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1. From which of the following study designs can conclusions regarding causality be made?

A. case-control B. cross-sectional C. retrospective cohort D. prospective interventional

2. The potential is reduced for BOTH bias and confounding with which of the following clinical trial element(s)?

A. blinding B. randomization C. use of a control group D. all of the above

3. Choose the CORRECT statement:

A. The potential for Type I error is limited to 20% in clinical trials with 80% power. B. Noninferiority trials seek to establish that one treatment is at least as good as another. C. Intention to treat analyses are preferred because they maintain randomization and mimic real life practice. D. Mean and standard deviation are the appropriate measures of central tendency and variability, respectively, for ordinal data.

4. Which of the following clinical trials has the HIGHEST internal validity?

A. An open-label, randomized, equivalence trial comparing 2 antibiotic regimens for treatment of community-acquired pneumonia in China B. A randomized, double-blind trial with very strict inclusion and exclusion criteria that used subtherapeutic doses of the active control medication C. A double-dummy trial that used stratified and block randomization to assign patients to either an oral active therapy, parenteral active therapy, or placebo, with all other aspects of the study protocol according to the institution's “usual care” D. A randomized, double-blind, Phase III clinical trial conducted in the United States and Europe that compared a new medication with placebo for treatment of moderately-severe Type 2 diabetes

5. Which of the following clinical trials has the HIGHEST external validity (assume U.S. clinical practice)?

A. An open-label, randomized, equivalence trial comparing 2 antibiotic regimens for treatment of community-acquired pneumonia in China B. A randomized, double blind trial with very strict inclusion and exclusion criteria that used subtherapeutic doses of the active control medication C. A double-dummy trial that used stratified and block randomization to assign patients to either an oral active therapy, parenteral active therapy, or placebo, with all other aspects of the methods according to the study institution's “usual protocols” D. A randomized, double blind, Phase III clinical trial conducted in the U.S. and Europe that compared a new medication with placebo for treatment of moderately-severe Type 2 diabetes

6. Choose the CORRECT clinical trial outcome/outcome description pairing below.

A. patient-reported compliance/single safety outcome B. heart failure exacerbation rate/single surrogate outcome C. change in blood pressure from baseline/single surrogate outcome D. rate of myocardial infarction, stroke, hospitalization, or all-cause mortality/composite of surrogate outcomes

7. What is the equation to calculate number needed to treat (NNT)?

A. 1/ARR B. 1/RRR C. 1-ARR D. 1-RRR

8. Which of the following searches would be MOST likely to yield a rheumatoid arthritis clinical practice guideline?

A. Search PubMed and limit to “Review Articles” B. Google search “how do I treat rheumatoid arthritis?” C. Search the American College of Cardiology website D. Search the National Guideline Clearinghouse website

9. Choose the CORRECT statement regarding the evidence-based medicine process.

A. The clinical question should be defined as generally as possible B. Quality of all information sources can be considered equivalent C. The first information retrieved should be used for the recommendation D. The final recommendation should incorporate quality evidence, clinical judgment, and patient preferences

10. A clinical pharmacist has been asked by a physician to recommend a new medication for neuropathic pain that is least likely to interact with a patient's multiple other medications. After searching clinical practice guidelines, primary literature, and drug interaction resources, the pharmacist has narrowed the options to pregabalin (Lyrica) and topiramate (Topamax). Which of the following factors would likely be MOST relevant for the pharmacist to consider when making an evidence-based recommendation?

A. primary literature quality, symptom severity, insurance coverage B. dosing frequency, boxed warnings, patient preference for capsules or tablets C. approval status for neuropathic pain, patient hepatic function, availability of a liquid dosage form D. working relationship between the physician and pharmacist, recent quality improvement strategies within the organization, pharmacist's anecdotal experiences with patients on both medications