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NBME 24 Answers

nbme24/Block 1/Question#1 (73.5 difficulty score)
A researcher hypothesizes that exposure to ...
Case-control study๐Ÿ”
tags: clinical_trials medicine 

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 +14 
submitted by lsmarshall(393),
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bigjimbo  classic nbme +1  
poisonivy  totally agree, I dont understand why the right answer is Case control since that is not experimental +1  
howdywhat  am I subject to this kind of poor wording for the day of the exam? +  
ajss  I bieleve so +1  



 +13 
submitted by thissitesucksnow(13),

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 +5 
submitted by catch-22(76),
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I odwu od a reoitecpvrtes roctoh rhee. I ndto' iknth shti uitsqoen is trrceoc dan oedsivrp oot litelt tfinrmaoino to teg hte rtrceoc srean.w eTim" teif"icnef is het erponta owdr reeh but tehy psyilm nid'td oiecrnds htat ptiovercseetr tcrooh luodw be a erbett isdeng eher as logn sa eht rveibsala aer doe.dc

sherry  I agree. I was hesitating between the two choices. I still think cohort study is better regarding the "risk". I hope this kind of questions wont pop out on the real thing. +2  
soph  I think key here was they were measuring risk though +  
yex  I also chose cohort, since it is comparing a given exposure. +  
raspberryslushy  I was also thinking retrospective cohort study - just as time efficient, can look at risk, and the Q stem said the cancer was common, and I think of case-control for rare conditions. It's like they forgot a cohort study could be retrospective. +1  
boostcap23  The classic example they always give for why not to do retrospective cohort is because patients who have whatever disease your testing for are more likely to remember all their risk factor exposures than a normal person that doesn't have any disease. Of course in this case I'm sure the people running the study would be the ones who figure out how much arsenic was in the water but this also would be very time consuming to figure out for each individual person in the study. Thus a case-control study where you look at a group of people with >50 arsenic exposure and a group <5 arsenic exposure and simply see who has cancer and who doesn't would be easier and take less time. +1  



 +3 
submitted by misterdoctor69(40),

I think something not mentioned yet is the fact that odds ratio can be used to estimate relative risk in RARE diseases as per the Rare Disease Assumption (where disease prevalence is <10%). Although the cancer in this question is described as "common," (common relative to other cancers), the cancer is still probably rare overall.




 +2 
submitted by cmun777(21),

I think the key on this question is recognizing how much "most time-efficient" jumps out in the question stem - a pretty unique thing to be specifically asking. Going off that and the fact they want to look at exposure -> outcome, by far the fastest approach would be to find people who currently have the dz in question and then just ask them if they have a previous exposure aka case-control.




 +1 
submitted by al1234(1),

If it had stated a 'Rare Cancer' I would have thought case control. But it said common cancer.... Any thoughts on this?




 +0 
submitted by soph(54),
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I tikhn yke eehr is etyh rae taginsienvitg eth hehtspisyo of mmutnao of innascire atwre acrssenei KRSI of rnec...ca. best yaw ot smareue isrk si csae roltnco.

nbmehelp  If they were measuring risk shouldn't it be a cohort study though? By looking at first aid.. +3  
270onstep1  They both can determine risk. Key here is the time efficiency of case-control studies when compared to cohort. +  
suckitnbme  Case-control only determines odds ratio which is not calculating risk. In rare diseases the odds ratio can be used as an estimate of the risk ratio however. +1  



 +0 
submitted by dentist(49),
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tyetpr odgo mymsrau

drdoom  welcome, O great physician of the skull and oral cavity. we revere your intricate understandings of the face, jaw, maxilla and all their tiny and hidden foramina. teach us your ways. +6