8/17/13

Research Abstract Ques.on Types

The abstract item format includes a summary

of an experiment or clinical inves<ga<on
presented in a manner commonly encountered
by a physician, eg, as an abstract that
accompanies a research report in a medical
journal.

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Examinees must interpret the abstract in order

to answer ques<ons on various topics, including
Decisions about care of an individual pa<ent
Biosta<s<cs/epidemiology
Pharmacology/therapeu<cs
Use of diagnos<c studies

Ques.on 1
A study involving 1,663 pa<ents from 195
centers in 15 countries. Inclusion criteria were
as follows: func<onal NYHA class III-IV, leT
ventricular ejec<on frac<on <35%, and current
treatment with standard therapy (i.e., ACE-
inhibitor and loop diure<c). Most pa<ents
were also on digoxin. Pa<ents were randomly
assigned to either the treatment arm (i.e.,
standard therapy and 25-50 mg spironolactone
once daily) or the placebo arm (i.e., standard
therapy and placebo).

Ques.on 1

Which of the following statements

regarding this study is true?
A. Reduc.on in all cause mortality
B. Placebo was no dierent than the
spiro group
C. A type 1 error has been made in
mortality
D. There were no improvement in
NYHA class

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2
In experimental models of hyperlipidemia, will diets supplemented with AtheroPLUS improve serum lipid
proles, reduce reac<ve oxygen species (ROS) produc<on which promotes oxida<on of LDL, and mi<gate
the high-fat, diet-induced reduc<on of HDL-associated an<oxidant enzymes paraoxonase1 (PON1)
(including both PON1 physiological ac<vity and serum levels) as well as platelet-ac<va<ng factor
acetylhydrolase (PAF-AH).
Twenty-four male Zucker rats were divided into 3 groups, with 8 rats each. For a period of 6 months, group
1 was fed a control diet, group 2 was fed a high-fat diet (HFD), and group 3 was fed a HFD and AtheroPLUS
supplementa<on. Serum blood samples were drawn at 6 months, measuring levels of serum LDL, HDL,
triglyceride, ROS, PON1, selenium and PAF-AH.
Main results
Serum markers in group 1 were used as a control. Total cholesterol, LDL, HDL, and triglyceride levels were
signicantly increased in group 2, as was ROS in the liver, which was 225% higher than levels found in the
control group (group 1). Furthermore, selenium blood levels were reduced by 42% in group 2 rats when
compared to group 1 rats. Compared to group 2, group 3 showed signicantly reduced triglyceride and ROS
(ROS 50% lower than levels found in the control group), while HDL, PON1 ac<vity and PON1 protein levels
were signicantly increased. Serum selenium levels were increased by 15% in group 3 rats when compared
to group 1 rats. For PON1 ac<vity, median serum levels increased by 54% compared to median levels in
group 2; for PON1 protein levels, median levels were 28% higher than median levels in group 2. There was
no signicant change in LDL and PAF-AH levels across all 3 groups.
Conclusion
In an experimental model of hypercholesterolemia, AtheroPLUS decreases serum triglyceride and ROS
levels, and it increases serum HDL and PON1, showing promise as a therapeu<c agent in hyperlipidemia.

2
This study most strongly supports which of the following
statements regarding AtheroPLUS?

A.It can be useful to reduce the risk of atherosclerosis in pa<ents.

B.It can reduce the pathologic eects resul<ng from
hypercholesterolemia.
C.It should be avoided in pa<ents with chronic liver problems.
D.It can reduce serum lipid levels in pa<ents on a high fat diet.
E.It can reduce serum PON1 enzyme ac<vity in pa<ents on a high fat
diet.

F.It may be protec<ve in hypercholesterolemia by restoring

the an<oxidant proper<es of PON1.

The correct answer is F. This study was performed on 24 rats

in 3 groups of 8 rats each. The point of the study, as in most
animal-based studies, is to oer evidence of the mechanism by
which the interven<on under considera<on actually works.
Choice F which states that [AtheroPLUS] may be protec<ve in
hypercholesterolemia by restoring the an<oxidant proper<es
of PON1 is a straighmorward conclusion reached by the
researchers for this study. It does not men<on anything about
the popula<on to which the data could be extrapolated. All of
the other answer choices specically men<on eects in the
human pa<ent popula<on.

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3
The next step in follow-up of this research
would be to conduct which of the following
types of study?
A.
B.
C.
D.
E.
F.

Cohort study
Case-control study
Cross-sec<onal study
Phase one clinical trial
Cross-over study
Replica<on in a dierent biological model

3
The correct answer is F. This par<cular study
was performed using 24 rats in 3 groups, each
with 8 rats. The small sample size is common
for early animal trials, yet a lot more
informa<on needs to be obtained before this
par<cular agent could be considered for
human trials. The next logical step is to
determine if these results could be replicated
in a dierent biological model, such as Sprague
Dawley rats.

4
Hepa<<s C (HCV) sero- prevalence in the United States accounts for 1.6% of the total
popula<on, equa<ng to an es<mated 4.1 million an<-HCVposi<ve persons na<onwide.
Vaccina<on against the hepa<<s A (HAV) and hepa<<s B (HBV) viruses is recommended as a
part of preven<ve measures for pa<ents with chronic liver disease.
Methods: A retrospec<ve chart review was conducted examining the HCV posi<ve inpa<ent
popula<on seen between July 2007 and July 2011. 3136 charts of admiped pa<ents were
reviewed revealing 328 (10.4%) HCV posi<ve pa<ents. Charts were analyzed for immunity to
HAV and HBV.
Results: The age of HCV posi<ve pa<ents ranged 28 97 years of age, 62.8% Male. Of the 328
an<-HCV posi<ve pa<ents, an< HAV IgG had been checked in 143 pa<ents (43.5%) and not
checked in 185 (56.4%) pa<ents. Of the 143 pa<ents 63 (44.1%) were immune and 80 (55.9%)
were non-immune. An<-HBV status was checked in 238 (72.5%) pa<ents and not checked in
90 pa<ents (27.5%). Of those tested for HBV 66 (46.1%) were found not infected and only
were then 11 immunized. (4.6%). Of the 238 tested 38 (16%) were found to be infected with
HBV chronically. Of the 328 a total of 81 (24.6%) pa<ents were never screened for either HAV
or HBV. On examina<on of follow-up records none (0%) of the pa<ents suscep<ble to HBV or
HAV were found to be vaccinated.

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Which of the following statements is true?

A. Rates of hepa<<s A and B vaccina<on were
acceptable
B. QIP analysis do not improvebeper pa<ent
care
C. Vaccina<on to Hepa<<s A was beper than B
D. Interven<on studies need to prove an
improvement in vaccina<on status amongst
these pa<ents.

5
Study Group performs long-term study on
eect of prostate-specic an<gen (PSA) in
decreasing mortality from prostate cancer.
First group: PSA tes<ng annually.
Second group: no PSA screening.
ATer 10 years, more people in PSA screening
group found to survived prostate cancer.
Authors of study conclude PSA screening
prolongs life due to early detec<on of prostate
cancer.

Studys conclusion aected by?

A. Lead-<me bias
B. Confounding variable
C. Length bias
D. Repor<ng bias
Lead time is the length of time between
E. Beta-error

the detection of a disease (usually

based on new, experimental criteria)
and its usual clinical presentation and
diagnosis (based on traditional criteria).

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An Italian inves<gator shows people who drink

coee more likely to develop pancrea<c
cancer. He concludes coee consump<on is
associated with pancrea<c cancer. Reviewing
the manuscript, you no<ce pa<ents who
consumed coee also smoked more cigarepes.

Conclusion of inves<gator may have been

aected by:
A. Lead-<me bias
B. Confounding variable
C. Length bias
D. Repor<ng bias
E. Beta-error

Inves<gator claims his study of 32 pa<ents

failed to show any benet using thromboly<cs
trea<ng pa<ents with myocardial infarc<on (p=
0.22). The journal editor refuses to accept the
paper on the basis of which of the following?
A. Type I error
B. Type II error (beta-error)
C. Confounding variable
D. Lack of signicance

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Which is true?
A. Type I error occurs when an inves<gator
declares a benet but there is none
B. In an inten<on-to-treat analysis, the
inves<gators ignore noncompliance and use
all pa<ents in the nal analysis
C. A study that uses sta<s<cs to combine
many randomized trials is referred to as a
meta-analysis
D. All of the above are true

A type I error, also known as an error of

the first kind, occurs when the null
hypothesis (H0) is true, but is rejected.
It is asserting something that is absent,
a false hit.

A type II error, also known as an error of

the second kind, occurs when the null
hypothesis is false, but erroneously
fails to be rejected. It is failing to assert
what is present, a miss.