Biostatistics and Lurking Variables Quiz

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Questions and Answers

What is one of the steps in the cycle of Biostatistical Analysis?

Conduct a literature review

Analyze data from multiple populations

Obtain a probability value through mathematical calculations (correct)

Develop a new medication

In which industry is it common for biostatisticians to work?

Construction industry

Retail sector

Pharmaceutical industry (correct)

Telecommunications

Which of the following tools is typically NOT used during a Biostatistical Analysis?

Classical statistic knowledge

Domain knowledge

Historical storytelling (correct)

Excel

What does the term 'lurking variables' refer to?

Variables that influence results but are not measured Signup and view all the answers

Which of the following best describes the effectiveness of public health interventions?

They can be assessed using biostatistical methods. Signup and view all the answers

What is the primary agency responsible for collecting and analyzing health data in the U.S.?

National Center for Health Statistics (NCHS) Signup and view all the answers

Which of the following is NOT a purpose of health statistics?

Conduct clinical trials Signup and view all the answers

What type of data is considered the most basic, reliable, and complete in U.S. health statistics?

Birth and death data Signup and view all the answers

What do lurking variables potentially affect in data analysis?

Data accuracy in conclusions Signup and view all the answers

How does the NCHS primarily gather its data?

From local records submitted by states and population surveys Signup and view all the answers

Which of the following health-related aspects is NOT included in NCHS surveys?

Vaccination rates Signup and view all the answers

What is Simpson's Paradox mainly associated with?

Incorrect conclusions due to lurking variables Signup and view all the answers

Which government levels are involved in collecting health statistics?

Local, state, and federal governments Signup and view all the answers

What information about the mother is typically included on a birth certificate?

Family details such as names and addresses Signup and view all the answers

What contributes to the inaccuracy of death certificates?

The cause of death being recorded as uncertain Signup and view all the answers

Which vital statistic is often underreported?

Spontaneous fetal deaths Signup and view all the answers

Why are infant mortality rates important in public health?

They serve as an indicator of a population's health and well-being. Signup and view all the answers

What is a critical aspect needed for calculating public health rates from vital statistics?

Knowledge of the population size being referred to Signup and view all the answers

What type of rates requires knowing the population in each specific age group?

Age-adjusted rates Signup and view all the answers

What role does the U.S. Census Bureau play in public health statistics?

Provides population counts and characteristics Signup and view all the answers

What is often included in vital statistics but may lack complete accuracy?

Death causes Signup and view all the answers

What is the main purpose of conducting a population count every 10 years?

To determine representation in the House of Representatives Signup and view all the answers

Which innovation was first introduced in the 2020 U.S. Census?

Internet and telephone response options Signup and view all the answers

What impact does census data have on federal funding and political representation?

It influences Congress's representation and funding distribution Signup and view all the answers

What was the controversy surrounding the citizenship question in the 2020 Census?

It was proposed to suppress responses from immigrant communities Signup and view all the answers

What new household categories were included in the 2020 Census?

Same-sex and opposite-sex relationships Signup and view all the answers

Which population groups are at risk of being undercounted in the census?

Only those without a permanent address Signup and view all the answers

What was the estimated number of people missed in the 2010 Census?

10 million Signup and view all the answers

How could errors in census data affect health statistics?

They can distort birth and death rates for undercounted groups Signup and view all the answers

What is the primary goal of public health surveillance?

To provide surveillance information to various stakeholders for action Signup and view all the answers

What are researchers required to do when handling confidential data?

Justify their need for the data and promise confidentiality Signup and view all the answers

What does the term 'stringent definitions' refer to in public health surveillance?

Strictly agreed-upon terminology necessary for effective data use Signup and view all the answers

What has been a consequence of fears related to HIV confidentiality?

A decrease in individuals seeking testing due to discrimination fears Signup and view all the answers

What is a step in the surveillance process following data collection?

Data interpretation Signup and view all the answers

How has recent policy shifted regarding HIV data reporting?

Reporting is now aligned with other communicable diseases with fewer confidentiality exceptions Signup and view all the answers

Which of the following is NOT a use of public health surveillance?

Assessing the proficiency of medical practitioners Signup and view all the answers

Which of the following statements about institutional review boards (IRB) is TRUE?

IRBs assess researchers’ claims and access requests based on data protection standards Signup and view all the answers

Study Notes

Biostatistics

Biostatistics is a branch of statistics that focuses on health-related data and its analysis.
Biostatisticians work in various sectors including pharmaceuticals, biotechnology, government agencies like NIH, CDC, and FDA, academia, and hospitals.
A biostatistical analysis is a cyclical process with five steps: taking a sample from a population, producing data from the sample through research, analyzing the data through graphs, histograms, scatterplots, and other methods, obtaining a probability value through mathematical calculations, and finally making inferences about the larger population based on the data.
Tools used during a biostatistical analysis include computing software like Excel or R, classical statistical knowledge, a study design, and domain knowledge.

Lurking Variables

Lurking variables are variables that can affect data without being explicitly accounted for in the study design, potentially leading to incorrect conclusions.
Simpson's Paradox exemplifies the consequence of not accounting for lurking variables. It shows that the relationship between two variables can appear reversed when a lurking variable is not considered.

Public Health Statistics

Health statistics, collected and analyzed by public health officials, play a vital role in monitoring the health of communities.
These statistics can be used to
- identify high-risk groups
- detect health threats
- plan health programs
- evaluate program efficacy
- prepare government budgets

Sources of Public Health Data

Federal, state, and local governments gather health statistics, which serve as raw material for research in epidemiology, environmental health, social and behavioral factors in health, and medical care systems.

National Center for Health Statistics (NCHS)

NCHS, part of the CDC, is the primary agency for collecting, analyzing, and reporting data on American health.
NCHS gathers data through two main methods:
- Data collected from local records by states, including vital statistics like births and deaths.
- Surveys conducted on representative population samples, focusing on aspects like health status, lifestyle, health-related behaviors, illness onset, diagnosis, disability, and medical care usage.

Birth and Death Data

Birth and death data are the most basic and reliable health data collected. Most births and deaths in the US are recorded on birth and death certificates filed by attending physicians, midwives, or other involved parties.
Birth certificates contain family details like names, addresses, ages, race/ethnicity, education, and medical information about prenatal care, birth weight, complications, and risk factors.
Death certificates may not be completely accurate, depending on the informer's knowledge of the deceased, especially for elderly individuals. Cause of death can be uncertain without an autopsy, and social stigma can lead to misreporting causes of death, particularly for conditions like AIDS or suicide.

Vital Statistics

Vital statistics include data on births, deaths, marriages, divorces, spontaneous fetal deaths, and induced abortions.
While marriage and divorce data are universally reported, they hold less significance for public health compared to other vital statistics.
Spontaneous fetal death reporting can be incomplete, especially for early-term losses.
Induced abortion reporting is often underreported, with some states excluding the woman's name for confidentiality purposes.
Infant mortality, used as an indicator of a population's health and well-being, is a key focus in public health. NCHS operates a system linking birth and death records for infants who died before their first birthday, furthering research on factors contributing to infant mortality.

The US Census

The US Census Bureau (Department of Commerce) provides population counts and characteristics crucial for accurate health statistics.
An accurate population count is essential for precise health statistics.
The US Census provides data on the geographic distribution of the population, as well as its sex, age, ethnicity, social, and economic characteristics, including education, housing, and health insurance status.
The US Census tracks population trends between decennial censuses through polls, surveys, birth/death records, immigration data, and school statistics.

Uses of US Census Data

US Census data is crucial for the functioning of the nation's social, political, economic, and industrial systems. It is essential for public health practices.

2020 US Census Innovations

The 2020 census was the first to allow responses via the internet and telephone.
It included all US residents, citizens, and non-citizens, and incorporated special populations like troops overseas, students, and prisoners.
Data collection started in Alaska in January 2020, with most households contacted by March 2020. Non-responding households received in-person visits from April 2020 onwards.

Political and Financial Impact of the US Census

Census data influences Congressional political representation and federal funds allocation to states and communities. Various interest groups monitor data collection methods to ensure equitable representation and resource allocation.

2020 Census Citizenship Question Controversy

The Trump administration proposed including a citizenship question in the 2020 census, which had been absent since 1950. The stated purpose was to enforce voting rights protections for minorities. However, courts rejected this explanation as "contrived," citing concerns that the true intent was to suppress responses in immigrant communities.
Cities and states with large immigrant populations feared an undercount, which would reduce political influence and federal funding.
After legal battles, the citizenship question was excluded from the 2020 census.

New Household Categories in the 2020 Census

The 2020 census introduced categories for same-sex and opposite-sex relationships, enabling more detailed public health statistics on homosexual couples and families.

Census Errors

Some individuals, including the homeless, undocumented immigrants, and fugitives, might be missed during census data collection.
Wealthy individuals with multiple homes may be counted twice.
In 2010, an estimated 10 million people were missed, and 36,000 were counted twice. Errors in census data can lead to inaccuracies in health statistics, particularly in birth and death rates for undercounted groups.

Confidentiality and Data Protection

There are concerns about potential privacy breaches within agencies handling confidential data, where employees or those with access to employees could misuse information to harm individuals.
Agencies handling sensitive data implement strict rules for data access. Researchers must:
- Explain and justify their need for the data.
- Promise to safeguard confidentiality.
Institutional Review Boards (IRB) or Data Protection Committees review researcher claims and decide whether to grant access based on community standards and data protection rules.

HIV Confidentiality Concerns

Fear of discrimination led to concerns that individuals would avoid HIV testing without privacy protections.
Anonymous HIV testing was allowed, with modified reporting to state health departments and CDC to maintain anonymity.
With advancements in HIV treatment, reporting is now handled similarly to other communicable diseases, with fewer exceptions to confidentiality.

Public Health Surveillance

Public health surveillance is the continuous and standardized collection, analysis, and interpretation of health data, presented promptly to those responsible for public health prevention and control.
The term stems from the French word "to watch over."
The goal is to provide information to public health personnel, physicians, government officials, and the public.
Surveillance uses data to drive action.

Uses of Surveillance

Public health surveillance is used for
- detecting epidemics
- estimating the range of health issues
- characterizing diseases
- identifying patients
- monitoring environmental agents
- assessing program effectiveness

Stringent Definitions in Surveillance

Stringent definitions of terms are crucial for effectively utilizing surveillance data. They enable comparison of work with other research.

Surveillance Process

The surveillance process involves four steps:
- Data Collection: Examples include the US Census, FLHealthCharts, and birth certificates.
- Data Analysis
- Data Interpretation
- Data Dissemination

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Description

Test your knowledge on biostatistics and the impact of lurking variables in research studies. Understand the cyclical process of biostatistical analysis and learn how unaccounted variables can lead to misleading conclusions. This quiz will challenge your understanding of these crucial concepts in health-related data analysis.