CIC Exam Questions Tutorials

In aretrospective case-control study, cases and controls are selected based on disease status. The case group is composed of individuals whohave the disease(cases), while the control group consists of individualswithout the disease. This design allows researchers to look back in time to assess exposure to potential risk factors.

Step-by-Step Justification:

Selection of Cases and Controls:

Cases: Individuals who already have the disease.

Controls: Individuals without the disease but similar in other aspects.

Direction of Study:

A retrospective study movesbackwardfrom the disease outcome to investigate potential causes or risk factors​.

Data Collection:

Uses past medical records, interviews, and laboratory results to determine past exposures.

Common Use:

Useful for studyingrare diseasessince cases have already occurred, making it cost-effective compared to cohort studies.

Why Other Options Are Incorrect:

B. without the disease:(Incorrect) This describes the control group, not the case group.

C. with the risk factor under investigation:(Incorrect) Risk factors are identified after selecting cases and controls.

D. without the risk factor under investigation:(Incorrect) The study investigates whether cases had prior exposure, not whether they lacked a risk factor.

CBIC Infection Control References:

APIC Text, Chapter on Epidemiologic Study Design​.

Qualitative studiesfocus on collectingsubjective data, including personal narratives, observations, and experiences. These data arenot numeric, and instead aim to explore themes and meaning from contextual, non-quantifiable information.

From theAPIC Text:

“Qualitative methods... Measures or data: Subjective, Unique, Differs over time, sample, and context.”

The correct answer is B, "1 and 4 only," indicating that the information can best be used to heighten awareness among Emergency Department (ED) staff and review the TB exposure control plan. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, tuberculosis (TB) remains a significant public health concern, particularly with the increasing proportion of cases among foreign-born persons in the United States. The data showing a rise from four to 22 states with over 50% of TB cases among foreign-born individuals highlights an evolving epidemiological trend that warrants targeted infection prevention strategies (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.1 - Conduct surveillance for healthcare-associated infections and epidemiologically significant organisms).

Heightening awareness among ED staff (option 1) is critical because the ED is often the first point of contact for patients with undiagnosed or active TB, especially those from high-prevalence regions. Increased awareness can improve early identification, isolation, and reporting of potential cases. Reviewing the TB exposure control plan (option 4) is equally important, as it allows the infection preventionist to assess and update protocols—such as ventilation, personal protective equipment (PPE) use, and screening processes—to address the heightened risk posed by the growing number of cases among foreign-born individuals (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.2 - Implement measures to prevent transmission of infectious agents).

Option 2 (inform staff who are foreign-born) is not the best use of this data, as the information pertains to patient demographics rather than staff risk, and targeting staff based on their origin could be inappropriate without specific exposure evidence. Option 3 (educate patients and visitors) is a general education strategy but less directly actionable with this specific epidemiological data, which is more relevant to healthcare worker preparedness and facility protocols. Combining options 1 and 4 aligns with CBIC’s emphasis on using surveillance data to guide prevention and control measures, ensuring a proactive response to the increased TB burden (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.5 - Use data to guide infection prevention and control strategies).