Question
Epidemiology Critique
Epidemiology
Critique Outline A. Collection of Data (50 points)
A.1. (5 Pts.) What were the objectives of the study? What
was the association of interest?
A.2. (10 Pts.) What was the primary outcome (e.g. disease) of interest? Briefly
explain how the outcome was measured. Was this accurately measured?
A.3. (10 Pts.) What was the primary exposure (risk factor)
of interest? Briefly explain how exposure was measured. Was this accurately
measured?
A.4. (5 Pts.) What type of study was conducted (study
design)?
A.5. (5 Pts.) Describe the process of subject selection.
Define the source population for this study, if possible.
A.6. (5 Pts.) Selection bias: If a case-control study, do
the controls appear to have the same distribution of exposures as the study
base that gave rise to the cases?
If a cohort study, is there
loss to follow-up, and if so, does it appear to be different for exposed and
unexposed? What is the retention rate in each group?
A.7. (5 Pts.) Information bias: What are some of the
sources of information (measurement) error, for either the exposure or outcome
measurement? Does this error/misclassification differ with respect to the other
factor (exposure or outcome) of interest and result in
information bias?
A.8. (5 Pts.) Confounding: Did the authors consider
potential confounders in the design of the study?
B. Analysis of Data (20 Pts.)
B.1. (2 Pts.) What methods were used to control
confounding? Were these sufficient (as far as you can tell)?
B.2. (8 Pts.) What measure of association was reported in
the study? Was this appropriate?
B.3. (10 Pts.)How was the uncertainty of the measure of
association (effect of random error or statistical significance) reported in
this study? Are the conclusions of the study consistent with the uncertainty of
the measure of association? C. Interpretation of Data (30 Pts.)
C.1. (10 Pts.) What was the major result of this
study?
C.2. (5 Pts.) How would the interpretation of this result
be affected by bias (e.g., selection
bias, information bias, or confounding)?
C.3. (5 Pts.) To what larger population may the result of
this study be generalized? Justify your restrictions (if any) to the
generalization of these results
C.4. (10 Pts.) Did the discussion section adequately
addresses the limitations of the study? Was the final conclusion of the paper a
balanced summary of the study findings? Do you agree with the authors?
Expert Solution
A.
Collection of Data
A.1.
Sotos-Prieto et
al. (2017) determine the relationship between diet quality for a prolonged
period with mortality rate and the risk of death. More interest is also given
to the risk of death from cardiovascular diseases.
A.2.
The primary
outcome being measured in the study is the risk of death. The participants'
risk of death or mortality is recorded mainly from the participant's death as
reported by their families. Also, participants' information is measured after
one year during the 12 years of study to determine their health status. This
study measured their hypertension, diabetes, alcohol consumption, and other
risk conditions. These measurements are accurate due to their thorough nature,
such as ascertaining deaths by capturing the participants' death
certificates.
A.3.
The primary
exposure measured in the study includes diet improvement or diet quality
reduction. Diet improvement is measured by assessing participants' diets every
four years through questionnaires. This method lacks accuracy due to the long
frequency of measurement.
A.4.
The research is
a cross-sectional quantitative study that determines numerical correlations of
two variables based on mathematical measurements and analysis.
A.5.
Little
information is given on participants' selection, except the qualification of
participants without cardiovascular diseases. Participants are taken from
nursing care, where nurses and health professionals are enrolled in the study
across the country for easier follow-up of the patients.
A.6.
Limited
selection bias was present, considering many participants from different study
areas in the research. For example, 90% of participant health information is
ascertained by the measure of follow-up rates.
A.7.
Some information
biases are present, considering that participants report their dietary data
after four years. However, this variable measurement error does not affect the
whole study due to the use of diet records.
A.8.
Despite the
consideration and minimization of potential confounders, residual confounders
remained in the study through unmeasured confounders, such as the assumption of
single diet elements and their synergies and their relation to mortality.
B.
Analysis of Data
B.1.
The use of
dietary records and biomarkers per year were used to ensure that the data
received after four years by the participants was more accurate. However, these
confounding controls are insufficient since single dietary elements are also
not considered.
B.2.
Different
measures of association are used in the study, such as between the three
dietary indices and their relation to mortality and science. This is necessary
to determine a more robust analysis.
B.3.
The measures of
association for different elements, such as the tree dietary standards, are
similar and are consistent with other studies' results. However, the study
declared limitations of using a single sectional study in determining
participants of the same socio-economic background.
C.
Interpretation of Data
C.1.
The major
results of the study are based on the three dietary standards used and the two
cohorts of participants who all describe the relationship between mortality and
death risk and the quality of diet. The research successfully describes the
critical place of dietary quality in reducing mortality, sickness, and death
risks.
C.2.
The
interpretation of the results may be affected by information bias due to
participant lack of accurate information and consideration of dietary elements,
which limits the knowledge on dietary improvement and how dietary improvement
increases.
C.3.
Since the study
corresponds to similar studies of different populations, the study can be
generalized to various socio-cultural populations, and not only the white
ethnic populations, which most health professionals are from.
C.4.
study's
discussion fails to give enough details on the study's limitations and the
methods used to reduce any potential confounding elements in the study. Not
enough information is given on how the lack of dietary elements was catered for
and how participatory information was adjusted to diet records. However, the
study's conclusion is satisfactory, considering the number of measures used for
the exposure conditions and the large population size that minimizes these
limitations.
References
Sotos-Prieto, M.,
Bhupathiraju, S. N., Mattei, J., Fung, T. T., Li, Y., Pan, A., ... & Hu, F.
B. (2017). Association of changes in diet quality with total and cause-specific
mortality. New England Journal of
Medicine, 377(2), 143-153. From DOI: 10.1056/NEJMoa1613502
Please enter your email address to h
- 100% Plagiarism-free
- 100% Human-written
