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Critically reading epidemiologic studies

Principles of Epidemiology for Public Health (EPID600). Critically reading epidemiologic studies. Victor J. Schoenbach, PhD home page Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill www.unc.edu/epid600/. Outline.

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Critically reading epidemiologic studies

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  1. Principles of Epidemiology for Public Health (EPID600) Critically reading epidemiologic studies Victor J. Schoenbach,PhD home page Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel Hill www.unc.edu/epid600/ Critically reading epidemiologic studies

  2. Outline Reading and writing Objectives, focus Epidemiologic literacy Steps in reading Organization of a journal article Application to an epidemiologic study Critically reading epidemiologic studies

  3. Reading and writing Various guides and books on critically reading epidemiologic studies Aschengrau & Seage chapter is good Better reader better writer Critically reading epidemiologic studies

  4. Objectives, focus Read/critique according to your objectives • Quick assessment of a reference • Systematic review of literature • Deep reading of an important article • Dissecting a study (e.g., exam article) A full evaluation requires considerable subject matter knowledge. Critically reading epidemiologic studies

  5. Epidemiologic literacy The expectation for this course • Understand concepts, methods, and basic knowledge we’ve covered • Ability to extend that through reading • Reason and apply logic about concepts, methods, and basic knowledge • Differentiate based on importance Critically reading epidemiologic studies

  6. Steps in reading Expect to read article more than once (quickly, slowly, on exercise bicycle) Read for big picture, read for details Look up references Try calculations Be prepared for irregularities Obtain consultation (except for an exam) Critically reading epidemiologic studies

  7. Organization of a journal article Abstract – all that most people will see Introduction – why read this article Methods – what was done Results – what was found Discussion – what it means References – the foundation for the study Tables and figures – ideally stand on own Critically reading epidemiologic studies

  8. Application to an epidemiologic study Study objective: • Describe and measure? • Examine associations? • Test hypotheses? Rationale is central Critique is keyed to these elements Critically reading epidemiologic studies

  9. Questions for final paper critique - 1 • Research objective and study rationale • Study design and study population • Key variables, measures, and data collection modes • Study conduct and quality control • Data analysis Critically reading epidemiologic studies

  10. Questions for final paper critique - 2 • Findings • Potential concerns • Linkage with previous knowledge • Conclusions, implications, recommendations • Overview of strengths and weaknesses Critically reading epidemiologic studies

  11. Grading guidelines • Graders will consider accuracy, understanding of epidemiologic concepts relevant to the article, appropriate use of epidemiologic terminology, and evidence of critical thinking and judgment. • Since epidemiologists can (and do) disagree, various answers may be acceptable if well articulated and supported. • For each question, up to 20% of the points (i.e., 2 out of 10) may be awarded for quality of expression (logical sequence, clarity, succinctness, diction and usage, sentence structure, grammar and spelling, careful proofing, and adherence to instructions). Critically reading epidemiologic studies

  12. Scoring – social comparison scale • Very poor / Seriously deficient – reflects very little learning (5-24%: 1-2 out of 10 points) • Poor / Unacceptable – disappointing (25-44%: 3-4 out of 10 points) • Fair / Acceptable – acceptable, but prefer not to be judged by this answer (45-64%: 5-6 out of 10 points) • Good / Very Good – shows proficiency in epidemiologic literacy (65-84%: 7-8 out of 10 points) • Excellent / Outstanding – a candidate for advertising the course (85-100%: 9-10 out of 10 points) Critically reading epidemiologic studies

  13. Mechanics • Write well-constructed paragraph(s), with complete, grammatically correct sentences, in logical sequence, appropriate transitions and good diction • Use an outline for your answer but not as your answer • Proof carefully (read aloud to yourself); use a spellchecker! Critically reading epidemiologic studies

  14. 1. Research objective, study rationale • What is the primary research objective? • What is the rationale for this objective? • How strong and well presented (e.g., conceptual framework, supporting evidence, logic) is the rationale in terms of: • public health importance • contribution to knowledge • How well-grounded is the rationale in the published literature (biological, epidemiological)? Critically reading epidemiologic studies

  15. 2. Study design and study population • Identify important design features • Compared to other choices, what are the advantages and disadvantages for the specific objective(s) of this study? • What is the study population? • What are major eligibility criteria? • How suited is study population, including eligibility criteria, for the objectives? Critically reading epidemiologic studies

  16. 3. Key variables, measures, and data collection modes • What are the key variables and their roles? • How are the variables defined & measured? • What are the major modes by which data were collected? • How suited are the variables, their definitions, their measurement methods, and the data collection modes for the objectives and rationale of this study? Critically reading epidemiologic studies

  17. 4. . Study conduct and quality control • How has study population been recruited? • What steps to minimize non-participation and selective factors in recruitment and retention? • How successful, overall, was the data collection? • What steps were taken to improve and document accuracy of data collected? Critically reading epidemiologic studies

  18. 5. Data analysis • Primary data analysis strategies used? • How are the primary variables coded? • Primary statistical parameters estimated? • How well suited is the choice of these parameters? • How many participants in the primary analyses? • How well do the authors deal with issues of multicausation? Critically reading epidemiologic studies

  19. 6. Findings • What are the main findings? • Which are most important? • How well have the authors presented them? • Should additional results or analyses been reported or data shown? • Are extraneous results presented? Critically reading epidemiologic studies

  20. 7. Potential concerns • Accounting for all prospective members of the study population • Does study population reflect the target population well? • Major threats to validity important for interpreting the findings? • How well did the authors discuss these threats to validity? Critically reading epidemiologic studies

  21. 8. Linkage with previous knowledge • Comparisons to findings from other relevant studies and discussion of reasons for differences? • Evaluate the evidence concerning the study objective, possible biological mechanisms and other criteria for causal inference • How relevant and responsive to the study rationale was this discussion? • In what ways, if any, have the authors advanced previous knowledge? Critically reading epidemiologic studies

  22. 9. Conclusions, implications, recommendations • What are the primary conclusions? Clear? • How well supported by findings & discussion? • How directly do they relate to the objective and rationale? • How well did authors address implications and/or give insightful recommendations for next steps. Critically reading epidemiologic studies

  23. 10. Strengths and weaknesses • Key strengths in regard to study objective(s)? • Take advantage of new methodology? • Do these advance the field? How? • Key limitations in regard to objective(s)? • Are limitations shared by other studies? • What would be needed to overcome limitations? Critically reading epidemiologic studies

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  27. The last word To: victor_schoenbach@unc.edu Subject: =?ks_c_5601-1987?B?KLGksO0pwve+yMDHILTjueizv7v1LCDE+8T7x9Egs7+79S4uLj8/P0A=?= (±¤°í)Â÷¾ÈÀÇ ´ã¹è³¿»õ, ÄûÄûÇѳ¿»õ...???@ ¾È³çÇϼ¼¿ä victor_schoenbach@unc.edu ´Ô!!! ¹æÇâÁ¦ ¶§¹®¿¡¸Ó¸®°¡¾ÆÇÁ½ÃÁÒ...! ÀÌ·¸°Ô ÇϽøéµË´Ï´Ù. ¸ðµç³¿»õ ¾ÇÃëÁ¦°ÅÀü¹®...... õ¿¬¿ø·áÁ¦Ç°À¸·ÎÀÎüÀü¿¬¹«ÇØÇÏ°íÀÚ¿¬Ä£È­ÀûÀÎÁ¦Ç°À¸·ÎµÎÅëÀ»À¯¹ßÇÏÁö

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