Day 4: Dry Eye, Sjogren's Syndrome, And Sjo

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| By Staci Johnson
Staci Johnson, Pharma & Biotechnology
Staci is a Pharmaceutical and Biotech Training Consultant with a successful track record in developing and implementing innovative sales training programs. She excels in creating compelling, effective, and engaging curriculums and has a collaborative, positive, and customer-focused approach.
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  • 1/39 Questions

    True or False:  The authors of the Akpek et al study concluded that primary Sjögren's syndrome seems to be underdiagnosed in patients with dry eye syndrome and should be the focus of diagnostic evaluations.

    • True
    • False
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About This Quiz

This quiz has been designed to test your knowledge of dry eye, Sjögren's syndrome, and the new LDT Sjö. You have 1 hour to complete the quiz. A passing grade is a 90% or above.

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  • 2. 

    True or False:  Only 25% of the patients with Sjögren's syndrome are women.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The statement "Only 25% of the patients with Sjögren's syndrome are women" is false. Sjögren's syndrome is known to predominantly affect women, with studies showing that about 90% of patients diagnosed with the syndrome are female. Therefore, the correct answer is false.

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  • 3. 

    True or False:  A healthy person may have an antibody seen in an autoimmune disease.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    It is possible for a healthy person to have an antibody seen in an autoimmune disease because antibodies can be present in the body without causing any symptoms or harm. Autoimmune diseases occur when the immune system mistakenly attacks healthy cells, leading to the production of specific antibodies. However, the presence of these antibodies does not necessarily indicate the presence of an autoimmune disease. In some cases, individuals may have these antibodies without developing any symptoms or disease, making it possible for a healthy person to have such antibodies.

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  • 4. 

    True or False:  Primary Sjögren's syndrome accounts for half of all cases of Sjögren's syndrome.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Primary Sjögren's syndrome is a chronic autoimmune disease that primarily affects the salivary and lacrimal glands, leading to dryness of the mouth and eyes. It can also affect other organs and systems in the body. The statement that primary Sjögren's syndrome accounts for half of all cases of Sjögren's syndrome is true. Primary Sjögren's syndrome refers to cases where the condition occurs on its own, without being associated with another autoimmune disease. Secondary Sjögren's syndrome, on the other hand, occurs in conjunction with another autoimmune disease, such as rheumatoid arthritis or lupus.

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  • 5. 

    Which of the following tests can be used for detecting Sjögren's syndrome?

    • Lactoferrin

    • Sjö

    • Ap4A

    • Lysozyme

    Correct Answer
    A. Sjö
    Explanation
    The correct answer is Sjö. Sjö is likely referring to Sjö test, which is a common diagnostic test used for detecting Sjögren's syndrome. Sjögren's syndrome is an autoimmune disorder that primarily affects the salivary and lacrimal glands, leading to symptoms such as dry mouth and dry eyes. The Sjö test measures the production and flow of saliva to determine if there is a decrease in salivary gland function, which is a characteristic feature of Sjögren's syndrome. The other options (lactoferrin, Ap4A, lysozyme) are not commonly used tests for detecting Sjögren's syndrome.

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  • 6. 

    Which of the following is the most common cause of evaporative dry eye?

    • Diabetes

    • Aging

    • Inflammation

    • Meibomian gland dysfunction

    Correct Answer
    A. Meibomian gland dysfunction
    Explanation
    Meibomian gland dysfunction is the most common cause of evaporative dry eye. The meibomian glands are responsible for producing the oily layer of tears that helps to prevent evaporation. Dysfunction of these glands can result in a decreased production of this oil, leading to increased evaporation of tears and dryness of the eyes. Diabetes, aging, and inflammation can also contribute to dry eye, but they are not the most common cause.

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  • 7. 

    Which of the following is NOT an advantage of diagnosing Sjögren's syndrome in the early stages of the disease?

    • Increases patients' chances for avoiding many serious complications

    • Helps patients receive proper treatment

    • Increases patients' chance for a cure

    • Helps patients improve their quality of life

    Correct Answer
    A. Increases patients' chance for a cure
    Explanation
    Diagnosing Sjögren's syndrome in the early stages of the disease does not increase patients' chances for a cure.

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  • 8. 

    Which of the following is considered the mainstay of dry eye treatment?

    • Corticosteroids

    • Omega-3 fatty acids

    • Artificial tears

    • Punctal plugs

    Correct Answer
    A. Artificial tears
    Explanation
    Artificial tears are considered the mainstay of dry eye treatment because they provide lubrication and moisture to the eyes, relieving the symptoms of dryness, irritation, and discomfort. They mimic the natural tears and help in maintaining the tear film on the surface of the eyes. Corticosteroids may be used in severe cases or for short-term relief, but they have potential side effects. Omega-3 fatty acids can support overall eye health, but they are not specifically targeted for dry eye treatment. Punctal plugs are used when artificial tears alone are not sufficient to retain moisture in the eyes.

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  • 9. 

    Which of the following is an abnormal antibody found in patients with systemic lupus erythematosus?

    • SS-B (La)

    • Anti-dsDNA

    • SP-1

    • SS-A (Ro)

    Correct Answer
    A. Anti-dsDNA
    Explanation
    Patients with systemic lupus erythematosus (SLE) often have abnormal antibodies in their blood. One of these antibodies is anti-dsDNA, which stands for anti-double-stranded DNA. This antibody specifically targets and binds to DNA, causing damage to cells and tissues. It is considered a hallmark antibody in SLE and is commonly used as a diagnostic marker for the disease. The presence of anti-dsDNA antibodies is associated with the development and progression of lupus nephritis, a serious kidney complication in SLE.

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  • 10. 

    Which of the following is considered a serious complication of Sjögren's syndrome?

    • Neurological problems

    • Heart disease

    • Diabetes

    • Low blood counts

    Correct Answer
    A. Neurological problems
    Explanation
    Neurological problems are considered a serious complication of Sjögren's syndrome. This autoimmune disorder primarily affects the moisture-producing glands, such as the salivary and tear glands. However, it can also cause inflammation in other parts of the body, including the nervous system. Neurological problems associated with Sjögren's syndrome can include peripheral neuropathy, which causes numbness and tingling in the extremities, as well as cognitive dysfunction and even seizures. These complications can significantly impact a person's quality of life and require medical management.

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  • 11. 

    Which of the following joints does rheumatoid arthritis most commonly affect?

    • Hips

    • Shoulders

    • Fingers

    • Knees

    Correct Answer
    A. Fingers
    Explanation
    Rheumatoid arthritis most commonly affects the fingers. This is because rheumatoid arthritis is an autoimmune disease that primarily targets the joints, causing inflammation and pain. The small joints in the fingers are often the first to be affected, leading to symptoms such as swelling, stiffness, and deformity. The disease can progress to other joints in the body, but the fingers are typically the initial and most commonly affected area.

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  • 12. 

    Which of the following is NOT considered a traditional biomarker for detecting Sjögren's syndrome?

    • ANA

    • SP-1

    • SS-A (Ro)

    • SS-B (La)

    Correct Answer
    A. SP-1
    Explanation
    SP-1 is not considered a traditional biomarker for detecting Sjögren's syndrome. This is because SP-1 is a transcription factor involved in gene regulation, and its presence or absence is not directly associated with the development or diagnosis of Sjögren's syndrome. In contrast, ANA (antinuclear antibodies), SS-A (Ro), and SS-B (La) are all traditional biomarkers that are commonly used in the diagnosis of Sjögren's syndrome.

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  • 13. 

    Multiple sclerosis is an inflammatory disease that destroys _____.

    • Cartilage

    • Liver function

    • WBCs

    • Myelin

    Correct Answer
    A. Myelin
    Explanation
    Multiple sclerosis is an inflammatory disease that affects the central nervous system. It causes the immune system to mistakenly attack the protective covering of nerve fibers called myelin. This destruction of myelin disrupts the normal flow of electrical impulses along the nerves, leading to a wide range of symptoms such as fatigue, muscle weakness, and problems with coordination and balance.

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  • 14. 

    How many patients were included in the study by Akpek et al which evaluated the rate of Sjögren's syndrome in patients with dry eye syndrome?

    • 186

    • 220

    • 362

    • 414

    Correct Answer
    A. 220
    Explanation
    Akpek et al conducted a study to evaluate the rate of Sjögren's syndrome in patients with dry eye syndrome. The correct answer is 220, which suggests that 220 patients were included in the study.

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  • 15. 

    Who is responsible for billing the patient's insurance company if the blood sample is collected at a third-party lab?

    • ECP

    • Third-party lab

    • IMMCO Diagnostics

    • Patient

    Correct Answer
    A. Third-party lab
    Explanation
    The third-party lab is responsible for billing the patient's insurance company if the blood sample is collected at their facility. As a third-party lab, they are contracted by healthcare providers to perform diagnostic tests and handle the billing process. They have the necessary infrastructure and expertise to submit claims to insurance companies and ensure that the patient's insurance is billed accurately for the services provided. This allows the healthcare provider to focus on patient care while the third-party lab handles the administrative tasks related to billing and insurance.

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  • 16. 

    Which of the following is NOT a feature of dry eye?

    • Inflammation

    • Hyperosmolarity

    • High TBUT

    • Abnormalities of the ocular surface

    Correct Answer
    A. High TBUT
    Explanation
    High TBUT (Tear Break-Up Time) is not a feature of dry eye. TBUT refers to the time it takes for the tears on the ocular surface to break up. In dry eye, the tear film is unstable and breaks up quickly, resulting in a low TBUT. Therefore, a high TBUT would indicate a normal or healthy tear film, which is not a characteristic of dry eye.

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  • 17. 

    Which of the following is NOT thought to be a contributor to autoimmune disease?

    • Heredity

    • Normal immune cell function

    • Ethnicity

    • Gender

    Correct Answer
    A. Normal immune cell function
    Explanation
    Normal immune cell function is not thought to be a contributor to autoimmune disease. Autoimmune diseases occur when the immune system mistakenly attacks healthy cells and tissues in the body. It is believed that factors such as heredity, ethnicity, and gender can increase the risk of developing autoimmune diseases. However, normal immune cell function is essential for a healthy immune system and is not considered a contributing factor to autoimmune diseases.

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  • 18. 

    When a patient goes to a third-party lab to have a Sjö test run, who provides the physician with the test results?

    • Third-party lab

    • RPS

    • IMMCO Diagnostics

    • LabCorp

    Correct Answer
    A. Third-party lab
    Explanation
    When a patient goes to a third-party lab to have a Sjö test run, the third-party lab is responsible for providing the physician with the test results.

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  • 19. 

    Anti-Sm is an abnormal antibody found in which of the following diseases?

    • Sjögren's syndrome

    • Systemic lupus erythematosus

    • Rheumatoid arthritis

    • Multiple sclerosis

    Correct Answer
    A. Systemic lupus erythematosus
    Explanation
    Anti-Sm is an abnormal antibody that is specifically associated with systemic lupus erythematosus (SLE). SLE is an autoimmune disease where the body's immune system mistakenly attacks its own tissues and organs. The presence of Anti-Sm antibodies is one of the diagnostic criteria for SLE and is found in a majority of patients with this disease. It is not commonly associated with Sjögren's syndrome, rheumatoid arthritis, or multiple sclerosis.

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  • 20. 

    Sjögren's syndrome dry eye and non-Sjögren's syndrome dry eye are subclasses of __________.

    • Age-related dry eye

    • Evaporative dry eye

    • Tear-defective dry eye

    • Aqueous-deficient dry eye

    Correct Answer
    A. Aqueous-deficient dry eye
    Explanation
    Sjögren's syndrome dry eye and non-Sjögren's syndrome dry eye are subclasses of aqueous-deficient dry eye. This means that both conditions fall under the category of aqueous-deficient dry eye, which is characterized by a lack of tear production due to dysfunction of the lacrimal glands. Sjögren's syndrome dry eye specifically refers to the condition occurring in individuals with Sjögren's syndrome, an autoimmune disorder that affects the moisture-producing glands of the body. Non-Sjögren's syndrome dry eye refers to the same symptoms of dry eye, but without the presence of Sjögren's syndrome.

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  • 21. 

    Of the patients that were diagnosed with Sjögren's syndrome as a result of the initial evaluation during the study conducted by Akpek et al, what percentage tested positive for SS-A (Ro) and SS-B (La) antibodies?

    • 33.3%

    • 66.6%

    • 75.5%

    • 81.8%

    Correct Answer
    A. 66.6%
    Explanation
    In the study conducted by Akpek et al, 66.6% of the patients diagnosed with Sjögren's syndrome tested positive for SS-A (Ro) and SS-B (La) antibodies.

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  • 22. 

    True or False:  Sjö is the only available test that identifies both organ-specific and non-organ-specific autoantibodies in Sjögren's syndrome.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Sjögren's syndrome is an autoimmune disease that affects the salivary glands and tear ducts, causing dry mouth and dry eyes. The Sjögren's syndrome test, also known as the Sjögren's antibody test, is used to detect autoantibodies that are specific to this condition. These autoantibodies can be both organ-specific, targeting the salivary glands and tear ducts, as well as non-organ-specific, affecting other parts of the body. Therefore, the statement that Sjögren's test identifies both organ-specific and non-organ-specific autoantibodies in Sjögren's syndrome is true.

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  • 23. 

    What is the rate of sensitivity and specificity for traditional tests for Sjögren's syndrome?

    • 20%-40%

    • 40%-60%

    • 60%-80%

    • 80%-100%

    Correct Answer
    A. 40%-60%
    Explanation
    The rate of sensitivity and specificity for traditional tests for Sjögren's syndrome is 40%-60%. This means that these tests can accurately identify the presence of the disease in 40% to 60% of cases, while also accurately ruling out the disease in 40% to 60% of cases. It is important to note that these tests may not be completely accurate and there can be false positive or false negative results.

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  • 24. 

    Approximately how many people over age 40 does dry eye affect in the United States?

    • 4 million

    • 11 million

    • 20 million

    • 40 million

    Correct Answer
    A. 20 million
    Explanation
    Dry eye is a common condition that affects a significant number of individuals over the age of 40 in the United States. The given answer of 20 million suggests that this is the approximate number of people over the age of 40 who are affected by dry eye in the country. This indicates a substantial prevalence of the condition and highlights the importance of addressing and managing it effectively.

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  • 25. 

    If you were suffering with aqueous-deficient dry eye, which of the following might be useful?

    • Plaquenil

    • Restasis

    • Doxycycline

    • Voltaren

    Correct Answer
    A. Restasis
    Explanation
    Restasis might be useful for aqueous-deficient dry eye because it is a medication specifically designed to increase tear production. Aqueous-deficient dry eye is characterized by a lack of tear production, so using Restasis can help alleviate the symptoms by promoting the production of tears. Plaquenil is an antimalarial drug, doxycycline is an antibiotic, and Voltaren is a nonsteroidal anti-inflammatory drug, none of which directly address the underlying issue of tear production in aqueous-deficient dry eye.

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  • 26. 

    In which journal was the retrospective study by Akpek et al published?

    • Clincial Immunology

    • British Journal of Ophthalmology

    • Cornea

    • Clinical Immunology

    Correct Answer
    A. Cornea
    Explanation
    The correct answer is Cornea. This is because the question is asking about the journal in which the retrospective study by Akpek et al was published. Therefore, the correct answer is the journal named "Cornea".

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  • 27. 

    Which of the following is NOT a way in which a physician may receive the results of the Sjö test?

    • Email/IMMCO online

    • Phone

    • Fax

    • Mail

    Correct Answer
    A. Phone
    Explanation
    A physician may receive the results of the Sjögren's test through email/IMMCO online, fax, or mail. However, phone is not a way in which a physician may receive the results of the Sjögren's test.

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  • 28. 

    Which of the following is a specific antibody to salivary gland proteins?

    • CA-6

    • SS-A (Ro)

    • SS-B (La)

    • ANA

    Correct Answer
    A. CA-6
    Explanation
    CA-6 is a specific antibody to salivary gland proteins. This means that CA-6 is specifically designed to target and bind to proteins found in the salivary glands.

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  • 29. 

    All of the following are considered proprietary biomarkers for detecting Sjögren's syndrome, except for:

    • SP-1

    • RF

    • PSP

    • CA-6

    Correct Answer
    A. RF
    Explanation
    RF (Rheumatoid Factor) is not considered a proprietary biomarker for detecting Sjögren's syndrome. RF is an autoantibody that is commonly associated with rheumatoid arthritis, but it is not specific to Sjögren's syndrome. On the other hand, SP-1, PSP (Salivary Protein-1), and CA-6 (Carbonic Anhydrase 6) are all proprietary biomarkers that have been identified as useful in the detection of Sjögren's syndrome.

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  • 30. 

    In the study conducted by Akpek et al, what percentage of patients had a combined aqueous and evaporative type of dry eye?

    • 52.9%

    • 67.5%

    • 75.2%

    • 86.9%

    Correct Answer
    A. 86.9%
    Explanation
    The study conducted by Akpek et al found that 86.9% of patients had a combined aqueous and evaporative type of dry eye.

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  • 31. 

    True or False:  The authors of the Shen et al paper concluded that SS-A (Ro), SS-B (La), RF, and ANA are useful markers for identifying patients with Sjögren's syndrome at early stages of the disease.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The authors of the Shen et al paper did not conclude that SS-A (Ro), SS-B (La), RF, and ANA are useful markers for identifying patients with Sjögren's syndrome at early stages of the disease.

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  • 32. 

    In the study conducted by Akpek et al, what percentage of patients with primary Sjögren's syndrome were diagnosed as a result of the initial evaluation?

    • 50%

    • 62%

    • 77%

    • 83%

    Correct Answer
    A. 50%
    Explanation
    According to the study conducted by Akpek et al, 50% of patients with primary Sjögren's syndrome were diagnosed as a result of the initial evaluation. This means that half of the patients in the study were able to receive a diagnosis during their first evaluation.

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  • 33. 

    True or False:  A patient with an autoimmune disease will always have an antibody to the affected organ.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    False. While it is true that autoimmune diseases involve the immune system attacking the body's own tissues, not all autoimmune diseases are characterized by the presence of antibodies to the affected organ. In some cases, the immune system may target other components of the body, such as cells or proteins, instead of producing antibodies against the affected organ. Therefore, it is not always the case that a patient with an autoimmune disease will have an antibody to the affected organ.

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  • 34. 

    How many cases of Sjögren's syndrome are thought to be undiagnosed?

    • 500,000

    • 1.5 million

    • 3 million

    • 6 million

    Correct Answer
    A. 3 million
    Explanation
    Approximately 3 million cases of Sjögren's syndrome are estimated to be undiagnosed. This suggests that a significant number of individuals with this condition are unaware of their diagnosis, which can lead to delayed or inadequate treatment. It is important for healthcare professionals to increase awareness and improve diagnostic methods to ensure that those affected receive appropriate care.

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  • 35. 

    What is the cumulative rate of sensitivity for Sjö?

    • 67%

    • 78%

    • 89%

    • 95%

    Correct Answer
    A. 89%
    Explanation
    The cumulative rate of sensitivity for Sjö is 89%. This means that out of all the cases of Sjö, 89% of them will test positive for the condition. This indicates a high level of accuracy in detecting Sjö, as a higher sensitivity rate means a lower chance of false negatives.

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  • 36. 

    Which of the following circumstances may result in a Sjö test receiving a QNS result?

    • Blood spots were considered layered

    • Blood spots exceeded the circles on the Whatman card

    • Blood spots saturated through to the back of the Whatman card

    • Blood specimen was contaminated

    Correct Answer
    A. Blood spots were considered layered
    Explanation
    If blood spots were considered layered, it means that there were multiple layers of blood spots on the Whatman card. This can result in a QNS (Quantity Not Sufficient) result for the Sjö test because the layered blood spots may not provide an adequate sample for the test. The test requires a certain amount of blood to be present in order to produce accurate results. If the blood spots are layered, it may indicate that there is not enough blood on each layer to meet the required quantity for the test, leading to a QNS result.

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  • 37. 

    In Akpek et al, how many patients that were identified during the initial evaluation as having primary Sjögren's syndrome tested positive for SS-A (Ro) or SS-B (La) antibodies?

    • 2

    • 4

    • 6

    • 8

    Correct Answer
    A. 8
    Explanation
    In the study conducted by Akpek et al, a total of eight patients who were initially identified as having primary Sjögren's syndrome tested positive for SS-A (Ro) or SS-B (La) antibodies.

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  • 38. 

    Which of the following is considered a key advantage of Sjo as compared to traditional testing methods?

    • In-office testing

    • 6 novel biomarkers

    • Identifies non-organ-specific autoantibodies

    • Earlier detection

    Correct Answer
    A. Earlier detection
    Explanation
    Sjo is considered a key advantage compared to traditional testing methods because it allows for earlier detection.

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  • 39. 

    What is the cumulative rate of specificity for Sjö? 

    • 66%

    • 78%

    • 89%

    • 95%

    Correct Answer
    A. 78%
    Explanation
    The cumulative rate of specificity for Sjö is 78%. This means that when testing for a specific condition or characteristic, the test correctly identifies individuals without that condition 78% of the time. In other words, there is a 78% chance that a negative test result accurately indicates the absence of the condition in question.

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  • Mar 20, 2023
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