Case reports in the literature suggested that drug X led to an increased miscarriage rate when administered during pregnancy.
Answer the following questions in detail on the Measures of Association.
1. Case reports in the literature suggested that drug X led to an increased miscarriage rate when administered during pregnancy. From the medical records in three large HMOs for the period 2001-2003, a group of women was identified who had been given drug X while pregnant. A group of women who were pregnant during the same time period but who did not receive drug X was also selected from medical records. Birth certificates, fetal death records and medical records were checked to determine whether each woman had a miscarriage or live birth for the specific pregnancy studied.
The following data resulted from the study:
Questions;
a.What type of study design is this?
b. On what basis did you decide which type of study it represents?
c. Determine whether there is an association between the exposure and the disease using the appropriate measure of association. Interpret your results.
2. You are concerned about the relationship between toxic waste sites and nervous system disorders. You identify 300 people who were recently diagnosed with nervous system disorders in Massachusetts. This group includes all individuals diagnosed nervous system disorders in 2004. You then randomly select a group of 300 healthy individuals from Massachusetts, frequency-matching on age, sex, and county of residence. You find that of those with nervous system disorders, 210 have a large toxic waste site within a mile of their home. Of the controls, 170 have a large toxic waste site within a mile of their home.
a. What study design is this?
b. On what basis did you determine the study design?
c. What type of comparison group was used in this study?
d. Given the data above, make a 2×2 table (see template below).
e. Calculate the appropriate measure of association between toxic waste site and nervous system disorders. Interpret your results.
f. Calculate the appropriate measures of the public health impact of exposure to a toxic waste site in nervous system disorders. Interpret your results.
3. In Rotterdam, The Netherlands, 4,802 people completed a baseline questionnaire in 1990 including information about diet, physical activity and weight. None of the individuals had a known diagnosis of diabetes. From 1990-1996, 164 subjects were diagnosed with diabetes. The researchers investigated the association of exercise and risk of diabetes in this study.
a. What study design is the Rotterdam Study?
b. On what basis did you determine the study design?
c. What type of comparison group was used in this study?
d. Given the data above, make a 2×2 table and calculate the diabetes incidence in each group.
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