FACRRM Assessment and Evaluation 2 — Questions and Answers
Question 1: A rural GP is evaluating whether a new triage protocol has improved patient outcomes. Which study design best establishes a causal relationship between the protocol and outcomes?
- Retrospective cohort study
- Before-and-after study with concurrent controls (Correct answer)
- Cross-sectional survey
- Case series analysis
Correct answer: Before-and-after study with concurrent controls
A before-and-after study with concurrent controls provides a comparison group that accounts for temporal trends, strengthening causal inference over uncontrolled designs.
Question 2: In a remote community health assessment, the team identifies high rates of rheumatic heart disease. Which population-level measure best quantifies the burden of this disease over time?
- Point prevalence
- Incidence density rate
- Attack rate
- Disability-adjusted life years (DALYs) (Correct answer)
Correct answer: Disability-adjusted life years (DALYs)
DALYs combine years of life lost to premature death and years lived with disability, providing a comprehensive measure of disease burden suitable for chronic conditions like RHD.
Question 3: A FACRRM candidate is reviewing a diagnostic study for point-of-care troponin in a rural ED. The test has sensitivity 90% and specificity 85%. Which statement about a positive result is correct?
- PPV depends only on sensitivity and specificity
- PPV increases as disease prevalence decreases
- PPV increases as disease prevalence increases (Correct answer)
- LR+ equals sensitivity divided by specificity
Correct answer: PPV increases as disease prevalence increases
Positive predictive value (PPV) rises with increasing disease prevalence because more true positives exist relative to false positives in the tested population.
Question 4: A rural health service uses a needs assessment framework to plan services. Which approach incorporates community members' own perceptions of their health needs?
- Normative needs assessment
- Comparative needs assessment
- Felt needs assessment (Correct answer)
- Epidemiological needs assessment
Correct answer: Felt needs assessment
Felt needs are those identified by community members themselves when asked what they consider to be their health problems or service gaps.
Question 5: During a clinical audit of diabetic foot care in a remote community, the team finds documentation compliance is 60%. Which audit cycle step should follow this finding?
- Re-audit immediately without intervention
- Implement targeted change and re-audit after an agreed interval (Correct answer)
- Abandon the audit and choose a new topic
- Report findings to state health department only
Correct answer: Implement targeted change and re-audit after an agreed interval
The audit cycle requires implementing a specific improvement intervention after identifying a gap, then re-auditing to determine whether the change achieved the desired standard.
Question 6: A GP in a remote area wants to assess whether a health promotion program reduced smoking rates. The most appropriate statistical test to compare proportions between two independent groups is:
- Paired t-test
- Pearson correlation coefficient
- Chi-squared test (Correct answer)
- Mann-Whitney U test
Correct answer: Chi-squared test
The chi-squared test compares observed versus expected frequencies for categorical variables such as smoking status (smoker/non-smoker) between two independent groups.
Question 7: Which type of validity refers to the extent that a health assessment instrument measures what it is theoretically intended to measure?
- Content validity
- Criterion validity
- Construct validity (Correct answer)
- Face validity
Correct answer: Construct validity
Construct validity evaluates whether an instrument truly measures the underlying theoretical construct it purports to assess, such as quality of life or functional status.
FACRRM Assessment and Evaluation 2
A rural GP is evaluating whether a new triage protocol has improved patient outcomes.
Which study design best establishes a causal relationship between the protocol and outcomes?