#1: Epidemiology in the News:

Randomized Trials (1 page)
According to the Centers for Disease Control (CDC), asthma is a leading chronic illness in children ages 5 to 17, a leading cause of school absenteeism, and the third highest cause of hospitalizations in children younger than 15 (2011). The costs associated with treating this chronic illness are high.
A number of randomized control trials have examined the effect of instituting a home management program for treating asthma in combination with pharmaceuticals. These studies found that, by implementing a structured home management program, the morbidity, severity, and frequency of asthmatic episodes were reduced (Agrawl, Singh, Mathew, & Malhi, 2005). Recent research is also exploring how and when to cut back on levels of medication as asthma episodes become controlled, further reducing the cost of this chronic illness; however, controversy remains over the long-term effects of reducing levels of medication due to the disparateness of asthma (Rogers & Reiberman, 2012).
For this Discussion, you are asked to identify an example of an experimental study design in the popular literature and consider the ethical implications of the randomized control trial design.
To prepare:
€¢    Search the Internet and credible websites to locate a news piece or article that features a randomized trial study design. The article should be from a widely distributed news source, accessible to and written for a lay audience. Possible sources include, but are not limited to, online magazines, online newspapers, and health news websites. Be sure to include a link to the article in your posting. You may not select an article already posted by one of your colleagues for this Discussion.
€¢    Critically analyze the following aspects of the research study:
o    Purpose
o    Study population
o    Length of the trial
o    Data collection methods
o    Outcome measures
o    Results and conclusions
o    Ethical issues associated with the study
€¢    Ask yourself: How did this research study benefit from its randomized design? What was discovered by randomization that might not otherwise have been demonstrated?
Write a cohesive scholarly response that addresses the following:
€¢    Summarize the research study addressing the aspects bulleted above. In your posting, provide a link to the article you selected.
€¢    Identify and discuss the ethical issues associated with this study.

References:
Agrawal, S. K., Singh, M., Mathew, J. L., & Malhi, P. (2005). Efficacy of an individualized written home-management plan in the control of moderate persistent asthma: A randomized, controlled trial. Acta Paediatrica, 94(12), 1742€“1746.
National Center for Disease Prevention and Health Promotion. (2011). Healthy youth! Health topics: Asthma. Retrieved from http://www.cdc.gov/HealthyYouth/asthma/#1
Rogers, L., & Reibman, J. (2012). Stepping down asthma treatment: How and when. Current Opinion in Pulmonary Medicine, 18(1). 70€“75. Retrieved from http://www.medscape.com/viewarticle/755183

#2: Epidemiologic Designs ( 1 page)
As introduced in the first few weeks of this course, investigators use various epidemiological study designs to study health problems and the effects of health interventions. You have examined several study designs, including descriptive designs (in Week 2) and analytic study designs that are observational (in Week 3) or experimental (this week). As a DNP student, you should be able to determine which study design would be most suitable for addressing a health problem of interest to you, as this is a foundation for evidence-based practice.
For this Discussion, you will consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for investigating the population health problem you selected for Assignment 1. In addition, you will consider which epidemiologic data sources you would use to examine your health problem.
To prepare:
€¢    Reflect on the population health problem you identified in Assignment 1, which you will use for Major Assessment 7, and your early review of the literature.
€¢    Identify a question for your study; this will help you select an appropriate design.
€¢    Consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for addressing your selected health problem based upon the assumptions and basic tenets of each design.
€¢    Determine which epidemiological design(s) would not be appropriate for your study and why.
€¢    Also, explore the various health data resources that were presented in Chapter 5 of the course text, Epidemiology for Public Health Practice. Consider which data resources you could use for your study, assessing the strengths and limitations of those resources.

Write a cohesive scholarly response that addresses the following:
€¢    Briefly summarize the population health problem you selected for Major Assessment 7, and state the study question you want to answer.
€¢    Explain which epidemiologic study design is most appropriate for your study, as well as the assumptions and tenets that support its application.
€¢    Analyze the strengths and the limitations of the potential data sources you might use for your study.

Readings
€¢    Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.
o    Chapter 6, Study Designs: Ecologic, Cross-Sectional, Case Control
o    Chapter 7, Study Designs: Cohort Studies

Chapter 6 presents an overview of analytic study designs used in epidemiology, differentiating between experimental studies (which will be addressed next week) and observational studies (the focus of this week). In the chapter, the authors address three varieties of observational studies€”ecological, cross-sectional, and case control. Chapter 7 addresses cohort studies, another form of observational design.
€¢    Doll, R., & Hill, A. B. (1999). Smoking and carcinoma of the lung. Bulletin of the World Health Organization, 77(1), 84€“93.
Retrieved from the Walden Library databases.

This landmark case-control study established the relationship between smoking and lung cancer.
€¢    Framingham Heart Study. (2008). Epidemiological background and design: The Framingham study. Retrieved from

The Framingham Heart Study is one of the first and largest cohort studies that measured the distribution of suspected risk factors in a large population and then tracked the development of heart disease in that cohort.
€¢    Papathanasiou, A. A., & Zintzaras, E. (2010). Assessing the quality of reporting of observational studies in cancer. Annals of Epidemiology, 20(1), 67€“73.
Retrieved from the Walden Library databases.

In this article, the authors assess the quality of reporting of observational cancer studies, noting opportunities for improvement.
€¢    Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). Strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Annals of Internal Medicine, 147(8), 573€“577.
Retrieved from the Walden Library databases.

A consortium of scientists and medical researchers created a checklist of 22 recommended items that should be included in reports about three common observational study designs: case-control, cohort, and cross-sectional studies. This collaborative effort is an important step toward the goal of improving the quality, credibility, and generalizability of analytical research.
€¢    Healthy People 2020. (2011). Topics & objectives index. Retrieved from  http://healthypeople.gov/2020/topicsobjectives2020/default.aspx

Healthy People 2020 focuses on improving population health locally and nationally. Review the topics and objectives of Healthy People 2020 as you prepare for Assignment 2.