Paper , Order, or Assignment Requirements This is epidemiology assignment require questions answer to be filled based on the

Paper , Order, or Assignment Requirements

This is epidemiology assignment require questions answer to be filled based on the article as well as some statements

Question 1:

Question 1 refers to the paper located in the assignment 2 folder in vUWS

Liu S, Manson EJ, Stampfer MJ, Hu FB et al. A prospective study of whole-grain intake and risk of type II diabetes Mellitus in US Women. American Journal of Public Health, 2000; 90:9.

Make sure your answers are no more than 100 words!!

(a) What was the study design and what are the advantages of using this design for their research questions? [2 mark]

(b) Compute the crude incidence rates of diabetes among this group of women [4 marks]

(c) Table 2 presents the adjusted relative risk of type II diabetes according to quintiles of Total Grain consumption (first 5 lines) relative to the 1st quintile (the lowest consumption as a reference). Calculate the unadjusted (crude, quintile –specific) incidence rate of diabetes by exposure to Total Grain and the crude relative risk (RR) of each quintile, in comparison to the first quintile. Comment in your own words whether any pattern of association between Total Grain consumption and Diabetes can be observed from the unadjusted crude RR [4 marks]

(d) In Table 2 model 2 (multivariables adjustment) of Whole Grain showed the RR of each quintile (increased consumption) relative to the lowest 1st.

What is the pattern of the association? [2 marks]

(e) Why the authors adjusted their analysis for physical activity, smoking alcohol intake and family history. You need to back up your argument with evidence from the data presented in Table 1.[4 marks]

(f) What is the main possible bias in this study? Provide arguments for your answer and how it will affect the estimates. [4 marks]

Question 2:

Tasmanian researchers conducted a case –control study to investigate the effect of dietary fat intake on melanoma (Skin Cancer). They hypothesised that people whose dietary fat intake is low will be more susceptible to skin cancer. The study compared 500 cases of melanoma with 500 controls. The controls were randomly selected from the state’s electoral roll. The researchers categorised the dietary fat intake into three categories High, Moderate and Low. They found that among skin cancer patients 150 were classified at the low and 80 at the high dietary fat intake whereas among control 130 were at the low and 100 were at the high.

Build a table to summarise the data above which will help you estimate the association between dietary fat intake and Skin cancer [4 points]

Calculate the relative risk (RR) of high fat intake versus low fat intake and the RR of medium to high fat intake in relation to the development of melanoma, what type of RR are these and explain in words the meaning of what you found [4 points].

Calculate the percent attributable risk due to exposure to low-dietary fat intake on Melanoma and explain in one or two sentences the meaning of your findings [4 points]

Calculated the population attributable risk of low-fat intake on melanoma and explain in words the meaning of such finding [4 points]

e) What do you think about the conclusions of the PAR regarding exposure to low fat diet to reduce melanoma? (no more than 3-4 sentences) [4 points}
Question 3

In a small cohort study investigating the effect of a rare exposure ( E), the following results were found:

Table 1 Disease

Yes

No
Yes 60

180
No 60

180
Exposure

Is there an association between exposure and disease? Show the way you reached the conclusion. [2 points]

A stratified analysis by Age-groups shows the following:

Younger adults Older adults
Disease Disease
Exposure
Yes

No

Exposure Yes No
Yes

30 90 Yes 40 80
No

40 80 No 30 90

What is the relative risk (RR) of exposure causing disease in younger adults and what is the RR in older adults? [ 4 points]

c- How do you explain this result? (No more than 60 words) [4 points]

Question 4

Give one example of typical bias for cohort study and explain why it creates a bias one example of typical bias for a case control study and explain why it is a bias [6 points] No more than half a page

Question 5

A study aims to determine the incidence of type 2 diabetes. A cohort of 200 people age 65 years or older who were initially disease –free participated in the study. One hundred and fifty people were examined at the end of 3 years. Fifty other participants from the initial cohort could not be examined, including 11 people who had died. Does this loss of participants represent a source of bias? Justify your answer. [4 points] no more than 150 word

 

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