Describe what your search strategy would be, including keywords, MeSH terms, inclusion and exclusion criteria, as well as evidence of the Boolean operators used

Discuss the possible defenses that could be reasonably asserted by the doctor to each claim, and why that defense might apply. Write a focused research question for this particular problem that will help you organise a search of the literature for an answer (use the PICO elements as appropriate).ntroduction to Clinical Epidemiology (401173)FINAL ASSIGNMENTAutumn, 2019Due date: 11.59pm , May 29 2019This assignment is based on the learning objectives and concepts as described in the Unit Learning Guide. There are 9 questions worth a total of 64 marks and this assignment will contribute 64% towards the total assessment for this subject.Your assignment should be typed, with adequate space left between questions. Assignments should be submitted via vUWS. Be as concise as possible in your answers, and use the number of marks allocated to each question as a guide for how much to write.Please note this is an individual exercise.Late assignments will not be accepted without prior approval.You are required to answer ALL questions (1-9)Page 1 of 7Answer questions 1-2 based on the following scenarios:Q1: Fred, a 65-year-old obese man with a history of type 2 diabetes mellitus and hypertension presents to the GP practice for a follow-up appointment. During the consultation, he asks whether there is a better medication to glicazide and metformin, his oral hypoglycemic medications, which he has been taking to control his blood sugar. His friend has recently been put on a newer oral hypoglycemic medication (Liraglutide, a glucagon-like peptide-1 analogue), which has been shown to help with weight management in patients with diabetes and obesity. Fred has been finding it very difficult to lose weight for a few years now as he has tried various lifestyle modifications. He asks whether the new oral hypoglycemic medications could be an option for him in weight reduction.Task [2 marks]a. Write a focused research question for this particular problem that will help you organise a search of the literature for an answer (use the PICO elements as appropriate).b. Identify the PICO elements in your research questionQ2: In the past 2 years, as an Infectious Disease Specialist in one of the tertiary hospitals in Australia, you have attended to 23 migrant patients who were referred by their General Practitioners with symptoms not typical of pulmonary tuberculosis. After taking a detailed history and performing appropriate physical examinations, as well as reviewing a range of relevant investigations, you clinically diagnosed and microbiologically confirmed that those patients have multi-drug resistance pulmonary tuberculosis (MDR-TB). The Public Health Department was notified of disease and the patients were managed accordingly. Now, you and some colleagues from Western Sydney University want to investigate the risk factors for MDR-TB.Task [2 marks]a. Write a focused research question for this particular problem that will help you organise a search of the literature for an answer (use the PICO elements as appropriate).b. Identify the PICO elements in your research questionQ3: Please select the single best answer for each of questions 3.I – VIII. Randomised controlled trials provide strong evidence that an observed effect is due to the intervention. One main reason is because [1 mark]:a) When the study participants are randomised, many characteristics and potential confounders are likely to be evenly distributed in the groupsb) It is easier to measure the outcome variable with great precision in randomised controlled trials compared to other study designs.c) The exposure level and the outcome are measured at the same timed) The study participants are volunteers and therefore motivated to take part in the studye) None of the aboveII.Blinding is an important feature of a randomised controlled trials because [1 marks]:a) It helps prevent measurement bias – the biased assessment of outcomesb) It helps reduce contamination and compliance problemsc) It helps reduce confounding and selection biasd) It is required to do an intention-to-treat analysise) It helps improve chance event and reduce misclassification III. Which of the following is true [1 mark]?a) Loss to follow-up can lead to selection bias in cohort studies.b) Selection bias can arise from conditioning on the common effect of the exposure and an uncontrolled independent risk factor for the outcome.c) Case-control studies are no more prone to selection bias than are cohort studies.d) Loss to follow-up is not a major source of bias in cohort studies.e) None of the above.IV. When epidemiologists judge the evidence to establish a possible cause of a health outcome, theyconsider [1 mark]:a) The strength of the association between an exposure and the outcomeb) Evidence that the exposure of interest has appeared before the outcome.c) Evidence showing that reductions in the exposure level will reverse the risk of the outcome.d) A, B and Ce) A and B onlyV. A double-blind study was designed to test the efficacy of a drug. One group of the patients consisting of 1227 participants were given a placebo and the other group of patients consisting of 1220 were given the active drug. Both groups were to be followed up for one year. After 6-months of the trial, 35% of participants in the placebo groups dropped out of the study and 4% of the participants taking the active drug dropped out of the study. What is the SINGLE BEST explanation for this occurrence [1 mark]?a) Failure of the active drugb) Insufficient information to interpret datac) Systematic errord) Chance evente) Breakdown of the double-blind studyVI. The highest level of evidence provided for cancer treatment usually comes from: [1 mark]a) Randomised control trialsb) Phase II clinical trialsc) Phase III clinical trialsd) Systematic reviews of observational studiese) Meta-analyses of intervention studiesPage 3 of 7VII. A recent study examined the association between tea consumption and ovarian cancer. The study included 414 women with primary epithelial ovarian, fallopian, or peritoneal cancer and 868 age-and region-matched women with non-neoplastic conditions. The adjusted odds ratio was 0.39 for those drinking tea daily and 0.23 for those drinking tea for 30 years, compared with non-tea drinkers. The study concluded that increasing frequency and duration of tea drinking, especially green tea, can reduce the risk of ovarian cancer.What type of study was conducted? [1 mark]a) Cross-sectional studyb) Prospective cohort studyc) Randomised controlled triald) Retrospective cohort studye) Case control studyQ4: Now select ONLY ONE research question from either Question 1 or 2 above that will help you organize a search of the clinical literature for an answer. If you were to search Medline/PubMed/Web of science for original research on this question:a. Describe what your search strategy would be, including keywords, MeSH terms, inclusion and exclusion criteria, as well as evidence of the Boolean operators used [4 marks].b. What type of study design would best be able to address your selected research question? State why [1 mark].c. Cite the best article from among those you find, using any referencing style of your choice [1 mark].Q5: Answer questions 5a-b based on the following information:A total of 1800 patients have a screening test to identify a protein called “FEN-59’ to determine patients at risk of lung carcinoma, followed by a standardized lung biopsy procedure. Of the 1800 children, 1533 have a negative FEN-59 and 267 have a positive FEN-59. In addition, a lung biopsy (gold standard) was done on all patients. Of those patients with a negative FEN-59, 1491 have a negative lung biopsy. In the group with a positive FEN-59, 259 have a positive lung biopsy.Construct a 2×2 table using the information provided above, and answer the following questions (a and b):a) Calculate the sensitivity of the FEN-59 [2 marks]b) Calculate the positive predictive value of the FEN-59 [2 marks]c) The negative predictive value is dependent on all of the following: prevalence, incidence, sensitivity and specificity [True/False] [1 mark]Please select the SINGLE BEST answer in questions 5e to fd) Using the image below, which value in the test result units is the point of maximum specificity? [1 mark]a) 30