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WK 3 DIS EPID

Observational Study Designs

A clinical pediatric nurse has noticed a rise in childhood asthma diagnoses among the Hispanic population served by the local clinic. The nurse is concerned about this increase in asthma incidence in the patient population and turns to the literature to explore current research on this topic. The nurse finds, through the reading, that there appears to be an association between parental smoking and childhood asthma and wonders if this could be the cause of the rise in cases.

This type of suspected association between a risk factor (exposure) and a particular outcome (childhood asthma) can be evaluated using an observational study design. A relevant case-control study would match a group of controls (no asthma) with the case group (asthma diagnosis). Both groups would then be assessed on certain historical exposures like (a) family history; (b) early childhood respiratory infections; (c) secondhand smoke exposure; (d) urban residence (ozone); and (e) obesity. Measures might include interviews, surveys, and medical records. If results show the case group has a higher rate of exposure to a given risk factor, the researcher may conclude that exposure results in greater odds of asthma.

In any epidemiological study, the design and methodology used should be appropriate for that study and for the research question. It is important for researchers to understand the strengths and limitations of each of the study designs and methods. This gives them a better chance of correctly interpreting results and synthesizing them for use in developing and implementing evidence-based population health programs. For this Discussion, you will explore the strengths and limitations of various types of observational study designs and critique their appropriateness for specific studies.

This type of suspected association between a risk factor (exposure) and a particular outcome (childhood asthma) can be evaluated using an observational study design. A relevant case-control study would match a group of controls (no asthma) with the case group (asthma diagnosis). Both groups would then be assessed on certain historical exposures like (a) family history; (b) early childhood respiratory infections; (c) secondhand smoke exposure; (d) urban residence (ozone); and (e) obesity. Measures might include interviews, surveys, and medical records. If results show the case group has a higher rate of exposure to a given risk factor, the researcher may conclude that exposure results in greater odds of asthma.

In any epidemiological study, the design and methodology used should be appropriate for that study and for the research question. It is important for researchers to understand the strengths and limitations of each of the study designs and methods. This gives them a better chance of correctly interpreting results and synthesizing them for use in developing and implementing evidence-based population health programs. For this Discussion, you will explore the strengths and limitations of various types of observational study designs and critique their appropriateness for specific studies.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 


WEEKLY RESOURCES

Learning Resources

Required Readings

·

· Friis, R. H., & Sellers, T. A. (2021). 
Epidemiology for public health practice (6th ed.). Jones & Bartlett.

. Chapter 6, “Study Designs: Ecologic, Cross-Sectional, Case Control”

. Chapter 7, “Study Designs: Cohort Studies”

· Bahr, R., Clarsen, B., Derman, W., Dvorak, J., Emery, C. A., Finch, C. F., Hägglund, M., Junge, A., Kemp, S., Khan, K. M., Marshall, S. W., Meeuwisse, W., Mountjoy, M., Orchard, J. W., Pluim, B., Quarrie, K. L., Reider, B., Schwellnus, M., Soligard, T., Stokes, K. A., … Chamari, K. (2020). 
International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS))Links to an external site.
British Journal of Sports Medicine
54(7), 372–389.

· Community Preventative Services Task Force. (n.d.). 

The community guideLinks to an external site.
.

· Framingham Heart Study. (n.d.). 

Epidemiological background and design: The Framingham heart studyLinks to an external site.

. 

· STROBE. (2021). 
HomeLinks to an external site..
 
 
The STROBE Checklist is considered the gold-standard in assessing the quality of observational research studies.

· U.S. Department of Health and Human Services. (n.d.). 

Healthy People 2030Links to an external site.
.

Articles for this week’s Discussion:

Note: By Day 1, your Instructor will assign you to a small group. Your group will be assigned 
two of the following articles to analyze.

· Batty, G. D., & Hamer, M. (2020). 
Vascular risk factors, Framingham risk score, and COVID-19: Community-based cohort studyLinks to an external site.. Cardiovascular Research, 
116(10), 16641665.

· Hillyer, G. C., Nazareth, M., Lima, S., Schmitt, K. M., Reyes, A., Fleck, E., Schwartz, G. K., & Terry, M. B. (2021). 
E-cigarette use among young adult patients: The opportunity to intervene on risky lifestyle behaviors to reduce cancer riskLinks to an external site.
Journal of Community Health. Advance online publication.

· Kebede, E., Kekulawala, M. (2021).
Risk factors for stillbirth and early neonatal death: A case-control study in tertiary hospitals in Addis Ababa, EthiopiaLinks to an external site.
BMC Pregnancy and Childbirth,
21(1), Article 641.

· Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). 
Risk factors for falls in hospital in-patients: A prospective nested case control studyLinks to an external site.
International Journal of Health Policy and Management
 (5), 300–306.

· Whittle, R. S., Diaz-Artiles, A. (2020). 
An ecological study of socioeconomic predictors in detection of COVID-19 cases across neighborhoods in New York CityLinks to an external site.
BMC Medicine, 18(1),Article 271.

· Spector, A. L., Quinn, K. G., McAuliffe, T. L., DiFranceisco, W., Bendixen, A., Dickson-Gomez, J. (2020). 
Health-related quality of life and related factors among chronically homeless adults living in different permanent supportive housing models: A cross-sectional studyLinks to an external site.
Quality of Life Research: An International Journal of Quality-of-Life Aspects of Treatment, Care and Rehabilitation
29(8), 20512061.

· Palència, L., Ferrando J., Marí-Dell’Olmo, M., Gotsens, M., Morrison, J., Dzurova, D., Lustigova, M., Costa, C., Rodríguez-Sanz, M., Bosakova, L, Santana, P., & Borrell, C. (2020). 
Socio-economic inequalities on cancer mortality in nine European areas: The effect of the last economic recessionLinks to an external site.
Cancer Epidemiology
69, Article 101827.

· Nguyen, L. H., Örtqvist, A. K., Cao, Y., Simon, T. G., Roelstraete, B., Song, M., Joshi, A. D., Staller, K., Chan, A. T., Khalili, H., Olén, O., & Ludvigsson, J. F. (2020). 
Antibiotic use and the development of inflammatory bowel disease: A national case-control study in SwedenLinks to an external site.
The Lancet. Gastroenterology & Hepatology
 (11), 986–995.

Required Media

· The Challenges of Conducting Trials 

Time Estimate: 2 minutes

· Let’s Learn Public Health. (2017, May 5). 

Epidemiological studies—made easy! [Video].Links to an external site.
 YouTube.

Note: The approximate length of this media piece is 10 minutes.

To prepare:

· Review the different types of observational study designs presented in the Learning Resources: ecologic, cross-sectional, case-control, and cohort.

· Carefully examine the characteristics, strengths, and limitations of each design.

· Consider when it is appropriate to use each of the observational study designs.

· Consider how using observational study designs can lead to improvements in population health.

· By Day 1 of this week, you should have received a communication from your Instructor assigning you to a small group to review two specific articles. Review the two articles your group was assigned, with a critical eye toward the researchers’ use of study design and their selected methods. Although several students will be assigned the same articles, this is NOT a group project; please submit your Discussion posts individually. You will then have the opportunity to discuss and share your thoughts with your colleagues.

By Day 3 of Week 3

In your assigned group area:

Post a brief description of the two studies you were assigned, with a particular focus on the study design and methods. Then:

· Describe at least one strength and one limitation of each study’s design.

· Identify the population, data sources, and epidemiologic measures of association that the authors used.

· Finally, share your insights about the appropriateness of the design for the study. Do you agree with the researchers’ choice of design?

· Do you agree with the researchers’ conclusions? Justify your reasoning.

·
Assigned DISCUSS ON THIS

· Palència, L., Ferrando J., Marí-Dell’Olmo, M., Gotsens, M., Morrison, J., Dzurova, D., Lustigova, M., Costa, C., Rodríguez-Sanz, M., Bosakova, L, Santana, P., & Borrell, C. (2020). 
Socio-economic inequalities on cancer mortality in nine European areas: The effect of the last economic recession
Links to an external site.

Cancer Epidemiology
69, Article 101827.

· Nguyen, L. H., Örtqvist, A. K., Cao, Y., Simon, T. G., Roelstraete, B., Song, M., Joshi, A. D., Staller, K., Chan, A. T., Khalili, H., Olén, O., & Ludvigsson, J. F. (2020). 
Antibiotic use and the development of inflammatory bowel disease: A national case-control study in Sweden
Links to an external site.

The Lancet. Gastroenterology & Hepatology
 (11), 986–995.

By Day 5 of Week 3

Post at least 
two substantive responses to peers 
in a different group who analyzed at least one different article in their initial post. Include information from the Learning Resources in your responses as appropriate. You may expand on each peer’s posting with additional insight and resources about study designs, ask a question to further the discussion, or offer polite disagreement or critique supported with evidence. You may also make a suggestion or comment that guides or facilitates the discussion. At least one of your response posts should address the applicability of observational studies for improving population health status.

By Day 7 of Week 3

Respond to any questions you may have been asked by your peers in 
your assigned group area. Note what you have learned and/or any insights you have gained as a result of reading the comments your peers made.

Reply

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