Organisation and information governance1. A 74-year-old woman, Meera Joshi, is diagnosed with a slow-growing prostate cancer after PSA-based case-finding. She dies 11 years later of pneumonia, with unchanged cancer volume on serial imaging. Which bias or screening effect is this scenario illustrating most clearly?A. Lead-time bias, because bringing the diagnosis forward always lengthens true survival from the disease itselfB. Overdiagnosis of a cancer that would not have caused symptoms or death in her lifetimeC. Length-time bias only, on the assumption that every screen-detected cancer is biologically aggressiveD. Allocation concealment failure in a parallel-group randomised trial of treatmentE. Funnel-plot asymmetry caused by missing small negative trials of the screening blood testCheck
Organisation and information governance2. A registrar describes a funnel plot of trials of a new oral agent for gout flares. Small studies cluster to the right of the pooled effect with large effects and wide standard errors; larger studies hug the null. What is the most appropriate concern?A. Possible small-study or publication bias, with imprecise trials of little benefit under-representedB. That concealed randomisation has definitely failed in every trial that was included in the meta-analysisC. That the pooled confidence interval on a forest plot must include the null value of 1D. That only a per-protocol analysis of the largest trial is now statistically permissibleE. That the specificity of any linked diagnostic test must be exactly 50%Check
Organisation and information governance3. A 33-year-old woman, Chloe Maguire, emails the practice asking for a copy of her full GP record. Identity is already verified. Under UK GDPR as explained by the ICO, what is the usual latest point by which the practice must respond?A. Forty working days, which remains the default under the original Data Protection Act 1998 for health recordsB. Within one month of the valid requestC. Seven calendar days because health data are always treated as a special-category fast-trackD. Only after the practice Caldicott Guardian has countersigned every printed page of the recordE. Never, because general practice records are listed as exempt from subject accessCheck
Organisation and information governance4. A 6-year-old boy, Yusuf Hassan, is seen with fever, conjunctivitis and a spreading maculopapular rash. You suspect measles. What is the legal notification duty in England?A. Notify the local UKHSA health protection team on clinical suspicion of measles, which is urgent, and do not wait for laboratory confirmationB. Wait for IgM before any notification because false clinical diagnoses of measles are still common in primary careC. Ask the diagnostic laboratory to notify the disease instead of the registered medical practitioner who saw himD. Only notify if the child has not completed two documented MMR dosesE. Email the local registrar of births and deaths rather than health protectionCheck