Analytical Epidemiology Homework 2

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Analytical Epidemiology


1. Based on the information provided, note whether the study is cross-sectional, ecologic, prospective cohort, retrospective cohort, or case control:

A.Association between second-generation antipsychotics and changes in body mass index in adolescents.

PURPOSE: To assess the association of second-generation antipsychotics (SGAs) with changes in body mass index (BMI) among adolescents compared with an untreated comparison group.

METHODS AND MATERIALS: In 2011, a XXX study was conducted using an electronic medical record database between January 2004 and July 2009.  Adolescents (12-19 years old), newly initiated on SGAs formed the exposure group and untreated adolescents formed the unexposed comparison group.  Records of both the exposed and unexposed groups were reviewed for slightly more than a year (395 days).  Baseline and follow-up BMI were evaluated for both groups.

Study type? _______ _________________________


B. Study of attention-deficit hyperactivity disorder and maternal smoking, alcohol use, and drug use during pregnancy.

OBJECTIVE: To address the association between attention-deficit hyperactivity disorder (ADHD) and prenatal exposure to maternal cigarette smoking, drugs of abuse, and alcohol.


METHOD: A study was conducted with 280 ADHD cases and 242 non-ADHD controls of both genders. Children and their relatives were assessed with structured diagnostic interviews to determine maternal behaviors during pregnancy.


Study type? _________________________________

C. Pediatric providers' self-reported knowledge, practices, and attitudes about concussion

Objective: To determine the self-reported practices and attitudes surrounding concussion diagnosis and management of primary care and emergency medicine providers.


METHODS: A survey was distributed to pediatric primary care and emergency medicine providers in a single, large pediatric care network.  For all survey participants (n=145), practices and attitudes about concussion diagnosis and treatment were queried.


Study type? _________________________________


D. Habitual Caffeine Intake and Risk of Hypertension in Women

OBJECTIVE: To examine the association between caffeine intake and incident hypertension in women.


DESIGN, SETTING, AND PARTICIPANTS: 155,594 US women free from physician-diagnosed hypertension followed up over 12 years. Caffeine intake and possible confounders were ascertained from regularly administered questionnaires. We also tested the associations with types of caffeinated beverages.


MAIN OUTCOME MEASURE: Incident physician-diagnosed hypertension


Study type? ___ ______________________________

E.Fish Consumption and Mortality from All Causes, Ischemic Heart Disease, and Stroke.

Objective: The present study examined the relation between fish consumption and mortality from all causes, ischemic heart disease, and stroke.

Methods: The fish consumption data in 1961-1963, 1079-1981, and 1989-1991 and mortality data in 36 countries were obtained from the Food and Agriculture Organization and the World Health Organization, respectively.

Study type? _________________________________



2. Groups that are selected for an ecologic study might be residents of a particular:            


A.   State

B.   Zip Code

C.   School

D.   All of the above


3. The ratio of the incidence rate of a disease in an exposed group to the incidence rate of the disease in a non-exposed group is the:


A.   Odds ratio

B.   Population risk difference

C.   Relative Risk

D.   None of the above



4.   Subjects are classified according to their exposure to a factor of interest and then are observed over time to document the incidence of disease in what type of study?              


A.   Prospective cohort study

B.   Case-control study

C.   Cross-sectional study

D.   Retrospective cohort study


5. What is one limitation of a cross-sectional study?


A. Must track addresses of study participants over time

            B. Cannot accurately measure exposure status

            C. Cannot establish temporal association between exposure and outcome

            D. Must collect information on outcomes from medical records


6. A case-control study is characterized by all of the following except:


A. Patients with the disease (cases) are compared with persons without the disease (controls)

            B. Incidence rates may be computed

            C. Assessment of past exposure may be biased

            D. It is relatively inexpensive and quick


7. A case-control study of the association between autism and the measles-mumps-rubella (MMR) vaccination was conducted.  There were 288 children in the study.  There were 96 children with autism in the study and 192 control children who did not have autism.  Of the children with autism, 79 had received the MMR vaccine.  Among the children without autism, 183 had received the MMR vaccine


A. Complete the 2x2 table including appropriate labels for the rows and columns.  Be sure to fill in your marginal totals.








B. What measure of association would be used in this type of study?



C. Calculate the measure of association for this study (show your work).




D. Is having received the MMR vaccine a risk for being diagnosed with autism?  Why or why not?





8. It has been hypothesized that bottle-fed infants are at a greater risk of ear infections compared to breast-fed infants. To test this hypothesis, investigators enrolled 227 babies who were breast-fed and 238 who were bottle-fed.  After 12 months of observation, they found that 68 breast-fed and 70 bottle-fed babies developed ear infections.


A. Complete the 2x2 table including appropriate labels for the rows and columns.  Be sure to fill in your marginal totals.







B. What measure of association would be used in this type of study?




C. Calculate the measure of association for this study (show your work).







D. Use your answer from “C” in a sentence to describer whether bottle-feeding is a risk or protective factor for ear infections.


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