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1. A physical examination and an audiometric test were given to 500 persons with

suspected hearing problem, of whom 300 were actually found to have them. The
result of the examination were as follows:
Physical examination
---------------------------------------------Hearing problem
-----------------------Result
Present
Absent
----------------------------------------------Positive
240
40
Negative
60
160
----------------------------------------------Total
300
200

Audiometric test
-------------------------------------------Hearing problem
--------------------------Result
Present
Absent
--------------------------------------------Positive
270
60
Negative
30
140
--------------------------------------------Total
300
200

Compare the two tests on their:

a. Sensitivity
b. Specificity
c. Predictive value positive
d. Predictive value negative
2. Since hearing is very important for the job for which the test id conducted, which

test do you recommend? Explain your answer

3. A colon cancer screening study is being conducted in Nottingham, England.

Individuals 50 to 70 year olds will be screened with the Hemoccult test. In this
test, a stool sample is tested for the presence of blood.
The Hemoccult test has a sensitivity of 75%.
a. If Nottingham has a prevalence of 12/1.000 for colon cancer, what is the
positive predictive value of the test?
b. If the Hemoccult test result is negative, no further testing is done. If the
Hemoccult test result is positive, the individual will have a second stool
sample tested with the Hemoccult II test. If the second sample also test
positive for blood, the individual will be referred for more extensive
evaluation. What is the effect on net sensitivity and net specificity of this
method of screening?
4. Two physician were asked to classify independently 100 chest x-rays as abnormal

or normal. The comparison of their classification is shown in the following table:

Classification of chest x-rays by physician 1 compared with physician 2
Physician 1
Physician 2
Total

Abnormal
40
10
50

Abnormal
Normal
Total

Normal
20
30
50

60
40
100

a. Calculate the value of kappa

b. What does the kappa represent

US population 1987
Age (year)
< 5
5 44
44 64
65 +
Total
Age (year)

Population
18,250,000
150,020,000
42,300,000
29,840,000
243,400,000

Death
Malignant neoplasms
469
17,082
103,488
2442,617
363,650

Population

Malign. neoplasms
Death
Rate*
< 5
18,250,000
469
5 44
150,020,000
17,082
44 64
42,300,000
103,488
65 +
29,840,000
2442,617
Total
243,400,000
363,650
* Death rate per 100,000 population

Accidents
3,871
50,377
14,807
25,838
94,893

Accidents
Death
Rate*
3,871
50,377
14,807
25,838
94,893

Population of Alaska 1987

Age (year)
< 5
5 44
44 64
65 +
Total
Age (year)
< 5
5 44

Population
60,000
368,000
78,000
19,000
525,000
Population
60,000
368,000

Death
Malignant neoplasms
0
52
180
210
442

Malignant neoplasms
Death
Rate*
0
52

Accidents
13
242
50
15
320

Accidents
Death
13
242

Rate*

44 64
78,000
180
65 +
19,000
210
Total
525,000
442
* Death rate per 100,000 population

50
15
320

Population of Florida 1987

Age (year)

Population

< 5
5 44
44 64
65 +
Total

812,000
6,543,000
2,528,000
2,140,000
12,023,000

Age (year)

Population

< 5
5 44
44 64
65 +
Total

812,000
6,543,000
2,528,000
2,140,000
12,023,000

Death
Malignant neoplasms
24
1,077
7,464
21,599
30,164

Malignant neoplasms
Death
Rate*
24
1,077
7,464
21,599
30,164

Accidents
260
2,584
794
1,482
5,120

Accidents
Death
260
2,584
794
1,482
5,120

Rate*

5. Death rate from all accidents in the age group 5 44 years old for US pop, alaska,

and florida!
6. Death rate from malignant neoplasm in the age group 65+ for US pop, alaska, and

florida!
7. Overall death rate for malignant neoplasm for US pop, alaska, florida
8. For overall death rate from all accidents for US pop, alaska, florida
9. Count the Expected number of death from neoplasm & Adjusted mortality rate
(direct method), then how much Adjusted mortality rate for Alaska and Florida?

Age
<5
5 44
45 64
65 +
Total

Death from neoplasm per

100,000
Alaska
Florida
0
3.0
14.1
16.5
230.8
295.3
1,105.3
1,009.3

US pop
18,250,000
150,020,000
42,300,000
29,840,000
243,400,000

Expected number of death

from neoplasm
Alaska
Florida

10. Count the Expected number of death from accidents (indirect method), then how

much SMR for Alaska and Florida?

Age

<5
5 44
45 64
65 +
Total

Death rate in
US pop per
100,000

Population
Alaska

Florida

21.2
33.6
35.0
86.6
39.0

60000
368000
78000
19000
525000

812,000
6,543,000
2,528,000
2,140,000
12,023,000

Expected number of death

per 100,000
Alaska
Florida