# L5 (T3): Collecting data about people & comparing the health of groups

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## 60 Questions

### What are the learning aims of the text?

To explain the need to compare health needs of different groups

### Which research question is mentioned in the text?

Is this disease increasing in prevalence?

### What is the purpose of case-control studies and RCTs?

To understand the principles of case-control studies and RCTs

### What do t test and $\chi^2$ (chi square) test help to understand?

The different uses of the t test and $\chi^2$ (chi square) test

### What is the meaning of p value and confidence intervals related to?

The relationship to sample size

Type I error

### What type of differences do we compare when looking at the health of groups?

Differences between groups over time

BSMS.AC.UK

### What is the role of the person with the email address provided in the text?

Lecturer in health care evaluation and improvement

### What does a p-value of 0.10 indicate in the context of the given example?

There is not enough evidence to suggest a difference in quality of life between women with epithelial ovarian cancer (EOC) and ovarian germ cell tumour (OGCT)

### What does a confidence interval containing the value 1 (OR=1) indicate in the context of the given example?

The exposure factor does not have a significant association with the disease or condition of interest

### In the context of comparing health outcomes of groups, when would a t-test or ANOVA be appropriate?

When comparing groups based on continuous data such as quality of life

Smaller p-value

### What does the p-value represent in a statistical test?

The probability that the observed difference (or one more extreme) could have occurred by chance if the groups compared were really alike

### In the context of comparing groups, when would a chi-squared test be appropriate?

When comparing groups based on categorical data such as disease presence or absence

### What does the null hypothesis in a t-test state?

There is no difference in quality of life between the groups being compared

### What does the alternative hypothesis in a chi-squared test state?

There is an association between the variables being tested

### What is the purpose of a confidence interval in statistical analysis?

To describe the range of values with a given probability that the true value of a variable is contained within that range

### When is a chi-squared test appropriate in the context of health outcomes?

When comparing the frequency of diagnosis between different groups

### In which study design is risk calculated using odds ratio instead of directly?

Case–control study

### Which study design focuses on individual-level data rather than population-level data?

Cross-sectional study

Ecological study

Cohort study

### Which study design compares groups differing in disease status and looks back at exposures of interest?

Case–control study

### In which study design is randomization used to reduce confounding and allow identification of causally related interventions?

Randomized controlled trial

### Which study design is conducted to ascertain the safe dose of a new drug, demonstrate safety, tolerability, efficacy, and effectiveness?

Randomized controlled trial

### In which study design are two groups selected—one with the condition and one without, and controls are matched to cases?

Case–control study

### Which study design can offer evidence of cause-effect relationship, identify multiple exposures, and is good for rare diseases?

Case–control study

### In which study design are risk calculations not directly feasible, leading to the use of odds ratio instead?

Case–control study

### What is the purpose of a Chi-square test as mentioned in the text?

To compare the health of groups

Not specified

### What does the null hypothesis in a Chi-squared test state?

There is no difference between the groups being compared

### What type of differences do we compare when looking at the health of groups?

Proportional differences

Cohort study

### What does a larger sample size lead to in terms of P value?

Decreased P value

### What is the primary reason why relative risk cannot be calculated in case control studies?

The predetermined selection of people into the case and control groups

### In case control studies, what do odds ratios help to interpret?

Risk factors for the outcome

### What is a challenge in ensuring exposure occurred before the onset of the outcome in case control studies?

Difficulty in identifying individuals with rare exposures

### What is a limitation of case control studies in calculating measures of risk when the exposure of interest is rare?

Limited ability to calculate relative risk

### What is a key advantage of case control studies in investigating rare outcomes?

Focus on identifying individuals who already have the outcome

### Why are case control studies considered cost-effective and shorter in duration compared to other study types?

Due to the retrospective nature of the study

### Which type of study design aims to minimize selection and information bias through random allocation and careful data collection?

Randomized controlled trial

### What is the main difference between efficacy and effectiveness in the context of treatments?

Efficacy refers to how well a treatment works in ideal lab conditions, while effectiveness assesses real-world scenarios

### What is the primary aim of randomized controlled trials (RCTs)?

To establish the safety and efficacy of new interventions

### What is the key role of randomization in RCTs?

To create identical scenarios between intervention and control groups

### What distinguishes RCTs from observational study designs like cross-sectional, ecological, cohort, and case-control studies?

RCTs are experimental, while observational studies are not

### What is the primary strength of randomized controlled trials (RCTs)?

Establishing safety and efficacy of interventions and minimizing biases

### What is the typical patient population like in randomized controlled trials (RCTs)?

Better educated and with fewer co-morbid and complex health conditions

### What is the main concern regarding the generalizability of RCT results?

Differences between RCT participants and those seen in everyday healthcare settings

Continuous data

### In non-inferiority trials, what is the nature of the hypothesis being tested?

The novel intervention is not any worse than a comparison

### What is a key consideration when collecting and analyzing data in the context of comparing the health of groups?

Understanding the distinction between categorical and continuous data

### What is a potential consequence of translating trial results to real-world healthcare settings?

Unforeseen consequences due to differences in patient populations

### Which study design involves selecting groups based on their outcome status, with one group having the outcome of interest and the comparison group not having the outcome but having had an outcome?

Cross-sectional studies

### In case-control studies, what is matched to make the case and control groups as similar as possible?

Confounding variables

### What type of data do ecological studies focus on?

Population-level data

Cohort studies

### What is the primary aim of randomized controlled trials?

Allocating groups to interventions or comparators

### In case-control studies, which variables are matched to make the case and control groups as similar as possible?

Confounding variables

## Study Notes

Comparative Study Designs and Data Collection

• Cross-sectional study involves surveying one group to test associations between exposures and outcomes
• Ecological study observes a community/population to test associations between exposures and outcomes
• Cross-sectional study focuses on individual-level data, while ecological study focuses on population-level data
• Cohort study follows disease-free participants to see if they develop a disease, usually with differing exposure groups
• Case–control study compares groups differing in disease status and looks back at exposures of interest
• Randomized controlled trial (RCT) allocates groups randomly to receive interventions, testing safety and efficacy
• In case-control studies, two groups are selected—one with the condition and one without, and controls are matched to cases
• Risk cannot be calculated in case-control studies, so odds ratio is used instead
• The African American Cancer Epidemiology Study (AACES) found associations between ovarian cancer and BMI, education
• Case-control studies can offer evidence of cause-effect relationship, identify multiple exposures, and are good for rare diseases
• RCTs are conducted to ascertain the safe dose of a new drug, demonstrate safety, tolerability, efficacy, and effectiveness
• RCTs use randomization to reduce confounding and allow identification of causally related interventions

Understanding Case Control Studies

• Case control studies involve interviewing, surveying, and examining historical health data of individuals to understand the risk of developing a particular outcome.
• The study is retrospective, allowing researchers to look back in time to determine the outcome and select suitable participants.
• Incidence and risk calculation in case control studies involve the probability of developing the outcome of interest.
• Relative risk cannot be calculated in case control studies due to the predetermined selection of people into the case and control groups.
• Instead of relative risk, case control studies calculate odds and interpret the results similarly, indicating protective or risk factors for the outcome.
• The study can identify risk factors and associations between exposure and outcome, such as the development of ovarian cancer in African-American women.
• Case control studies are particularly useful for investigating rare outcomes, as they focus on identifying individuals who already have the outcome.
• The study minimizes selection and information bias if executed well, making it a valuable research design.
• Case control studies are cost-effective and shorter in duration compared to other study types because of their retrospective nature.
• However, it may be challenging to ensure that exposure occurred before the onset of the outcome in case control studies.
• The study is limited in calculating measures of risk, such as prevalence, incidence, and relative risk, particularly when the exposure of interest is rare.
• In scenarios where an exposure of interest is rare, case control studies may not have individuals with that exposure, making it difficult to draw conclusions about its association with the outcome.

Comparing the Health of Groups and Research Study Designs

• The text discusses the importance of comparing the health of different groups for various research questions related to health outcomes, disease prevalence, and risk factors.
• It explains the utility of comparing the health of groups in understanding the effectiveness of preventative interventions and treatments.
• It introduces the means of comparing the health of groups, including cross-sectional studies, ecological studies, cohort studies, case-control studies, and randomized controlled trials.
• Cross-sectional studies involve surveying one group at a specific moment to test associations between exposures and outcomes, with a focus on individual-level data.
• Ecological studies observe communities or populations to test associations between exposures and outcomes, focusing on population-level data.
• Cohort studies follow disease-free participants over time to observe the development of a condition or disease, usually involving multiple groups differing in exposure.
• Case-control studies involve selecting groups based on their outcome status, with one group having the outcome of interest and the comparison group not having the outcome but having had an outcome.
• Randomized controlled trials allocate groups to interventions or comparators to test the safety and effectiveness of interventions.
• Case-control studies are retrospective and select participants based on differing outcome status, aiming to make the case and control groups as similar as possible, potentially using a matching process for confounding variables.
• Variables not of interest are matched in case-control studies, while the exposure being studied is not matched, and the study looks back in time to identify the historical prevalence of exposures in each group.

Test your knowledge of comparative study designs and data collection with this quiz. Explore cross-sectional, ecological, cohort, and case-control studies, as well as randomized controlled trials. Identify key characteristics and applications of each study design and understand their roles in epidemiological research.

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