Multiple-choice question – Community medicine and pharmacology

Methodological problems with meta-analysis are all except: Data dredging Data peeking Derivation of pooled estimate with perception of the error Averaging differences among heterogeneous studies. Ans: Derivation of pooled estimate with perception of the error. A statistical analysis known as a meta-analysis integrates the findings of various scientific investigations. When there are numerous scientific studies that address the same issue and each one reports measures that are anticipated to have some degree of error, meta-analyses can be conducted. Data dredging (also known as data snooping or p-hacking) is the misuse of data analysis to find patterns in data that can be presented as statistically significant, thus dramatically increasing and understating the risk of false positives. This is done by performing many statistical tests on the data and only reporting those that come back with significant results.[1] Peeking poses a serious risk to the integrity of any online controlled experiment since it can wildly raise the Type I error rate and invalidate any confidence intervals or computations for significance.[2] 2. Transparency in research practices can be increased by all except: Preregistration Open data Power analysis HARKing. Ans: HARKing. Preregistration refers to the practice of explicitly stating one’s hypotheses and analysis plans before data collection. A more advanced form of preregistration – which is becoming increasingly common – is to submit your introduction and proposed methods and planned analysis directly to a journal for peer review. In a registered report, the manuscript is evaluated on the basis of the introduction, methods, and planned analysis (everything but the results!). If the registered report is accepted, the researchers are provided a guarantee that if they conduct their research according to the prespecified methods, the journal will publish their research, irrespective of what the results of the study would be.any changes made in the methodology after registration would result in breach in terms and conditions of the preregistration process. Open data is the practice of sharing primary research data and materials to a publicly accessible online repository. Power analysis refers to the practice of conducting a power calculation before collecting any data, to estimate and justify the sample size required in order to detect a specified effect.[3] HARKing describes the dubious research technique of “presenting a post hoc hypothesis in the introduction of a research report as if it were an a priori hypothesis.” 3. HARKing in academic journals is: Hypothesizing after the results are known Hypothesizing and retrieving known facts Highlighting and retaining knowledge about already proven facts All of the above. Ans: Hypothesizing after the results are known. HARKing (hypothesizing after the results are known) termed by social psychologist Norbert Kerr refers to the questionable research practice (QRP) of presenting a post hoc hypothesis in the introduction of a research report as if it were a hypothesis based on assumed principles and deductions from conclusions of previous research and generated before the inception of the the new study. A crucial feature of HARKing is that post hoc hypothesizing is misrepresented as a priori hypothesizing. HARKing occurs when a researcher tests a priori hypothesis but then excludes it from their research report after learning the results of their test; incorrect kinds of post hoc analysis and/or post hoc thinking may then lead to a post hoc hypothesis.[4,5] 4. Which QRP is prevented by open data? HARKing File drawer problems Underreporting null effects p-hacking. Ans: Underreporting null effects. Open data are data that are openly accessible, exploitable, editable, and shared by anyone for any purpose. Open data are licensed under an open license.[6] The goals of the open data movement are similar to those of other “open (-source)” movements such as open-source software, open-source hardware, open content, open specifications, open education, open educational resources, open government, open knowledge, open access, open science, and the open web. The growth of the open data movement is paralleled by a rise in intellectual property rights.[7] Hypothesizing after the results are known (HARKing) file drawer problems occur when authors are more likely to submit, or editors are more likely to accept, positive results than negative or inconclusive results. P value hacking, also known as data dredging, data fishing, data snooping, or data butchery, is an exploitation of data analysis in order to discover patterns which would be presented as statistically significant, when in reality, there is no underlying effect.[8] 5. HARKing can be avoided by researchers by: Providing open materials Providing open data Preregistration of their study Using a large sample size. Ans: Preregistration of their study. Open material: Author’s public sharing of materials that were used in a study, “such as survey items, stimulus materials, and experiment programs” (Kidwell et al., 2016, p. 3). Digitally shareable materials are posted on open-access repositories, which makes them publicly available and accessible. Depending on licensing, the material can be reused by other authors for their own studies. Components that are not digitally shareable (e.g., biological materials and equipment) must be described in sufficient detail to allow reproducibility.[9] Open data: Data that are openly accessible, exploitable, editable, and shared by anyone for any purpose. Open data are licensed under an open license. Preregistration is the practice of registering the hypotheses, methods, and/or analyses of a scientific study before it is conducted.[10,11] 6. Under the National AIDS Control Programme (NACP) which of the following is not used in the “opioid substitution therapy (OST)” Subcutaneous buprenorphine Tuberculosis screening and treatment cascade Community-based screening Oral methadone. Ans: Subcutaneous buprenorphine. OST is a process in which opioid-dependent injecting drug users (IDUs) are provided with long-acting opioid agonist medications for a long period of time under medical supervision along with psychosocial interventions. OST as a HIV prevention strategy among IDUs was formally integrated in NACP in 2007 during its third phase. Pharmaceutical Compounds Commonly Used as Opioid Substitution Therapy Medicines Methadone Methadone was the first and currently the most common opioid used as an OST medicine globally. Methadone is a pure opioid agonist, available for oral use either as a liquid or as a tablet. Buprenorphine: Buprenorphine is a partial opioid agonist available for use as a sublingual tablet. It is the second most commonly used OST medicine worldwide. Slow-release oral morphine: Morphine is a pure opioid agonist and commonly used in cancer patients for alleviation of pain. The slow-release formulation is available as a tablet.[12,13] 7. Ketogenic diet is used as adjuvant therapy in Resistant epilepsy Parkinson’s disease Narcolepsy ADHD. Ans: Resistant epilepsy. In 1921, Russel Wilder first proposed that a ketone-producing diet could be as effective as fasting for the treatment of epilepsy and coined the term “ketogenic diet.” In particular, the KD can mimic the metabolic effects of fasting without significant calorie deprivation.[14] 8. A 56-year-old hypertensive man has been successfully treated with a thiazide diuretic for the past 4 years. Over the past 3 months, his diastolic pressure has steadily increased, and he has been started on an additional antihypertensive medication. He now complains of sleep disturbances, and he is no longer able to complete three sets of tennis. The second antihypertensive medication is most likely to be which of the following agents? Metoprolol Lisinopril Nifedipine Losartan. Ans: Metoprolol. The adverse effects of beta-receptor antagonists referable to the central nervous system (CNS) include fatigue, sleep disturbances (including insomnia and nightmares), and depression.[15] 9. Sparsentan is the new drug approved by the FDA to Reduce proteinuria in adults with primary immunoglobulin A nephropathy Treat non-CNS manifestations of alpha-mannosidosis Treat anemia caused by chronic kidney disease for adults on dialysis for at least 4 months Treat relapsed or refractory mantle cell lymphoma in adults. Ans: Reduce proteinuria in adults with primary immunoglobulin A nephropathy. Sparsentan is an endothelin and angiotensin II receptor antagonist, approved for medical use in the United States in February 2023. It is a medication used for the treatment of primary immunoglobulin A nephropathy.[16,17] 10. All are true regarding sequential trial except Detects a significant result as soon as it is achieved Conducted on matched pair of subjects Is applicable to all the types of drugs Is plotted continuously as the trial proceeds. Ans: Is applicable to all the types of drugs. Sequential trials are preplanned, repeated series of comparisons that are stopped as soon as a decision can be made as to whether one treatment can be regarded as superior to another, or that both are equally effective. Fewer patients, however, cannot be guaranteed, since the number of patients will vary if the same trial is repeated. Instead, one would try to make a reduction more likely by ensuring that the sizes of most (say 90%) of the resulting trials would be smaller. This design is applicable only to those drugs and disease for which clinical end points are achieved quickly.[18,19] Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.