1. A new screening tool to detect lung cancer was recently developed by a group of researchers at the Medical University of South Carolina (MUSC). Computerized Axial Tomography (CAT) scanning of the chest is one of the best approaches currently being used to screen for lung cancer. The MUSC research group is trying to determine whether their screening tool is better than the CAT scan. The researchers piloted the study among 65,000 individuals who were at high risk of developing lung cancer and had previously been screened using the CAT scan. Disease prevalence was known to be 25% in this population. The new screening tool identified 9,650 individuals with a positive result. Of these individuals, 5,700 tested positive using the CAT scan (33 points total). Round all answers to the nearest whole number. a) Set-up the 2 X 2 table for the data {4 points}. New screening Tool Lung Cancer Status (from CAT scan results) Present Positive a= Negative c= Total Total a+c= Absent b= a+b= d= c+d= b+d= Total screened population (a+b+c+d)= 64,000 b) Calculate and interpret the sensitivity of the new screening tool {8 points}. c) Calculate and interpret the specificity of the new screening tool {8 points} d) Calculate and interpret the positive predictive value (PPV) {8 points} e) Would you implement the new screening tool that the researchers at MUSC developed into a widespread public health program? Justify why or why not? {5 points} Use the diagram below to answer Question 2. 2. The diagram shows how probability of detection is related to the rate of disease progression. Each arrow represents the length of detectable preclinical phase, from initial detectability to clinical diagnosis (Dx). What type of screening bias is represented in this diagram? Briefly justify your answer. Be sure to include the definition of the bias and its impact on the screening program. (6 points) 3. In a small community, school-aged children are required to provide proof of having the Diptheria, Pertussis, and Tetanus (DPT) vaccine. However, some families decline to get their children vaccinated for religious reasons. If 87% of school-aged children receive the DPT vaccination, this high coverage, which decreases risk of Diptheria or Pertussis exposure and affords protection to persons who cannot be vaccinated, is referred to as ____________________. (5 points) 4. In 2010, there were 3,000,000 cases of tuberculosis in the US and 3,000,000 cases of tuberculosis in Namibia (in southern African). While the US usually records 1,000,000 cases of tuberculosis a year, Namibia usually records anywhere between 2,000,000 and 4,000,000 a year. When compared to the usual rates in the US, the amount of tuberculosis in the US for 2010 can be described as ________________ . Compared to the usual rates of tuberculosis in Namibia, the 2010 tuberculosis rates can best be described as _______________. (6 points)