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NBME 23 Answers

nbme23/Block 1/Question#13 (43.5 difficulty score)
A researcher is asked to prospectively ...
Prevalence: above the standard; Incidence: above the standard🔍,📺
tags: prevalence incidence 

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submitted by aladar50(40),
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So htrs’ee 001 eter,sdsin adn hte rvepeelacn tefra 2 yreas is 10= ta eht gienngnbi, +5 ni eht isfrt e,yra +10 dsecno ,ryea nad -3 taht h,eedla rfo a ttloa eeealrpvnc fo 22 ensetdirs ro 0=/122022 ectrn.ep huTs, pcleaenvre = aoevb eth ratasndd. For cindeien,c ’tsi 51 ewn assec otu fo 09 sendtries vore eth 2 yarse 0(10 latot srntieesd – 01 ttha ardayle dah l,crus)e or 51 new relusc erp 108 speer.itnaty⋅a hTsi duwlo be 383. new leucsr rpe 0010 yrsinattpa⋅ee if ouy otdapelratex it uot -- asylbilca (0)18100/0 * 15 -- s,thu iencceidn = eovab eth ardantsd.

zelderonmorningstar  Okay I feel like an idiot cause I thought: Above the Standard = Doing a good job keeping old people from getting ulcers. Thumbs up. Below the Standard = I wouldn’t let my worst enemy into your ulcer ridden elder abuse shack. +53  
aladar50  @zelderon Ohh damn. I could totally see how one could view the answer choices that way. I think it is important to read how they are phrased - they are asking if the center is above THE standard or below THE standard. The “standard” is an arbitrary set point, and the results of the study are either above or below that cut off. Maybe if it was “above/below standards” that would work. Also, being above the standard could either be a good thing or bad thing. If say you were talking about qualifying for a competition and you have to do 50 push ups in a minute, then being above=good and below=bad. In this case, having more ulcers than the standard = bad. +4  
saynomore  @aladar Thank you!!! but how did you get the 15 new ulcers per 180 patient⋅years? I mean I understand the 15 part, but not the second part ... hence why I messed this up, lol :| +2  
aladar50  @saysomore Because the study is looking at 100 residents over a period of 2 years. Since 10 already had the disease at the start, when looking at incidence you only include the subjects that have /the potential/ of developing the disease, so 90 patients over 2 years. This would be 90 patient⋅years per year, or a total of 180 patient⋅years over the course of the study. +7  
sympathetikey  @zelderonmorningstar I thought the same exact thing. Had the right logic, but then just put the backwards answer. +3  
kai  I wonder if they chose this wording on purpose just to fuck with us or if this was accidental. My guess is there's some evil doctor twirling his thumbs somewhere thinking you guys are below the standard. +15  
symptomatology  Got it wrong!messed up in understanding options, Btw, 15/90 is somewhat 16 percent and their standerd is 50/1000 5 percent!.. this is how i knew that incidance is way up! +  
donttrustmyanswers  Patients with an ulcer are not immune to getting new ulcers --> You should include all patients at risk. But either way, the answer is the same as long as you can read NBME speak. +  
doublethinker  Damn, guess my reading comprehension is not "up to the standard" of the NBME writers. Smh. +  
prolific_pygophilic  If you forgot that its patient years (15/180) not (15/90) you still get the right answer because they are both above 5% :). +  

submitted by keshvi(8),
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i euotndc otbh eht eplrcenvae dan nicidcnee sgiun etpnati - ra.eys sI ti roctirnec ot ues iettpan yersa for ?lpevcneare

submitted by jigyasa(1),
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yWh evha ouy ektna 081 sa tientpa rasey? s'tIn tnieapt yeasr cacdtleula sa no fo psttaien edtpuillmi yb the urmben fo seyra teyh uf?rsef

underd0g  Yup! 90 patients x 2 years = 180 patient years Incidence excludes the 10 patients with pre-existing ulcers before the study began (100-10=90) +1