Epidemiology and Biostatistical Critique - Assignment Example

Epidemiology and Biostatistical Critique Epidemiology and Biostatistical Critique 0 Introduction Epidemiology as a scientific discipline studies the distribution as well as the determinants of health related states or events in particular populations and applies this study to control the health problems within the area of study. It is founded on strong scientific methods of enquiry (CDC, 2004). Epidemiology is a data driven discipline and relies on objective approaches to collect, analyze and interpret data. It relies on and applies concepts from other scientific disciplines such as biostatistics and informatics (CDC, 2012). This paper will be a critique of Elsa S. Strotmeyer et al research article that is based on an epidemiological study. This research was carried out to describe retention by age and visit type with a view to determine the characteristics associated with visit types in a longitudinal study among older adults (Strotmeyer et al, 2010). The article will be critiqued against the basic principles governing epidemiology and biostatistics to determine whether the components of its research design supports the research question. 2.0 The Research Question Direct health-care providers and epidemiologists differ in their approach to who constitutes a patient. This is despite the fact that all of them are concerned with the occurrence and subsequent control of a disease (CDC, 2012). Biostatisticians are concerned with general health of the inhabitants of a community or area while Clinicians are interested in the health of the individual (CDC, 2004). Biostatistically therefore this study has succeeded in identifying its patient subjects. The sample of this cardiovascular health study was 5888 persons aged between 65-102 years irrespective of their individual health status (Strotmeyer, et al, 2010). Both the clinician and epidemiologist would be interested in diagnosing the correct type of cardiovascular disease that the patient is suffering from (CDC, 2012). The point of departure which this study succeeds in doing is that it seeks to establish how age affects long term retention of participants in a cardiovascular health study. It also aimed at determining characteristics of visit types for a longitudinal epidemiological study of older adults (Strotmeyer et al, 2010). The choice of population in this study will influence the application of the findings of this study in other settings. The research question is contained in the abstract party of this research paper. The question presents a statement of purpose because it clearly states what is actually being investigated (Thompson Writing Program, 2014). The purpose of this research is stated in the introductory paragraph. The authors are therefore able to determine how advancement in age affects the participation of adults in their study. The research reports on how to make up for the decline in participation in the cohort study and helps to support the hypothesis that an increase in age affects the cohorts’ participation in the study through clinical visits (Kestenbaum, 2009). The hypothesis is directional because it predicts that an increase in the participant’s age would affect their participation through clinical visits. Advancement in age may reduce their clinical visit participation and overall rejection to participate all together (aspsychology101.wordpress.com, 2009). 3.0 Intervention There study seeks to investigate the retention of participants in the longitudinal cohort study for their cardiovascular health study. The study carries out on a comparative analysis between participation by clinical visits between 1998-99 and 2005-06. The study is able to establish that age among other risk factors negatively affected retention for in-person visits (Strotmeyer, 2010). The study in question is not interventional but observational because the mode of visits is predetermined in the consent form. However, the authors let everything unfold by itself because none is urged to opt for one mode of visitation over the other (Kestenbaum, 2009). 4.0 Appropriateness of the study Design The research design is appropriate because of the study population that was narrowed down to adults of ages between 65-100 among non-institutionalized ambulatory men and women. This enables the study authors to determine how age and other relevant risk factors affect in-person participation (Kastenbaum, 2009). This choice has placed emphasis on proportionality of age, race and gender which effectively enables the study findings to be applied in other settings (Kastenbaum). 5.0 Power analysis and Procedure The research has been reduced to an optimal size but that which enables it to enable the detection of statistical significance (Suresh & Chandrashekara, 2012). The total sample size is 5888 and the ages of the sample for the study are between 65 and 100 with an overall mean of 73 (Stritmeyer et al, 2010). The outcome expected for this study that is age and participant retention is of importance and has been taken care of. This is because; there are age related health factors that may hamper participation such as dementia, reduced cognitive functions and reduced physical function affect this age more which translates to their retention in the study (Suresh & Chandreshakara, 2012). The comparison between the 1998-99 and 2005-06 group enables the detection of the difference in retention between the two periods. The 2005-06 re-recruitments for re-evaluation enables the establishment of scientific rather than statistical significance (Suresh & Chandreshaka, 2012). 6.0 Research Methods and Inference The cohort study enables the research authors to study not only the fact that age affects retention but they are also able to investigate other outcomes. They were able to determine the characteristics that are associated with the visit types (Kasternbaum, 2009). The selection of the cohort study approach enables them to study the age factor and the temporal relationship it has with reduction in retention. This strengthens the evidence for age factor in retention for longitudinal cardiovascular health study (Kasternbaum, 2009). 7.0 Sampling Criteria The study sample should be varied enough to enable any particular research to produce consistent results ( Kastenbaum, 2009). The sample incudes 58% women and 16% black people in four sites (Strotmeyer, 2009). The study does not appreciate the population dynamics of the four counties by including other subjects like Hispanics who are a substantial in proportion. As for the women, it may produce the consistent results. 8.0 Intervention and Control Treatment Conditions There are no control measures taken for this study and there is no intervention treatment in this study. Therefore this critique will not discuss its applicability in the present circumstances. 9.0 Statistical tests used in the study The study has applied the sex adjusted generalized estimating equation model. This has been used to establish the relationship between age and participation in a clinical visit and to adjust standard errors in the estimates so as to account for intra-person correlation (Strotmeyer, 2012). It has also utilized the chi square tests and variance analysis. This enables the analysis of other variables such as age, sex, race, clinic site, level education, smoking habits, weight and cognitive abilities (Strotmeyer, 2012). Other tests would be used such as univariate linear regression. This would be appropriate in determining attendance outcomes with regard to the age factor (Kastenbaum, 2009). 10.0 Accuracy of the Inferences made in the Study The inferences made in the study are accurate because they are able to predict the outcomes. This is because it is able to establish the fact that advanced age is associated with the low retention of participants in the study. This study also highlights the attendant factors such as lifestyles, physical activity and cognition which are age related. 11.0 Significance The study establishes that advanced age affects participants’ retention in a cohort longitudinal study. This is of clinical significance because outcomes and consistency of outcomes are dependent on retention (Kastenbaum, 2009). 12.0 Literature Review The paper lacks a literature review and therefore does not explain the comparison between this research and other previous ones. From this fact we are unable to understand the theoretical basis for the work that is being carried out (Hofstee, 2006). Readers are therefore unable to understand the new study dimensions and the significance of this research (Hofstee, 2006). However, this does not raise doubts as to the expertise and timeliness of this research. 13.0 Evidence and Validity The study sets out to determine how advanced age affects participant retention in a cardiovascular health study. There is a high level of this evidence that the subjects older than 80 years old have poor retention compared to those lower than this age (Strotmeyer et al, 2012). This strengthens the evidence for age and inability or challenges associated with retention for the older adults above 80 (Kasternbaum, 2009). 14.0 Threats to Validity and how to they have been controlled The measurements adopted must closely represent the actual data. The research should be representative of the entire population in the four selected sites (Kastenbaum, 2009). At the beginning 58% of the subjects were female and 17 % of the total sample were back (Strotmeyer et al, 2012). This however overlooks the race reality in the selected sites by separating blacks and lumping up other races together. On the other hand, it may be presuming that the general population is made up of blacks and whites. To correct this, the research should further proportionately address the issue of race by specifying other races as blacks have been particularly singled out (Kastenbaum, 2009). Works cited AS Revision 101. (2014). Scientific Testing; The Process of Scientific Testing in Psychology. Retrieved December 6, 2014, from http://www. aspsychology101.wordpress.com CDC. (2006). Principles of Epidemiology in Public Health Practice http://www.cdc.gov/ophss/csels/dsepd/SS1978/SS1978.pdf Duke University. (2014). What makes a Good Research Question? Retrieved December 6, 2014, from https://twp.duke.edu/writingdtudio Hofstfee, E. (2006). Constructing a Good Dissertation; A Practical Guide to Finishing a Masters, MBA, or PhD on Schedule. Retrieved December 6, 2014, from https://www.exactica.co.za/dn/exactica-book-literature-review.pdf Kestenbaum, B. (2009). Epidemiology and Biostatistics; An Introduction to Clinical Research. NY: Springer. Stotmeyer, E.S., Arnold, A. M., Boudreau, R. M., Ives, D.G., Cushman, M., Robbins, J. A., Harris, T. B., &Newmann, A. B. (2010). Long-term retention of older adults in the cardiovascular health study: Implications for studies of the oldest old. The Journal American Geriatrics Society, 58(4), 696-701. Suresh, K., & Chandrashekara, S. (2012). Sample Size Estimation and Power analysis and Clinical Research Studies. Journal of Human Reproductive Science, 5(1), 7-13. Read More