Worksheets[archive] Ujian IKK Juni 2025
Total questions: 51
Worksheet time: 1hrs 28mins
1. A population-based study showed that the incidence rate of cardiovascular disease is 15 cases per 1000 person-years. If the study population was followed for 8 years and 3000 individuals were included, how many new cases of cardiovascular disease would be expected during the study period?
45
120
360
450
500
2. A case-control study on contraceptive use and breast cancer disease included 150 cases and 300 controls. There were 90 cases and 60 controls who reported contraceptive use. What is the odds ratio (OR) for breast cancer associated with contraceptive use?
0.5
1.5
3.0
6.0
9.0
3. A cohort study followed the 400 sweet drinkers and 600 non-drinkers for 8 years to determine the association between sweet drinks and diabetes. During this time, 32 customers and 12 non-customers acquired diabetes mellitus. What is the relative risk (RR) of developing diabetes mellitus among sweet consumers compared to non-consumers?
0.25
2.0
2.5
4.0
8.0
4. A randomized controlled trial was conducted to determine the efficacy of a new medicine in preventing stroke in atrial fibrillation. A total of 500 patients were enrolled, 250 randomly assigned to receive the medicine and another 250 randomized to receive a placebo. After a year of follow-up, 15 patients in the drug group had a stroke, compared to 35 in the placebo group. What is the Absolute Risk Reduction (ARR) associated with the vaccine?
0.04
0.06
0.08
0.10
0.20
5. A randomized controlled trial was conducted to determine the efficacy of a new cholesterol-lowering drug in preventing heart attacks. 400 patients were randomly divided into two groups: 200 received the drug, and 200 received a placebo. After two years, 20 medication patients and 40 placebo people had heart attacks. What is the Number Needed to Treat (NNT) to prevent one cardiovascular event with the medication?
5
8
10
12
20
6. What is the relative risk (RR) of developing heart disease among individuals consuming a high-fat diet compared to those consuming a low-fat diet?
1.5
2.0
3.0
4.0
4.5
7. What is the attributable risk (AR) of heart disease associated with a high-fat diet?
0.03
0.10
0.15
0.20
3.00
8. What does this value represent?
Measurement errors
Confounding
Effect modification
Non-response bias
No bias indicated
9. Which test is more effective in accurately diagnosing people with TB?
Sputum smear microscopy, which detects more real TB patients with higher specificity
GeneXpert test, which detects more real TB cases with higher sensitivity
Because both tests are equally sensitive, neither is more effective at detecting tuberculosis patients
Sputum smear microscopy is faster and less expensive, making it more dependable
GeneXpert test is preferred because it has higher specificity but lower sensitivity compared to sputum smear microscopy
10. Which test is better at correctly identifying patients without TB?
GeneXpert test offers higher specificity and fewer false positives
Sputum smear microscopy offers higher specificity and fewer false positives
GeneXpert test offers higher sensitivity and finds more true negatives
Sputum smear microscopy offers higher sensitivity and finds more true negatives
Both tests have equal specificity, so neither is better at identifying patients without TB
11. What is the annual risk of developing HIV infection in men working in factory B in 2010?
5.4%
6.6%
7.5%
11.1%
17.5%
12. What is the prevalence of HIV among male employees at factory B on January 31, 2010, and January 31, 2011, respectively?
6.6% and 5%
6.6% and 18.3%
5.7% and 10.0%
5.7% and 11.6%
6.6% and 11.6%
13. What is the absolute increase in HIV prevalence (risk difference) among male employees at Factory B from January 31, 2010, to January 13, 2011?
1.6%
4.3%
5.0%
5.9%
11.7%
14. What is the most appropriate study design for the case illustration?
Retrospective cohort study
Prospective cohort study
Case-control study
Case-cohort study
Randomized controlled trial
15. How many times more likely were participants with CRD to die, relative to those without CRD?
0.75
3.03
6.06
6.66
9.09
16. What is the incidence of influenza mortality attributable to the presence of CRD?
0.033
0.067
0.133
0.167
0.267
17. What study design would be most appropriate for identifying the risk factors associated with this outbreak in the hospital?
Cohort study
Case-control study
Nested case-control study
Cross-sectional study
Ecological study
18. What type of data would be most critical to collect for the investigation?
Number of hospital beds in the surgery ward
Details of recent antimicrobial use among patients
Ventilation system design in the surgery ward
Cleaning frequency of non-clinical areas
Meal preferences of the patients
19. What is the priority to contain the CDI outbreak in the hospital?
Deep cleaning the operating room and surgical ward
Conducting environmental sampling to locate the CDI source
Administering broad-spectrum antibiotics to all patients
Immediate isolation of infected patients
Enhancing the frequency of staff training sessions
20. Which infection prevention strategy is most effective for preventing future CDI outbreaks in the hospital?
Universal screening of all admitted patients for CDI colonization
Routine environmental swabbing of high-risk wards
Implementation of antimicrobial stewardship programs
Mandating patient vaccination for CDI prevention
Discontinuing the use of invasive devices like central lines
21. What is the percentage agreement between Pathologist 1 and Pathologist 2?
75%
80%
84%
88%
90%
22. What is the interobserver kappa agreement of measurement?
0.30
0.43
0.67
0.73
0.85
23. How do you conclude based on the agreement between Pathologist 1 and Pathologist 2?
Poor agreement, suggesting a need for further training
Fair agreement, but improvements are needed
Moderate agreement, acceptable for clinical practice
Substantial agreement, indicating reliable diagnostic practices
Almost perfect agreement, demonstrating excellent consistency
24. Which of the following biases could potentially compromise the accuracy of this study?
Selection bias
Recall bias
Observer bias
Attrition bias
All of the above
25. Which method would be most effective in reducing selection bias?
Concealing the study's goals from the participants
Only including participants who consistently use the digital health application
Only interviewing patients at high risk
Letting participants decide which group they want to be in
Randomly assigning participants to either the intervention or control group
26. How can recall bias be minimized in this study?
Increasing the length of the study to gather more information
Giving participants the flexibility to report data whenever they want
Relying on objective data that was recorded by the app
Having doctors or nurses check the accuracy of participants' reports
Excluding participants who do not follow the program closely
27. Which study design is most appropriate for this research?
Case-cohort study
Cohort study
Randomized controlled trial
Cluster-randomized trial
Stepped-wedge trial
28. What measure would best assess the effectiveness of the screening program in reducing colorectal cancer mortality?
Prevalence Ratio (PR)
Odds Ratio (OR)
Risk Ratio (RR)
Incidence Rate Ratio (IRR)
Correlation coefficient (r)
29. How would you interpret it if the relative risk is 0.65?
The odds of dying from colorectal cancer are 0.65 times lower in the screened group
The screened group has a 65% chance of surviving colorectal cancer
There's a 65% reduction in risk due to screening
The unexposed group had a 35% lower risk of dying from colorectal cancer than the exposed group
The exposed group had a 35% lower risk of dying from colorectal cancer compared to the unexposed group
30. What kind of research design is being implemented?
Case-crossover study
Factorial randomized controlled trial
Parallel randomized controlled trial
Crossover randomized controlled trial
Pragmatic clinical trial
31. Participants in the memory-boosting supplement trial switched from the supplement to a placebo (or vice versa) after a washout period. Why is the washout time important for this study?
Allow researchers to analyze data from the first phase before starting the second phase
Enable researchers to recruit more participants
Speed up the trial period
Prevent the effects of the first therapy from influencing the outcomes of the second treatment
Make sure participants forget the instructions from the first phase
32. What is the key advantage of this study over a parallel-group RCT?
Receiving only one treatment reduces complexity
Elimination of the need for randomization
Acting as their own control, reducing variability
Requirement of fewer visits from participants
Guarantee of no side effects from treatments
33. During a severe influenza outbreak, researchers conducted a randomized controlled study to assess the effectiveness of a new antiviral drug in hospitalized individuals with severe influenza pneumonia. Patients were randomly randomized in a 2:1 ratio to either a new antiviral medication (N=180) or a placebo (N=90). A seven-point ordinal scale from full recovery to death was used to assess patients' clinical state 28 days after treatment. What is the purpose of randomization in this study?
To describe the allocation of patient characteristics across the groups
To enable researchers to select participants based on their health conditions to maintain an equal distribution of severe cases in each group
To facilitate the study by streamlining the participant assignment process for researchers
To guarantee that every participant receives consistent care regardless of their assigned group
To improve the chances of demonstrating treatment effectiveness by assigning a larger portion of patients to the treatment group
34. What is the most appropriate study design for this research?
Multilevel study
Ecological study
Retrospective cohort study
Nested case-control study
Cross-sectional analytic study
35. Which type of data is primarily used in this study?
Individual-level exposure and outcome data
Group-level or population-level aggregated data
Randomized clinical trial data
Longitudinal cohort data with individual follow-up
Case-control matched pair data
36. What is the main limitation of using national-level data in this type of research?
Ecological fallacy, in which group-level relationships do not hold true at the individual level
Provide precise individual dietary intake information to improve accuracy
Unable to adjust for confounding variables such as socioeconomic status and healthcare access
Allowance for randomized exposure to salt intake
A guarantee of causation between salt consumption and hypertension through the utilization of data from multiple nations
37. In a case-control study investigating the relationship between occupational solvent exposure and the likelihood of developing multiple sclerosis (MS), researchers discovered that age is a potential confounder. How can researchers account for this confounder in their analysis?
Stratification of the analysis by age categories
Matching of cases and controls by age
Inclusion of age as a covariate in multivariable regression
Randomization of participants into exposure groups
All of the above
38. Which factors are regarded as potential confounders when studying the effect of a risk factor on disease outcome?
Variables that lie on the causal pathway between exposure and outcome
Variables associated with both the exposure and the outcome
Variables that are associated only with the exposure
Variables that are associated only with the outcome
Variables that are related to neither exposure nor outcome
39. Researchers analyze asthma symptoms in 1,000 children living in 20 different cities. They gather data on each child's tobacco smoke exposure and family history of asthma, along with city-level air pollution and access to healthcare services (city level). Children's asthma symptoms may be affected by personal and city factors since they live in cities. What study design is most appropriate for this research?
Multilevel study
Ecological study
Retrospective cohort study
Nested case-control study
Cross-sectional analytic study
40. A randomized controlled study was carried out by a research team to assess a new drug's efficacy in treating chronic migraine. 300 participants were chosen at random to receive either the new medication or a placebo as part of the trial. The recruitment approach unintentionally favored younger patients with milder migraine symptoms for the treatment group, leading to an unequal distribution of baseline features between groups. What does this research indicate about bias?
Selection bias
Attrition bias
Measurement bias
Recall bias
Sampling bias
41. What is the percentage agreement between the glucometer and the laboratory autoanalyzer?
20.6%
38.2%
41.1%
58.8%
79.4%
42. What is the inter-observer kappa agreement of measurement?
10.0%
22.1%
54,2%
63.1%
95.0%
43. How do you conclude the agreement between hospital staff X and Y?
Slight agreement
Fair agreement
Moderate agreement
Substantial agreement
Almost perfect agreement
44. In a citywide survey of 6,000 adults from multiple areas, researchers estimated diabetes prevalence. A 60% first response rate was achieved via mailing health questionnaires. To increase participation, non-responders were called, and 800 more completed the questionnaire. A greater percentage of these late responders than early responders reported having diabetes.
What evidence suggests bias in this research?
Assessor bias
Information bias
Non-response bias
Measurement bias
Confounding
45. Researchers intended to enroll 9,000 people for a large study investigating the association between exercise habits and depression. To increase enrollment, the study was extensively promoted on social media, community centers, and in local newspapers. In three weeks, the target number of participants had been reached, and retention was >95% throughout the entire study.
What evidence suggests bias in this research?
Healthy volunteer bias
Assessor bias
Measurement Bias
Confounding
Effect modification
46. Researchers investigated whether nurses' styles, such as wearing colorful uniforms or accessories, impacted the quality of their patient care. During their regular shifts, nurses were videotaped. A panel of impartial experts, who were not aware of the nurses' styles, assessed the tapes using a validated checklist for patient care performance. The evaluations focused solely on objective criteria for care quality.
What evidence suggests bias in this research?
Confounding
Effect modification
Non-response bias
Measurement Bias
No bias indicated
47. A case-control study investigates the relationship between previous pesticide exposure and the likelihood of developing Parkinson's disease. During extensive interviews, researchers ask patients with Parkinson's disease and healthy controls to recall their pesticide exposure over the previous 20 years. Patients with Parkinson's disease are more driven to remember and report potentially dangerous exposures; therefore, they recall pesticide contact more thoroughly than controls.
What evidence suggests bias in this research?
Healthy volunteer bias
Assessor bias
Confounding
Effect modification
Recall bias
48. What study design would be most appropriate for investigating the risk factors of the outbreak?
Case report
Case-control study
Cohort study
Cross-sectional study
Pragmatic clinical trial
49. How would you prioritize control measures to contain the outbreak?
Implementation of contact precautions and isolation protocols for infected patients
Provision of educational sessions and training for healthcare workers on administration
Application of contact precautions and isolation protocols for non-infected patients
Promotion of hand hygiene practices among healthcare workers and enforcement of strict compliance
Collection of detailed family medical history
50. What strategies would you not recommend for preventing future outbreaks of multidrug-resistant bacteria in the hospital?
Implementation of active surveillance programs for early outbreak detection
Regular review and updating of infection control policies and procedures based on current scientific evidence and guidelines
Development of antimicrobial stewardship programs to optimize antibiotic use and prevent resistance
Enforcement of strict infection control measures, including hand hygiene, proper disinfection, and isolation protocols
Unrestricted antibiotic use without monitoring or established guidelines
Nama / NIM / Minat (backup)
