Epidemiology Medical Studies Questions

1. Identify the type of bias (if any) in each of the following scenarios and explain your rationale using a few complete sentences:

a. In a case-control study of the association between calcium intake and development of obesity, investigators are concerned that some study participants may have forgotten to report using calcium supplements, but that this problem occurred equally among cases and controls. What type of bias does this represent, if any?

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b. In a case-control study of the association between HPV and multiple sexual partners, cases with multiple sexual partners are more likely to participate because they are concerned that having had multiple sexual partners caused their infection. What type of bias does this represent, if any?

c. In a cohort study of oral contraceptive use and phlebitis, physicians screen oral contraceptive users for phlebitis more often than non-users. What type of bias does this represent, if any?

2. For each of the following scenarios, identify the most appropriate study design to use, and justify your choice in a few complete sentences.

a. Investigators are interested in determining whether coffee consumption is related to increased risk of breast cancer in men. Male breast cancer is a rare disease, with less than 2,000 cases diagnosed each year in the U.S.

b. Government officials are concerned about the long-term impact of the Hurricane Katrina disaster on children. Specifically, they are hypothesizing that children who were left homeless as a result of the storm will have an increased risk of obesity as teenagers. A team of epidemiologists is awarded a multi-million dollar grant to study this hypothesis over the next five years.

c. UMass researchers are interested in risk factors for new-onset sexually transmitted diseases (STDs) during college. They have access to a large population of students without STDs. Unfortunately, STDs have a high incidence rate in this population.

d. Epidemiologists are interested in examining whether extended iPod use causes hearing loss in young adults. They have very little funds available for this study, and the study must be completed within one year. Additionally, very few young adults have hearing loss.

3. Your research team is studying the association between smoking and dating violence among college students. They are concerned that alcohol use may be a confounder of this relationship. The results of their cross-sectional study are reported below.

Overall Sample

Smokers Non-smokers
Dating violence 30 70 100
No dating violence 18 82 100
48 152 200

Alcohol Drinkers
Smokers Non-smokers
Dating violence 5 45 50
No dating violence 8 72 80
13    117 130

Alcohol Non-drinkers

Smokers Non-smokers
Dating violence 25 25 50
No dating violence 10 10 20
35 35 70

a. What is the odds ratio for smoking and dating violence among all participants? Interpret this result.

b. What is the odds ratio for smoking and dating violence among participants who consume alcohol? Interpret this result.

c. What is the odds ratio for smoking and dating violence among participants who do not consume alcohol? Interpret this result.

d. Is alcohol consumption a confounder of the association between smoking and dating violence? Why or why not?

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