Deck 10: Who Sank the Boat Association and Causation

Question 1

The Bradford Hill criteria should be applied:

A)To all interesting associations
B)Only to associations with a large relative risk (>5)
C)Only to positive associations
D)Only to valid positive associations
E)Only to valid associations, both positive and negative

Answer 1

Only to valid associations, both positive and negative

Question 2

The figure above depicts the only possible causes of a disease X.Using this, which of the following statements is/are true? (Select all that apply)

A)A, B, C, D and E are all component causes of disease X
B)P, Q and R are all component causes of disease X
C)B is a necessary cause of disease X
D)B is a sufficient cause of disease X
E)B is a necessary and sufficient cause of disease X

Answer 2

A, B, C, D and E are all component causes of disease X
B is a necessary cause of disease X

Question 3

If it is estimated that 25% of cases of a disease can be attributed to poor diet, 30% to poor hygiene, 40% to tobacco smoking and 20% to high alcohol consumption which
One of the following statements is true? (Select all that apply)

A)Tobacco smoking has the highest population attributable fraction?
B)Tobacco smoking has the highest attributable fraction?
C)There is a problem with the data because the % sum to more than 100%
D)Eliminating all four of these exposures would prevent all cases of this disease
E)B, C and D are all true

Answer 3

Tobacco smoking has the highest population attributable fraction?

Question 4

Which of Bradford Hill's criteria must be met for an association to be considered causal? (Select all that apply)

A)Strength
B)Dose‐response
C)Temporality
D)Plausibility
E)Consistency

Question 5

Which one of the following statements best describes the Bradford Hill criteria?

A)They must all be met before something can be declared a cause of a disease
B)At least 5 of the criteria must be met before something can be declared a cause of a disease
C)They help us to make definitive judgements regarding causation
D)They are merely aids to judgement
E)They were not peer‐reviewed and so can be ignored

Question 6

In a study of smoking and ovarian cancer, a history of smoking was strongly associated with one rare type of ovarian cancer (mucinous cancers) but not with any
Of the other more common types of ovarian cancer.This pattern of results suggests
(select the best option):

A)The association with mucinous cancer is likely to be causal because it is specific for that type of ovarian cancer
B)The association between smoking and mucinous cancer is unlikely to be due to recall bias
C)The association with mucinous cancer is unlikely to be causal because there was no association with the other types of ovarian cancer
D)The association is unlikely to be causal because it is not plausible that smoking could affect the ovaries
E)None of the above

Question 7

The results of a case‐control study showed a strong and statistically significant association between high triglyceride levels and heart attack that persisted after
Adjusting for age, sex, gender and blood cholesterol levels so the investigators
Concluded that the relationship was causal.This conclusion is:

A)Justified because the association did not change when the investigators adjusted for possible confounders
B)Justified because the association was statistically significant
C)Justified because the association was strong
D)Not justified because the groups were not matched for potential confounders
E)Not justified because having a heart attack might lead to increased triglyceride levels

Question 8

An effective programme to prevent a chronic disease should target (select one):

A)The necessary cause, for complete control
B)A sufficient cause, for certain control
C)Any component cause
D)The component cause with the highest Relative Risk
E)The component cause with the highest Population Attributable Fraction
F)Thecomponentcausethatismostcommoninthepopulation

Question 9

Which of the following are necessary causes (select all that apply)?

A)Mycobacterium tuberculosis for TB
B)Cigarette smoking for lung cancer
C)Obesity for type 2 diabetes
D)Human papillomavirus (HPV) for cancer of the cervix
E)Sunburn for skin cancer