1. Review Session November 29, 2010

2. Questions Study Design - 1 Questionnaires were mailed to every 10 th person listed in city telephone directory. Each person was asked to list age, sex, smoking habits, and respiratory symptoms, during the preceding seven days. About 20% of questionnaires were completed and returned. About 10% of respondents reported having upper respiratory infections. Cross sectional/prevalence and/ prevalence

3. Questions Study Design - 2 1500 employees of a major aircraft company were initially examined in 1951 and were classified by diagnostic criteria for coronary artery disease (CAD). Later New cases of CAD have been identified by examinations every three years and through death certificates. Incidence rate in different subgroups have been computed Subgroups from 1951 could be could be smokers or non smokers; obese and non obese, Prospective cohort study

4. Questions Study Design - 3 A 39 year old woman presents with a mild sore throat, fever, malaise, and headache, and is treated with penicillin for presumed streptococcal infection. She returns in a week with hypertension, fever, rash, and abdominal pain. She responds favorably to chloramphenicol after a diagnosis of rocky mountain spotted fever Case report

5. Questions Study Design - 4 A random sample of middle age sedentary adults was selected from four survey/census tracts, and each person was examined for coronary artery disease (CAD). All persons without disease were randomly assigned to either a two year program of aerobic exercise or a two year arthritis prevention non aerobic exercise program. Both groups were observed semi annually for incidence of CAD. Randomized control trial

6. Questions Study Design - 5 50 patients of thyroid cancer are identified and surveyed by patient interviews to identify previous radiation exposure Note that there is No control group Case series

7. Questions Study Design - 6 Patients admitted for carcinoma of stomach and patients without a diagnosis of cancer are interviewed about their chewing tobacco history to assess possible association of chewing tobacco and gastric cancer Note that there is a control group without disease Hence Case control design Case control study

8. Questions Study Design - 7 Data on median income for households in census tracts within a large metropolitan county in USA were obtained from census bureau current population survey. Air pollution levels were measured in these same census tracts during a period f one month. The data were analyzed using a geographic information system (GIS) to produce maps showing pollution and income levels by census tracts Note it is looking at group data (air pollution and income) Ecologic study design/ correlation

9. Questions Study Design - 8 In a village 100 Neonatal tetanus cases were compared with 300 neonates without history of neonatal tetanus (controls); 17% of cases gave history of butter application to umbilical cord; compared to 7% of controls. a) State a study design b) Make a 2x2 table and calculate Odds Ratio.

10. How to draw 2x2 table Exposure Disease + Or Cases Neonatal Tetanus Disease - Controls Healthy neonates Butter applied Butter not - applied Total

11. How to draw 2x2 table Exposure Disease + Or Cases Neonatal Tetanus Disease - Controls Healthy neonates Butter applied Butter not - applied Total100300

12. How to draw 2x2 table Exposure Disease + Or Cases Neonatal Tetanus Disease - Controls Healthy neonates Butter applied 17 (7/100 x300) =21 Butter not - applied Can u fill? Total100300

13. How to draw 2x2 table Exposure Disease + Or Cases Neonatal Tetanus Disease - Controls Healthy neonates Butter applied 17 (7/100 x300) =21 Butter not - applied 100-17 = 83 300-21= 279 Total100300

14. How to draw 2x2 table Exposure Disease + Or Cases Neonatal Tetanus Disease - Controls Healthy neonates Butter applied 1721 Butter not - applied 83279 Total100300

15. How to draw 2x2 table Exposure Disease + Or Cases Neonatal Tetanus Disease - Controls Healthy neonates Butter applied (a)17(b)21 Butter not - applied ( c)83(d)279 Total100300

16. Odds Ratio Done in Case Control Study Also in Cross Sectional Study ad/bc =(17x279) / 21x83 = 4743/1743

17. Question In a village 100 Neonatal tetanus cases were compared with 300 neonates without history of neonatal tetanus (controls); 6% of cases were delivered by skilled birth attendants compared 19% of controls. Make a 2x2 table and calculate Odds Ratio. a) Make a 2x2 table and calculate Odds Ratio. b) Interpret Odds Ratio

18. Question- Relative Risk A cohort study regarding exposure to animal hides, followed 400 exposed and 400 non exposed subjects for five years to observe the development of dermatitis. Of the exposed 180 developed dermatitis and those who were unexposed 50 developed dermatitis. Calculate the Relative Risk and interpret DERM+ DERM - TOT ANM HID+ 180 220 400 ANM HID- 50 350 400 180/400=.45 50/400-=.125 RR=.45/.125=3.6 Incidence

19. How to draw 2x2 table Exposure Disease + Or Cases Dermatitis Disease - No Dermatitis Total Animal Hides + 400 Animal Hides - 400

20. How to draw 2x2 table Exposure Disease + Or Cases Dermatitis Disease - No Dermatitis Total Animal Hides + 180 (a) 220 (b) 400 Animal Hides - 50 © 350 (d) 400

21. Relative Risk RR = a/ (a+b) b/(b+d) Calculate

22. Explain the design of case control study What measure of association is used in a case control study ODDS RATIO