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NBME 23 Answers

nbme23/Block 4/Question#12 (54.7 difficulty score)
Investigators conduct a prospective, ...
Strength of association, temporal relationship, dose-response gradientπŸ”,πŸ“Ί
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 +12 
submitted by rainlad(25),
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ym pcraapoh to shit tuqnieos asw to einiamtle lal eth ewsarn icschoe taht dnoinetme etiiccpiyfs ro istiynstve,i cnesi the tdaa reeh idd not repoidv ornamonftii toaub nay rsot fo nnsgcreie tse.t

atht tlef em whit tow olbespsi ernasw i:hccoes I imdtlneeai teh noe bauto yssccniteon of rteho itdes,us encis on eothr issuetd rwee emoneitdn ni eth eitqusno ets.m

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makinallkindzofgainz  this is exactly how I reasoned through it. Were we correct in our line of thinking? We'll never knooooow +  
qball  But will you ever know on the real thing? +3  
drdoom  but will you ever know in real life? you may do the right thing (given time constraints, & information available), but outcome is bad; maybe you do the wrong thing, but the outcome is good (despite your decision). how to know the difference? +3  
veryhungrycaterpillar  Your way works too, but I did it a little differently. I eliminated everything except the ones with "temporal relationship" since you can clearly see there is a temporal relationship in the vignette as well as the data set. Then I eliminated the one with sensitivity with the same reasoning as yours. +  



 +8 
submitted by usmle11a(83),
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sygu hawct ihts : uKs/wpcnva:/uouwsbtuschhwoo?t.tYG/.moyeTtw=

wyayna (sp. i tgo ti orwgn)

)A neoseerossd-p = oobcgailil ui.atipbilsly ps. wshemoo q.uale )B )C E) sienyv;tstii w ngDro) ym snawre; ctcssnneyoi fo rheot tsiusde ( it watsn papdiel to ertho onmesiiu)tmc

usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +4  
usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +  
stemcellpsc  wouldn't D be also true based on this video? +  



 +1 
submitted by docred123(7),
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anC emsneoo leepsa hfretru palixne siht seoiqntu? htWa sbiiotacisaltt isnlaasy dsluho I eb hnkiitgn uab?to

vshummy  I got this wrong but best I could come up with was this was about Bradford Hill Criteria for establishing causality. And of the 9 included, F has the most that are actually included in the information given to us. I chose D but I think since we don't know about other study results, we can't include it as directly answering the question about *this* study. https://en.m.wikipedia.org/wiki/Bradford_Hill_criteria Someone double check me here: A: biologic plausibility is a weak point in the criteria, according to the wiki. Also probably not true in regards to this study. B: Sensitivity is not part of the criteria C: " " D: We don't know about consistency E: " B " +26  
mousie  Found this ... still confused about why A and D are wrong though... https://stats.stackexchange.com/questions/534/under-what-conditions-does-correlation-imply-causation +1  
2zanzibar  The three criteria for causality are: 1) empirical association (i.e. strength of association; a change in independent variable correlates or is associated with a change in dependent variable), 2) time order (i.e. temporal relationship; the independent variable must come before change in the dependent variable, or plainly stated, cause must come before effect). and 3) nonspuriousness (i.e. dose-response gradient; the relationship between 2 variables is due to a direct relationship between the two, not because of the actions of changes in a third variable... this can be evinced by a dose-dependent response). +10  



 +1 
submitted by brise(65),

I chose anything that would help show a relationship strength: got rid of anything with specificity and sensitivity in it. Leaving only D and F: Temporal relationship sounds more in line with relationship than consistency of other studied. Also how would the consistency of other studies prove anything for the relationship between intervention and child language score in this study?




 +0 
submitted by fexx(18),
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wtf idkna uoisteqn saw ?hsti hwere eht hlel am i eenv iggon to use thees ctocsnep in dm!ecinei?