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Interpreting The Data - Critically Analyse The Strengths And Weaknesses Of Different Epidemiological Study Designs - Case Study Assessment Answer

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Case Study Assessment Answer

Assignment Task: Learning Outcomes The purpose of this assessment task is for you to:
  1. Explain how the disease is measured in populations, calculate, interpret and communicate measures of association  and difference;
  2. Critically analyse the strengths and weaknesses of different epidemiological study designs;
  3. Demonstrate an understanding of basic concepts and methods of biostatistics.
  4. Interpret confidence intervals, p-values and sample size and communicate their meaning.
  5. Use epidemiological and biostatistical principles to critically evaluate and interpret and communicate findings from epidemiological research.
  6. Explain and contextualise the concepts of population, sampling, measurement, bias, confounding and causation.
Case Studies Requirements Please choose 3 of the 4 case studies provided below (Approximately 450 words per case study- the total word count for the assessment is 1350+/- 10%)  Details of each case study are on the following pages. Case Study 1. When findings conflict  Case Study 2: Interpreting the data  Case study 3. Which screening test is best? Case study 4: What is the best way to reduce stillbirth? The case studies are to be written for an educated but a mainly non-scientific audience of policymakers, and should, therefore, be written in language that this group would understand.  CASE STUDY 1 This case study encompasses learning outcomes:
  1. Critically analyse the strengths and weaknesses of different epidemiological study designs;
  2. Explain and contextualise the concepts of population, sampling, measurement, bias, confounding and causation.
Randomised controlled trials are considered the gold standard in regards to evidence generation. Sometimes the relationships observed in clinical trials, however, do not reflect what is observed at the population level.  Presented below are 2 abstracts that have examined the relationship between induction of labour and the risk of caesarean birth using 2 different study designs- an experimental and observational study.   Questions to address in your assessment:
  • What is the relationship between induction of labour and caesarean birth identified in each of the studies?
  • Are there any differences in methodology (beyond study type) between the 2 studies?
  • Considering the specific strengths and weakness of the two design types why might the result differ? Discuss 2 potential causes of the differences.
Case Study 2: Interpreting the data This case study encompasses learning outcomes:
  1. Demonstrate an understanding of basic concepts and methods of biostatistics.
  2. Interpret confidence intervals, p-values and sample size and communicate their meaning.
  3. Use epidemiological and biostatistical principles to critically evaluate and interpret and communicate findings from epidemiological research.
Prostate cancer is the most commonly diagnosed cancer in men in Australia. More than 3000 men die of prostate cancer in Australian every year. A study was done to determine whether a new type of estrogen-like therapy increases survival time in men diagnosed with prostate cancer.  The study randomised 389 prostate cancer patients to receive a new estrogen-like therapy or a placebo. Patients were followed from the time of commencing randomized treatment until either they died (from their prostate cancer disease or from other causes) or they were still alive at the end of follow-up 4-6 years later.  Case Study Assessment Answer Case Study Assessment Answer
  • You have been asked to assist in the writing up of the manuscript for publication.
  • Please describe the findings in Figure and Tables.
  • What statistical tests were used to generate each of the results, why were those tests chosen?
  • Compare the survival of patients in the two treatment groups in the figure.
  • What are the correct interpretations of the data?
  • Does the new estrogen therapy work?

 Case study 3. Which screening test is best?

This case study encompasses learning outcomes:
  1. Use epidemiological and biostatistical principles to critically evaluate and interpret and communicate findings from epidemiological research.
  2. Explain and contextualise the concepts of population, sampling, measurement, bias, confounding and causation.
 Cervical cancer is the growth of abnormal cells in the lining of the cervix. There are about 900 new cases of cervical cancer diagnosed in Australia each year. Approximately 250 women died from cervical cancer in 2016 and the mortality rate for cervical cancer has reduced by half following the introduction of the National Cervical Screening Program in 1991. This screening program involved a Pap smear test, performed every 2 years where scientists looked for precancerous changes to the cells under the microscope.   In December 2017 there were changes to the Australian Cervical Cancer screening program to employ a new type of test on the back of a number of larger international randomized controlled trials. In the new test, instead of looking for changes in cells of the cervix, scientists instead look for the virus, HPV that causes cancer.   The results of one of these trials that compared the new HPV screening to standard screening is presented below. Case Study Assessment Answer
  • Please compare the performance of 2 screening processes and consider any bias’ that may be present.
  • Which approach is best?  
  • Do you agree with the changes made to the national screening program? Please justify your choice. Please include all calculations. 
Case Study 4. What is the best way to reduce stillbirth? This case study encompasses learning outcomes:
  1. Explain how the disease is measured in populations, calculate, interpret and communicate measures of association and difference;
  2. Critically analyse the strengths and weaknesses of different epidemiological study designs;
  3. Explain and contextualise the concepts of population, sampling, measurement, bias, confounding and causation.
 The rates of stillbirth have remained unchanged for the last 2 decades and addressing this has become a key health priority area for state and national governments. You have been asked to identify a modifiable risk factor for stillbirth to target in a public health campaign to reduce stillbirth. You initially go to the literature and identify 2 modifiable risk factors that are related to stillbirth- maternal smoking in pregnancy and the mother predominantly sleeping on her back compared to on her side over pregnancy. You undertake a study using routinely reported population-based data to determine the rate of stillbirth in smokers and non-smokers. You also ask all women how they slept during pregnancy.   The results of your analysis are presented below.   Case Study Assessment Answer Case Study Assessment Answer
  • What is the rate of stillbirth in your population?
  • Please describe the relationship of each factor with stillbirth and how much disease the risk factor causes.
  • If you were to pick one factor to target which would it be and why? Justify your answer.
  • Do the results suggest a targeted risk factor approach or population-based intervention. Please show all calculations. 
  •  What study design did you choose to assess maternal sleeping?
  • Was it the most appropriate to answer this question?
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