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Retired NBME 23 Answers

nbme23/Block 4/Question#12 (reveal difficulty score)
Investigators conduct a prospective, ...
Strength of association, temporal relationship, dose-response gradient ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +16  upvote downvote
submitted by โˆ—rainlad(33)
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my approach to this question was to eliminate all the answer choices that mentioned specificity or sensitivity, since the data here did not provide information about any sort of screening test.

that left me with two possible answer choices: I eliminated the one about consistency of other studies, since no other studies were mentioned in the question stem.

not sure if I oversimplified things, but it led me to the right answer!

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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? +4
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. +



 +10  upvote downvote
submitted by โˆ—usmle11a(102)
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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)

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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



 +3  upvote downvote
submitted by โˆ—fexx(23)
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wtf kinda question was this? where the hell am i even going to use these concepts in medicine?!

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 +2  upvote downvote
submitted by docred123(9)
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Can someone please further explain this question? What biostatistical analysis should I be thinking about?

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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 " +28
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 +2
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). +14



 +1  upvote downvote
submitted by โˆ—brise(86)
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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?

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 +0  upvote downvote
submitted by medst(1)
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I do not know if that was 100% correct but I agree with eliminating answers contain sensitivity or specificity because that is not a screening test and eliminating other studies as they did not mention anything about other studies, here is what I think we here have 2 numerical values 9 interval variables ) so we will use statistical test person correlation as it needs 2 interval variable and graph done by the test will give us idea about strength of the correlation. temopral relationship ( temporality )means : tests whether the outcome occurs after the effect (e.g., surgical site infection occurs after incision of the skin) dose response relationship : tests whether greater exposure usually leads to a higher occurrence of the outcome (e.g., the greater the exposure to ionizing radiation, the higher the risk of malignancy) . and both can be applicable here . source : amboss.

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