SCENARIO & LEARNING TASKS 14

Case 1.
Please carefully study the article entitles: “Tobacco smoking as a risk factor for depression:
A 26-year population-based follow up study”

Learning Tasks 1:
After you carefully read through the article above, please discuss the following
questions:

1. Draw a figure of the study design with its attributes.

2. What are the dependent and independent variables of that study?
3. What are the confounding variables of that study?
4. Describe two major conditions of study group and control group in a cohort study!
5. How did the researcher choose the control group?
6. How did the researcher control the effect of confounding variables? Is that the way by design
or by analysis?
7. Explain how the researcher did that (no 6)!
8. Why do the researchers choose this study design? Describe two reasons.
9. What is its CRUDE RR of the study? Provide the interpretation!
10. What is its SPECIFIC RR after being controlled for its tobacco consumption level? Provide
the interpretation!

Case 2.
Carefully examine the following table.
Social Non-Smokers Smokers All
Class
Alcohol Intake Alcohol Intake
Heavy Moderate Light Total Heavy Moderate Light Total
I and II 11/84 5/79 11/169 27/332 6/28 3/13 1/26 10/67 37/399
III 4/22 3/25 12/162 19/209 4/17 2/7 6/38 12/62 31/271
IV and V 0/14 1/18 12/91 13/123 7/19 2/18 8/70 17/107 30/230
15/120 9/122 35/422 59/664 17/64 7/38 15/134 39/236 98/900

Learning Tasks 2:
After you examined the above table, please calculate the following:

1. What is the CRUDE RR?

2. What is the SPECIFIC RR after being controlled for its social class variable?
3. What is the SPECIFIC RR after its smoking variable is controlled for?
4. What is the SPECIFIC RR after both smoking and social class variables are controlled for?
5. Provide the interpretation of thoseRR!

Case 3:
A study at Stockholm had observed 216 children who received BCG immunization when they
were aged below 6 years and 358 children who did not have BCG immunization since 1989-1992.
The study was set up in 1994. In 1995-1996, all children were examined to find out atopic disease
incidence (atopic: a type of allergic disease). The study result shows that 36% who had BCG
immunization and 41% who did not have BCG immunization are suffering from atopic disease (2
= 2.6; p > 0,05).

Learning Tasks 3:
Based on the above case, please answer the following questions:

1. What is the study design of the case above?

2. Draw figure of the study with its attributes?
3. What is the main requirement if we want to choose that design?
4. What is the RR?
5. Does the RR in this study also occur in a population? Describe your reasons!

Case 4.
Carefully read the article entitles: “Risk of herpes zoster among patients with chronic
obstructive pulmonary disease: a population-based study”

Learning Tasks 4:
After you carefully read through the article above, please discuss the following
questions:

1. Please draw the study profile/design with its attributes

2. Where the exposure and the outcome data were obtained from?
3. What is the dependent and independent variables?
4. Identify the confounding variables in this study!
5. What is the crude RR and what does it mean?
SCENARIO & LEARNING TASKS 15
Case 1.
Please carefully study the article entitles“Prolonged breastfeeding reduces risk of breast
cancer in Sri Lankan women: a case-control study”

Learning Tasks 1:
After you carefully read through the article above, please discuss the following
questions:
1. Draw a figure of the study with its attributes.
2. Was this study hospital based or population based or combination?
3. Explain its dependent and independent variables!
4. Explain its case definition!
5. Explain the source and methods of selecting control from the study!
6. Is the above study part of a match-paired design? Why or why not? Describe three reasons.
7. Do the cases represent their population? Do the controls represent their population?
8. Are cases and controls comparable? If not, which part is not comparable?
9. How does the researcher control the effect of confounding variables?
10. What is its CRUDE OR? Provide an interpretation!

Case 2.
Carefully examine the following table.
Table 2.1 Use of IUD in sometime pregnant and never pregnant patients and controls in
different age groups
Age Patients Control
group Sometime Never Pregnant Total Sometime Never Pregnant Total
(year) Pregnant Pregnant
IUD No IUD IUD No IUD IUD No IUD IUD No IUD
≤ 15 0 1 0 7 8 0 0 0 3 3
16-20 13 44 27 93 177 5 19 7 196 227
21-25 26 74 28 87 215 25 131 7 163 326
26-30 20 50 3 19 92 21 86 3 49 159
31-35 7 12 1 3 23 4 21 0 1 26
Total 66 181 59 209 515 55 257 17 412 741

Learning Tasks 2:
After you examined the above table, please calculate the following:

1. What is the CRUDE OR? Please provide an interpretation!

2. Calculate 95% CI (confidence interval) of the CRUDE OR using below formula:

95% CI = (OR) exp [+ 1.961/a+1/b+1/c+1/d]

3. After it is controlled for age variable, what is its SPECIFIC OR? What is the interpretation?
4. What is the SPECIFIC OR after being controlled for obstetric history variable? What is the
interpretation?

Case 3:
Carefully read the article entitles: “Risk factors for psoriasis: a case control study”

Learning Tasks 3:
Based on the above case, please answer the following questions:

1. What is the dependent (or response) variable of this study?

2. What are the objectives of this study?
3. What are risk factors investigated or what are independent variables of this study?
4. Was this study hospital based or population based?
5. How long the cases were collected?
6. Who was the control group?
7. Regarding which variables cases and control was comparable?
(a) Regarding which variables cases and control was not comparable?
(b)What must be done to control these confounding variables?
8. See Table-3. How do you determine the most dominant risk factors?
9. See Table-3. Which risk factor had the highest OR? What was the 95% CI for this risk factor?
10. What were the OR and 95% CI of variable place of recidence? Explain, what does it mean?