers, healthcare providers, and researchers to better understand the burden of mental health conditions and to develop effective prevention and treatment strategies.

    • This question is part of the following fields:

      • General Adult Psychiatry
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  • Question 9 - Which statement accurately describes depression in older adults? ...

    Incorrect

    • Which statement accurately describes depression in older adults?

      Your Answer:

      Correct Answer: SSRIs increase risk of falls

      Explanation:

      Antidepressants in the Elderly: Maudsley Guidelines 14th Edition Summary

      Antidepressants have a similar response rate in the elderly as in younger adults, but factors such as physical illness, anxiety, and reduced executive functioning can affect prognosis. SSRIs and TCAs are equally effective, but TCAs have higher withdrawal rates in the elderly. NICE recommends starting with an SSRI, then trying another SSRI of a newer generation antidepressant if there is no response. If this fails, an antidepressant from a different class can be considered, but caution is needed with TCAs and MAOIs due to adverse effects and drug interactions. There is no ideal antidepressant for elderly patients, and choice should be based on individual cases. SSRIs are generally better tolerated than TCAs, but increase the risk of gastrointestinal bleeds, hyponatremia, and falls. Agomelatine is effective and well-tolerated in older patients, but requires frequent liver function tests. Fish oils are probably not effective, and highly anticholinergic medicines increase the risk of dementia. Elderly patients may take longer to respond to antidepressants, and it is recommended that they continue taking them for at least 2 years following remission.

    • This question is part of the following fields:

      • Old Age Psychiatry
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  • Question 10 - A previous truck driver has been effectively treated with olanzapine after being diagnosed...

    Incorrect

    • A previous truck driver has been effectively treated with olanzapine after being diagnosed with schizophrenia and hopes to eventually go back to his former job. According to the DVLA, how long must the individual be in good and stable condition before they can resume driving?

      Your Answer:

      Correct Answer: 36 months

      Explanation:

      For individuals diagnosed with chronic psychosis, the DVLA mandates a minimum of 3 months of stability before they can resume driving standard cars and motorcycles. However, for those driving LGVs of PCVs, this period is extended to 3 years. Similar guidelines apply to those with acute psychotic disorders and hypomania/mania. In the case of severe anxiety of depression, LGV/PCV drivers may be allowed to resume driving after 6 months of stability.

    • This question is part of the following fields:

      • Organisation And Delivery Of Psychiatric Services
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SESSION STATS - PERFORMANCE PER SPECIALTY

Research Methods, Statistics, Critical Review And Evidence-Based Practice (2/3) 67%
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