Additional Practice Questions Question & Answer Guide (With Explanation)

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Key Explanation

This topic involves additional practice questions. A strong answer should include explanation, application, and examples.

Original Question

ADDITIONAL PRACTICE QUESTIONS on Screening a) There was a recent public health campaign to have the current youth cohort receive a third booster for Mumps (of the MMR vaccine). Of all 14,000 youth at the University of Guelph, 80% have been fully and appropriately immunized. A laboratory test identifies titers for Mumps, which confirms a person’s Immunity. The sensitivity of the lab test is 90% and the specificity is 86%. What would be the apparent prevalence of mumps immunity according to the lab test? What are the positive and negative predictive values for these test results? b) b) An emergency room nurse is trying to triage the last 100 patients entering the hospital. For all 60 patients who presented with fever symptoms (45 actually have a fever), he simultaneously administers an oral thermometer reading for internal body heat and palpates their lymph nodes to determine swelling. An elevated body temperature and/or swollen glands may indicate a fever compared with regular body temperature and normal glands. The sensitivity of the oral thermometer is 95% and its specificity is 60%. The lymph node check has a specificity of 80% and a sensitivity of 80%. What are the net sensitivity and net specificity for his triage protocol? c) The apparent prevalence of Johne’s Disease on organic sheep farms in Ontario is 35% of all farms (n=165) according to a test that has a positive predictive value of 80% and a sensitivity of 60%. What is the specificity and negative predicative values for this scenario? What is the true prevalence of Johne’s among organic sheep farms? d) d) An estimated 9,000 men at risk for prostate cancer are living in Guelph and have not been screened (150 of these men actually have prostate cancer). A two-stage screening process is used in order to conserve resources, the first test has a sensitivity of 90% and a specificity of 65%, and the second test (only given to men positive for the first screening test) has a sensitivity of 75% and a specificity of 90%. What is the net sensitivity and net specificity for this screening protocol? What impact does this have on the proportion of false negative and false positive results? What would you recommend to public health to improve their testing strategy in order to more effectively diagnose those men who actually have prostate cancer?

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