Phm002 Epidemiology : Comparability Of Assessment Answers
Answer:
Summary of the study and findings
The purpose of the study is to evaluate the hypothesis that alcohol consumption is associated with maximization of the risk of endometrial cancer. it was hypothesized that the occurrence of endometrial cancer can be developed through increasing circulation of the estrogens levels. Therefore, this study investigated the association between lifetime alcohol consumption and endometrial cancer risk. The researchers conducted a population-based case control study in Alberta, Canada in between 2006 to 2006 where they considered 514 incident of endometrial cancer with 962 frequency age-matched control, the study collected from Alberta, Canada pathology center. The participants completed in-person interviews where they were inquiring about their lifetime consumption of alcohol and other health factors and lifestyle factors relevant to the study. Participants reported usual consumptions of beer, wine, and other liquors. Moreover, the authors compiled the data of drinking pattern reported over the lifestyle in order to estimate the exposure of alcohol.
The result of the research showed that the lifetime consumption of alcohol is relatively low. compared to who are abstainer women who are showing 38% and 35% lower risk of developing endometrial cancer. Rather study showed that the alcohol acts as a protective factor for decreasing the alcohol consumption even for abstainers. The average lifetime consumption of all types of alcohol was proved associated with the lower risk of endometrial cancer. 1 drink of alcohol per day averaged over the lifetime is significantly reduce the risk of endometrial cancer No evidence was accumulated that showed the effect modification by body mass index, menopausal status, hormonal therapy, and physical activity. The effect also did not differ by type one or type 2 endometrial cancer.
Summary table of the criteria:
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Selection 1) Is the case definition adequate? a) yes, with independent validation, * b) yes, e.g., record linkage or based on self reports c) no description
2) Representativeness of the cases a) consecutive or obviously representative series of cases * b) potential for selection biases or not stated
3) Selection of Controls a) community controls * b) hospital controls c) no description
4) Definition of Controls a) no history of disease (endpoint) * b) no description of source
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Comparability 1) Comparability of cases and controls on the basis of the design or analysis a) Study controls for no history of hysterectomy or endometrial ablation. * b) study controls for alcohol consumption |
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Exposure
1) Ascertainment of exposure a) secure record (eg surgical records) * b) structured interview where blind to case/control status * c) interview not blinded to case/control status d) written self report or medical record only e) no description
2) Same method of ascertainment for cases and controls a) yes * b) no
3) Non-Response rate a) same rate for both groups * b) non respondents described c) rate different and no designation |
A definition of each criterion and an explanation:
The selection of the study defined as the study design where one or more sample are followed prospectively and subsequent status to evaluate with the respect to a specific disease or outcome that are conducted for determining which initial participants exposure is associated with the risk factor. Here the selection of the study is adequate. The one star can be given since the researchers considered population-based case control study of women with the history of alcohol consumption and no cancer history as the exposed group in Albert Canada from 2002 to 2006 for assessing the association between the physical activity and endometrial cancer. Selection of non-exposed group had no history of hysterectomy or endometrial ablation. The Ascertainment of exposure was also given one star since the researchers used a questionnaire for obtaining data and additional data was extracted from the Alberta Cancer Registry and pathology. The selection of control was from the hospital community and the control group has no history of the disease. Therefore, selection of study can be awarded as two stars.
The comparison of the study defined as the comparison between the exposed group and control group in order to evaluate the association between disease and risk factors. According to Vacek et al. (2016), the comparison between the two groups is essential for obtaining accurate data. Here, the study compared exposed group and control group in order to evaluate the association between alcohol consumption and an increase of risk of endometrial cancer. Researchers also drew the comparison between the participants of this study based on alcohol consumption and other studies. The potential bias were recalled since the data collected from pathology record.
The exposure of the study defined as the certain exposure that increases the risk of occurrence of the disease. According to Madsen et al. (2015), the exposure of the study obtaining from the secure data and semi structured interview provide the accurate result for the association between risk factor and disease. The study assessment was done by tertiles and mostly it was recorded linkage. The same method was used for assessing the case and control, which in turn helped in reducing potential bias of the study. Two star can be given for the secure record and structured interview. However, study only described response rate, non respond rate was not mentioned.
Summary of the conclusion:
According to Shivappa et al. (2016), the methodology of the study is crucial for successfully investigating any issues. The overall methodology of the study was fair quality. Here, researcher considered population-based case-control study for with 514 incidents of the cancer cases with 962 frequency aged-matched control. The selection can be awarded two due to independent validation and definition of control. The researchers have taken control group and exposed group for finding the association between endometrial cancer and alcohol consumption. According to , the investigation considering two groups through an interview and other diagnosis provide accurate data. The comparison between two groups can be awarded as one star since the study controls for gender and alcohol consumption, risk of developing endometrial cancer. Since the responding rate was mentioned in the study, no other rate was mentioned , the response rate cannot be awarded.
References:
Friedenreich CM, Spiedel TP, and Neilson HK et al., (2013). Case-control study of lifetime alcohol consumption and endometrial cancer risk. Cancer Causes Control. 24 1995-2003.
Madsen, C., Baandrup, L., Dehlendorff, C. and Kjær, S.K., 2015. Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors: a nationwide case–control study. Acta obstetricia et gynecologica Scandinavica, 94(1), pp.86-94.
Pennington, M., Gentry-Maharaj, A., Karpinskyj, C., Miners, A., Taylor, J., Manchanda, R., ... and Menon, U. 2016. Long-Term secondary care costs of endometrial cancer: a prospective cohort study nested within the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). PloS one, 11(11), e0165539.
Secord, A. A., Hasselblad, V., Von Gruenigen, V. E., Gehrig, P. A., Modesitt, S. C., Bae-Jump, V., and Havrilesky, L. J. 2016. Body mass index and mortality in endometrial cancer: a systematic review and meta-analysis. Gynecologic oncology, 140(1), 184-190.
Shivappa, N., Hébert, J. R., Zucchetto, A., Montella, M., Serraino, D., La Vecchia, C., and Rossi, M. 2016. Dietary inflammatory index and endometrial cancer risk in an Italian case–control study. British Journal of Nutrition, 115(1), 138-146.
Vacek, P. M., Slauterbeck, J. R., Tourville, T. W., Sturnick, D. R., Holterman, L. A., Smith, H. C., ... and Beynnon, B. D. 2016. Multivariate analysis of the risk factors for first-time noncontact ACL injury in high school and college athletes: a prospective cohort study with a nested, matched case-control analysis. The American journal of sports medicine, 44(6), 1492-1501.
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