Assignment 3: Assessing the Quality of Epidemiologic Studies

Due end-of-day Sunday September 24, 2023

Course: EPI3010 - Applied Epidemiology
Semester: Fall 2023
Instructor: Dr Lucy Nganga

Student ID Student Name

Student 1 667333 Bonia Liana Ishimwe
Student 2 667144 Adeniji Abdur-Rahman Adekunle
Student 3

Full Student
Marks Score
MCQ 10
Matching 10
Compare & Contrast 8
SAQ 12
Total 40

Reading / Reference documents

0. Assessing Epi Studies.pptx
1. Zaccai JH How to assess epidemiological studies. Postgrad Med J 2004; 80:140-147
Multiple choice answer Questions (MCQs)
Bold the correct answer Marks Score
Which one of these is not a threat to validity
a. Bias
b. Confounding
c. Chance
1 d. Lack of association between exposure & disease 1
Which of the following epi studies has a restricted study sample?
a. Male Circumcision RCT - S. Africa
b. Framingham Heart Study (FHS)
c. Male Circumcision RCT - Kenya
2 d. ART START study 1
What is bias in epidemiology?
a. Systematic error
b. Random error
c. Distortion of the exposure-disease association by a 3rd factor
3 d. When a 3rd factor is in the causal pathway between exposure & disease 1
Which of the following study designs has the ability to control for unknown confounders
a. RCT
b. Cross sectional study
c. Prospective cohort study
4 d. Case control 1
Which of the following parameters is used to estimate the potential for disease prevention and/or control
a. Relative Risk (RR)
b. Attributable Risk (AR)
c. P-value
5 d. Odds Ratio (OR) 1
All of the following are used to determine the type of statistical analysis done in an epi study except
a. Study hypothesis/question
b. Type of variables measured
c. How bias was controlled at design stage
6 d. Study design 1
You assess the role of chance in the results of an epi study by
a. Assessing the validity of the study
b. Checking the width of the 95% CI
c. Evaluating whether the study was generalizable
7 d. Assessing the way the study was conducted 1
Another name for chance in epidemiology is
a. Confounding
b. Random error
c. Systematic error
8 d. interaction 1
Another name for external validity is
a. Inference
b. Attributable risk
c. Methodological quality
9 d. Generalizability 1
Another name for internal validity is
a. Attributable risk
b. Generalizability
c. Inference
10 d. Methodological quality 1
Total MCQs 10
Matching Questions
Weakness
A. Lack of representativeness
Each epi study design has weakness B. Differential loss to follow-up
C. Lack of temporal sequence
Match the weaknesses (A to E) to the study design D. Ecological fallacy
where it most commonly occurs E. Recall bias
Study design Weakness (choose A – E) Marks Score
1 Case control E 2
2 Cohort study B 2
3 Ecological study D 2
4 Cross sectional study C 2
5 RCT A 2
Total Matching 10

Compare & Contrast Questions

Be brief
For example, compare & contrast xenobiotic vs endobiotic compounds
Answer: differences / similarities/example of each (if asked)
Xenobiotic compounds originate from outside the body while endobiotic compounds are mostly produced
How to answer inside the body.
Compare & Most xenobiotic compounds are harmful while endobiotic compounds are helpful to the body.
Contrast An example of a xenobiotic compound is a carbon monoxide & an example of an endobiotic compound is an
Questions hormone

Question Answer Marks Score

Compare & contrast systematic vs
1 random error
Compare & contrast selection vs
information (measurement) bias
2 Giving an example of each
Systematic error is consistent, reproducible error that is not
determined by chance while random error is inconsistent error
caused by chance differences that occur when taking repeated
measurements. 2
 Selection bias is error due to systematic differences in
characteristics between those who take part in a study
and those who do not while information bias is
systematic error arising from inaccurate measurement
(or classification) of subjects on study variable(s).
 Selection bias can be controlled by ensuring high
response rates while information bias can be controlled
by using data collection tools.
 An example of selection bias is healthy- worker bias and
an example of information bias is recall bias. 2

Response rate is the proportion of study subjects that participate in

Compare & contrast response rate
vs attrition rate
3 Pg 143 Zaccai paper
the study while attrition rate is the proportion of study participants
who are lost during follow-up.
2
Internal validity is the extent to which systematic error is
minimized in the conduct of the study while external
validity is the extent to which the results of a study are
applicable to other populations.

What are the major differences between

internal vs external validity 1.5
Mention some similarities between
4 internal vs external validity They both show the efficacy of the study results. 0.5
Total Compare & Contrast 8
Short Answer Questions (SAQs)
Question Answer Marks Score
Method Study Design
i Restriction Cohort
List 3 ways to control confounding at design stage. ii Randomization RCT
1 Relate each method to the study design that utilizes it iii Matching Case control 3
A confounder is a risk factor for disease.
i
A confounder is associated with exposure.
ii
Name 3 properties A confounder is not in the causal pathway between exposure & outcome.
2 of a confounder iii 3

How can you control

3 random error in an epi study Random error can be controlled by increasing the sample size 2

Read, understand & synthesize paragraph 1

on page 143 (Zaccai paper).
i A random error might occur affecting the study
List two (2) potential effects of a low The applicability of the study might not apply to
4 response rate in a study? ii other studies 2

Look at the 8 criteria for causality listed in Table 2, Pg 145 of Consistency because the association
the Zaccai paper between HPV DNA in cervical
specimens and cervical cancer is
In your opinion, which criteria most clearly demonstrates the consistent in many investigations in
5 association between HPV & cervical cancer? different countries and populations. 2
Total SAQs 12