Centers for Disease Control and Prevention Morgantown, West Virginia June 20-24, 2011 Teach Epidemiology Professional Development Workshop Day 3

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3 Teach Epidemiology

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6 National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

“… 23% did not complete the choking game question.”

What would you ask the author?

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18 Teach Epidemiology

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20 Ms. Wilson After-School, Make-Up Homework Hall

21 Talking too much on a cell phone causes students not to do their homework. a c b d Label the 2x2 Table

22 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework.

23 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework. Place the data into the 2x2 Table

24 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework

25 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework Which of the following statements can be made based on the above data: A: 15 of 20 students, who did not do their homework, had cell phones. B: 15 of 20 students, who had cell phones, did not do their homework.

26 Breast Implants No Breast Implants No Connective Tissue Disease 31,1801, ,80586,318 Cohort Study – The Nurses’ Health Study (1976) Which of the following statements can be made based on the above data: A: 15 of 20 students, who did not do their homework, had cell phones. B: 15 of 20 students, who had cell phones, did not do their homework. Total Connective Tissue Disease Risk

27 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework Which of the following statements can be made based on the above data: A: 15 of 20 students, who did not do their homework, had cell phones. B: 15 of 20 students, who had cell phones, did not do their homework. RiskX Odds

28 Odds A ratio of the probability of occurrence of an event to that of its nonoccurrence. Talking too much on a cell phone causes students not to do their homework.

29 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total 15 5 Which of the following statements can be made based on the above data: A: 15 of 20 students, who did not do their homework, had cell phones. B: 15 of 20 students, who had cell phones, did not do their homework. A ratio of the probability of occurrence of an event to that of its nonoccurrence. 15 to 5 or 3 to 1 Odds Talking too much on a cell phone causes students not to do their homework. 20

30 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total 15 5 Which of the following statements can be made based on the above data: A: 15 of 20 students, who did not do their homework, had cell phones. B: 15 of 20 students, who had cell phones, did not do their homework. Talking too much on a cell phone causes students not to do their homework. 20 Nothing A ratio of the probability of occurrence of an event to that of its nonoccurrence. 15 to 5 or 3 to 1 Odds Compared to what?

31 CompareDivideCount Talking too much on a cell phone causes students not to do their homework.

32 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total 15 5 Which of the following statements can be made based on the above data: A: 15 of 20 students, who did not do their homework, had cell phones. B: 15 of 20 students, who had cell phones, did not do their homework. Talking too much on a cell phone causes students not to do their homework. 20 Nothing A ratio of the probability of occurrence of an event to that of its nonoccurrence. 15 to 5 or 3 to 1 Odds Compared to what? What did Ms. Wilson do?

33 Talking too much on a cell phone causes students not to do their homework. What did Ms. Wilson do?

34 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework to 1 10 to 30 or 1 to 3 Place the data into the 2x2 Table

35 What mathematical computation would allow them to complete the statement: The odds of having a cell phone were ____ times greater among students who had not done their homework compared to students who did do their homework. a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework to 1 10 to 30 or 1 to 3

What mathematical computation would allow them to complete the statement: The odds of having a cell phone were ____ times greater among students who had not done their homework compared to students who did do their homework. 36 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework to 1 3 / 1 = 3 1 / 3 =.33 3 /.33 = to 30 or 1 to 3

37 Odds Ratio Ratio of odds in favor of exposure among cases to the odds in favor of exposure among controls. Talking too much on a cell phone causes students not to do their homework. Relative Odds

38 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework Odds Ratio What mathematical computation would allow them to complete the statement: The odds of having a cell phone were ____ times greater among students who had not done their homework compared to students who did do their homework..43

39 a c b d Did Not Have Cell Phone Did Not Do Homework Did Homework Had Cell Phone Total Talking too much on a cell phone causes students not to do their homework Odds Ratio What mathematical computation would allow them to complete the statement: The odds of having a cell phone were ____ times greater among students who had not done their homework compared to students who did do their homework. 1

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The Journey Detectives in the Classroom - Investigation 2-6: The Journey

Analogy Detectives in the Classroom - Investigation 2-6: The Journey

Epi Talk Study Design Epi Talk Procedures and methods, established beforehand, that are followed by the investigator conducting the study. Detectives in the Classroom - Investigation 2-6: The Journey

Timing When are the passengers identified as exposed or unexposed? E When are the passengers identified as sick or not sick? DZ Timing When does the epidemiologist start to observe the journey? - Detectives in the Classroom - Investigation 2-6: The Journey

Time E DZ Label the Train Tracks - Detectives in the Classroom - Investigation 2-6: The Journey

Time Study Design: E DZ Label the Train Tracks - Controlled Trial Detectives in the Classroom - Investigation 2-6: The Journey

Time Healthy People Controlled Trial Flow Diagram - Healthy People E Random Assignment E DZ Detectives in the Classroom - Investigation 2-6: The Journey

Time Study Design: Label the Train Tracks Cohort Study Detectives in the Classroom - Investigation 2-6: The Journey

Cohort Study Just as in the controlled trial, the epidemiologist is also on the train during the entire journey. But there is an important difference. The epidemiologist is not telling passengers what to do. Rather, the epidemiologist is just observing them and counting. Passengers are not being told to have or not have an exposure, they are just living their normal lives. The epidemiologist, on the ride for the whole journey, just keeps observing everyone’s exposures and whether or not they develop the disease during the journey. Label the Train Tracks Detectives in the Classroom - Investigation 2-6: The Journey

Time E DZ Label the Train Tracks - Study Design: Cohort Study Detectives in the Classroom - Investigation 2-6: The Journey

Time Healthy People Cohort Study Flow Diagram - Healthy People E E DZ Detectives in the Classroom - Investigation 2-6: The Journey

Time Healthy People Cohort Study Flow Diagram - Healthy People E E DZ Controlled Trial Detectives in the Classroom - Investigation 2-6: The Journey

Time Healthy People Cohort Study Flow Diagram - Healthy People E E DZ Controlled Trial Random Assignment Detectives in the Classroom - Investigation 2-6: The Journey

Review Observational Studies Epi Talk Epidemiologic studies of natural experiments in which the investigator is not involved in the intervention other than to record, classify, count, and statistically analyze results. Detectives in the Classroom - Investigation 2-6: The Journey

Time Label the Train Tracks Study Design: Case-Control Study Detectives in the Classroom - Investigation 2-6: The Journey

The epidemiologist is not on the journey. Rather, the epidemiologist is waiting at the train station at the end of the journey. As passengers get off the train, the epidemiologist selects sick passengers for the case group and selects passengers who are similar but not sick for the control group. The epidemiologist then asks each person in the case group and control group questions about their exposures during the train ride. The epidemiologist relies on passengers’ memories of their exposures that occurred during the train ride. Label the Train Tracks Case-Control Study Detectives in the Classroom - Investigation 2-6: The Journey

Time E DZ Label the Train Tracks - Study Design: Case-Control Study Detectives in the Classroom - Investigation 2-6: The Journey

Case-Control Study Observational Study Flow Diagram Flow Diagram Time DZ - E E E E Detectives in the Classroom - Investigation 2-6: The Journey

Time Label the Train Tracks Study Design: Cross-Sectional Study Detectives in the Classroom - Investigation 2-6: The Journey

The epidemiologist, who has not been on the journey, stops the train somewhere during the trip (kind of like a train robbery) and takes a “snapshot” of all the passengers by asking them whether or not they have the exposure and whether or not they have the disease. Then the epidemiologist leaves the train and goes home to analyze the data from that particular day. The journey continues without the epidemiologist. Label the Train Tracks Cross-Sectional Study Detectives in the Classroom - Investigation 2-6: The Journey

E DZ Time Label the Train Tracks - Study Design: Cross-Sectional Study Detectives in the Classroom - Investigation 2-6: The Journey

Cross-Sectional Study Observational Study Flow Diagram Flow Diagram Time E E - DZ Detectives in the Classroom - Investigation 2-6: The Journey

Epi Talk Controlled Trial Epi Talk An epidemiologic experiment in which subjects are assigned into groups to receive or not receive a hypothesized beneficial intervention. Detectives in the Classroom - Investigation 2-6: The Journey

Epi Talk Cohort Study Epi Talk An analytical epidemiological study design in which the investigator selects a group of exposed individuals and a group of unexposed individuals and follows both groups to compare the frequency with which the disease occurs in each group. Detectives in the Classroom - Investigation 2-6: The Journey

Epi Talk Case-Control Study Epi Talk An analytical epidemiological study design in which the investigator selects a group of individuals with a disease (cases) and a group of similar individuals without the disease (controls) and compares the frequency with which an exposure occurred in the cases versus the controls. Detectives in the Classroom - Investigation 2-6: The Journey

Epi Talk Cross-Sectional Study Epi Talk An analytical epidemiological study design in which the investigator selects a group of individuals and determines the presence or absence of a disease and the presence or absence of an exposure at the same time. Detectives in the Classroom - Investigation 2-6: The Journey

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Are realistic; simulate the way a person’s understanding is tested in the real world Ask students to “do” the subject rather than simply recall what was taught Require judgment and innovation to address an unstructured problem, rather than following a set routine Require a repertoire of knowledge and skill be used efficiently and effectively Are messy and murky Allow opportunities for rehearsal, practice, consultation, feedback, and refinement Epidemiology and the Energy Balance Equation Characteristics of Authentic Assessments

69 Epidemiology and the Energy Balance Equation

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71 Think Like an Epidemiologist Challenge Handout

Authentic Assessment Teach Epidemiology Epi – Grades 6-12 Are realistic; simulate the way a person’s understanding is tested in the real world Require judgment and innovation to address an unstructured problem, rather than following a set routine Ask students to “do” the subject rather than simply recall what was taught Replicate the context in which a person would be tested at work, in the community, or at home Are messy and murky Require a repertoire of knowledge and skill to be used efficiently and effectively Allow opportunities for rehearsal, practice, consultation, feedback, and refinement

73 Epi Challenge

74 Epi Challenge

Think Like an Epidemiologist Challenge New Jersey Science Olympiad, March 15, 2011 Thank you for competing in the 3 rd Think Like an Epidemiologist Challenge. You worked with others, developed epidemiologic knowledge and skills, and used judgment and innovation to actually "do" epidemiology under pressure. We hope you enjoyed the challenge. Name School Teach Epidemiology Robert Wood Johnson Foundation Detectives in the Classroom Special thanks to the Epidemiology Section of the American Public Health Association for allowing us to distribute their Section pins to the student participants in the 2011 Think Like an Epidemiologist Challenge. Handout

Habits of Mind Research on thinking and behavior reveals some identifiable characteristics of effective thinkers. It is not necessarily scientists, artists, mathematicians, or the wealthy who demonstrate these behaviors. They have been found in mechanics, teachers, entrepreneurs, salespeople, and parents - people in all walks of life. The following habits of mind can be included in project outcomes and assessed through self-reflection, journals, discussions, and rubrics. Adapted from A. L. Costa and B. Kallick, eds., Discovering and Exploring Habits of Mind (Alexandria, Virginia: Association for Supervision and Curriculum Development, 2000) Handout

Habits of Mind

111 Time Check 10:15 AM

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113 Teach Epidemiology

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116 Teach Epidemiology

Epi Team Challenge Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Time Healthy People - E Random Assignment E DZ Controlled Trial Time Healthy People - E E DZ Cohort Study Time DZ E E E E Case-Control Study Time E E DZ Cross-Sectional Study DZ What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist is involved during the entire time from exposure to disease. Assign treatment and control groups. Follow through time and compare risk of disease in treatment group with risk of disease in control group. Give exposure to treatment group, but not control group. What’s My Design? Practice Clue Trial Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Assign treatment and control groups. What’s My Design? Clue 1 Begin Epi Team Challenge Trial Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Observational Study Flow Diagram DZ - E E E E Clue 2 Case-Control Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Observational Study Clue 3 What’s My Design? Cohort, Case-Control, and Cross-Sectional Studies Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Follow through time and compare risk of disease in exposed group with risk of disease in the unexposed group. Clue 4 Trial and Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Follow through time and compare risk of disease in treatment group with risk of disease in control group. Give exposure to treatment group, but not control group. Clue 5 Trial What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist is involved during the entire time from exposure to disease. Clue 6 Trial and Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Select a group of people with disease and a similar group of people without disease. Clue 7 Case-Control Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Healthy People Flow Diagram - Healthy People E E Random Assignment Non-Observational Study Clue 8 Trial What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Observational Study Flow Diagram E E - DZ Clue 9 Cross Sectional Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Compare odds of exposure in the two groups. Clue 10 Case-Control Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Healthy People Flow Diagram - Healthy People E E DZ Random Assignment Clue 11 Trial What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Flow Diagram Clue 12 Cross Sectional Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Flow Diagram DZ Observational Study Clue 13 Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Ask each person about both exposure and disease at that point in time. What’s My Design? Clue 14 Cross Sectional Study Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Ask both groups about their exposures in the past. What’s My Design? Clue 15 Case-Control Study Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Healthy People Flow Diagram - Healthy People Random Assignment Clue 16 Trial What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Disease risk in exposed group is compared to disease risk in unexposed group. Clue 17 Trial, Cohort Study, and Cross Sectional Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Flow Diagram E E - DZ Clue 18 Cross Sectional Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Select a healthy study sample. Clue 19 Trial (?) and Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Observe who has and has not been exposed. Clue 20 Cohort and Cross-Sectional Studies What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Clue 21 Give exposure to treatment group, but not control group. Trial What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Healthy People Flow Diagram - Healthy People E E Observational Study Clue 22 Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist is involved after disease has occurred and relies on subjects’ memories to gather information about exposure. Clue 23 Case-Control Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Select a study sample. Clue 24 Trial, Cohort, Case-Control, and Cross Sectional Studies What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Healthy People Flow Diagram - Healthy People E E DZ Observational Study Clue 25 Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist gathers data only at that one point in time. Clue 26 Cross Sectional Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Flow Diagram DZ Clue 27 Trial and Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Follow through time and compare risk of disease in exposed group to risk of disease in unexposed group. Clue 28 Trial and Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist is involved during the entire time from exposure to disease. Clue 29 Trial and Cohort Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Flow Diagram E E DZ Clue 30 Cross Sectional Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Flow Diagram DZ - Clue 31 Case-Control Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Ask each person about both exposure and disease at that point in time. Epidemiologist gathers data only at that one point in time. Disease risk in exposed group is compared to disease risk in unexposed group. Select a study sample. Clue 32 Cross Sectional Study What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist is involved after disease has occurred and relies on subjects’ memories to gather information about exposure. Select a group of people with disease and a similar group of people without disease. Compare percent of exposed people in the two groups. Ask both groups about their exposures in the past. Case-Control Study Clue 33 What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist is involved during the entire time from exposure to disease. Select a healthy study sample. Follow through time and compare risk of disease in exposed group to risk of disease in unexposed group. Observe who has and has not been exposed. Cohort Study Clue 34 What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Epidemiologist is involved during the entire time from exposure to disease. Assign treatment and control groups. Follow through time and compare risk of disease in treatment group with risk of disease in control group. Give exposure to treatment group, but not control group. Trial Clue 35 What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

End Epi Team Challenge What’s My Design? Detectives in the Classroom - Investigation 2-7: Epi Team Challenge

Detectives in the Classroom - Investigation 2-8: Which Design Is Best? Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Cross- Sectional Cohort Case- Control Controlled Trial Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Which study design is the fastest? Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Which study designs are the most time consuming? Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Most Scientifically Sound Which study design is the most scientifically sound? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Most Scientifically Sound Can Study Rare Diseases Which study design is best for studying rare diseases? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Most Scientifically Sound Possible Time-Order Confusion Can Study Rare Diseases Which study designs do not identify the time order of exposure and disease? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Possible Time-Order Confusion Can Study Rare Diseases Which study design gives the least confidence in findings? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Which study design provides the best measure of exposure? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Most Accurate Observational Study Which study design is the most accurate observational study? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Least Expensive Most Accurate Observational Study Which study design is the least expensive? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Least Expensive Unethical for Harmful Exposures Most Accurate Observational Study Which study design would be unethical for harmful exposures? Time Consuming Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Least Expensive Good Measure of Exposure Which study design provides a good measure of exposure? Most Accurate Observational Study Time Consuming Unethical for Harmful exposures Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Least Expensive Most Expensive Most Accurate Observational Study Which study designs are the most expensive? Good Measure of Exposure Time Consuming Unethical for Harmful exposures Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Least Expensive Relatively Less Expensive and Relatively Fast Most Accurate Observational Study Which study design is relatively less expensive and relatively fast? Time Consuming Unethical for Harmful exposures Most Expensive Good Measure of Exposure Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Least Confidence in Findings Most Scientifically Sound Best Measure of Exposure Possible Time-Order Confusion Can Study Rare Diseases Least Expensive Relatively Less Expensive and Relatively Fast Possible Error in Recalling Past Exposures Most Accurate Observational Study Which study design creates the possibility of error in recalling past exposures? Time Consuming Unethical for Harmful exposures Most Expensive Good Measure of Exposure Epi Team Challenge Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

Cross-Sectional Study Case-Control Study Cohort Study Trial Main WeaknessesMain StrengthsStudy Designs Fastest Time Consuming Most Scientifically Sound Best Measure of Exposure Can Study Rare Diseases Least Expensive Relatively Less Expensive and Relatively Fast Possible Error in Recalling Exposures Most Accurate Observational Study Which Design Is Best? Time Consuming Unethical for Harmful exposures Most Expensive Possible Time-Order Confusion Least Confidence in Findings Good Measure of Exposure It depends …. Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

It depends on …. Regulations Time urgency How much is known about the association Money Whether the exposure is believed to be beneficial Detectives in the Classroom - Investigation 2-8: Which Design Is Best?

DZ E E d b c a Flow Diagram 2x2 Table Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables & “fit” Designs, Diagrams, and Tables Healthy People - E E DZ

E E a 2x2 Table Where do these people “fit” in the 2x2 table? Flow Diagram Controlled Trial Healthy People E E DZ Random Assignment Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E b Flow Diagram 2x2 Table Healthy People E E DZ Random Assignment Where do these people “fit” in the 2x2 table? Controlled Trial Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E c Flow Diagram 2x2 Table Flow Diagram Healthy People E E DZ Random Assignment Where do these people “fit” in the 2x2 table? Controlled Trial Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E d 2x2 Table Flow Diagram Healthy People E E DZ Random Assignment Where do these people “fit” in the 2x2 table? Controlled Trial Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E c Flow Diagram 2x2 Table Where are these people in the flow diagram? Cohort Study Healthy People E E DZ Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E a 2x2 Table Where are these people in the flow diagram? Flow Diagram Cohort Study Healthy People E E DZ Healthy People Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E d Flow Diagram 2x2 Table Where are these people in the flow diagram? Cohort Study Healthy People E E DZ Healthy People Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E b Flow Diagram 2x2 Table Where are these people in the flow diagram? Cohort Study Healthy People E E DZ Healthy People Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E a Where do these people go in the 2x2 table? 2x2 Table Flow Diagram Case-Control Study DZ E E E E Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E c Where do these people go in the 2x2 table? Flow Diagram 2x2 Table Case-Control Study DZ E E E E Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

Flow Diagram DZ E E b 2x2 Table Where do these people go in the 2x2 table? Case-Control Study DZ E E E E Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

Flow Diagram DZ E E d 2x2 Table Where do these people go in the 2x2 table? Case-Control Study DZ E E E E Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E a Flow Diagram 2x2 Table Where do these people go in the 2x2 table? Cross-Sectional Study E E DZ Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E c Flow Diagram 2x2 Table Where do these people go in the 2x2 table? Cross-Sectional Study E E DZ Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E d Flow Diagram 2x2 Table Where do these people go in the 2x2 table? Cross-Sectional Study E E DZ Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

DZ E E b Flow Diagram 2x2 Table Where do these people go in the 2x2 table? Cross-Sectional Study E E DZ Detectives in the Classroom – Investigation 2-9: Designs, Diagrams, and Tables

The goal of every epidemiological study is to harvest valid and precise information about the relationship between an exposure and a disease in a population. The various study designs merely represent different ways of harvesting this information. Essentials in Epidemiology in Public Health Ann Aschengrau and George R. Seage III Making Group Comparisons and Identifying Associations Teach Epidemiology

195 National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

196 Time Check 11:00 AM

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198 Teach Epidemiology

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201 Teach Epidemiology

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204 Teach Epidemiology

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207 Teach Epidemiology

208 Teach Epidemiology Teachers Team-Teaching Teachers (TTTT)

209 They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas. They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question. Ken Bain, What the Best College Teachers Do Metacognition Teach Epidemiology Epi – Grades 6-12

210 National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

211 Time Check 2:00 PM

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213 Teach Epidemiology

214 Teach Epidemiology Teachers Team-Teaching Teachers (TTTT)

215 They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas. They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question. Ken Bain, What the Best College Teachers Do Metacognition Teach Epidemiology Epi – Grades 6-12

216 National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

217 Time Check 2:45 PM

218

219 Teach Epidemiology

220 Time Check 3:00 PM

221

222 Teach Epidemiology

223 Teach Epidemiology Teachers Team-Teaching Teachers (TTTT)

224 Teach Epidemiology Teachers Team-Teaching Teachers (TTTT)

225 They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas. They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question. Ken Bain, What the Best College Teachers Do Metacognition Teach Epidemiology Epi – Grades 6-12

226 National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

227

228 Critical Reviews

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242

243 Time Check 4:00 PM