Biostatistics & Study Design USMLE Step 1 Practice Question
A 78-year-old woman with advanced dementia (MRI shows cerebral atrophy) presents with baseline Mini-Cog score of 0/30. Her daughter reports progressive memory loss over 3 years despite donepezil therapy. Vital signs are stable (BP 138/82, HR 72, RR 16, Temp 98.6°F). Subsequent cognitive assessments at 3 and 6 months remain 0/30. No acute delirium is noted. Because the instrument cannot capture further deterioration below the minimum score, which measurement problem limits this study?
Answer choices
- ACeiling effect
- BSpectrum bias
- CPositive likelihood ratio
- DPublication bias
- EFloor effectCorrect answer
- FHawthorne effect
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