Question: Directions: Aswer All Question Briefly On This Worksheet. DO NOT Ere The Original Problem Members. You Enrolled 6.500 Men Ta 2005 And Followed Them For 10 Year. Liver Cancer Is Your Outcome One Of The Men Had Liver Cancer At The Start Of The Study Of The Men Who Drunk Alcohol Dally (0-2,000) Turting In 1990, 50 Were Diagnosed With Hilver Cancer During …

Directions: Aswer all question briefly on this worksheet. DO NOT ere the original problem members. You enrolled 6.500 men ta 2005 and followed them for 10 year. Liver cancer is your outcome one of the men had liver cancer at the start of the study of the men who drunk alcohol dally (0-2,000) turting In 1990, 50 were diagnosed with Hilver cancer during the 10-year period. or those who abstained from alcohol in 2005, 50 had llver cancer diagnosed during the 10-year period. Nobody dled or was lost to follow up during the study period. 1. What is the research question in this study? 2. What type of study design is this, and how can you tell Be specific 3. Complete the standard epidemiology table. Include the numbers and the proper headings Total 2×2 table Total 4. Calculate the relative risk. Show formulas and work. 5. The p-value on your RR is p0.03. Is your RR statistically significant? Explain how do you know? 6. Explain the meaning of the RR finding in a sentence. 7. You conducted additional studies with these men and found that the RR for those who drank one drink per day was 1.50 (95% CI:1.32-1.67) in comparison to the abstainers. For those men who drank three or more drinks per day the RR compared to the abstainers was 4.20 (95% CI 2.68-5.85). Which one of Hill’s criteria does this illustrate? Explain B. You also conducted a review of the research literature and found that similar studies examining the relationship between alcohol consumption and liver cancer found the following: Smithson et al. RR 3.3 (95% CI:1.95-5.20) Ribera et al. RR 2.1 (95% CI:1.17.3.33) Gonzalez et al. RR 2.75 (95% CI 2.26-3.45) Which one of Hill’s criteria does this illustrate? Explain. 9. Excluding those from #7 and 18, name 2 other criteria from Hill list that we have already established? Explain 10. Researchers are starting to feel pretty confident that daily alcohol consumption is CAUSALLY linked with liver cancer. What do you think is the one other Hill’s criterion that researchers would like to have that would make them feel even more strongly about causality in this relationship? Review from Module 2: Find the incidence rate per 100,000 of liver cancer for each group for 11-13. Show formula work Fil. Daily drinkers 12. Abstainers 13. Total study group PBH ZOZ/HCA ZOZ Epidemiology 14. Find the prevalence of drinking daily in this group of study participants. Show formula/work. 15. Since liver cancer in a relatively rare disease, we could have selected 100 patients with liver cancer to be in a study instead of doing the study that took 10 years described above. Which study design would this be, and how do you know? 16. Who else would we need to participate in the study described in #15, and what characteristics should they have? 17. What are some of the typical confounders that would apply for either study? How and when would you plan to handle these? 18. What types of bias do you think might occur with either study design? 19. Liver cancer has multiple causes other than alcohol consumption, such a hepatis B, hepatitis C, non-alcoholic fatty liver disease, obesity, and diabetes. These would also potentially confound the association. Explain the meaning/definition/criteria of confounding using one of these as an example and alcohol consumption and liver cancer as the exposure and disease, respectively. 20. Bonus: Look at #7. We can tell from the information provided that there are probably more people in the “one drink a day” group than the “3+ drinks per day”. How can we tell?